bluuebunny/crossref_metadata_2025 huggingface dataset:
Coordination between leaf CO2 diffusion and Rubisco properties allows maximizing photosynthetic efficiency in Limonium species
Authors: Galmés Jeroni , Molins Arántzazu , Flexas Jaume , Conesa Miquel À.
Published: June 2017

High photosynthetic efficiency intrinsically demands tight coordination between traits related to CO2 diffusion capacity and leaf biochemistry. Although this coordination constitutes the basis of existing mathematical models of leaf photosynthesis, it has been barely explored among closely related species, which could reveal rapid adaptation clues in the recent past. With this aim, we characterized the photosynthetic capacity of 12 species of Limonium, possessing contrasting Rubisco catalytic properties, grown under optimal (WW) and extreme drought conditions (WD). The availability of CO2 at the site of carboxylation (Cc) determined the photosynthetic capacity of Limonium under WD, while both diffusional and biochemical components governed the photosynthetic performance under WW. The variation in the in vivo caboxylation efficiency correlated with both the concentration of active Rubisco sites and the in vitro‐based properties of Rubisco, such as the maximum carboxylase turnover rate (kcatc) and the Michaelis–Menten constant for CO2 (Kc). Notably, the results confirmed the hypothesis of coordination between the CO2 offer and demand functions of photosynthesis: those Limonium species with high total leaf conductance to CO2 have evolved towards increased velocity (i.e. higher kcatc), at the penalty of lower affinity for CO2 (i.e. lower specificity factor, Sc/o).
Pediatric liver transplantation for fulminant hepatic failure secondary to intentional iron overdose
Authors: Lai Joanne , Chu Jaime , Arnon Ronen
Published: June 2017

Acute iron poisoning may lead to life‐threatening hepatotoxicity. We present the cases of two pediatric patients with hepatotoxicity following intentional iron ingestion that progressed rapidly to fulminant hepatic failure despite treatment with deferoxamine. Liver transplantation was lifesaving in both patients. These cases emphasize the need for a high index of suspicion for iron ingestion, close monitoring for liver toxicity, and timely consideration for liver transplantation.
Post‐traumatic stress disorder and health‐related quality of life in the siblings of the pediatric bone marrow transplantation survivors and post‐traumatic stress disorder in their mothers
Authors: Gizli Çoban Özge , Sürer Adanır Aslı , Özatalay Esin
Published: June 2017

Although BMT is lifesaving in many childhood diseases, it was found to be related to anxiety, depression, and PTSD in parents, and PTSD, anxiety and overall low self‐esteem in siblings. Research on siblings' HRQoL is limited. The aim of this study was to investigate PTSD and HRQoL in siblings (donor and non‐donor) of pediatric BMT survivors and PTSD in their mothers, compared to the healthy controls. Thirty‐five siblings and their mothers and 35 healthy peers and their mothers were recruited as the study group and as the comparison group, respectively. In children, Child PTSD‐Reaction Index for PTSD and PedsQL for HRQoL were used. PTSD Checklist‐Civilian Version was used for PTSD in mothers. The study group, both children and mothers, obtained significantly higher PTSD rates than the control group. Children in the study group also reported significantly poorer HRQoL than the control group in all scales. As a novel finding, there was a significant negative correlation between siblings' and mothers' PTSD scores and siblings' PedsQL scores, indicating that PTSD symptoms in siblings and mothers significantly led to impairment in siblings' HRQoL or vice versa. Thus, the identification and treatment of siblings and mothers with PTSD seems imperative.
Home phototherapy in vitiligo
Authors: Mohammad Tasneem F. , Silpa‐Archa Narumol , Griffith James L. , Lim Henry W. , Hamzavi Iltefat H.
Published: June 2017

Vitiligo is a disorder characterized by the development of depigmented macules and patches. Narrowband ultraviolet B phototherapy is a standard of care treatment and is used both as monotherapy and in combination with other treatment modalities to induce repigmentation. Although phototherapy is safe and effective, its use is limited due to the significant time commitment required and associated costs. Home phototherapy is a safe and effective alternative to make phototherapy more accessible to patients. However, it is often underutilized due to lack of physician experience and comfort as well as misconceptions regarding its safety and efficacy. This article provides a brief overview of the use of phototherapy in vitiligo with a focus on home phototherapy in order to increase awareness and use of this treatment modality.
Can the Apgar Score be Used for International Comparisons of Newborn Health?
Authors: Siddiqui Ayesha , Cuttini Marina , Wood Rachel , Velebil Petr , Delnord Marie , Zile Irisa , Barros Henrique , Gissler Mika , Hindori‐Mohangoo Ashna D , Blondel Béatrice , Zeitlin Jennifer ,   the Euro‐Peristat Scientific Committee
Published: June 2017

Background

The Apgar score has been shown to be predictive of neonatal mortality in clinical and population studies, but has not been used for international comparisons. We examined population‐level distributions in Apgar scores and associations with neonatal mortality in Europe.

Methods

Aggregate data on the 5 minute Apgar score for live births and neonatal mortality rates from countries participating in the Euro‐Peristat project in 2004 and 2010 were analysed. Country level associations between the Apgar score and neonatal mortality were assessed using the Spearman rank correlation coefficient.

Results

Twenty‐three countries or regions provided data on Apgar at 5 minutes, covering 2 183 472 live births. Scores <7 ranged from 0.3% to 2.4% across countries in 2004 and 2010 and were correlated over time (ρ = 0.88, P < 0.01). There were large differences in healthy baby scores: scores of 10 ranged from 8.8% to 92.7% whereas scores of 9 or 10 ranged from 72.9% to 96.8%. Countries more likely to score 10 s, as opposed to 9 s, for healthy babies had lower proportions of Apgar <7 (ρ = −0.43, P = 0.04). Neonatal mortality rates were weakly correlated with Apgar score <7 (ρ = −0.06, P = 0.61), but differences over time in these two indicators were correlated (ρ =0.56, P = 0.02).

Conclusions

Large variations in the distribution of Apgar scores likely due to national scoring practices make the Apgar score an unsuitable indicator for benchmarking newborn health across countries. However, country‐level trends over time in the Apgar score may reflect real changes and merit further investigation.
Improving feed efficiency in fish using selective breeding: a review
Authors: de Verdal Hugues , Komen Hans , Quillet Edwige , Chatain Béatrice , Allal François , Benzie John A.H. , Vandeputte Marc
Published: June 2017

Improving feed efficiency (FE) is key to reducing production costs in aquaculture and to achieving sustainability for the aquaculture industry. Feed costs account for 30–70% of total production costs in aquaculture; much work has been done on nutritional and husbandry approaches to improve FE but only a limited amount of research has been devoted to using genetics, despite its potential. This paper reviews past work to improve FE in fish using selective breeding and assess future directions. Direct selection on FE traits requires methods to measure individual feed consumption and estimate FE efficiently and accurately. This is particularly difficult to do in fish because of the environment in which they live. Many of the published studies on FE were found to be inaccurate because of methodological problems. The relatively low heritability estimates of FE traits in fish published to date are probably partly as a result of inaccurate measurements of feed intake. Improving ways to measure the individual feed intake with high accuracy will be critical to the successful application of genetics to improving FE. Indirect selection criteria that could be used to improve FE (including growth after starvation/refeeding, body composition, neuropeptides or hormone levels) are discussed. Promising approaches to measuring feed intake accurately that may enable these studies to be undertaken are identified. More work using these will be needed prior to assessing the practicality of the introduction of direct or indirect traits for FE in fish genetic improvement programmes.
The redistributive impact of hypocrisy in international taxation
Authors: Hakelberg Lukas , Schaub Max
Published: June 2017

Why do tax havens, whose attractiveness for foreign investors depends upon financial secrecy, agree to automatically report account data to foreign governments? From a contractualist perspective, their cooperation should be motivated by the expectation of joint gains. Prior to such agreement, however, tax havens expected outflows of foreign capital and reductions in economic activity as likely outcomes. We show that the United States (US) imposed automatic information exchange on these countries without itself participating. The result is a strongly redistributive regime that worsens the economic situation of tax havens. By means of a difference‐in‐differences analysis, we ascertain a substantial and statistically significant negative effect of a US sanction threat on the value of assets held by foreigners in tax havens relative to non‐havens. The effect becomes stronger when the US is included in the non‐haven group. The analysis confirms the US's ability to redistribute financial wealth internationally through organized hypocrisy.
Dissecting the benefits of long‐term non‐invasive ventilation in patients with distinct neuromuscular disorders
Authors: Boentert Matthias
Published: June 2017

See related Article
Reference data for BabyBody‐plethysmographic measurements in Chinese neonates and infants
Authors: Jiang Gaoli , Li Albert , Wang Libo , Qian Liling , Cao Yun , Huang Jianfeng , Wan Chengzhou , Zhang Xiaobo
Published: June 2017

Background and objective

Population‐specific pulmonary function reference data are essential to identify the nature and severity of respiratory diseases. However, there is a lack of reference data for Chinese neonates and infants. The objective of this study was to develop reference data for tidal breathing and plethysmographic measurements for Chinese subjects during the first 2 years of life.

Methods

Data of tidal breathing and plethysmography from healthy Chinese neonates (≤28 days) and infants (1–24 months) using the Jaeger MasterScreen BabyBody were collated. All subjects were sedated for the tests. Multivariable analyses were performed to determine predictive variables for the pulmonary function parameters. Reference equations for outcomes were constructed using multilevel modelling and the LMS (lambda–mu–sigma) method was used for establishing smoothed reference percentiles.

Results

Four hundred and ten healthy subjects were tested. Acceptable measurements of tidal breathing analysis and plethysmography outcomes were obtained in 396 (96.6%) and 370 (90.4%) subjects, respectively. Normal reference percentiles and equations for the main parameters of tidal breathing and plethysmography were derived from test occasions of 211 neonates and 185 infants. Body weight, crown–heel length and age were significantly associated with lung function, of which length was the strongest predictor.

Conclusion

This study provides reference data of BabyBody‐plethysmographic measurements for healthy Chinese subjects in their first 2 years of life. Weight and length are the strongest predictors for neonatal and infant lung function, respectively.
Assessing the readiness of the BRICS grouping for mutually beneficial financial integration
Authors: Bonga‐Bonga Lumengo
Published: June 2017

This paper assesses the extent of transmission of volatility shocks in the equity and foreign exchange markets among BRICS (Brazil, Russia, India, China and South Africa) countries to infer the degree of risk sharing and the possibility of a beneficial financial integration among its member countries. To this end, the paper makes use of the spillover index methodology suggested by Diebold and Yilmaz (). Nonetheless, the paper extends this methodology by incorporating ex ante volatility measures that account for long memory in equity and foreign exchange markets. The paper finds asymmetric influences among BRICS countries in relation to the cross transmission of risks. The finding of the paper implies the possibility of unequal benefit that could result from a possible capital market liberalization between the BRICS countries.
A dose‐escalation study of combretastatin A4‐phosphate in healthy dogs
Authors: Abma E. , Smets P. , Daminet S. , Cornelis I. , De Clercq K. , Ni Y. , Vlerick L. , de Rooster H.
Published: June 2017

Combretastatin A4‐Phosphate (CA4P) is a vascular disrupting agent revealing promising results in cancer treatments for humans. The aim of this study was to investigate the safety and adverse events of CA4P in healthy dogs as a prerequisite to application of CA4P in dogs with cancer.

Ten healthy dogs were included. The effects of escalating doses of CA4P on physical, haematological and biochemical parameters, systolic arterial blood pressure, electrocardiogram, echocardiographic variables and general wellbeing were characterised. Three different doses were tested: 50, 75 and 100 mg m−2.

At all 3 CA4P doses, nausea, abdominal discomfort as well as diarrhoea were observed for several hours following administration. Likewise, a low‐grade neutropenia was observed in all dogs. Doses of 75 and 100 mg m−2 additionally induced vomiting and elevation of serum cardiac troponine I levels. At 100 mg m−2, low‐grade hypertension and high‐grade neurotoxicity were also observed.

In healthy dogs, doses up to 75 mg m−2 seem to be well tolerated. The severity of the neurotoxicity observed at 100 mg m−2, although transient, does not invite to use this dose in canine oncology patients.
Epirubicin in the treatment of canine histiocytic sarcoma: sequential, alternating and rescue chemotherapy
Authors: Mason S. L. , Finotello R. , Blackwood L.
Published: June 2017

The aims of this study were to report treatment outcomes for dogs with histiocytic sarcoma (HS) treated with both lomustine and epirubicin, and to report response rates to epirubicin as a rescue therapy in dogs previously treated with lomustine. Medical records of dogs with a diagnosis of HS that were treated with both lomustine and epirubicin were retrospectively evaluated. Of 29 dogs receiving epirubicin alternating with, or subsequent to lomustine treatment, including in a rescue setting, response to epirubicin could be assessed in 20 with an overall response rate (ORR) of 29% and biological response rate (BRR) of 71%. Median time to progression (TTP) in 12 of these 20 dogs in which it was assessable was 69 days (range: 40‐125 days). For dogs treated in the rescue setting epirubicin specific ORR was 19% and BRR 63%. Median TTP in the 9 of these 16 dogs in which it was assessable was 62 days (range: 40‐125 days). Median survival time for all dogs treated with both epirubicin and lomustine was 185 days (range: 27‐500 days). Some dogs with HS respond to epirubicin and dogs treated with combinations of epirubicin and lomustine have modestly improved survival times compared with single agent studies, and similar to dogs with HS treated with alternating lomustine and doxorubicin. Single agent epirubicin is also a valid short term rescue therapy for canine HS.
A dog as a generalist plant detection tool
Authors: Mclean I G , Sargisson R J
Published: June 2017

We tested the training of a dog as a generalist plant detector, to be used when plants are at low density or are difficult to find. Using a match‐to‐sample (MTS) protocol and a 10‐choice array, the dog found 11 plant species with 100% reliability from the first trial, and all 19 species tested with 100% reliability after three trials. The dog reliably found other parts of the same plant species when only one part was offered (e.g. flowers offered and leaves found). The methodology focussed on successful detection of an array of species, but false alarms (FAs) are also an issue when using any detection system. Most FAs given by the dog were of the plant used in the immediately preceding trial (proactive interference), which would not occur in an operational situation. Dogs have the potential to serve as generalist plant detectors, and training with the MTS protocol is a suitable and efficient method for producing such a dog.
Thermal Predictions of the AGR-3/4 Experiment With Post Irradiation Examination Measured Time-Varying Gas Gaps
Authors: Hawkes Grant L. , Sterbentz James W. , Maki John T. , Pham Binh T.
Published: June 2017

A thermal analysis was performed for the advanced gas reactor test experiment (AGR-3/4) with post irradiation examination (PIE) measured time (fast neutron fluence) varying gas gaps. The experiment was irradiated at the advanced test reactor (ATR) at the Idaho National Laboratory (INL). Several fuel irradiation experiments are planned for the AGR Fuel Development and Qualification Program, which supports the development of the very high-temperature gas-cooled reactor under the advanced reactor technologies project. The AGR-3/4 test was designed primarily to assess fission product transport through various graphite materials. Irradiation in the ATR started in December 2011 and finished in April 2014. Forty-eight (48) tristructural-isotropic-fueled compacts were inserted into 12 separate capsules for the experiment. The purpose of this analysis was to calculate the temperatures of each compact and graphite layer to obtain daily average temperatures using PIE-measured time (fast neutron fluence) varying gas gaps and compare with experimentally measured thermocouple (TC) data. PIE-measured experimental data were used for the graphite shrinkage versus fast neutron fluence. PIE dimensional measurements were taken on all the fuel compacts, graphite holders, and all of the graphite rings used. Heat rates were input from a detailed physics analysis for each day during the experiment. Individual heat rates for each nonfuel component were input as well. A steady-state thermal analysis was performed for each daily calculation. A finite element model was created for each capsule.
Magnetic cannon: The physics of the Gauss rifle
Authors: Chemin Arsène , Besserve Pauline , Caussarieu Aude , Taberlet Nicolas , Plihon Nicolas
Published: June 2017

The magnetic cannon is a simple device that converts magnetic energy into kinetic energy. When a steel ball with low initial velocity impacts a chain consisting of a followed by addition steel balls, the last ball in the chain gets ejected at a much larger velocity. The analysis of this spectacular device involves an understanding of advanced magnetostatics, energy conversion, and the collision of solids. In this article, the phenomena at each step of the process are modeled to predict the final kinetic energy of the ejected ball as a function of a few parameters that can be experimentally
Meshfree computation of electrostatics and related boundary value problems
Authors: Wang J. , Hao Y.
Published: June 2017

We discuss a meshfree method for solving boundary value problems in physics. The method uses random data interpolation and radial basis functions that depend on the distance, instead of the usual basis functions that depend on the position. As an example, we apply this method to the electrostatic problem of two parallel plates inside a conducting cylinder and discuss its convergence and robustness. The method is shown to be robust and flexible and can be an efficient alternative to mesh-based methods for solving computational problems involving irregular domains.
Elementary example of energy and momentum of an extended physical system in special relativity
Authors: Serafin Kamil , Głazek Stanisław D.
Published: June 2017

An instructive paradox concerning the classical description of energy and momentum of extended physical systems in special relativity theory is explained using an elementary example of two point-like massive bodies rotating on a circle in their center-of-mass frame of reference, connected by an arbitrarily light and infinitesimally thin string. From the point of view of the inertial observers who move with respect to the rotating system, the sums of the energies and momenta of the two bodies oscillate, instead of being constant in time. This result is understood in terms of the mechanism that binds the bodies: the string contributes to the total system energy and momentum no matter how light it is. Its contribution eliminates the unphysical oscillations from the system total four-momentum. The generality of the relativistic approach, applied here to the rotor example, suggests that in every extended physical system its binding mechanism contributes to its total energy and momentum.
Complete Genome Sequence of Edwardsiella ictaluri Isolate RUSVM-1 Recovered from Nile Tilapia (
Oreochromis niloticus
) in the Western Hemisphere
Authors: Reichley Stephen R. , Waldbieser Geoffrey C. , Soto Esteban , Lawrence Mark L. , Griffin Matt J.
Published: June 2017

Edwardsiella ictaluri
is a Gram-negative bacillus that has recently been implicated in disease outbreaks in tilapia and zebrafish. We report here the complete and annotated genome sequence of an isolate from a Nile tilapia (
Oreochromis niloticus
), which contains a chromosome of 3,630,639 bp and two plasmids.
Complete Genome Sequence of Biocontroller Bacillus velezensis Strain JTYP2, Isolated from Leaves of
Echeveria laui
Authors: Wang Beibei , Liu Hu , Ma Hailin , Wang Chengqiang , Liu Kai , Li Yuhuan , Hou Qihui , Ge Ruofei , Zhang Tongrui , Liu Fangchun , Ma Jinjin , Wang Yun , Wang Haide , Xu Baochao , Yao Gan , Xu Wenfeng , Fan Lingchao , Ding Yanqin , Du Binghai
Published: June 2017

Bacillus velezensis
JTYP2 was isolated from the leaves of
Echeveria laui
in Qingzhou, China, and may control some of the fungal pathogens of the plant. Here, we present the complete genome sequence of
B. velezensis
JTYP2. Several gene clusters related to its biosynthesis of antimicrobial compounds were predicted.
Genome Sequence of
Prosthecochloris
sp. Strain HL-130-GSB, from the Phylum
Chlorobi
Authors: Thiel Vera , Drautz-Moses Daniela I. , Purbojati Rikky W. , Schuster Stephan C. , Lindemann Stephen , Bryant Donald A.
Published: June 2017

The genome of the green sulfur bacterium
Prosthecochloris
sp. strain HL-130-GSB, isolated from a cyanobacterial mat obtained from Hot Lake, a saline meromictic lake in Washington, USA, comprises 2,437,774 bp in a single contig. The genome is predicted to encode 2,565 proteins and contain 47 tRNA genes and 2 rRNA operons.
First Insights into the Genome Sequence of Clostridium oryzae DSM 28571, Isolated from the Soil of a Japanese Rice Field
Authors: Poehlein Anja , Gippert Anna Lena , Bierenbroodspot Maaike J. , Daniel Rolf
Published: June 2017

Clostridium oryzae
was originally isolated from the soil of a Japanese rice field.
C. oryzae
represents a novel species within the genus
Clostridium
and is associated with anaerobic rice straw degradation. Here, we present the draft genome sequence of
C. oryzae
DSM 28571 (5.076 Mbp), containing 4,590 predicted protein-coding genes.
Complete Genome Sequence of the Campylobacter cuniculorum Type Strain LMG 24588
Authors: Miller William G. , Yee Emma , Revez Joana , Bono James L. , Rossi Mirko
Published: June 2017

Campylobacter cuniculorum
is a thermotolerant species isolated from farmed rabbits (
Oryctolagus cuniculus
). Although
C. cuniculorum
is highly prevalent in rabbits farmed for human consumption, the pathogenicity of this organism in humans is still unknown. This study describes the whole-genome sequence of the
C. cuniculorum
type strain LMG 24588 (=CCUG 56289
T
).
Draft Genome Sequences of Six Enterococcus faecalis Strains Isolated from Malaysian Clinical and Environmental Origins
Authors: Daniel Diane Sunira , Gan Han Ming , Lee Sui Mae , Dykes Gary A. , Rahman Sadequr
Published: June 2017

Enterococcus faecalis
is known to cause a variety of nosocomial infections, including urinary tract infections. Antibiotic resistance and virulence properties in this species are of public concern. The draft genome sequences of six
E. faecalis
strains isolated from clinical and environmental sources in Malaysia are presented here.
Complete Genome Sequence of a Legionella longbeachae Serogroup 1 Strain Isolated from a Patient with Legionnaires’ Disease
Authors: Slow Sandy , Anderson Trevor , Miller James , Singh Siddharth , Murdoch David , Biggs Patrick J.
Published: June 2017

Legionella longbeachae
serogroup 1, predominantly found in soil and composted plant material, causes the majority of cases of Legionnaires’ disease (LD) in New Zealand. Here, we report the complete genome sequence of an
L. longbeachae
serogroup 1 (sg1) isolate derived from a patient hospitalized with LD in Christchurch, New Zealand.
Medicoeconomic analysis of lobectomy using thoracoscopy versus thoracotomy for lung cancer: a study protocol for a multicentre randomised controlled trial (Lungsco01)
Authors: Pagès Pierre-Benoit , Abou Hanna Halim , Bertaux Anne-Claire , Serge Aho Ludwig Serge , Magdaleinat Pierre , Baste Jean-Marc , Filaire Marc , de Latour Richard , Assouad Jalal , Tronc François , Jayle Christophe , Mouroux Jérome , Thomas Pascal-Alexandre , Falcoz Pierre-Emmanuel , Marty-Ané Charles-Henri , Bernard Alain
Published: June 2017

Introduction

In the last decade, video-assisted thoracoscopic surgery (VATS) lobectomy for non-small cell lung cancer (NSCLC) has had a major effect on thoracic surgery. Retrospective series have reported benefits of VATS when compared with open thoracotomy in terms of postoperative pain, postoperative complications and length of hospital stay. However, no large randomised control trial has been conducted to assess the reality of the potential benefits of VATS lobectomy or its medicoeconomic impact.

Methods and analysis

The French National Institute of Health funded Lungsco01 to determine whether VATS for lobectomy is superior to open thoracotomy for the treatment of NSCLC in terms of economic cost to society. This trial will also include an analysis of postoperative outcomes, the length of hospital stay, the quality of life, long-term survival and locoregional recurrence. The study design is a two-arm parallel randomised controlled trial comparing VATS lobectomy with lobectomy using thoracotomy for the treatment of NSCLC. Patients will be eligible if they have proven or suspected lung cancer which could be treated by lobectomy. Patients will be randomised via an independent service. All patients will be monitored according to standard thoracic surgical practices. All patients will be evaluated at day 1, day 30, month 3, month 6, month 12 and then every year for 2 years thereafter. The recruitment target is 600 patients.

Ethics and dissemination

The protocol has been approved by the French National Research Ethics Committee (CPP Est I: 09/06/2015) and the French Medicines Agency (09/06/2015). Results will be presented at national and international meetings and conferences and published in peer-reviewed journals.

Trial registration number

NCT02502318.
Association of hypercapnia on admission with increased length of hospital stay and severity in patients admitted with community-acquired pneumonia: a prospective observational study from Pakistan
Authors: Iqbal Nousheen , Irfan Muhammad , Zubairi Ali Bin Sarwar , Awan Safia , Khan Javaid A
Published: June 2017

Objective

To determine whether the presence of hypercapnia on admission in adult patients admitted to a university-based hospital in Karachi, Pakistan with community-acquired pneumonia (CAP) correlates with an increased length of hospital stay and severity compared with no hypercapnia on admission.

Study design

A prospective observational study.

Settings

Tertiary care hospital in Karachi, Pakistan.

Methods

Patients who met the inclusion criteria were enrolled in the study. The severity of pneumonia was assessed by CURB-65 and PSI scores. An arterial blood gas analysis was obtained within 24 hours of admission. Based on arterial PaCO2levels, patients were divided into three groups: hypocapnic (PaCO2<35 mm Hg), hypercapnic (PaCO2>45 mm Hg) and normocapnic (PaCO2<35–45 mm Hg).

Outcomes

The primary outcome was the association of hypercapnia on admission with mean length of hospital stay. Secondary outcomes were the need for mechanical ventilation, ICU admission and in-hospital mortality.

Results

A total of 295 patients of mean age 60.20±17.0 years (157 (53.22%) men) were enrolled over a 1-year period. Hypocapnia was found in 181 (61.35%) and hypercapnia in 57 (19.32%) patients. Hypercapnic patients had a longer hospital stay (mean 9.27±7.57 days), increased requirement for non-invasive mechanical ventilation (NIMV) on admission (n=45 (78.94%)) and longer mean time to clinical stability (4.39±2.0 days) compared with the other groups. Overall mortality was 41 (13.89%), but there was no statistically significant difference in mortality (p=0.35) and ICU admission (p=0.37) between the three groups. On multivariable analysis, increased length of hospital stay was associated with NIMV use, ICU admission, hypercapnia and normocapnia.

Conclusion

Hypercapnia on admission is associated with severity of CAP, longer time to clinical stability, increased length of hospital stay and need for NIMV. It should be considered as an important criterion to label the severity of the illness and also a determinant of patients who will require a higher level of hospital care. However, further validation is required.
Return to work of cancer patients after a multidisciplinary intervention including occupational counselling and physical exercise in cancer patients: a prospective study in the Netherlands
Authors: Leensen Monique C J , Groeneveld Iris F , Heide Iris van der , Rejda Tomas , van Veldhoven Peter L J , Berkel Sietske van , Snoek Aernout , Harten Wim van , Frings-Dresen Monique H W , de Boer Angela G E M
Published: June 2017

Objectives

To support return to work (RTW) among cancer patients, a multidisciplinary rehabilitation programme was developed which combined occupational counselling with a supervised physical exercise programme during chemotherapy. The aim was to investigate RTW rates of cancer patients and to evaluate changes in work-related quality of life and physical outcomes.

Design

Longitudinal prospective intervention study using a one-group design.

Setting

Two hospitals in the Netherlands.

Participants

Of the eligible patients, 56% participated; 93 patients with a primary diagnosis of cancer receiving chemotherapy and on sick leave were included. Patients completed questionnaires on RTW, the importance of work, work ability (WAI), RTW self-efficacy, fatigue (MFI), and quality of life (EORTC QLQ C-30) at baseline and 6, 12 and 18 months follow-up. Before and after the exercise programme 1-repetition maximum (1RM) muscle strength and cardiorespiratory fitness (VO2peak) were assessed.

Results

Six months after the start of a multidisciplinary rehabilitation programme that combined occupational counselling with a supervised physical exercise programme, 59% of the cancer patients returned to work, 86% at 12 months and 83% at 18 months. In addition, significant improvements (p<0.05) in the importance of work, work ability, RTW self-efficacy, and quality of life were observed, whereas fatigue levels were significantly reduced. After completing the exercise programme, 1RM muscle strength was significantly increased but there was no improvement in VO2peak level.

Conclusions

RTW rates of cancer patients were high after completion of the multidisciplinary rehabilitation programme. A multidisciplinary rehabilitation programme which combines occupational counselling with a supervised physical exercise programme is likely to result in RTW, reduced fatigue and increased importance of work, work ability, and quality of life.
Herbal medicine (Hyeolbuchukeo-tang or Xuefu Zhuyu decoction) for treating primary dysmenorrhoea: protocol for a systematic review of randomised controlled trials
Authors: Jo Junyoung , Leem Jungtae , Lee Jin Moo , Park Kyoung Sun
Published: June 2017

Introduction

Primary dysmenorrhoea is menstrual pain without pelvic pathology and is the most common gynaecological condition in women. Xuefu Zhuyudecoction (XZD) or Hyeolbuchukeo-tang, a traditional herbal formula, has been used as a treatment for primary dysmenorrhoea. The purpose of this study is to assess the current published evidence regarding XZD as treatment for primary dysmenorrhoea.

Materials and methods

The following databases will be searched from their inception until April 2017: MEDLINE (via PubMed), Allied and Complementary Medicine Database (AMED), EMBASE, The Cochrane Library, six Korean medical databases (Korean Studies Information Service System, DBPia, Oriental Medicine Advanced Searching Integrated System, Research Information Service System, Korea Med and the Korean Traditional Knowledge Portal), three Chinese medical databases (China National Knowledge Infrastructure (CNKI), Wan Fang Database and Chinese Scientific Journals Database (VIP)) and one Japanese medical database (CiNii). Randomised clinical trials (RCTs) that will be included in this systematic review comprise those that used XZD or modified XZD. The control groups in the RCTs include no treatment, placebo, conventional medication or other treatments. Trials testing XZD as an adjunct to other treatments and studies where the control group received the same treatment as the intervention group will be also included. Data extraction and risk of bias assessments will be performed by two independent reviewers. The risk of bias will be assessed with the Cochrane risk of bias tool. All statistical analyses will be conducted using Review Manager software (RevMan V.5.3.0).

Ethics and dissemination

This systematic review will be published in a peer-reviewed journal. The review will also be disseminated electronically and in print. The review will benefit patients and practitioners in the fields of traditional and conventional medicine.

PROSPERO registration number

CRD42016050447.
Qualitative analysis of 6961 free-text comments from the first National Cancer Patient Experience Survey in Scotland
Authors: Cunningham Maggie , Wells Mary
Published: June 2017

Objectives

To analyse free-text responses from the first Scottish Cancer Patient Experience Survey (SCPES) to understand patients’ experiences of care, identify valued aspects and areas for improvement.

Design

Inductive thematic analysis of seven free-text comment boxes covering all stages of the cancer experience, from a national cohort survey.

Setting and participants

Adult cancer patients diagnosed across all Health Boards in Scotland between July 2013 and March 2014, and who had an inpatient stay or hospital visit between January and September 2014. 2663 respondents (of n=4835 survey respondents) provided 6961 free-text comments.

Main outcome measures

Positive and negative themes of patients’ experiences. Differences in the proportion of positive to negative comments by demographics.

Methods

Data were analysed as follows: (1) comments were initially categorised at a high level (eg, positive, negative, miscellaneous, etc); (2) inductive codes were derived and applied to all relevant comments; (3) codes sharing similar meaning were amalgamated into subthemes, and code frequencies were measured; (4) subthemes were mapped into overarching themes; (5) difference in the proportion of positive to negative comments by demographics were analysed using χ2tests.

Results

Participants made more positive than negative comments (1:0.78). Analysis highlighted the importance to patients ofFeeling that Individual Needs Are MetandFeeling Confident Within the System. Comments also provided insight into howProcessesandStructureswithin the system of care can negatively impact on patients’ experience. Particular issues were identified with care experiences in the lead-up to diagnosis.

Conclusions

This analysis provides a detailed understanding of patients’ cancer care experiences, therefore indicating what aspects matter in those experiences. Although the majority of comments were positive, there were a significant number of negative comments, especially about the lead-up to diagnosis. Comments suggest patients would value greater integration of care from services involved in their treatment for cancer.
Community gardening, community farming and other local community-based gardening interventions to prevent overweight and obesity in high-income and middle-income countries: protocol for a systematic review
Authors: Heise Thomas L , Romppel Matthias , Molnar Sandra , Buchberger Barbara , Berg Agnes van den , Gartlehner Gerald , Lhachimi Stefan K
Published: June 2017

Introduction

The worldwide prevalence of overweight/obesity has continued to rise over the last decades. To reverse this trend, public health authorities are exploring cost-effective interventions, especially in high-income and middle-income countries. Community gardening offers a unique opportunity for individuals to enhance physical activity levels and improve their diet. However, synthesised evidence on the short-term or long-term effectiveness and on the costs of community gardening interventions to prevent overweight/obesity remains limited. Therefore, this review will investigate: (1) the effectiveness of voluntary participation in community gardening compared with no or a control intervention on overweight/obesity and associated health outcomes, (2) effects on different subgroups of populations and (3) the costs of community gardening interventions.

Methods and analysis

We will conduct a systematic review, limited to evaluations of community gardening interventions with controlled quantitative and interrupted time series designs. To identify relevant articles, we will systematically search 12 academic and 5 grey literature databases, as well as 2 trial registers and 6 websites. Articles will then be assessed for eligibility based on a predefined set of criteria. At least two independent reviewers will assess each article for relevance, before evaluating the methodological quality and potential bias of the studies. Data relevant to the objectives of this review will be extracted and cross-validated. Any disagreements will be mediated by a third reviewer. If feasible, meta-analyses of primary outcomes (overweight/obesity, physical activity, food intake, energy intake) will be conducted. We will use the Grading of Recommendations Assessment, Development and Evaluation method to assess the overall quality of evidence.

Ethics and dissemination

For this review, no ethical approval is required as we will only extract and analyse secondary data. We aim to submit the final review manuscript to an open access journal for publication and disseminate results via conferences and social media.

Trial registration number

International Prospective Register of Systematic Reviews (PROSPERO)(CRD42017043696).
Relationships between socioeconomic position and objectively measured sedentary behaviour in older adults in three prospective cohorts
Authors: Shaw Richard John , Čukić Iva , Deary Ian J , Gale Catharine R , Chastin Sebastien FM , Dall Philippa M , Skelton Dawn A , Der Geoff
Published: June 2017

Objectives

To investigate whether sedentary behaviour in older adults is associated with a systematic and comprehensive range of socioeconomic position (SEP) measures across the life course. SEP measures included prospective measures of social class, income, educational qualifications and parental social class and contemporaneous measures of area deprivation.

Setting

Glasgow and the surrounding (West of Scotland) combined with Edinburgh and the surrounding area (the Lothians).

Participants

Community-dwelling adults aged around 79, 83, and 64 years from, respectively, the Lothian Birth Cohort 1936 (LBC1936) (n=271) and the 1930s (n=119) and 1950s (n=310) cohorts of the West of Scotland Twenty-07 study.

Primary outcome measure

Sedentary behaviour was measured objectively using an activPAL activity monitor worn continuously for 7 days and used to calculate percentage of waking time spent sedentary.

Results

Among retired participants, for most cohort and SEP combinations, greater social disadvantage was associated with increased sedentary time. For example, in the Twenty-07 1930s cohort, those most deprived on the Carstairs measure spent 6.5% (95% CI 0.3 to 12.7) more of their waking time sedentary than the least deprived. However, for employed people, the relationship between SEP and sedentary behaviour was much weaker. For example, in terms of social class differences, among the retired, the most disadvantaged spent 5.7% more waking time sedentary (95% CI 2.6% to 87%), whereas among the employed, there was effectively no difference (−0.5%; 95% CI −9.0 to 8.0).

Conclusions

Diverse SEP measures were associated with increased sedentary behaviour among retired people. There was little evidence for a relationship between SEP measures and sedentary behaviour among employed older adults. Prior to retirement, the constraints of the workplace may be masking effects that are only apparent at weekends.
Experiences with Lean Six Sigma as improvement strategy to reduce parenteral medication administration errors and associated potential risk of harm
Authors: van de Plas Afke , Slikkerveer Mariëlle , Hoen Saskia , Schrijnemakers Rick , Driessen Johanna , de Vries Frank , Bemt Patricia van den
Published: June 2017

In this controlled before-after study the effect of improvements, derived from Lean Six Sigma strategy, on parenteral medication administration errors and the potential risk of harm was determined.

During baseline measurement, on control versus intervention ward, at least one administration error occurred in 14 (74%) and 6 (46%) administrations with potential risk of harm in 6 (32%) and 1 (8%) administrations. Most administration errors with high potential risk of harm occurred in bolus injections: 8 (57%) versus 2 (67%) bolus injections were injected too fast with a potential risk of harm in 6 (43%) and 1 (33%) bolus injections on control and intervention ward. Implemented improvement strategies, based on major causes of too fast administration of bolus injections, were: Substitution of bolus injections by infusions, education, availability of administration information and drug round tabards.

Post intervention, on the control ward in 76 (76%) administrations at least one error was made (RR 1.03; CI95:0.77-1.38), with a potential risk of harm in 14 (14%) administrations (RR 0.45; CI95:0.20-1.02). In 40 (68%) administrations on the intervention ward at least one error occurred (RR 1.47; CI95:0.80-2.71) but no administrations were associated with a potential risk of harm. A shift in wrong duration administration errors from bolus injections to infusions, with a reduction of potential risk of harm, seems to have occurred on the intervention ward.

Although data are insufficient to prove an effect, Lean Six Sigma was experienced as a suitable strategy to select tailored improvements. Further studies are required to prove the effect of the strategy on parenteral medication administration errors.
Midwifery and women's health
Authors: Shorten Allison
Published: June 2017

EBN Perspectives bring together key issues from the commentaries in one of our nursing topic themes.
The safety, efficacy and cost-effectiveness of stress echocardiography in patients with high pretest probability of coronary artery disease
Authors: Papachristidis Alexandros , Demarco Daniela Cassar , Roper Damian , Tsironis Ioannis , Papitsas Michael , Byrne Jonathan , Alfakih Khaled , Monaghan Mark J
Published: June 2017

Objective

In this study, we assess the clinical and cost-effectiveness of stress echocardiography (SE), as well as the place of SE in patients with high pretest probability (PTP) of coronary artery disease (CAD).

Methods

We investigated 257 patients with no history of CAD, who underwent SE, and they had a PTP risk score >61% (high PTP). According to the National Institute for Health and Care Excellence guidance (NICE CG95, 2010), these patients should be investigated directly with an invasive coronary angiogram (ICA). We investigated those patients with SE initially and then with ICA when appropriate. Follow-up data with regard to Major Adverse Cardiac and Cerebrovascular Events (MACCE, defined as cardiovascular mortality, cerebrovascular accident (CVA), myocardial infarction (MI) and late revascularisation for acute coronary syndrome/unstable angina) were recorded for a period of 12 months following the SE. The tariff for SE and ICA is £300 and £1400, respectively.

Results

106 patients had a positive SE (41.2%) and 61 of them (57.5%) had further investigation with ICA. 15 (24.6%) of these patients were revascularised. The average cost per patient for investigations was £654.09. If NICE guidance had been followed, the cost would have been significantly higher at £1400 (p<0.001). Overall, 5 MACCE (2.0%) were recorded; 4 (3.8%) in the group of positive SE (2 CVAs and 2 MIs) and 1 (0.7%) in the group of negative SE (1 CVA). There was no MI and no need for revascularisation in the negative SE group.

Conclusion

Our approach to investigate patients who present with de novo chest pain and high PTP, with SE initially and subsequently with ICA when appropriate, reduces the cost significantly (£745.91 per patient) with a very low rate of MACCE. However, this study is underpowered to assess safety of SE.
Field behaviour of screw micropiles subjected to axial loading in cohesive soils
Authors: Guo Zhengyang , Deng Lijun
Published: June 2017

Field tests of full-scale screw micropiles with a diameter varying from 76 to 114 mm and a length varying from 1.6 to 3 m were undertaken to investigate the axial pile capacities, load-transfer mechanism, and end installation torques of the piles in cohesive soils. Forty tests were performed on piles subjected to axial compressive and tensile loads. Six tests were instrumented with strain gauges on the pile shaft. Results showed the piles reached the limit state before the displacement exceeded 10% of the shaft diameter. The majority of axial load was transferred to the threaded segment. The adhesion coefficient of the top smooth shaft at the limit state was less than 0.1. The failure mode along the cylindrical threaded shaft was cylindrical shearing along the edge of the threads; the threads increased the axial capacities of the segment. Axial capacities of the threaded tapered segment were 43% on average greater than that of a cylindrical segment with the equivalent volume. Compressive capacities of all test piles were estimated and the results agreed reasonably well with the measured capacities. A theoretical torque model was proposed to estimate the end installation torques based on the cone penetration test results; the theoretical results matched the measured end torques very well.
Phase time and transmission probability in the traversal of a PT-symmetric potential: The case of an electromagnetic waveguide
Authors: Mauro M. Di , Esposito S. , Naddeo A.
Published: June 2017

We study the unconventional transmission properties of a wave packet through a PT-symmetric potential region as describing the actual electromagnetic wave propagation along a waveguide filled with gain and loss media. The nontrivial behavior of the transmission probability manifests in the giant amplification of the incident electromagnetic signal of given wavelengths for well-defined configurations, depending on the gain/loss contrast. Maximum transmission peaks are related to spectral singularities and a strict correlation exists between the “resonant” wavelengths and the gain/loss contrast. The transit times are as well calculated, showing their surprising vanishing in the opaque barrier limit, independently of the gain/loss contrast, which is reminiscent of some sort of Hartman effect. Also, nonlocal effects manifest in the presence of negative delay times for given configurations, while a correlation is apparent between maximum delay times and transmission probability peaks, though appreciably depending on the gain/loss contrast.