bluuebunny/crossref_metadata_2025 huggingface dataset:
Review article: the incidence and risk factors for irritable bowel syndrome in population‐based studies
Authors: Creed Francis
Published: July 2019

Background

In the absence of prior gastrointestinal infection, the risk factors for irritable bowel syndrome (IBS) are not well established.

Aim

To identify the incidence and risk factors for IBS in general population samples

Methods

Narrative review of population‐based studies. Electronic databases were searched using the keywords “incidence,” “onset,” “epidemiology,” “population,” “risk factors” with “irritable bowel syndrome” with subsequent hand searching. Inclusion criteria were: population‐based, adults, prospective design (including retrospective case cohorts), clinical or research diagnosis of IBS and exclusion of individuals who had IBS prior to recruitment.

Results

Of 1963 papers, 38 were included; all provided data on risk factors, 27 reported incidence. The median incidence of physician‐diagnosed IBS in 19 general population cohorts was 38.5 per 10 000 person‐years (interquartile range = 20‐45.3). In 14 cohorts with specific medical disorders, median incidence was 92 per 10 000 person‐years (IQR: 73.9‐119). Apart from gastroenteritis, the most common risk factors were other medical disorders, female sex, age (both young and old), anxiety and depression, life events/stress, frequent healthcare use, pain and sleep disorders. The results were conflicting for alcohol consumption, smoking and BMI. Incidence rates were similar in different countries but risk factors differed.

Conclusions

Incidence rates were generally lower than previous estimates reflecting physician‐diagnosed IBS. The results highlight the importance of other medical and psychosocial problems in the onset of IBS in addition to prior gastrointestinal infections. Aetiological research could be enhanced by studying the underlying mechanisms relating to all of these risk factors.
Safety of thoracoscopic esophagectomy after induction chemotherapy for locally advanced unresectable esophageal squamous cell carcinoma
Authors: Akiyama Yuji , Iwaya Takeshi , Endo Fumitaka , Nikai Haruka , Baba Shigeaki , Chiba Takehiro , Kimura Toshimoto , Takahara Takeshi , Otsuka Koki , Nitta Hiroyuki , Mizuno Masaru , Kimura Yusuke , Koeda Keisuke , Sasaki Akira
Published: July 2019

Introduction

Recent studies have reported that induction chemotherapy with docetaxel plus cisplatin and 5‐fluorouracil (DCF) is an effective treatment for unresectable, locally advanced esophageal cancer. The aim of this study was to investigate the safety and feasibility of thoracoscopic esophagectomy (TE) after DCF for initially unresectable esophageal squamous cell carcinoma (ESCC).

Methods

Twenty‐three patients with initially unresectable T4 thoracic ESCC underwent TE after induction DCF.

Results

The neighboring organs with tumors were the tracheobronchus in nine patients, thoracic aorta in 13, and pericardium and diaphragm in three each (concurrent overlapping invasion occurred in five patients). The mean total operation time was 556.3 ± 107.2 minutes, and the mean time of the thoracic procedure was 258.9 ± 83.9 minutes. The mean total blood loss was 166.2 ± 117.8 mL, and the loss during the thoracic procedure was 33.5 ± 24.6 mL. All patients achieved complete R0 resection under TE. No conversions to open thoracotomy were performed. The postoperative morbidity rate was 34.8%. The postoperative hospital stay was 24.3 (range, 13‐38) days. Five patients had recurrence: four had distant metastasis (lung, two; liver, three; and one with overlap), and one had mediastinal lymph node recurrence. No local recurrence was noted at the site of the primary T4 tumor.

Conclusions

TE was safely performed in 23 patients after DCF therapy for locally advanced unresectable ESCC. Induction DCF, followed by TE, could be an alternative treatment for unresectable T4 ESCC.
Pharmacist‐led, video‐stimulated feedback to reduce prescribing errors in doctors‐in‐training: A mixed methods evaluation
Authors: Parker Hazel , Farrell Odran , Bethune Rob , Hodgetts Ali , Mattick Karen
Published: July 2019

Aims

To develop and evaluate a feasible, authentic pharmacist‐led prescribing feedback intervention for doctors‐in‐training, to reduce prescribing errors.

Methods

This was a mixed methods study. Sixteen postgraduate doctors‐in training, rotating though the surgical assessment unit of 1 UK hospital, were filmed taking a medication history with a patient and prescribing medications. Each doctor reviewed their video footage and made plans to improve their prescribing, supported by feedback from a pharmacist. Quantitative data in the form of prescribing error prevalence data were collected on 1 day per week before, during and after the intervention period (between November 2015 and March 2017). Qualitative data in the form of individual semi‐structured interviews were collected with a subset of participants, to evaluate their experience. Quantitative data were analysed using a statistical process chart and qualitative data were transcribed and analysed thematically.

Results

During the data collection period, 923 patient drug charts were reviewed by pharmacists who identified 1219 prescribing errors overall. Implementation of this feedback approach was associated with a statistically significant reduction in the mean number of prescribing errors, from 19.0/d to 11.7/d (estimated to equate to 38% reduction; P < .0001). Pharmacist‐led video‐stimulated prescribing feedback was feasible and positively received by participants, who appreciated the reinforcement of good practice as well as the opportunity to reflect on and improve practice.

Conclusions

Feedback to doctors‐in‐training tends to be infrequent and often negative, but this feasible feedback strategy significantly reduced prescribing errors and was well received by the target audience as a supportive developmental approach.
An evaluation of the user‐friendliness of Bayesian forecasting programs in a clinical setting
Authors: Kumar Alzana A. , Burgard Marc , Stacey Sonya , Sandaradura Indy , Lai Tony , Coorey Christine , Cincunegui Marisol , Staatz Christine E. , Hennig Stefanie
Published: July 2019

Aims

To evaluate 3 Bayesian forecasting (BF) programs—TDMx, InsightRx and DoseMe—on their user‐friendliness and common liked and disliked features through a survey of hospital pharmacists.

Methods

Clinical pharmacists across 3 Australian hospitals that did not use a BF program were invited to a BF workshop and complete a survey on programs they trialled. Participants were given 4 case scenarios to work through and asked to complete a 5‐point Likert scale survey evaluating the program's user‐friendliness. Liked and disliked features of each program were ascertained through written responses to open‐ended questions. Survey results were compared using a χ2 test of equal or given proportions to identify significant differences in response.

Results

Twenty‐seven pharmacists, from hospitals, participated. BF programs were rated overall as user‐friendly with 70%, 41% and 37% (P = .02) of participants recording a Likert score of 4 or 5 for DoseMe, TDMx and InsightRx, respectively. Participants found it easy to access all required information to use the programs, understood dosing recommendations and visualisations given by each program, and thought programs supported decision‐making with >50% of participants scoring a 4 or 5 across the programs in these categories. Common liked features across all programs were the graphical displays and ease of data entry, while common disliked features were related to the units, layout and information display.

Conclusion

Although differences exist between programs, all 3 programs were most commonly rated as user‐friendly across all themes evaluated, which provides useful information for healthcare facilities wanting to implement a BF program.
Qualitative exploration of the renal stone patients’ experience and development of the renal stone‐specific patient‐reported outcome measure
Authors: Ragab Mostafa , Baldin Nikolay , Collie Jane , Tran Maxine G.B. , Al‐Hayek Sami , S. Parsy Kasra , Armitage James , Wiseman Oliver
Published: July 2019

Objectives

To investigate the experience of patients living with renal calculi via a qualitative methodology, aiming to develop and validate a disease‐specific patient‐reported outcome measure (PROM) for renal stones, the Cambridge Renal Stone PROM (CReSP).

Patients, Subjects and Methods

Patients with radiologically confirmed renal calculi who had undergone a range of management options were invited to focus groups or semi‐structured interviews to elicit patient input and generate the PROM content. The developed renal stone PROM underwent validity studies included Cronbach's α for internal consistency, Spearman's and Pearson's correlation coefficients for test–retest reliability. Discriminant validity was assessed by Pearson's correlation coefficients vs the EuroQol five‐dimensional five‐level questionnaire (EQ‐5D‐5L). Our project has Health and Social Care Research Ethics Committee approval.

Results

A total of 106 subjects participated in creating the newly developed PROM. In all, 36 patients were invited to 22 semi‐structured interviews and four focus groups, until reaching saturation. Major issues reported, and themes selected for the renal stone PROM included pain, anxiety, limitations to social life and tiredness, urinary symptoms, dietary changes’ impacts, and gastrointestinal tract symptoms. Reliability analysis for 30 patients to determine internal consistency using Cronbach's α with a mean (range) of 0.91 (0.90–0.93) within domains and Cronbach's α between domains was 0.92. Average inter‐item Pearson's and Spearman's correlation within domains was performed, with a Pearson's correlation mean (range) of 0.77 (0.73–0.85) and Spearman's correlation mean (range) of 0.72 (0.63–0.77). The test–retest Pearson's correlation mean (range) was 0.85 (0.57–0.95). Validity assessment was performed for 20 patients vs 20 controls. Pearson's correlation with EQ‐5D‐5L was −0.74, showing the newly developed PROM successfully discriminated patients with kidney stones. Our final renal stone PROM consists of 14 questions that are rated on a Likert scale; the higher the score, the worse the effect on a patient's quality of life.

Conclusions

Although pain was the most frequent symptom, other health‐related and social well‐being issues significantly impacted patients’ lives. Our validated patient‐derived CReSP is a new instrument, specifically tailored to measure renal stone disease health outcomes from the patient's point of view.
Caregiver creation of participation‐focused care plans using Participation and Environment Measure Plus (PEM+), an electronic health tool for family‐centred care
Authors: Bosak Dianna L. , Jarvis Jessica M. , Khetani Mary A.
Published: July 2019

Background

Family‐centred care (FCC) is a model for rehabilitation practice that focuses on collaborative partnerships between providers and clients (i.e., children and their caregivers). FCC is a best‐practice standard and is expected to yield better outcomes for children and greater caregiver satisfaction with rehabilitation services. A commonly cited barrier to implementing FCC is perceptions about caregiver capability to contribute to designing an initial plan of care, due to lack of skill and/or interest.

Objectives

The aim of this study is to address FCC barriers through three objectives: (a) report the proportion of caregivers that created multiple care plans using PEM+, an electronic health tool, (b) assess the proportion of caregivers that created complete and participation‐focused care plan(s) and that exceeded criteria of a complete plan, and (c) describe characteristics of caregivers that did not create a complete care plan.

Methods

Study objectives were addressed via secondary analyses of a subset of data from the PEM + pilot trial. Participants were caregivers (N = 18) of children with developmental disabilities (aged 0–5 years) receiving rehabilitation services in an early childhood programme. A deductive analytic approach was used to code care plan content to criteria and to determine proportion of caregivers with a complete and participation‐focused care plan and those that exceeded the criteria.

Results

Multiple care plans were created by 72% of the caregivers, 83% caregivers created at least one care plan that was complete and participation‐focused per criteria, and 83% exceeded the criteria.

Conclusion

The high occurrence of caregivers who developed multiple care plans and who developed high‐quality care plans, in their completeness and participation‐focused features, suggests that caregivers are interested and capable of participating in a collaborative goal setting process when using PEM+. This indicates that FCC is feasible to implement in clinical workflow with the use of an electronic health tool, which may better facilitate such care. PEM+ warrants further efficacy testing prior to implementation.
Auckland regional telemedicine retinopathy of prematurity screening network: A 10‐year review
Authors: Simkin Samantha K. , Misra Stuti L. , Han Jina V. , McGhee Charles N. J. , Dai Shuan
Published: July 2019

Importance

Retinopathy of prematurity (ROP) is a potentially blinding condition affecting the retinae of premature infants. Effective screening is necessary for timely treatment.

Background

The Auckland Regional Telemedicine ROP (ART‐ROP) network, utilizes wide‐field digital imaging for ROP screening. This study reviews the ART‐ROP network.

Design

Retrospective analysis of the ART‐ROP database.

Participants

Files of infants in ART‐ROP from 2006 to 2015.

Methods

Data on infant demographics, ROP stage, treatment and outcome was collected.

Main Outcome Measures

The efficacy of ART‐ROP in the management of ROP.

Results

A review of 1181 infants across three neonatal intensive care units, was completed. Infants had a mean of four screening sessions with no infants who met ROP screening criteria being missed. Type 1 ROP was present in 83 infants, who had significantly lower average birth weight 786 ± 191 g compared to 1077 ± 285 g (P < .001), and gestational age 25.3 ± 1.7 weeks compared to 27.8 ± 2.2 weeks (P < .001) than the screened cohort. The number of infants requiring screening increased (R2 = .7993), yet treatment rates decreased (R2 = .9205) across the time period. Out‐patient clinic follow‐up was attended by 75.10% of infants screened and there was no missed ROP in those infants seen.

Conclusions and Relevance

ART‐ROP solely uses wide‐field digital imaging for ROP diagnosis, and management, including discharge, of infants. This detailed review of ART‐ROP indicates an increase in screening demand, but a decrease in the rate of type 1 ROP. The ART‐ROP telemedicine model demonstrates real potential to address workforce shortage in ROP screening.
CREDIT CONSTRAINTS AND LABOR SUPPLY: EVIDENCE FROM BANK BRANCHING DEREGULATION
Authors: Dao Bui Kien , Ume Ejindu S.
Published: July 2019

This paper examines labor supply adjustment‐both at the intensive and extensive margins‐following financial market development. Specifically, we exploit the staggered passage of bank branching deregulation in the United State to study the impact of relaxing credit constraints on labor supply decisions. We find strong evidence that improvements in how credit markets function decrease weekly hours worked, and that the effect is most significant for the lower‐middle (marginal) income group. Furthermore, we observe heterogeneous responses across demo graphic groups (race and income). In contrast, we find little to no evidence that deregulation has a significant impact on the extensive margin of participation.
Effects of maize straw‐derived biochar application on soil temperature, water conditions and growth of winter wheat
Authors: Yan Qiuyan , Dong Fei , Li Junhui , Duan Zengqiang , Yang Feng , Li Xun , Lu Jinxiu , Li Feng
Published: July 2019

Biochar application to soil has been widely accepted as an approach to enhance soil carbon sequestration, promote nutrient use efficiency and improve crop yields. Maize straw‐derived biochar application is also a novel practice for the sustainable use of straw waste. However, it remains unclear whether biochar modifies soil temperature, thereby influencing winter wheat growth. Field experiments were conducted for 2 years to answer this question. Maize straw‐derived biochar was applied at rates of 0 (B0), 20 (B20), 40 (B40) and 60 (B60) t ha−1 in the field plots. Biochar application increased the soil temperature compared to the unamended control plot for all growth stages. The highest soil temperatures occurred at 40‐cm depth in the B40 treatment and 20‐cm depth in the B60 treatment. Biochar application also enhanced the soil water content of the winter wheat fields during the growing seasons, with a maximum effect achieved at a rate of biochar application of 40 t ha−1. However, water content did not increase with increasing rate of application. Biochar application decreased the soil bulk density, and this effect was enhanced with increasing rates of biochar application. The largest grain yield was obtained in the B40 treatment, resulting from an increase in aboveground biomass and effective spike number. Our study suggests that biochar application potentially improves the grain yield of winter wheat from the increased soil temperature. This conclusion needs to be confirmed by a long‐term study on biochar application.

Highlights

The effects of rates of biochar application on wheat growth and yield were evaluated.

Response of soil temperatures to biochar application improves understanding of underlying mechanisms involved.

Warmer soil temperature and lower soil bulk density with large rates of biochar were unfavourable for water storage and wheat growth.

Biochar application at a rate of 40 t ha−1 was optimal to enhance wheat growth and grain yield.
Resilience of ecosystem processes: a new approach shows that functional redundancy of biological control services is reduced by landscape simplification
Authors: Feit Benjamin , Blüthgen Nico , Traugott Michael , Jonsson Mattias
Published: July 2019

Functional redundancy can increase the resilience of ecosystem processes by providing insurance against species loss and the effects of abundance fluctuations. However, due to the difficulty of assessing individual species’ contributions and the lack of a metric allowing for a quantification of redundancy within communities, few attempts have been made to estimate redundancy for individual ecosystem processes. We present a new method linking interaction metrics with metabolic theory that allows for a quantification of redundancy at the level of ecosystem processes. Using this approach, redundancy in the predation on aphids and other prey by natural enemies across a landscape heterogeneity gradient was estimated. Functional redundancy of predators was high in heterogeneous landscapes, low in homogeneous landscapes and scaled with predator specialisation. Our approach allows quantifying functional redundancy within communities and can be used to assess the role of functional redundancy across a wide variety of ecosystem processes and environmental factors.
Catching the whale: A comparison of place promotion strategies through the lens of Amazon HQ2
Authors: Nager Adams B. , Lowe Reed Allison S. , Langford W. Scott
Published: July 2019

Identifying potential sites for firm relocation or expansion is a negotiated process that involves both firms and localities. Some firms focus on profit enhancement through cost minimization, while others seek qualities that maximize talent attraction and benefit corporate identity. Simultaneously, localities seek to maximize the economic welfare for residents through job creation and place‐based economic development strategies. The purpose of this work is to examine how localities use place promotion strategies to attract relocating or expanding firms based on analysis of proposals submitted by communities in response to the 2017 Amazon HQ2 Request for Proposals. Our results support literature streams that argue quality of life and talent attraction, as well as cost are priorities for place‐based economic development strategies. We present a complete picture of place promotion strategies that localities use to differentiate themselves and avoid competing only on cost in the competitive marketplace of corporate recruiting.
Global encounters: Voluntourism, development and global citizenship in Fiji
Authors: McLennan Sharon J.
Published: July 2019

This paper explores the rise of voluntourism in Fiji, a country reliant on tourism but which is a relatively new market for voluntourism. It draws from research examining the role of voluntourism in development through a case study of the experiences and discourse of voluntourists, a host community, and the staff of a commercial voluntourism organisation in Fiji. While voluntourism is the focus of significant and necessary critique, this research showed that narrow conceptions of what the outcomes of voluntourism should be – usually articulated as development or global citizenship – do not adequately account for the complex web of relationships and impacts that result from the voluntourism encounter. Instead, in this research a more complex picture emerged of the encounters facilitated by the voluntourism experience; the multiple relationships formed between volunteers and hosts; and the learning that took place, particularly within home stays. In this paper these encounters are explored using a wide‐angled view of development, drawing on Hart's (2001; Progress in Human Geography, 25, 649–658) conception of d/Development, to explore the relationship between development and global citizenship and how these are shaped by, and interact with, historical and contemporary global processes; from colonialism to commercialised volunteering. As such, this paper argues for a more nuanced and reflective approach to voluntourism and voluntourists, one which does not overlook the critiques, but which acknowledges the ways in which voluntourism encounters are shaping broader development trajectories within the contexts in which they occur; and for more attention to be paid to the way in which the discourses of global citizenship and development are co‐articulated and expressed in voluntourism practices.
Irrigation amount and ploidy affect the turfgrass potential of crested wheatgrass (Agropyron cristatum)
Authors: Robins Joseph G. , Jensen Kevin B. , Waldron Blair L. , Bushman B. Shaun
Published: July 2019

Crested wheatgrass (Agropyron cristatum [L.] Gaertn.) germplasm is available in tetraploid and diploid forms. In addition to rangeland revegetation and forage production, the tetraploid crested wheatgrasses also commonly provide low‐maintenance turfgrass production. It is unknown how well the smaller leaves and plants of the diploid form compare to the tetraploid form for turfgrass production. Herein, we describe the analysis and results from two line‐source irrigation studies to quantify the difference in turfgrass performance across irrigation levels for 10 crested wheatgrass population representing tetraploid and diploid levels. The results were based on growth habit, color, density and quality. We found differences among the trait values among the irrigation levels, among the populations and between the two ploidy levels. Overall, there is substantial variation within the crested wheatgrass germplasm for turfgrass production and quality. The diploid germplasm possesses excellent low‐maintenance turfgrass potential, particularly when greater aesthetics and quality are desired. However, the greater spread and rhizomatous growth habit present in some tetraploid populations suggest great potential for the tetraploid germplasm, particularly when soil stabilization is a primary concern.
Clinical impacts of sun exposures on the faces and hands of Japanese women of different ages
Authors: Flament F. , Velleman D. , Yamamoto S. , Nicolas A. , Udodaira K. , Yamamoto S. , Morimoto C. , Belkebla S. , Negre C. , Delaunay C.
Published: July 2019

Objective

To assess the impacts of sun exposures on some skin signs on the faces and hands of differently aged Japanese women, according to their distinct behaviours towards vis à vis sun exposure.

Methods

Two comparable cohorts of Japanese women (aged 18–83 years) were created according to their usual behaviour towards sun exposure i.e. non‐sun‐phobic (N = 495) and sun‐phobic (N = 516) and through their regular use(s) of a photo‐protective product. Standard photographs (full‐face and 45° lateral) allowed to focus on 18 facial signs that were graded by 15 experts, using a referential skin ageing Atlas. From these two cohorts, two sub‐cohorts (114 and 122 women) were created with regard to the similar clinical aspects of the dorsal side of their hands (Left vs. Right) that were further graded. Absolute differences in the scores of each sign were used (non‐sun‐phobic minus sun‐phobic), by age‐ranges, to better ascertain the impact of sun exposures and photo‐protection.

Results

Facial signs related to skin wrinkles/texture and pigmentary spots were found significantly more accentuated among non‐sun‐phobic women and show an early onset (20–30 years). Facial sagging and crow’s feet wrinkles appear delayed (30–40 years). The severity of vascular disorders was found to be similar in the two cohorts. The absolute differences in the grading’s of almost all signs were unsurprisingly found increased with advancing ages, illustrating the combination of chronological and photo‐ageing processes. With regard to hands, differences in skin texture and pigmentary disorders are of a late onset (40–50 years) and were found much increased at older ages. The cutaneous signs of the hands of Japanese women can hardly be taken as reliable markers of their photo‐ageing status.

Conclusion

The present work illustrates, for the first time, some specificities of the impact of sun exposures on the facial skin of Japanese women, pinpointing the fact that some facial signs are of an early onset. Results significantly confirm the importance of both sun avoidance coupled with photo‐protective measures.
Consumers’ attitudes towards and acceptance of 3D printed foods in comparison with conventional food products
Authors: Manstan Tiffany , McSweeney Matthew B.
Published: July 2019

Little research currently exists in the literature on consumers’ perceptions of 3D printed foods; thus, present research aimed to investigate this topic. Two focus groups (n = 8 and 12) were conducted to identify what consumers believe about 3D food printing. Responses from the focus groups were used to create an online survey investigating consumer attitudes towards 3D printed foods in comparison with conventional foods, as well as consumer beliefs about 3D food printing. Based on the results of the survey, three clusters were identified: the markedly interested cluster (n = 140), moderately interested cluster (n = 98) and the not interested cluster (n = 91). The markedly interested cluster wanted to know more about 3D printed food, and believed it could reduce the cost of food and benefit people in the future. The moderately interested cluster was excited to try printed food. Conversely, the third cluster believed 3D printed foods were unacceptable and not safe to consume.
The HLA‐DRB1 risk alleles for multiple sclerosis are differentially expressed in blood cells of patients from Southern Italy
Authors: Pisapia Laura , Cerillo Ilaria , Farina Federica , Zimbardo Arianna , Barba Pasquale , Orefice Giuseppe , Gianfrani Carmen , Strazzullo Maria , Del Pozzo Giovanna
Published: July 2019

HLA gene expression has an important role in the autoimmune disease predisposition. We investigated the mRNA expression profile of the risk alleles HLA‐DRB1*15 and HLA‐DRB1*13 in a cohort of subjects both multiple sclerosis (MS) patients and healthy controls. Moreover, we explored the expression of the allele HLA‐DRB1*11 that is very frequent in our cohort from southern Italy. We found that the expression of MS‐associated alleles in heterozygous MS patients was always higher than the nonassociated alleles. The differential risk allele expression occurred also in nonaffected subjects, though with a lower increment compared to MS patients.
Infertility‐related knowledge in childbearing‐age women with breast cancer after chemotherapy
Authors: Huang Sheng‐Miauh , Tseng Ling‐Ming , Lai Jerry Cheng‐Yen , Lien Pei‐Ju , Chen Ping‐Ho
Published: July 2019

Aim

The purposes of this study were to describe the degree of knowledge and explore the factors associated with knowledge of infertility among women of childbearing age with breast cancer.

Methods

In this cross‐sectional study, we recruited women of childbearing age with a diagnosis of breast cancer who had completed chemotherapy at a hospital in Taipei from 2015 through 2016. Face‐to‐face interviews were completed with 201 (62%) of 324 eligible women, asking about sociodemographic variables, disease and treatment characteristics, fertility intention, and infertility‐related knowledge.

Results

The result showed one in 10 women had thought about becoming pregnant after completion of breast cancer chemotherapy. The mean score of infertility knowledge among participants was low, especially for general knowledge. Women with higher levels of education had better knowledge scores. Fertility intention score, especially for the domain of the pregnant risk, was negatively associated with infertility knowledge score.

Conclusion

Women with breast cancer lacked knowledge about infertility and underestimated the possibility of infertility. We suggest future patient education on infertility after cancer treatment and about reproductive technology in oncologic practice before treatment begins.
Incident atrial fibrillation in patients undergoing bariatric surgery: a systematic review and meta‐analysis
Authors: Chokesuwattanaskul Ronpichai , Thongprayoon Charat , Bathini Tarun , Sharma Konika , Watthanasuntorn Kanramon , Lertjitbanjong Ploypin , Pachariyanon Pavida , Prechawat Somchai , Mao Michael A. , Torres‐Ortiz Aldo , Cheungpasitporn Wisit
Published: July 2019

Background

There are controversial data regarding the relationship between bariatric surgery and atrial fibrillation (AF). This meta‐analysis was performed to evaluate (i) the incidence and (ii) the risk of AF in patients following bariatric surgery.

Aims

To explore the incidence and risk factors of AF in patients after bariatric surgery.

Methods

A literature search was conducted utilising MEDLINE, EMBASE and Cochrane Database from inception through March 2019. We included studies that evaluated the (i) incidence and (ii) risk of AF in patients after bariatric surgery. Pooled incidence and odds ratios (OR) with 95% confidence interval (CI) were calculated using random effects meta‐analysis.

Results

Seven cohort studies consisting of 7681 patients undergoing bariatric surgery were enrolled in this systematic review. The prevalence of AF in patients undergoing bariatric surgery ranged between 0% and 4.6%. Overall, the pooled estimated incidence of AF following bariatric surgery was 5.3% (95% CI: 1.9–13.8) at a median follow‐up time of 7.9 years (interquartile range (IQR) 4.1–15.0 years). Compared to controls, the pooled OR of AF among patients undergoing bariatric surgery was 0.42 (95% CI: 0.22–0.83) at a median follow‐up time of 7.9 years (IQR 7.2–19.0 years). Egger regression test demonstrated no significant publication bias in our meta‐analysis of AF incidence following bariatric surgery.

Conclusion

The overall estimated incidence of AF following bariatric surgery was 5.3%. Our study demonstrates a significant beneficial association between bariatric surgery and AF, with a 0.42‐fold decreased risk of AF. Future large‐scale studies are needed to confirm the potential benefits of bariatric surgery on risk of AF.
Practical management approach to gastroparesis
Authors: Longley Kieran J. , Ho Vincent
Published: July 2019

Gastroparesis is a syndrome characterised by delayed gastric emptying in the absence of mechanical obstruction. Symptoms can include early satiety, abdominal pain, bloating, vomiting and regurgitation which cause significant morbidity in addition to nutritional deficits. There is a higher prevalence in diabetics and females, but the incidence in the Australian population has not been well studied. Management of gastroparesis involves investigating and correcting nutritional deficits, optimising glycaemic control and improving gastrointestinal motility. Symptom control in gastroparesis can be challenging. Nutritional deficits should be addressed initially through dietary modification. Enteral feeding is a second‐line option when oral intake is insufficient. Home parenteral nutrition is rarely used, and only accessible through specialised clinics in the outpatient setting. Prokinetic medication classes that have been used include dopamine receptor antagonists, motilin receptor agonists, 5‐HT4 receptor agonists and ghrelin receptor agonists. Anti‐emetic agents are often used for symptom control. Interventional treatments include gastric electrical stimulation, gastric per‐oral endoscopic myotomy, feeding jejunostomy and gastrostomy/jejunstomy for gastric venting and enteral feeding. In this article we propose a framework to manage gastroparesis in Australia based on current evidence and available therapies.
Evaluation of inflammatory skin infiltrate following Aedes aegypti bites in sensitized and non‐sensitized mice reveals saliva‐dependent and immune‐dependent phenotypes
Authors: Henrique Maressa O. , Neto Leila S. , Assis Josiane B. , Barros Michele S. , Capurro Margareth L. , Lepique Ana P. , Fonseca Denise M. , Sá‐Nunes Anderson
Published: July 2019

During probing and blood feeding, haematophagous mosquitoes inoculate a mixture of salivary molecules into their vertebrate hosts’ skin. In addition to the anti‐haemostatic and immunomodulatory activities, mosquito saliva also triggers acute inflammatory reactions, especially in sensitized hosts. Here, we characterize the oedema and the cellular infiltrate following Aedes aegypti mosquito bites in the skin of sensitized and non‐sensitized BALB/c mice by flow cytometry. Ae. aegypti bites induced an increased oedema in the ears of both non‐sensitized and salivary gland extract‐ (SGE‐)sensitized mice, peaking at 6 hr and 24 hr after exposure, respectively. The quantification of the total cell number in the ears revealed that the cellular recruitment was more robust in SGE‐sensitized mice than in non‐sensitized mice, and the histological evaluation confirmed these findings. The immunophenotyping performed by flow cytometry revealed that mosquito bites were able to produce complex changes in cell populations present in the ears of non‐sensitized and SGE‐sensitized mice. When compared with steady‐state ears, the leucocyte populations significantly recruited to the skin after mosquito bites in non‐sensitized and sensitized mice were eosinophils, neutrophils, monocytes, inflammatory monocytes, mast cells, B‐cells and CD4+ T‐cells, each one with its specific kinetics. The changes in the absolute number of cells suggested two cell recruitment profiles: (i) a saliva‐dependent migration; and (ii) a migration dependent on the immune status of the host. These findings suggest that mosquito bites influence the skin microenvironment by inducing differential cell migration, which is dependent on the degree of host sensitization to salivary molecules.
Genomics education in nursing in Hong Kong, Taiwan and Mainland China
Authors: Chair Sek Ying , Waye Mary Miu Yee , Calzone Kathleen , Chan Carmen Wing Han
Published: July 2019

Aim

To identify issues and challenges of genomics education in Hong Kong, Taiwan and Mainland China.

Background

The use of genetics/genomics in health care, such as genetic testing, pharmacogenomics and tumour profiling in the context of cancer, is increasing. The rapid application of genetics/genomics in clinical practice requires healthcare providers to be competent to practise genetics‐related patient care.

Sources of evidence

We reviewed current practices in genomics education in nursing in Hong Kong, Taiwan and Mainland China, including the opportunities for nurses to advance their knowledge and recommendations to incorporate genomics education in the nursing curriculum in these regions.

Findings

While many citizens and health professionals recognize the importance of new and exciting research areas of genomics/genetics, there are still many gaps in the translation of genetic/genomic medicine into clinical practice. There is also a similar lack of genetics professionals in China.

Conclusion

Hong Kong, Taiwan and Mainland China face challenges in promoting genetic education in nursing. A strategic approach in a coordinated effort ineffectively translating genomic knowledge into healthcare practice should be established in these three regions.

Implications for nursing and policy

Nursing educators in Hong Kong, Taiwan and Mainland China should link with the international nursing community (e.g. Global Genomics Nursing Alliance) and form closer networks to improve education in the area of genetics and genomics. From a policy level, genomics education is suggested to be incorporated in nursing curriculum to enhance nurses’ competency in incorporating genetics/genomics service into patient care.
3D printing of Cordyceps flower powder
Authors: Teng Xiuxiu , Zhang Min , Bhandri Bhesh
Published: July 2019

Cordyceps militaris is a fungus that has been used as a functional food in China because it contains many kinds of active components (such as cordycepin, polysaccharides, ergosterol, mannitol, etc.). Cordyceps flowers are dried and also available in powder form with poor rehydration behavior. Considering taste, mouthfeel and appearance of printed products, the optimal printing formulation (powder: water: isomaltose: oil = 10:10:3:1) was obtained through response surface methodology. The rheological properties of rehydrated powder were enhanced due to the lubricating action of oil and the moisture absorption by isomaltose, reducing the line breakage but still showed structural collapse. Fortunately, the disadvantages of the above formulation were overcome by the addition of 1% (w/w powder) gum. The new formulation (powder: water: isomaltose: oil: agar = 10:10:3:1:0.1) exhibited the best printing results and there was a little effect on cordycepin content through 3D printing technology. The effectiveness of this new formulation as a printing ink was confirmed by low‐field nuclear magnetic resonance, rheological and textural measurements.

Practical applications

Cordyceps flowers and isomaltose contain many functional factors. 3D printing technology has the ability to design an appealing appearance, and capability of producing variety of textures by manipulating the internal structure. The combination of the two provides consumers with rich functional factors while attracting consumers to increase their acceptability of Cordyceps flowers. This study provides new ideas for other variety of food printing materials and demonstrates the shape development of foods by 3D printing.
Size characterization of moringa (Moringa oleifera) seeds and optimization of the dehulling process
Authors: Fakayode Olugbenga Abiola , Akpan David Eyo , Ojoawo Olayemi Olubunmi
Published: July 2019

The size of moringa seeds was characterized, and the dehulling process parameters were optimized. The effects of moisture content, feed rate, operational speed, and beater‐drum clearance on dehulling efficiency were studied. A 4 × 5 central composite rotatable design was employed, and multiple linear regression was utilized for analyzing data at 5% significant level. Experimental results were used to validate predicted optimum conditions. Processing parameters were related to dehulling efficiency using developed mathematical models. Maximum dehulling efficiencies of 81.14, 85.66, and 96.03% were obtained for the small, medium, and big sizes respectively. The moringa seed size and other processing factors were found to have significant effect on the dehulling efficiency. Predicted optimum values of 83.62, 88.18, and 99.69% for small‐, medium‐, and big‐sized categories, respectively, were obtained at 9.38%wet basis moisture content, 1.35 kg/min feed rate, 844.61 rpm dehulling speed, and 6.38 mm beater‐drum clearance. The experimental values were 84.33, 88.97, and 99.76% for small‐, medium‐, and big‐sized categories, respectively, under the optimal conditions. Variations between values obtained experimentally and predicted were negligible and statistically insignificant; therefore, the selected models were adjudged to adequately predict the dehulling efficiencies for all the size categories.

Practical Applications

Despite the benefits derived from moringa seeds, dehulling of the seeds has been a tedious operation. Considering this, a moringa dehuller was developed, and the performance was evaluated. However, for an efficient system, it is imperative to understand the mechanisms of the various important factors influencing the dehulling process and their interactions. The approach of considering one factor per time consumes time and is unrealistic to obtain the right optimal conditions; making it impractical to optimize the dehulling process using such approach. Considering this, RSM was employed to optimize the moringa dehulling process parameters. Mathematical models were developed to predict responses during the dehulling process using RSM. For efficient machine performance, the seeds were graded into various sizes and the effects of moisture content, feed rate, operational speed, and beater‐drum clearance on the dehulling efficiency were investigated and optimized. Results obtained in the study would be useful to moringa seed processors.
Microbiota of periodontal pockets and root canals in induced experimental periodontal disease in dogs
Authors: Gadê‐Neto Cícero R. , Rodrigues Ronaldo R. , Louzada Lidiane M. , Arruda‐Vasconcelos Rodrigo , Teixeira Fabrício B. , Viana Casarin Renato C. , Gomes Brenda P. F. A.
Published: July 2019

Aim

To investigate the relationship between the microbiota of periodontal pockets (PP) and root canals (RC) in dogs submitted to experimental periodontal disease (ExPD).

Methods

ExPD was induced by combining cotton and wire ligatures. After 125 days, microbiological samples were collected from PP and RC. Strains isolated from 19 teeth were submitted to DNA extraction, 16S rRNA gene amplification and gene sequencing. Pearson's χ2‐ and Fisher's exact tests and McNemar's test were used when appropriate.

Results

The number of species in PP was greater than in RC, with prevalence of obligate anaerobes and Gram‐negative bacteria. In the PP predominated Fusobacterium necrophorum, Porphyromonas gingivalis, Prevotella loescheii, Campylobacter gracilis and Veillonella parvula. In the RC samples, 9 had microbial growth, with predominance of the following genera: Staphylococcus, Streptococcus and Neisseria. Eight genera were common to both sites in the same tooth. PP presented a greater number of species than the RC. No significant difference was observed in the species found in PP and RC in the same tooth.

Conclusion

Microbial composition of the RC could be modulated by the presence of periodontal disease, especially in cases of severe periodontal destruction. RC microbiota was less complex and diverse than the PP.
Peroxisome proliferator‐activated receptor gamma participates in the acquisition of brain ischemic tolerance induced by ischemic preconditioning via glial glutamate transporter 1 in vivo and in vitro
Authors: Zhao Cong‐Cong , Jiang Meng‐Yang , Zhang Ling‐Yan , Hu Yu‐Yan , Hu Zhen‐Jie , Zhang Meng‐Yue , Qi Jie , Su A‐Chou , Lou Nan , Xian Xiao‐Hui , Zhang Jing‐Ge , Li Wen‐Bin , Zhang Min
Published: July 2019

Glial glutamate transporter 1 (GLT‐1) plays a vital role in the induction of brain ischemic tolerance (BIT) by ischemic preconditioning (IPC). However, the mechanism still needs to be further explained. The aim of this study was to investigate whether peroxisome proliferator‐activated receptor gamma (PPARγ) participates in regulating GLT‐1 during the acquisition of BIT induced by IPC. Initially, cerebral IPC induced BIT and enhanced PPARγ and GLT‐1 expression in the CA1 hippocampus in rats. The ratio of nuclear/cytoplasmic PPARγ was also increased. At the same time, the up‐regulation of PPARγ expression in astrocytes in the CA1 hippocampus was revealed by double immunofluorescence for PPARγ and glial fibrillary acidic protein. Then, the mechanism by which PPARγ regulates GLT‐1 was studied in rat cortical astrocyte‐neuron cocultures. We found that IPC [45 min of oxygen glucose deprivation (OGD)] protected neuronal survival after lethal OGD (4 h of OGD), which usually leads to neuronal death. The activation of PPARγ occurred earlier than the up‐regulation of GLT‐1 in astrocytes after IPC, as determined by western blot and immunofluorescence. Moreover, the preadministration of the PPARγ antagonist T0070907 or PPARγ siRNA significantly attenuated GLT‐1 up‐regulation and the neuroprotective effects induced by IPC in vitro. Finally, the effect of the PPARγ antagonist on GLT‐1 expression and BIT was verified in vivo. We observed that the preadministration of T0070907 by intracerebroventricular injection dose‐dependently attenuated the up‐regulation of GLT‐1 and BIT induced by cerebral IPC in rats. In conclusion, PPARγ participates in regulating GLT‐1 during the acquisition of BIT induced by IPC.

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Cover Image for this issue: doi: 10.1111/jnc.14532.

Open Science: This manuscript was awarded with the Open Materials Badge

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Cordycepin improves behavioral‐LTP and dendritic structure in hippocampal CA1 area of rats
Authors: Han Yuan‐Yuan , Chen Zhao‐Hui , Shang Ying‐Jie , Yan Wen‐Wen , Wu Bao‐Yan , Li Chu‐Hua
Published: July 2019

Cordycepin, an adenosine analog, has been reported to improve cognitive function, but which seems to be inconsistent with the reports showing that cordycepin inhibited long‐term potentiation (LTP). Behavioral‐LTP is usually used to study long‐term synaptic plasticity induced by learning tasks in freely moving animals. In order to investigate simultaneously the effects of cordycepin on LTP and behavior in rats, we applied the model of behavioral‐LTP induced by Y‐maze learning task through recording population spikes in hippocampal CA1 region. Golgi staining and Sholl analysis were employed to assess the morphological structure of dendrites in pyramidal cells of hippocampal CA1 area, and western blotting was used to examine the level of adenosine A1 receptors and A2A receptors (A2AR). We found that cordycepin significantly improved behavioral‐LTP magnitude, accompanied by increases in the total length of dendrites, the number of intersections and spine density but did not affect Y‐maze learning task. Furthermore, cordycepin obviously reduced A2AR level without altering adenosine A1 receptors level; and the agonist of A2AR (CGS 21680) rather than antagonist (SCH 58261) could reverse the potentiation of behavioral‐LTP induced by cordycepin. These results suggested that cordycepin improved behavioral‐LTP and morphological structure of dendrite in hippocampal CA1 but did not contribute to the improvement of learning and memory. And cordycepin improved behavioral‐LTP may be through reducing the level of A2AR in hippocampus. Collectively, the effects of cordycepin on cognitive function and LTP were complex and involved multiple mechanisms.

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