bluuebunny/crossref_metadata_2025 huggingface dataset:
Testing the role of sport event personality on the development of event involvement and loyalty
Authors: Alexandris Kostas
Published: May 2016

Purpose

– The purpose of this paper is to test: the applicability of Aaker’s (1997) brand personality model in the context of mountain running races; and the influence of event personality on event involvement and loyalty.

Design/methodology/approach

– In total, 177 runners (n=177) at two mountain running races participated in the study and filled the brand personality (Aaker, 1997) and leisure involvement (Kyleet al., 2004a, b) questionnaires.

Findings

– The confirmatory factor analysis provided support for the factorial validity of the brand personality and event involvement models. The analysis confirmed also the structural model. Four of the five personality facets (excitement, competence, ruggedness and sincerity) significantly influenced the three dimensions of event involvement, which in their turn influenced event loyalty (intention to participate and W-O-M communications).

Practical implications

– The topic of brand personality is important for building brand equity and guiding market positioning in the growing running races sector. The current study provides event organizers with a tool for measuring the personality of their events. Furthermore, it explains how event personality influences the development of event involvement, which is an important variable for the development of event loyalty.

Originality/value

– It contributes to the academic literature in two ways: first, the construct of brand personality has not been previously applied in the context of outdoor sport events and especially mountain running races; and second, while it has been theoretically proposed (Aaker, 1997; Keller, 2008) and empirically supported (Eisend and Stokburger-Sauer, 2013) in the general marketing literature that brand personality is associated with positive behavioral and attitudinal (e.g. brand loyalty and brand involvement) outcomes, there has been no published research to test the relationships among brand personality, involvement and loyalty in the context of outdoor sport events.
Impact of construction-related rework on selected Ugandan public projects
Authors: Kakitahi John Muhumuza , Alinaitwe Henry Mwanaki , Landin Anne , Mone Simon James
Published: May 2016

Purpose

The purpose of this paper was to assess the magnitude of the impact of construction-related rework on selected project budgets and schedule in public building construction in Uganda. The magnitude of construction-related rework was the mean determined over construction contracts under a selected project and expressed as a percentage of the construction contract sum.

Design/methodology/approach

A single case multi-unit study approach was adopted. A case study protocol was prepared that included a checklist, observation schedules and an interview guide. The three instruments were used to collect data from building contractors and end-users (the teaching staff and medical assistants). Representatives of the client entity and the end-users provided sufficient project documentation and related supplementary information for the study.

Findings

Construction-related rework was predominantly attributable to design information omissions, unacceptable workmanship and inadequate supervision of the contractor. Lightning conductor, electrical and roofing installations were the building elements that had the highest frequency of rework. It was further determined that the mean percentage of rework related impact on project budget and schedule was approximately 4.53 and 8.42 per cent, respectively.

Originality/value

The findings inform policy makers about likely areas that contribute to significant wastage and value loss in quality management of public sector projects. The research advocates for improved data collection protocols, integration of adequate design management and a whole life value philosophy during the public building construction process.
Agricultural practices for food safety threaten pest control services for fresh produce
Authors: Karp Daniel S. , Moses Rebekah , Gennet Sasha , Jones Matthew S. , Joseph Shimat , M'Gonigle Leithen K. , Ponisio Lauren C. , Snyder William E. , Kremen Claire
Published: May 2016

Over the past decade, several foodborne disease outbreaks provoked widespread reforms to the fresh produce industry. Subsequent concerns about wildlife vectors and contaminated manures created pressure on growers to discontinue use of manure‐based composts and remove nearby semi‐natural vegetation. Despite widespread adoption, impacts of these practices on ecosystem services such as pest control have not been assessed.

We used a landscape‐scale field experiment to quantify associations between compost applications, semi‐natural vegetation, pest control services and lettuce yields on organic farms throughout California's Central Coast, a region experiencing food safety reforms.

We found that farms with surrounding semi‐natural vegetation supported a diverse arthropod assemblage, whereas a herbivore‐dominated assemblage occupied farms in simplified landscapes. Moreover, predatory arthropods consumed more herbivores at sites with more surrounding non‐crop vegetation and reduced aphid pest infestations in lettuce.

Compost improved lettuce yields by increasing soil nutrients and organic matter, but affected neither pest control nor Escherichia coli prevalence.

Synthesis and applications. Food safety concerns are prompting practices that simplify farms and landscapes. Our results demonstrate that two practices – elimination of manure‐based composts and removal of non‐crop vegetation – are likely having negative impacts on arthropod biodiversity, pest control and soil quality. Critically, our findings and previous research suggest that compost can be applied safely and that habitat removal is likely ineffective at mitigating food safety risk. There is thus scope for co‐managing fresh produce fields for food safety, ecosystem services, and biodiversity through applying appropriately treated composts and stopping habitat removal.
Comparison Between Direct and Video‐assisted Laryngoscopy for Intubations in a Pediatric Emergency Department
Authors: Eisenberg Matthew A. , Green‐Hopkins Israel , Werner Heidi , Nagler Joshua
Published: May 2016

Objectives

The objective was to compare video‐assisted laryngoscopy (VAL) to direct laryngoscopy (DL) on success rate and complication rate of intubations performed in a pediatric emergency department (ED).

Methods

This is a retrospective cohort study of attempted intubations of children aged 0–18 years in a pediatric ED between 2004 and 2014 with first attempt by an ED provider. In VAL, the laryngoscopist attempts direct visualization of the glottis with a C‐MAC video laryngoscope while the video monitor is used for real‐time guidance by a supervisor, back‐up visualization for the laryngoscopist should the direct view be inadequate, and confirmation of endotracheal tube passage through the vocal cords. We performed univariate comparisons of intubations using DL to intubations using VAL on rates of first‐pass success, complications, and whether the patient was successfully intubated by an ED provider. We then created a logistic regression model to adjust for provider experience level, difficult airway characteristics, and indications for intubation to compare intubations using DL to intubations using VAL for each outcome.

Results

We identified 452 endotracheal intubations of 422 unique patients, of which 445 intubations had a first attempt by an ED provider. Six intubations were excluded due to insufficient information available in the record. Of the included intubations, 240 (55%) were attempted with DL and 199 (45%) with VAL. The overall first‐pass success rate was 71% in the DL group and 72% in the VAL group. After adjustment for covariates, the first‐pass success rate was similar between laryngoscopy approaches (adjusted odds ratio = 1.23, 95% confidence interval = 0.78 to 1.94).

Conclusions

We found no difference between DL and VAL with regard to first‐pass intubation success rate, complication rate, or rate of successful intubation by ED providers for children undergoing intubation in a pediatric ED.
Safety, Pharmacokinetics and Pharmacodynamics of the Selective Glucocorticoid Receptor Modulator AZD5423 after Inhalation in Healthy Volunteers
Authors: Werkström Viktoria , Prothon Susanne , Ekholm Ella , Jorup Carin , Edsbäcker Staffan
Published: May 2016

AZD5423 is a selective glucocorticosteroid receptor modulator developed for the inhaled use in asthma and COPD. This study reports the initial, first‐in‐man, single and repeat dose‐escalating studies in healthy male individuals, including one cohort of male Japanese individuals. Inhaled, nebulized AZD5423 was safe and well tolerated up to and including the highest doses tested for up to 2 weeks of once‐daily treatment. Plasma exposure suggested dose‐proportional pharmacokinetics and dose‐related effects on 24‐hr plasma and urine cortisol. There were no or marginal effects on other biomarkers tested (osteocalcin, TRAP5b, DHEA‐S and 4β‐OH‐cholesterol). No clinically relevant differences in safety or pharmacokinetics could be distinguished between the two study populations, although hypothalamus–pituitary–adrenal (HPA) effects appeared to be marginally greater in the Japanese‐ versus the Caucasian‐dominant study population. AZD5423, inhaled via nebulization, can be used in healthy individuals at doses of at least 300 μg for 2 weeks. The effects on the HPA axis reported herein, together with efficacy data reported elsewhere, indicate that benefit–risk ratio may be improved relative to conventional inhaled steroids.
The use of Ethics Decision‐Making Frameworks by Canadian Ethics Consultants: A Qualitative Study
Authors: Kaposy Chris , Brunger Fern , Maddalena Victor , Singleton Richard
Published: May 2016

In this study, Canadian healthcare ethics consultants describe their use of ethics decision‐making frameworks. Our research finds that ethics consultants in Canada use multi‐purpose ethics decision‐making frameworks, as well as targeted frameworks that focus on reaching an ethical resolution to a particular healthcare issue, such as adverse event reporting, or difficult triage scenarios. Several interviewees mention the influence that the accreditation process in Canadian healthcare organizations has on the adoption and use of such frameworks. Some of the ethics consultants we interviewed also report on their reluctance to use these tools. Limited empirical work has been done previously on the use of ethics decision‐making frameworks. This study begins to fill this gap in our understanding of the work of healthcare ethics consultants.
Adversaries at the Bedside: Advance Care Plans and Future Welfare
Authors: Kestigian Aidan , London Alex John
Published: May 2016

Advance care planning refers to the process of determining how one wants to be cared for in the event that one is no longer competent to make one's own medical decisions. Some have argued that advance care plans often fail to be normatively binding on caretakers because those plans do not reflect the interests of patients once they enter an incompetent state. In this article, we argue that when the core medical ethical principles of respect for patient autonomy, honest and adequate disclosure of information, institutional transparency, and concern for patient welfare are upheld, a policy that would allow for the disregard of advance care plans is self‐defeating. This is because when the four principles are upheld, a patient's willingness to undergo treatment depends critically on the willingness of her caretakers to honor the wishes she has outlined in her advance care plan. A patient who fears that her caretakers will not honor her wishes may choose to avoid medical care so as to limit the influence of her caretakers in the future, which may lead to worse medical outcomes than if she had undergone care. In order to avoid worse medical outcomes and uphold the four core principles, caregivers who are concerned about the future welfare of their patients should focus on improving advance care planning and commit to honoring their patients’ advance care plans.
A 47‐year‐old woman with hypercapnia and altered mental status
Authors: Bellucci Brian , Qiao Renli
Published: May 2016

Permissive hypercapnia is a commonly used ventilator strategy in attempt to improve refractory hypoxemia. The rationale of such practice is based on the assumption that hypercapnia, although associated with altered mental status, is well tolerated. Here, we report a case in which the altered mental status caused by hypercapnia is underlined by a life‐threatening mechanism. The case indicates the severity of hypercapnia may have been mistakenly overlooked in the past.
Sexual receptivity of Anastrepha obliqua (Diptera: Tephritidae) wild females affected by nutrition and egg load
Authors: Medeiros‐Santana Luanda , Zucoloto Fernando Sérgio
Published: May 2016

The influence of feeding, egg load and stage of ovarian development on the sexual receptivity of some insect species has been reported. This work investigated the effects of different brewer's yeast concentrations in the diet offered to females of West Indian fruit fly, Anastrepha obliqua, on their sexual receptivity. Wild females were fed on artificial diets containing 2.0 g brewer's yeast per 100 mL of water (low‐yeast diet, LY diet), 6.5 g yeast per 100 mL of water (high‐yeast diet, HY diet) or only sucrose (Su diet) and then placed with the males. Female sexual receptivity tests were carried out in acrylic boxes in the laboratory under controlled conditions (temperature, humidity and light). Females fed on the HY diet were more sexually receptive to male courtship than the other females. Additionally, when fed on the same diet (HY diet), those females with higher egg load were more sexually receptive. The data suggest that the ingestion of a protein source is essential for increasing sexual receptivity and that egg load is the most important factor affecting sexual receptivity of A. obliqua females.
Progranulin haploinsufficiency causes biphasic social dominance abnormalities in the tube test
Authors: Arrant A. E. , Filiano A. J. , Warmus B. A. , Hall A. M. , Roberson E. D.
Published: May 2016

Loss‐of‐function mutations in progranulin (GRN) are a major autosomal dominant cause of frontotemporal dementia (FTD), a neurodegenerative disorder in which social behavior is disrupted. Progranulin‐insufficient mice, both Grn+/− and Grn−/−, are used as models of FTD due to GRN mutations, with Grn+/− mice mimicking the progranulin haploinsufficiency of FTD patients with GRN mutations. Grn+/− mice have increased social dominance in the tube test at 6 months of age, although this phenotype has not been reported in Grn−/− mice. In this study, we investigated how the tube test phenotype of progranulin‐insufficient mice changes with age, determined its robustness under several testing conditions, and explored the associated cellular mechanisms. We observed biphasic social dominance abnormalities in Grn+/− mice: at 6–8 months, Grn+/− mice were more dominant than wild‐type littermates, while after 9 months of age, Grn+/− mice were less dominant. In contrast, Grn−/− mice did not exhibit abnormal social dominance, suggesting that progranulin haploinsufficiency has distinct effects from complete progranulin deficiency. The biphasic tube test phenotype of Grn+/− mice was associated with abnormal cellular signaling and neuronal morphology in the amygdala and prefrontal cortex. At 6–9 months, Grn+/− mice exhibited increased mTORC2/Akt signaling in the amygdala and enhanced dendritic arbors in the basomedial amygdala, and at 9–16 months Grn+/− mice exhibited diminished basal dendritic arbors in the prelimbic cortex. These data show a progressive change in tube test dominance in Grn+/− mice and highlight potential underlying mechanisms by which progranulin insufficiency may disrupt social behavior.
The impact of sport on health status, psychological well‐being and physical performance of adults with haemophilia
Authors: von Mackensen S. , Harrington C. , Tuddenham E. , Littley A. , Will A. , Fareh M. , Hay C. R. M. , Khair K.
Published: May 2016

Background

There is increasing recognition that sport is important for individuals with haemophilia; however, there remains a paucity of data of the importance of this in adults, many of whom already have joint pathology related to childhood bleeds and treatment access. This multicentre, cross‐sectional study presents the impact of sport on health‐related quality of life (HRQoL), physical performance and clinical outcomes in adults with haemophilia.

Results

Fifty adults aged 35.12±14.7 with mild (n = 12), moderate (n = 10), or severe (n = 28) haemophilia A (70%) or B (30%) from four haemophilia centres across the United Kingdom participated in the study. A total of 64% were overweight/obese according to their BMI; median orthopaedic joint scores using the WFH Orthopaedic Joint Score (OJS) were 6 (range 0–48). On a VAS pain scale (range of 0–10), patients reported mean score of 5.66 ± 2.4. 36% of participants reported not doing any sport, mainly due to their physical condition. However, 64% of participants reported undertaking sporting activity including contact sports, mostly twice per week in average 4 h week−1. Participating in sport did not have a statistically significant impact on HRQoL; except in the domain ‘sport and leisure’ of the Haem‐A‐QoL. Patients doing more sport reported significantly better HRQoL than those doing less sport (P < 0.005). Those doing sport for more than 4 h week−1 had a significantly better physical performance than patients doing less sport (assessed with Hep‐Test‐Q). Encouraging physical activity and sport in older patients with haemophilia may have a direct impact on their HRQoL; thus, education about sport activity should be incorporated into routine haemophilia care.
Predictors of non‐adherence to prescribed prophylactic clotting‐factor treatment regimens among adolescent and young adults with a bleeding disorder
Authors: Witkop M. L. , McLaughlin J. M. , Anderson T. L. , Munn J. E. , Lambing A. , Tortella B.
Published: May 2016

Introduction

Adherence to clotting‐factor treatment regimens, especially among adolescents and young adults (AYAs), is under‐researched.

Aim

We determined factors associated with better adherence to prophylaxis.

Methods

From April through December 2012, a convenience sample of AYA (aged 13–25 years) persons with haemophilia or von Willebrand disease (VWD) completed an online survey that assessed adherence to prescribed prophylactic treatment regimens [Validated Haemophilia Regimen Treatment Adherence Scale (VERITAS)‐Pro]. Logistic regression analysis assessed demographic and clinical factors related to non‐adherence (VERITAS‐Pro≥57).

Results

Seventy‐three prophylactically treating AYAs participated. Of which, 88%, 8% and 4% had haemophilia A, B and VWD respectively. Almost all (90%) had severe disease and 58% had never developed an inhibitor. Most were aged 13–17 years (56%), white (78%), non‐Hispanic (88%), never married (94%) and had some type of health insurance (96%). Median VERITAS‐Pro score was 48 (range = 25–78) and 22 (30%) participants were non‐adherent to prophylaxis (VERITAS‐Pro≥57). Final logistic regression modelling suggested that, compared to those aged 13–17 years, participants aged 18–25 years were 6.2 (95% CI: 1.8–21.0; P < 0.01) times more likely to be non‐adherent. Compared to respondents whose mother had at least a Bachelor's degree, respondents whose mother did not were 3.8 (95% CI: 1.0–14.3; P = 0.05) times more likely to be non‐adherent.

Conclusions

Results suggest that adherence efforts should be especially targeted to young adults as they transition from adolescence (i.e. parental supervision) and assume primary responsibility for their bleeding disorder care. Healthcare providers should be mindful of AYAs whose mothers have less formal education and ensure that adequate time and resources are dedicated to family adherence education.
The male beard hair and facial skin – challenges for shaving
Authors: Maurer M. , Rietzler M. , Burghardt R. , Siebenhaar F.
Published: May 2016

The challenge of shaving is to cut the beard hair as closely as possible to the skin without unwanted effects on the skin. To achieve this requires the understanding of beard hair and male facial skin biology as both, the beard hair and the male facial skin, contribute to the difficulties in obtaining an effective shave without shaving‐induced skin irritation. Little information is available on the biology of beard hairs and beard hair follicles. We know that, in beard hairs, the density, thickness, stiffness, as well as the rates of elliptical shape and low emerging angle, are high and highly heterogeneous. All of this makes it challenging to cut it, and shaving techniques commonly employed to overcome these challenges include shaving with increased pressure and multiple stroke shaving, which increase the probability and extent of shaving‐induced skin irritation. Several features of male facial skin pose problems to a perfect shave. The male facial skin is heterogeneous in morphology and roughness, and male skin has a tendency to heal slower and to develop hyperinflammatory pigmentation. In addition, many males exhibit sensitive skin, with the face most often affected. Finally, the hair follicle is a sensory organ, and the perifollicular skin is highly responsive to external signals including mechanical and thermal stimulation. Perifollicular skin is rich in vasculature, innervation and cells of the innate and adaptive immune system. This makes perifollicular skin a highly responsive and inflammatory system, especially in individuals with sensitive skin. Activation of this system, by shaving, can result in shaving‐induced skin irritation. Techniques commonly employed to avoid shaving‐induced skin irritation include shaving with less pressure, pre‐ and post‐shave skin treatment and to stop shaving altogether. Recent advances in shaving technology have addressed some but not all of these issues. A better understanding of beard hairs, beard hair follicles and male facial skin is needed to develop novel and better approaches to overcome the challenge of shaving. This article covers what is known about the physical properties of beard hairs and skin and why those present a challenge for blade and electric shaving, respectively.
Do smear‐layer removal agents affect the push‐out bond strength of calcium silicate‐based endodontic sealers?
Authors: Carvalho N. K. , Prado M. C. , Senna P. M. , Neves A. A. , Souza E. M. , Fidel S. R. , Sassone L. M. , Silva E. J. N. L.
Published: May 2016

Aim

To evaluate the effect of 17% ethylenediaminetetraacetic acid (EDTA), 2.25% peracetic acid (PA) or 10% citric acid (CA) on the push‐out bond strength of calcium silicate‐based endodontic sealers [MTA Fillapex (Angelus, Londrina, Brazil) and Total Fill BC Sealer (FKG, La Chaux‐de‐Fonds, Switzerland)] to root dentine after different periods of immersion in phosphate‐buffered saline (PBS). AH Plus (Dentsply DeTrey, Konstaz, Germany) was used as a reference material for comparison.

Methodology

Thirty human maxillary incisors were selected and three 1‐mm discs were obtained from the middle third of each root. On the axial surface of each disc, three 0.8‐mm‐diameter holes were drilled through the dentine. After standardized irrigation, each dentine disc from the same root was treated for smear‐layer removal with one of the three tested chelating solutions: EDTA, PA or CA. After that, the holes were dried with paper points and filled with one of the three test root canal sealers. The filled dental slices were further immersed in PBS solution (pH 7.2) for 7 days (T1) or 30 days (T2) at 37 °C, before the push‐out assay. Friedman, Kruskal–Wallis and Mann–Whitney tests were used respectively to estimate the impact of the independent variables (solutions, sealers and period of PBS immersion) on the push‐out bond strength. The level for significance was set at α = 5% and data were further subjected to a Bonferroni correction.

Results

Solutions and periods of immersion did not significantly influence the displacement resistance (P = 0.285, and P = 0.104, respectively) of sealers to root dentine. On the other hand, the type of sealer significantly affected the push‐out bond strength (P = 0.000). AH Plus was associated with greater resistance to dislodgment compared with Total Fill BC Sealer and MTA Fillapex (P = 0.000). MTA Fillapex resulted in the lowest push‐out bond strength (P = 0.000).

Conclusion

The use of different chelating agents did not influence the push‐out bond strength of endodontic sealers. Calcium silicate‐based sealers had lower push‐out bond strength values compared with a conventional epoxy resin‐based sealer (AH Plus).
Drying kinetics and quality of uvaia (Hexachlamys edulis (O. Berg)) powder obtained by foam‐mat drying
Authors: Branco Ivanise Guilherme , Kikuchi Thatyana Tammy , Argandoña Eliana Janet Sanjinez , Moraes Izabel Cristina Freitas , Haminiuk Charles Windson Isidoro
Published: May 2016

Investigations were carried out to study the influence of the formulation on the drying characteristics and the final quality of foam‐mat‐dried uvaia pulp powder, such as total phenolic content, carotenoids and antioxidant activity. Two formulations were developed (one with 3.5% albumin (Alb.), 0.25% carboxymethylcellulose (CMC) and 0.25% xanthan gum (XG), and the other containing only 7% albumin) and dried at 60 and 70 °C. Drying kinetics showed only a falling rate at both temperatures and formulations. Mathematical models were fitted to the experimental data to describe the drying kinetics. The Page model provided the best description of the foams. The higher temperatures reduced the drying time and increased the effective diffusivity. Compared with the fresh pulp, the uvaia powder at 70 °C exhibited decreased antioxidant activity, total phenolics and carotenoids contents.
Available data point to a 4‐km‐high Tibetan Plateau by 40 Ma, but 100 molecular‐clock papers have linked supposed recent uplift to young node ages
Authors: Renner Susanne S.
Published: May 2016

The aims of this study were to synthesize data on the orogeny of the Tibetan Plateau (TP), with a focus on its elevation since the collision of the Eurasian and Indian plates, and to review the arguments in 100 phylogeny‐cum‐biogeography papers that have linked young inferred divergence times to recent TP uplift phases. I surveyed the literature on the geological history of the TP, focusing on different types of data used to infer its past height. I also tabulated the supposed TP history (and supporting references) in papers since 1998. Since the early 1990s, evidence from tectonics, isotopes, fossils and climate simulations increasingly indicates that the TP has been 4–5 km high since the mid‐Eocene. The data also indicate that the Indian summer monsoon, South‐east Asian summer monsoon, and Central Asian winter monsoon arose at different times and are unrelated to Tibetan uplift. A growing number of studies by biologists, however, are linking node ages between 0.5 and 15 Ma to specific (author‐dependent) uplift phases of the TP citing geological papers that are outdated or miscited. Biogeography of the TP thus currently appears to be in a self‐created bubble that encloses hundreds of authors and referees. Our understanding of the biogeography of Tibet requires up‐to‐date interpretation of its geological history and more fieldwork on local ecological habitat diversity, the plateau's history during the Pleistocene and the distribution of possible refugia.
Arterial blood pressure in anesthetized neonates and infants: a retrospective analysis of 1091 cases
Authors: Weber Frank , Honing Gijsbert H. M. , Scoones Gail P.
Published: May 2016

Background

Hypotension during general anesthesia in neonates and infants is considered to contribute to poor neurological outcome.

Aim

The aim of this retrospective analysis was to determine the incidence of hypotension after induction of anesthesia and sustained hypotension (>10 min) during the anesthesia, and to determine factors contributing to the development of (sustained) hypotension.

Method

We performed a retrospective analysis of 1091 electronic anesthesia records from children <1 year. Patients were stratified for age (group 1: <1 month, group 2: 1–3 months, group 3: 4–6 months, group 4: >6 months). Hypotension was defined as a mean arterial pressure (MAP) <35 mmHg in patients ≤6 months and <43 mmHg in patients >6 months.

Results

The incidence of hypotension after induction was highest in group 1 (25.5%) [P = 0.009 vs group 2 (13.3%), P < 0.0001 vs groups 3 (3.4%) and 4 (1.0%)], in group 2, it was higher than in groups 3 and 4 (P < 0.0001), and in group 3, it was higher than in group 4 (P = 0.033). The incidence of sustained hypotension was highest in group 1 (43.6%) (P < 0.0001 vs groups 2–4), followed by group 2 (15.7%) [P < 0.0001 vs group 3 (3.4%) and P = 0.006 vs group 4 (8.8%)] and group 4 (P = 0.004 vs group 3). Hypotension after induction occurred more often in emergency procedures than in elective procedures in groups 1 (P = 0.002), 2 (P = 0.029), and 3 (P = 0.037).

Conclusion

Hypotension, both postinduction and sustained during surgery, is a common phenomenon in anesthetized children under 1 year, peaking in neonates. Generally accepted lower limits of MAP in anesthetized infants urgently need to be defined, enabling us to develop anesthesia strategies avoiding cerebral hypoperfusion.
Ontogenesis secretion and senescence of Tocoyena bullata (Vell.) Mart. (Rubiacaeae) colleters
Authors: Miguel E. C. , Da Cunha M. , Miguel T. B. A. R. , Barros C. F.
Published: May 2016

Colleters are secretory structure present on many families including Rubiaceae. Particular characteristics have been described about colleters secretory cells, however senescence process are still under debate. Tocoyena bullata (Vell.) Mart. (Rubiaceae) shoot apex were collected at Jardim Botânico do Rio de Janeiro, RJ/Brazil. Stipules were separated and fragments were fixed in 2.5% glutaraldehyde and 4.0% formaldehyde in 0.05 m sodium cacodylate buffer, pH 7.2, post fixed in 1.0% osmium tetroxide in the same buffer, dehydrated in acetone, critical‐point‐drying, sputtered coated and observed. For light microscopy fragments were fixed and dehydrated, infiltrated with historesin and stained with 1% toluidine blue. For transmission electron microscopy, the samples were infiltrated with Epoxi resin. Colleters are present on stipule adaxial surface. On the beginning of development, these structures are recognized as small projections. Later on, colleters differentiated and secrete by cuticle rupture. The colleters senescence occurs in a concomitant and indissoluble way of programmed cell death. Ultrastructural analyses during the process strongly suggest the senescence is based on a non‐autolitic programmed cell death. T. bullata colleters, present at stipule abaxial surface are cylindrical secretory structures. Colleters secretory cells originated as stipule projections; differentiate; secrete and senesce by programmed cell death. The secretion and the cell dead occurs in a concomitantly and indissoluble way.
Introduction to Schauer and The Force of Law
Authors: Canale Damiano , Tuzet Giovanni
Published: May 2016

The paper introduces the debate, hosted by the present Journal, on Schauer's book The Force of Law. It points out some starting points of the discussion and puts into question the status of contemporary jurisprudence.
The Ultimate Force of the Law: On the Essence and Precariousness of the Monopoly on Legitimate Force
Authors: Poscher Ralf
Published: May 2016

In his new book, Fred Schauer adopts a prototypical approach to the law in order to reestablish the importance of “The Force of Law”, and I strongly support his claim that there are interesting things to be said about the relationship between law and force. One aspect concerns the special kind of force to which the law is related. In the tradition of political philosophy, this kind of force has often been characterized with the state's monopoly on legitimate force. Whereas the essay will support the idea that the law has a monopoly of force, it will challenge the idea that it is its legitimacy that makes it characteristic. It is a monopoly not so much on legitimate, but on ultimate force. The robustness of the force the law is—prototypically—related to, however, should not obscure the fact that the relation between law and force is quite delicate and precarious. Three strategies of the law to manage this fundamental precariousness are pointed out.
A Reply to Five Friends
Authors: Schauer Frederick
Published: May 2016

For an academic, there is no greater reward than having one's scholarship taken seriously. The five distinguished scholars who have contributed to this symposium on The Force of Law (Schauer ) have done just that, with varying degrees of agreement and disagreement, praise and criticism. But even critical commentary, and perhaps especially critical commentary, is evidence of serious engagement. More importantly, the commentaries contained here have advanced our understanding of law in valuable ways. I respond to each in this reply, but with full acknowledgment that my responses cannot do justice to the full breadth of their contributions and challenges. My hope is not that I will persuade readers that I am correct and my critics mistaken, but rather that the reader who absorbs both the challenges and my response will come away with a greater understanding of the issues that The Force of Law seeks to place on the agenda of contemporary jurisprudence.
An Automatic Test for the Umbrella Alternatives
Authors: Wyłupek Grzegorz
Published: May 2016

The paper proposes a new test for detecting the umbrella pattern under a general non‐parametric scheme. The alternative asserts that the umbrella ordering holds while the hypothesis is its complement. The main focus is put on controlling the power function of the test outside the alternative. As a result, the asymptotic error of the first kind of the constructed solution is smaller than or equal to the fixed significance level α on the whole set where the umbrella ordering does not hold. Also, under finite sample sizes, this error is controlled to a satisfactory extent. A simulation study shows, among other things, that the new test improves upon the solution widely recommended in the literature of the subject. A routine, written in R, is attached as the Supporting Information file.
Mineralization of organic nitrogen from farm manure applications
Authors: Bhogal A. , Williams J. R. , Nicholson F. A. , Chadwick D. R. , Chambers K. H. , Chambers B. J.
Published: May 2016

This study aimed to quantify the amount of nitrogen (N) mineralized from the organic fraction of farm manures under field conditions. Nine different farm manures were stripped of their ammonium‐N content prior to soil incorporation and establishment of ryegrass at two sites in England. Grass N uptake and nitrate‐N leaching were measured for five consecutive seasons and compared with an untreated control, with the sum of N uptake + leaching (net of the control) used as an estimate of the amount of organic N mineralized from the applied manures. The amount mineralized was related to thermal time (cumulative day degrees above 5 °C – CDD), with two distinct phases – an initial phase up to 2300 CDD (c.18 months under UK climatic conditions) where mineralization proceeded at rates ranging between 0.005 and 0.027%mineralized/CDD and a slower phase at >2300 CDD, where rates were negligible at <0.001%mineralized/CDD. There was no difference between soil types, both being light‐textured (<20% clay), but there were differences between manure types depending on the manure C: organic N ratios. For pig slurry and layer manure (C:organic N = 9–12:1), up to 70% of the organic N was mineralized, compared to 10–30% mineralization from the cattle slurry and straw‐based farmyard manures‐FYMs (C:organic N = 10–21:1).The relationships derived provide a useful tool for predicting both the amount and timing of manure N release, with important implications for both crop N uptake and leaching risk.
Retention in care of HIV‐infected pregnant and lactating women starting ART under Option B+ in rural Mozambique
Authors: Llenas‐García Jara , Wikman‐Jorgensen Philip , Hobbins Michael , Mussa Manuel Aly , Ehmer Jochen , Keiser Olivia , Mbofana Francisco , Wandeler Gilles ,   SolidarMed and IeDEA‐Southern Africa
Published: May 2016

Objective

In 2013, Mozambique adopted Option B+, universal lifelong antiretroviral therapy (ART) for all pregnant and lactating women, as national strategy for prevention of mother‐to‐child transmission of HIV. We analysed retention in care of pregnant and lactating women starting Option B+ in rural northern Mozambique.

Methods

We compared ART outcomes in pregnant (‘B+ pregnant’), lactating (‘B+ lactating’) and non‐pregnant non‐lactating women of childbearing age starting ART according to clinical and/or immunological criteria (‘own health’) between July 2013 and June 2014. Lost to follow‐up was defined as no contact >180 days after the last visit. Multivariable competing risk models were adjusted for type of facility (type 1 vs. peripheral type 2 health centre), age, WHO stage and time from HIV diagnosis to ART.

Results

Over 333 person‐years of follow‐up (243 ‘B+ pregnant’, 65'B+ lactating’ and 317 ‘own health’ women), 3.7% of women died and 48.5% were lost to follow‐up. ‘B+ pregnant’ and ‘B+ lactating’ women were more likely to be lost in the first year (57% vs. 56.9% vs. 31.6%; P < 0.001) and to have no follow‐up after the first visit (42.4% vs. 29.2% vs. 16.4%; P < 0.001) than ‘own health’ women. In adjusted analyses, risk of being lost to follow‐up was higher in ‘B+ pregnant’ (adjusted subhazard ratio [asHR]: 2.77; 95% CI: 2.18–3.50; P < 0.001) and ‘B+ lactating’ (asHR: 1.94; 95% CI: 1.37–2.74; P < 0.001). Type 2 health centre was the only additional significant risk factor for loss to follow‐up.

Conclusions

Retention among PLW starting option B+ ART was poor and mainly driven by early losses. The success of Option B+ for prevention of mother‐to‐child transmission of HIV in rural settings with weak health systems will depend on specific improvements in counselling and retention measures, especially at the beginning of treatment.
In Vitro
Susceptibility of Global Surveillance Isolates of Pseudomonas aeruginosa to Ceftazidime-Avibactam (INFORM 2012 to 2014)
Authors: Nichols Wright W. , de Jonge Boudewijn L. M. , Kazmierczak Krystyna M. , Karlowsky James A. , Sahm Daniel F.
Published: May 2016

Broth microdilution antimicrobial susceptibility testing was performed for ceftazidime-avibactam and comparator agents against 7,062 clinical isolates of
Pseudomonas aeruginosa
collected from 2012 to 2014 in four geographic regions (Europe, Asia/South Pacific, Latin America, Middle East/Africa) as part of the International Network for Optimal Resistance Monitoring (INFORM) global surveillance program. The majority of isolates were susceptible to ceftazidime-avibactam, with the proportions susceptible differing marginally across the four regions (MIC
90
, 8 to 16 μg/ml; 88.7 to 93.2% susceptible), in contrast to lower susceptibilities to the following comparator β-lactam agents: ceftazidime (MIC
90
, 32 to 64 μg/ml; 71.5 to 80.8% susceptible), meropenem (MIC
90
, >8 μg/ml; 64.9 to 77.4% susceptible), and piperacillin-tazobactam (MIC
90
, >128 μg/ml; 62.3 to 71.3% susceptible). Compared to the overall population, susceptibility to ceftazidime-avibactam of isolates that were nonsusceptible to ceftazidime (
n
= 1,627) was reduced to between 56.8% (Middle East/Africa; MIC
90
, 64 μg/ml) and 68.9% (Asia/South Pacific; MIC
90
, 128 μg/ml), but these percentages were higher than susceptibilities to other β-lactam agents (0 to 44% susceptible, depending on region and agent; meropenem MIC
90
, >8 μg/ml; 26.5 to 43.9% susceptible). For this subset of isolates, susceptibilities to amikacin (MIC
90
, >32 μg/ml; 53.2 to 80.0% susceptible) and colistin (MIC
90
, 1 μg/ml; 98.5 to 99.5% susceptible) were comparable to or higher than that of ceftazidime-avibactam. A similar observation was made with isolates that were nonsusceptible to meropenem (
n
= 1,926), with susceptibility to ceftazidime-avibactam between 67.8% (Middle East/Africa; MIC
90
, 64 μg/ml) and 74.2% (Europe; MIC
90
, 32 μg/ml) but again with reduced susceptibility to comparators except for amikacin (MIC
90
, >32 μg/ml; 56.8 to 78.7% susceptible) and colistin (MIC
90
, 1 μg/ml; 98.9 to 99.3% susceptible). Of the 8% of isolates not susceptible to ceftazidime-avibactam, the nonsusceptibility of half could be explained by their possession of genes encoding metallo-β-lactamases. The data reported here are consistent with results from other country-specific and regional surveillance studies and show that ceftazidime-avibactam demonstrates
in vitro
activity against globally collected clinical isolates of
P. aeruginosa
, including isolates that are resistant to ceftazidime and meropenem.
An Immunocompromised Child with Bloodstream Infection Caused by Two Escherichia coli Strains, One Harboring NDM-5 and the Other Harboring OXA-48-Like Carbapenemase
Authors: Hasassri M. Earth , Boyce Thomas G. , Norgan Andrew , Cunningham Scott A. , Jeraldo Patricio R. , Weissman Scott , Patel Robin , Banerjee Ritu , Pogue Jason M. , Kaye Keith S.
Published: May 2016

We describe a 16-year-old neutropenic patient from the Middle East with bloodstream infection caused by two carbapenemase-producing
Escherichia coli
isolates that we characterized by whole-genome sequencing. While one displayed meropenem resistance and was
bla
NDM
positive, the other demonstrated meropenem susceptibility yet harbored
bla
OXA181
(which encodes a
bla
OXA48
-like enzyme). This report highlights the challenge of laboratory detection of
bla
OXA48
-like enzymes and the clinical implications of genotypic resistance detection in carbapenemase-producing
Enterobacteriaceae
.
Purification of Plasmodium Sporozoites Enhances Parasite-Specific CD8
+
T Cell Responses
Authors: Billman Zachary P. , Seilie Annette M. , Murphy Sean C.
Published: May 2016

Malaria infection caused by
Plasmodium
parasites continues to cause enormous morbidity and mortality in areas where it is endemic, and there is no licensed vaccine capable of inducing sterile protection. Hyperimmunization with attenuated whole sporozoites can induce sterile protective immune responses targeting preerythrocytic antigens. Most animal models of hyperimmunization rely on sporozoites dissected from mosquito salivary glands and injected without further purification. In BALB/c mice, repeated small doses of
P. yoelii
sporozoites progressively expand the population of sporozoite-specific CD8
+
T cells. In this study, large secondary doses of unpurified sporozoites unexpectedly led to contraction of sporozoite-specific CD8
+
T cell responses in sporozoite-primed mice. While sporozoite-primed CD8
+
T cells alternatively can be expanded by secondary exposure to
Listeria monocytogenes
expressing recombinant
Plasmodium
antigens, such expansion was potently inhibited by coinjection of large doses of unpurified sporozoites and by uninfected salivary glands alone. Purification of sporozoites away from mosquito salivary gland debris by density gradient centrifugation eliminated salivary gland-associated inhibition. Thus, the inhibitory effect appears to be due to exposure to uninfected mosquito salivary glands rather than sporozoites. To further assess the effect of salivary gland exposure on later sporozoite vaccinations, mice were immunized with uninfected salivary glands from a single mosquito. Compared to naive mice, salivary gland presensitization reduced subsequent liver burdens by 71%. These data show that a component(s) in mosquito salivary glands reduces liver infection, thereby limiting antigen dose and contributing to lower-magnitude T cell responses. These findings suggest that sporozoite immunogenicity studies be performed using purified sporozoites whenever feasible.
Inverse psoriasis treated with ustekinumab
Authors: Campos Manuel António , Varela Paulo , Baptista Armando , Moreira Ana Isabel
Published: May 2016

Inverse psoriasis is characterised by the involvement of flexural skin folds. This form of psoriasis has distinct clinical and therapeutic features. This report refers to the case of a 48-year-old Caucasian man who was observed in our department, with a clinically and biopsy proven diagnosis of inverse psoriasis. For 2 years, the patient was treated with different combinations of corticosteroids, vitamin D analogues and methotrexate, with no satisfactory response. Given the lack of a clinical response and comorbidities, latent tuberculosis was excluded, and we started treatment with ustekinumab. We chose this biological agent because the patient was a long-distance truck driver and refused the possibility of autoinjections. The patient underwent three ustekinumab injections, which resulted in significant improvement of pruritus, erythaematous lesions and quality of life.
Effects of an air pollution personal alert system on health service usage in a high-risk general population: a quasi-experimental study using linked data
Authors: Lyons R A , Rodgers S E , Thomas S , Bailey R , Brunt H , Thayer D , Bidmead J , Evans B A , Harold P , Hooper M , Snooks H
Published: May 2016

Background

There is no evidence to date on whether an intervention alerting people to high levels of pollution is effective in reducing health service utilisation. We evaluated alert accuracy and the effect of a targeted personal air pollution alert system, airAware, on emergency hospital admissions, emergency department attendances, general practitioner contacts and prescribed medications.

Methods

Quasi-experimental study describing accuracy of alerts compared with pollution triggers; and comparing relative changes in healthcare utilisation in the intervention group to those who did not sign-up. Participants were people diagnosed with asthma, chronic obstructive pulmonary disease (COPD) or coronary heart disease, resident in an industrial area of south Wales and registered patients at 1 of 4 general practices. Longitudinal anonymised record linked data were modelled for participants and non-participants, adjusting for differences between groups.

Results

During the 2-year intervention period alerts were correctly issued on 208 of 248 occasions; sensitivity was 83.9% (95% CI 78.8% to 87.9%) and specificity 99.5% (95% CI 99.3% to 99.6%). The intervention was associated with a 4-fold increase in admissions for respiratory conditions (incidence rate ratio (IRR) 3.97; 95% CI 1.59 to 9.93) and a near doubling of emergency department attendance (IRR=1.89; 95% CI 1.34 to 2.68).

Conclusions

The intervention was associated with increased emergency admissions for respiratory conditions. While findings may be context specific, evidence from this evaluation questions the benefits of implementing near real-time personal pollution alert systems for high-risk individuals.