bluuebunny/crossref_metadata_2025 huggingface dataset:
Nurse–physician communication – An integrated review
Authors: Tan Tit‐Chai , Zhou Huaqiong , Kelly Michelle
Published: March 2017

Aim and objective

To present a comprehensive review of current evidence on the factors which impact on nurse–physician communication and interventions developed to improve nurse–physician communication.

Background

The challenges in nurse–physician communication persist since the term ‘nurse‐doctor game’ was first used in 1967, leading to poor patient outcomes such as treatment delays and potential patient harm. Inconsistent evidence was found on the factors and interventions which foster or impair effective nurse–physician communication.

Design

An integrative review was conducted following a five‐stage process: problem identification, literature search, data evaluation, data analysis and presentation.

Methods

Five electronic databases were searched from 2005 to April 2016 using key search terms: “improve*,” “nurse‐physician,” “nurse,” “physician” and “communication” in five electronic databases including the Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PubMed, Science Direct and Scopus.

Results

A total of 22 studies were included in the review. Four themes emerged from the data synthesis, namely communication styles; factors that facilitate nurse–physician communication; barriers to effective nurse–physician communication; and interventions to improve nurse–physician communication.

Conclusion

This integrative review suggests that nurse–physician communication still remains ineffective. Current interventions only address information needs of nurses and physicians in limited situations and specific settings but cannot adequately address the interprofessional communication skills that are lacking in practice. The disparate views of nurses and physicians on communication due to differing training backgrounds confound the effectiveness of current interventions or strategies.

Relevance to clinical practice

Cross‐training and interprofessional educational from undergraduate to postgraduate programmes will better align the training of nurses and physicians to communicate effectively. Further research is needed to determine the feasibility and generalisability of interventions, such as localising physicians and using communication tools, to improve nurse–physician communication. Organisational and cultural changes are needed to overcome ingrained practices impeding nurse–physician communication.
Are the Laffer curve and the green paradox mutually exclusive?
Authors: Bosi Stefano , Desmarchelier David
Published: March 2017

In this paper, we study the relationship between the Laffer curve and the green paradox in the context of a Ramsey model with endogenous labor supply in which pollution increases consumer demand (through a compensation effect). We find that—in the long run—the conditions under which a Laffer curve and a green paradox emerge are mutually exclusive. Indeed, the Laffer curve exists under a weak compensation effect, while the green paradox requires a strong effect. Also, we find that, in the short run, limit cycles may arise in the presence of a Laffer curve, while they never occur under a green paradox.
Description of Pintomyia salomoni sp. n., a new phlebotomine species from northwest Argentina
Authors: FUENZALIDA A. D. , QUINTANA M. G.
Published: March 2017

A new species of phlebotomine sandfly is described and illustrated using male and female specimens collected in the provinces of Jujuy and Tucumán, Argentina. Both male and female morphological characters allow the inclusion of the new species within the Pintomyia genus, Pifanomyia subgenus, serrana series (Diptera: Psychodidae). The species was denominated as Pintomyia salomoni n. sp., and is closely related to Pintomyia (Pifanomyia) torresi and Pintomyia (Piffanomyia) boliviana.
Salinization of the soil solution decreases the further accumulation of salt in the root zone of the halophyte Atriplex nummularia Lindl. growing above shallow saline groundwater
Authors: Alharby Hesham F. , Colmer Timothy D. , Barrett‐Lennard Edward G.
Published: March 2017

Water use by plants in landscapes with shallow saline groundwater may lead to the accumulation of salt in the root zone. We examined the accumulation of Na+ and Cl− around the roots of the halophyte Atriplex nummularia Lindl. and the impacts of this increasing salinity for stomatal conductance, water use and growth. Plants were grown in columns filled with a sand–clay mixture and connected at the bottom to reservoirs containing 20, 200 or 400 mM NaCl. At 21 d, Na+ and Cl− concentrations in the soil solution were affected by the salinity of the groundwater, height above the water table and the root fresh mass density at various soil depths (P < 0.001). However, by day 35, the groundwater salinity and height above the water table remained significant factors, but the root fresh mass density was no longer significant. Regression of data from the 200 and 400 mM NaCl treatments showed that the rate of Na+ accumulation in the soil increased until the Na+ concentration reached ~250 mM within the root zone; subsequent decreases in accumulation were associated with decreases in stomatal conductance. Salinization of the soil solution therefore had a feedback effect on further salinization within the root zone.
Prefrontal oxygenation and the acoustic startle eyeblink response during exercise: A test of the dual‐mode model
Authors: Tempest Gavin D. , Parfitt Gaynor
Published: March 2017

The interplay between the prefrontal cortex and amygdala is proposed to explain the regulation of affective responses (pleasure/displeasure) during exercise as outlined in the dual‐mode model. However, due to methodological limitations the dual‐mode model has not been fully tested. In this study, prefrontal oxygenation (using near‐infrared spectroscopy) and amygdala activity (reflected by eyeblink amplitude using acoustic startle methodology) were recorded during exercise standardized to metabolic processes: 80% of ventilatory threshold (below VT), at the VT, and at the respiratory compensation point (RCP). Self‐reported tolerance of the intensity of exercise was assessed prior to, and affective responses recorded during exercise. The results revealed that, as the intensity of exercise became more challenging (from below VT to RCP), prefrontal oxygenation was larger and eyeblink amplitude and affective responses were reduced. Below VT and at VT, larger prefrontal oxygenation was associated with larger eyeblink amplitude. At the RCP, prefrontal oxygenation was greater in the left than right hemisphere, and eyeblink amplitude explained significant variance in affective responses (with prefrontal oxygenation) and self‐reported tolerance. These findings highlight the role of the prefrontal cortex and potentially the amygdala in the regulation of affective (particularly negative) responses during exercise at physiologically challenging intensities (above VT). In addition, a psychophysiological basis of self‐reported tolerance is indicated. This study provides some support of the dual‐mode model and insight into the neural basis of affective responses during exercise.
Red blood cells derived from whole blood treated with riboflavin and ultraviolet light maintain adequate survival in vivo after 21 days of storage
Authors: Cancelas Jose A. , Slichter Sherrill J. , Rugg Neeta , Pratt P. Gayle , Nestheide Shawnagay , Corson Jill , Pellham Esther , Huntington Marty , Goodrich Raymond P.
Published: March 2017

BACKGROUND

Pathogen reduction (PR) of whole blood (WB) may increase blood safety when applied before component separation. This study evaluates the in vivo performance of red blood cells (RBCs) derived from WB treated with the riboflavin and ultraviolet (UV) light PR (Mirasol) system.

STUDY DESIGN AND METHODS

This was a prospective, two‐center, single‐blind, randomized, two‐period, crossover clinical trial designed to evaluate autologous 51Cr/99mTc‐radiolabeled recovery and survival of RBCs derived from Mirasol‐treated WB compared to untreated WB. RBCs were stored in AS‐3 for 21 days at 1 to 6°C. In vitro RBC variables were characterized. Frequency and severity of treatment‐emergent adverse event (TEAE) and neoantigenicity were determined.

RESULTS

Twenty‐four healthy adult volunteers (n = 12 per site) were evaluated. The Mirasol 24‐hr RBC recoveries were 82.5 ± 3.9% with one‐sided 95% lower confidence limit of 80.9%, meeting US Food and Drug Administration acceptance criteria, albeit at lower level than controls (91.7 ± 6.8%, p < 0.001). Mean RBC survival and T50 were reduced in the Mirasol group (61 and 23 days, respectively) versus controls (82 and 36 days, respectively; p < 0.001) with a mean area under the curve survival of treated RBCs of 83% of untreated controls. End‐of‐storage hemolysis in the Mirasol group was 0.22 ± 0.1% (control, 0.15 ± 0.1%; p < 0.001). No neoantigenicity or differences in TEAEs were found.

CONCLUSION

RBCs derived from Mirasol WB and stored for up to 21 days in AS‐3 maintained acceptable cell quality and recovery, albeit modestly reduced compared with untreated RBCs. Mirasol WB may represent a valid single WB PR platform that allows manufacture of RBC for storage for up to 21 days.
Reviewer Acknowledgements
Authors: Young James
Published: March 2017

International Journal of Social Science Studies (IJSSS) would like to acknowledge the following reviewers for their assistance with peer review of manuscripts for this issue. Many authors, regardless of whether IJSSS publishes their work, appreciate the helpful feedback provided by the reviewers. Their comments and suggestions were of great help to the authors in improving the quality of their papers. Each of the reviewers listed below returned at least one review for this issue.Reviewers for Volume 5, Number 4 Abdul Azim Akhtar, Independent Academic & Researcher, Delhi, IndiaAgboola O. Paul, Universiti Teknologi Malaysia, MalaysiaAntónio Calha, Polytechnic Institute of Portalegre, PortugalBegoña Montero-Fleta, Universitat Politécnica de València, SpainE.Ozan Aksoz, Anadolu University, TurkeyEmanuele Achino, C. D. T. O., ItalyGhazali Bello Abubakar, Sokoto State University, NigeriaHanaa Youssef Shaarawy, October University for Modern Sciences and Arts (MSA), EgyptHyejin Lee, Tufts University, MA, USA and Konkuk University, Seoul, South KoreaJulia M. Mack, Gannon University, USAK.O. Aramide, The Polytechnic Ibadan, NigeriaMałgorzata Haładewicz, Opole University of Technology, PolandRachita Shrivastava Roy, Department of Higher Education, Chhatisgarh-India, IndiaRasa Poceviciene, Siauliai University, LithuaniaShun - Jen Hsiao, University of Washington, USAValentina Evangelista, G. d’Annunzio University, ItalyYanzhe Zhang, Jilin University, China , China/AustraliaZafer İbrahimoglu, Marmara University, Turkey
Multi-Objective Shape Optimization Design for Liquefied Natural Gas Cryogenic Helical Corrugated Steel Pipe
Authors: Yang Zhixun , Yan Jun , Chen Jinlong , Lu Qingzhen , Yue Qianjin
Published: March 2017

Recently, the flexible cryogenic hose has been preferred as an alternative to exploit offshore liquefied natural gas (LNG), in which helical corrugated steel pipe is the crucial component with C-shaped corrugation. Parametric finite element models of the LNG cryogenic helical corrugated pipe are established using a three-dimensional shell element in this paper. Considering the nonlinearity of cryogenic material and large geometric structural deformation, mechanical behaviors are simulated under axial tension, bending, and internal pressure loads. In addition, design parameters are determined to optimize the shape of flexible cryogenic hose structures through sectional dimension analysis, and sensitivity analysis is performed with changing geometric parameters. A multi-objective optimization to minimize stiffness and stress is formulated under operation conditions. Full factorial experiment and radial basis function (RBF) neural network are applied to establish the approximated model for structure analysis. The set of Pareto optimal solutions and value range of parameters are obtained through nondominated sorting genetic algorithm II (NSGA-II) under manufacturing and stiffness constraints, thereby providing a feasible optimal approach for the structural design of LNG cryogenic corrugated hose.
Electronic and optical properties of rocksalt-phase tungsten nitride (B1-WN)
Authors: Metaxa Chrysoula , Ozsdolay Brian D. , Zorba Triantafillia , Paraskevopoulos Konstantinos , Gall Daniel , Patsalas Panos
Published: March 2017

The optical and electronic properties of rocksalt structure tungsten nitride (B1-WN) were investigated by x-ray photoelectron spectroscopy (XPS) and UV–visible-Fourier transform infrared optical reflectivity. Both 111-textured polycrystalline and epitaxial WN(111) films with [N]/[W] ratios of 1.12 and 0.87, respectively, were found to be electron conductors with partially filled W-5d conduction bands. However, their electronic behavior is dominated by high conduction electron losses, which are attributed to scattering at both anion and cation vacancies and are more pronounced for films with high nitrogen content, yielding high resistivity values of 1.4–2.8 mΩ cm. The dielectric function is well described with a Drude–Lorentz model over a large wavelength range from 0.2 to 100 μm, and exhibits an ε1 that becomes negative above a relatively high critical wavelength that increases with increasing nitrogen content from 22 to 100 μm. Compositional interpolation of XPS data provides a W4f7/2 electron binding energy for pure stoichiometric B1-WN of 31.9 eV, while increasing the N-content results in a reduction of the density of states from the W-5dt2g bands at and near the Fermi level. The overall results do not confirm the predicted promising plasmonic properties of B1-WN but instead reveal possible alternative applications for this compound as photothermal or epsilon-near-zero material.
Impact of atmospheric pressure nonequilibrium plasma discharge on polymer surface metrology
Authors: Scally Laurence , Lalor James , Cullen Patrick J. , Milosavljević Vladimir
Published: March 2017

Due to the attraction of plasma technologies as a clean and efficient means of surface modification, significant research has gone into the physical and chemical aspects of polymer functionalization. In this study, it was shown that the use of an atmospheric plasma jet can efficiently modify the surface of polyethylene terephthalate samples and change their hydrophobic properties to more hydrophilic characteristics. The dependence on the changes with respect to time, distance, and atomic oxygen (O I) intensity were considered as factors. It was found that with closer proximity to the plasma source (without causing thermal degradation) and with increasing levels of O I, that the changes of water contact angle and surface free energy can be maximized. It was also observed that the electron energy distribution function, for a given chemistry, significantly differed with changes in distance from the jet nozzle. This shows that for this type of plasma jet system, the bulk of the chemical reactions occur in the nozzle of the jet and not in the surrounding atmosphere. Therefore, this leads to more efficient energy transfer, higher gas temperatures, and better surface activation of samples when compared to systems that produce external chemical reactions due to more diffusion in the surrounding atmosphere and loss of reactive species to other atoms and molecules that are present.
Plasma-assisted atomic layer epitaxial growth of aluminum nitride studied with real time grazing angle small angle x-ray scattering
Authors: Anderson Virginia R. , Nepal Neeraj , Johnson Scooter D. , Robinson Zachary R. , Nath Anindya , Kozen Alexander C. , Qadri Syed B. , DeMasi Alexander , Hite Jennifer K. , Ludwig Karl F. , Eddy Charles R.
Published: March 2017

Wide bandgap semiconducting nitrides have found wide-spread application as light emitting and laser diodes and are under investigation for further application in optoelectronics, photovoltaics, and efficient power switching technologies. Alloys of the binary semiconductors allow adjustments of the band gap, an important semiconductor material characteristic, which is 6.2 eV for aluminum nitride (AlN), 3.4 eV for gallium nitride, and 0.7 eV for (InN). Currently, the highest quality III-nitride films are deposited by metalorganic chemical vapor deposition and molecular beam epitaxy. Temperatures of 900 °C and higher are required to deposit high quality AlN. Research into depositing III-nitrides with atomic layer epitaxy (ALEp) is ongoing because it is a fabrication friendly technique allowing lower growth temperatures. Because it is a relatively new technique, there is insufficient understanding of the ALEp growth mechanism which will be essential to development of the process. Here, grazing incidence small angle x-ray scattering is employed to observe the evolving behavior of the surface morphology during growth of AlN by ALEp at temperatures from 360 to 480 °C. Increased temperatures of AlN resulted in lower impurities and relatively fewer features with short range correlations.
High-performance light-emitting diodes based on carbene-metal-amides
Authors: Di Dawei , Romanov Alexander S. , Yang Le , Richter Johannes M. , Rivett Jasmine P. H. , Jones Saul , Thomas Tudor H. , Abdi Jalebi Mojtaba , Friend Richard H. , Linnolahti Mikko , Bochmann Manfred , Credgington Dan
Published: March 2017

Adding a twist for enhanced performance

The efficiency of organic light-emitting diodes (OLEDs) is fundamentally governed by the ratio of emissive singlet to dark triplet excitons that are formed from spin-polarized electron and hole currents within the material. Typically, this has set an upper limit of 25% internal quantum efficiency for OLEDs. Di
et al.
manipulated the ratio of spin states through a modification of process chemistry. They introduced a rotation of the molecular structure, which inverted the spin-state energetics and enhanced OLED performance.

Science
, this issue p.
159
Draft Genome Sequences of 12 Feline Bartonella henselae Isolates
Authors: Woudstra Cédric , Fach Patrick , Chomel Bruno B. , Haddad Nadia , Boulouis Henri-Jean
Published: March 2017

Bartonella henselae
is the main causative agent of cat scratch disease. In this report, we present the draft genome sequences of 12 strains of
Bartonella henselae
originating from the United States, Denmark, and France. These strains were isolated from cats and belonged to either 16S rRNA genotype I or 16S rRNA genotype II.
Draft Genome Sequence of Corynebacterium pseudotuberculosis Strain PA05 Isolated from an Ovine Host in Pará State, Brazil
Authors: Lima Alyne Cristina Sodré , de Moura Vitória Almeida Gonçalves , Pinheiro Kenny da Costa , Paixão Carla Thais Moreira , da Costa Wana Lailan Oliveira , Folador Adriana Ribeiro Carneiro , Guaraldi Ana Luiza de Mattos , Ramos Rommel T. J. , Silva Artur , Marques Joana Montezano
Published: March 2017

We report here the draft genome sequence of
Corynebacterium pseudotuberculosis
PA05, isolated from an ovine host in Pará State, Brazil.
C. pseudotuberculosis
is an etiological agent of diseases with veterinary and medical importance. The genome contains 2,435,137 bp, a G+C content of 52.2%, 2,295 coding sequences, five pseudogenes, 53 tRNAs, and six rRNAs.
Complete Genome Sequences of Isolates of Enterococcus faecium Sequence Type 117, a Globally Disseminated Multidrug-Resistant Clone
Authors: Tedim Ana P. , Lanza Val F. , Manrique Marina , Pareja Eduardo , Ruiz-Garbajosa Patricia , Cantón Rafael , Baquero Fernando , Coque Teresa M. , Tobes Raquel
Published: March 2017

The emergence of nosocomial infections by multidrug-resistant sequence type 117 (ST117)
Enterococcus faecium
has been reported in several European countries. ST117 has been detected in Spanish hospitals as one of the main causes of bloodstream infections. We analyzed genome variations of ST117 strains isolated in Madrid and describe the first ST117 closed genome sequences.
Draft Genome Sequences of 24 Lactococcus lactis Strains
Authors: Backus Lennart , Wels Michiel , Boekhorst Jos , Dijkstra Annereinou R. , Beerthuyzen Marke , Kelly William J. , Siezen Roland J. , van Hijum Sacha A. F. T. , Bachmann Herwig
Published: March 2017

The lactic acid bacterium
Lactococcus lactis
is widely used for the production of fermented dairy products. Here, we present the draft genome sequences of 24
L. lactis
strains isolated from different environments and geographic locations.
Factors related to receipt of non-cancer-related transurethral prostatectomy: findings from a large prospective study of 106 769 middle-aged and older Australian men
Authors: Joshy Grace , Soga Kay , Korda Rosemary J , Patel Manish I , Banks Emily
Published: March 2017

Background

Transurethral prostatectomy (TURP) is a common surgical intervention for chronic lower urinary tract symptoms (LUTS). Little large-scale evidence exists on factors related to receipt of non-cancer-related TURP.

Methods

A prospective study of men aged ≥45 years participating in the 45 and Up Study, a large Australian cohort study, without prior prostatectomy and/or bowel/genital/urinary-tract cancer; questionnaire data were linked to hospitalisations and deaths. HRs for TURP were estimated in relation to multiple factors, adjusting for confounders.

Results

There were 3416 incident TURPs among 106 769 men (median follow-up 5.8 years), with rates of 1.8, 5.3, 9.1 and 11.4/1000 person-years for ages 45–54, 55–64, 65–74 and ≥75 years, respectively. Age-adjusted rates of TURP varied markedly according to baseline LUTS from 2.2/1000 person-years with no/mild symptoms to 30.7/1000 person-years with severe symptoms. Annual household income ≥$70 000 versus <$20 000, having private health insurance and living in major cities were associated with higher TURP rates; there were no significant differences according to baseline diabetes, stroke, high blood pressure or cardiovascular disease. Men reporting severe versus no physical functioning limitation, high versus low psychological distress or poor versus excellent self-rated health were 36–51% more likely to undergo procedures overall, but were 24–37% less likely to undergo procedures following additional adjustment for need (baseline LUTS).

Conclusions

TURP rates were most strongly related to baseline LUTS and age, consistent with appropriate health services targeting. Lower TURP rates in men experiencing socioeconomic disadvantage and with poor health/disability, after accounting for baseline LUTS, suggest inequity and factors such as frailty and risks related to surgery.
Northern Shanghai Study: cardiovascular risk and its associated factors in the Chinese elderly—a study protocol of a prospective study design
Authors: Ji Hongwei , Xiong Jing , Yu Shikai , Chi Chen , Fan Ximin , Bai Bin , Zhou Yiwu , Teliewubai Jiadela , Lu Yuyan , Xu Henry , Zhang Yi , Xu Yawei
Published: March 2017

Introduction

Cardiovascular (CV) diseases are the leading cause of death and disability in the world. Increasing lifespans and ageing populations also contribute to an increasing CV burden. However, in China, there were few well-designed cohort studies focusing on the elderly population, let alone an established CV risk score. The objective of this study is to establish a CV risk score based on a community-dwelling Chinese elderly population, determining the profile of the associated CV risk factors and target organ damages (TODs), so as to guide the later intervention.

Methods and analysis

The Northern Shanghai Study is an ongoing prospective community-based study. After enrolment, clinical examination, anthropometric measurement and a questionnaire will be administered to each participant at baseline and after every 2 years in the follow-up. Our tests and examinations include: blood/urine sample and biochemical measurements, office blood pressure recording, carotid ultrasonograph, echocardiograph, pulse wave velocity, pulse wave analysis, 4-limb blood pressure recording, body mass index, etc. Baseline measurement will also include the assessments on TODs and the conventional CV risk factors. In the follow-up, the incidence of CV events and mortality will be recorded. The Northern Shanghai Risk Score will be calculated, with considerations on CV risk factors and TODs.

Ethics and dissemination

This study was approved by the Shanghai Tenth People's Hospital Institutional Review Board. All participants signed a written consent form.

Trial registration number

NCT02368938; Pre-results.
Evaluation of an alternative care provider clinic for severe sleep-disordered breathing: a study protocol for a randomised controlled trial
Authors: Ip-Buting Ada , Kelly Jenny , Santana Maria J , Penz Erika D , Flemons W Ward , Tsai Willis H , Fraser Kristin L , Hanly Patrick J , Pendharkar Sachin R
Published: March 2017

Introduction

Despite the high prevalence of sleep-disordered breathing (SDB) and the significant health consequences associated with untreated disease, access to diagnosis and treatment remains a challenge. Even patients with severe SDB (severe obstructive sleep apnoea or hypoventilation), who are at particularly high risk of adverse health effects, are subject to long delays. Previous research has demonstrated that, within a sleep clinic, management by alternative care providers (ACPs) is effective for patients with milder forms of SDB. The purpose of this study is to compare an ACP-led clinic (ACP Clinic) for patients with severe SDB to physician-led care, from the perspective of clinical outcomes, health system efficiency and cost.

Methods and analysis

The study is a randomised, controlled, non-inferiority study in which patients who are referred with severe SDB are randomised to management by a sleep physician or by an ACP. ACPs will be supervised by sleep physicians for safety. The primary outcome is positive airway pressure (PAP) adherence after 3 months of therapy. Secondary outcomes include: long-term PAP adherence; clinical response to therapy; health-related quality of life; patient satisfaction; healthcare usage; wait times from referral to treatment initiation and cost-effectiveness. The economic analysis will be performed using the perspective of a publicly funded healthcare system.

Ethics and dissemination

Ethics approval was obtained from the Conjoint Health Research Ethics Board (ID: REB13-1280) at the University of Calgary. Results from this study will be disseminated through presentations at scientific conferences and publication in peer-reviewed journals.

Trial registration number

NCT02191085; Pre-results.
Listening to paediatric primary care nurses: a qualitative study of the potential for interprofessional oral health practice in six federally qualified health centres in Massachusetts and Maryland
Authors: Bernstein Judith , Gebel Christina , Vargas Clemencia , Geltman Paul , Walter Ashley , Garcia Raul , Tinanoff Norman
Published: March 2017

Objectives

To explore the opportunities for interprofessional collaboration (IPC) to improve paediatric oral health in federally qualified health centres (FQHCs), to identify challenges to IPC-led integration of oral health prevention into the well-child visit and to suggest strategies to overcome barriers.

Sample

Nurse managers (NMs), nurse practitioners (NPs), paediatric clinical staff and administrators in six FQHCs in two states were interviewed using a semistructured format.

Design

Grounded theory research. Topics included feasibility of integration, perceived barriers and strategies for incorporating oral health into paediatric primary care.

Measurements

Qualitative data were coded and analysed using NVivo 10 to generate themes iteratively.

Results

Nurses in diverse roles recognised the importance of oral health prevention but were unaware of professional guidelines for incorporating oral health into paediatric encounters. They valued collaborative care, specifically internal communication, joint initiatives and training and partnering with dental schools or community dental practices. Barriers to IPC included inadequate training, few opportunities for cross-communication and absence of charting templates in electronic health records.

Conclusions

NMs, NPs and paediatric nursing staff all value IPC to improve patients' oral health, yet are constrained by lack of oral health training and supportive charting and referral systems. With supports, they are willing to take on responsibility for introducing oral health preventive measures into the well-child visit, but will require IPC approaches to training and systems changes. IPC teams in the health centre setting can work together, if policy and administrative supports are in place, to provide oral health assessments, education, fluoride varnish application and dental referrals, decrease the prevalence of early childhood caries and increase access to a dental home for low-income children.
Mortality, greenhouse gas emissions and consumer cost impacts of combined diet and physical activity scenarios: a health impact assessment study
Authors: Tainio Marko , Monsivais Pablo , Jones Nicholas RV , Brand Christian , Woodcock James
Published: March 2017

Objective

To quantify changes in mortality, greenhouse gas (GHG) emissions and consumer costs for physical activity and diet scenarios.

Design

For the physical activity scenarios, all car trips from <1 to <8 miles long were progressively replaced with cycling. For the diet scenarios, the study population was assumed to increase fruit and vegetable (F&V) consumption by 1–5 portions of F&V per day, or to eat at least 5 portions per day. Health effects were modelled with the comparative risk assessment method. Consumer costs were based on fuel cost savings and average costs of F&V, and GHG emissions to fuel usage and F&V production.

Setting

Working age population for England.

Participants

Data from the Health Survey for England, National Travel Survey and National Diet and Nutrition Survey.

Primary outcomes measured

Changes in premature deaths, consumer costs and GHG emissions stratified by age, gender and socioeconomic status (SES).

Results

Premature deaths were reduced by between 75 and 7648 cases per year for the physical activity scenarios, and 3255 and 6187 cases per year for the diet scenarios. Mortality reductions were greater among people of medium and high SES in the physical activity scenarios, whereas people with lower SES benefited more in the diet scenarios. Similarly, transport fuel costs fell more for people of high SES, whereas diet costs increased most for the lowest SES group. Net GHG emissions decreased by between 0.2 and 10.6 million tons of carbon dioxide equivalent (MtCO2e) per year for the physical activity scenarios and increased by between 1.3 and 6.3 MtCO2e/year for the diet scenarios.

Conclusions

Increasing F&V consumption offers the potential for large health benefits and reduces health inequalities. Replacing short car trips with cycling offers the potential for net benefits for health, GHG emissions and consumer costs.
Understanding the acceptability and adherence to paediatric antiretroviral treatment in the new formulation of pellets (LPV/r): the protocol of a realist evaluation
Authors: Nebot Giralt Ariadna , Nöstlinger Christiana , Lee Janice , Salami Olawale , Lallemant Marc , Ouma Onyango , Nyamongo Isaac , Marchal Bruno
Published: March 2017

Background

Improving access to paediatric HIV treatment requires both large-scale treatment programmes and medication that is adapted to infants and children's needs. The WHO recommends lopinavir/ritonavir as first-line antiretroviral therapy for all HIV-infected children younger than 3 years. There is currently little evidence on the acceptability of, and adherence to, a formulation of this combination treatment if given in the form of pellets. This protocol presents how we will carry a realist evaluation to assess the factors that contribute to the acceptability and adherence to the new pellets formulation in 3 hospitals in Kenya.

Methods

We structured the protocol along the realist evaluation cycle following 4 steps: (1) the initial programme theory, (2) the study design, (3) the data collection methods and (4) the data analysis plan. Theories of behavioural sciences were reviewed for frames that could provide insights into how using such new formulations may contribute to better acceptability and adherence.

Ethics and dissemination

This study was approved by the Institutional Review Board of the Institute of Tropical Medicine, the Ethical Committee of the University Hospital Antwerp and the Kenyatta National Hospital/University of Nairobi Ethics and Research Committee. We aim to disseminate the findings through international conferences and peer-reviewed journals and to share them with Drugs for Neglected Diseases initiative's (DNDi) programme managers and with the Kenyan healthcare providers.

Discussion

In developing this study, we encountered some challenges. First, methods to measure the acceptability of any formulation and adherence to it are not standardised. The second challenge is common in realist evaluation and relates to how to choose from different potentially interesting theoretical frameworks. We identified relevant and empirically tested theories from behavioural science that may be helpful in our study. We will test them in 3 settings by exploring the multilevel factors that influence acceptability and adherence of this new paediatric Antiretroviral (ARV) formulation.
Rapid detection ofcfiAmetallo-β-lactamase-producingBacteroides fragilisby the combination of MALDI-TOF MS and CarbaNP
Authors: Ho Pak-Leung , Yau Chong-Yee , Ho Lok-Yan , Chen Jonathan H K , Lai Eileen L Y , Lo Stephanie W U , Tse Cindy W S , Chow Kin-Hung
Published: March 2017

Aims

Carbapenem resistance inBacteroides fragilisis emerging and is mainly attributed to insertion sequence (IS)-mediated activation of the carbapenemase genecfiA. We investigated the use of matrix-assisted laser desorption ionisation time-of-flight mass spectrometry (MALDI-TOF MS) and the CarbaNP assay for the rapid identification of these strains.

Methods

This study used the Bruker MALDI Biotype system and the mass spectra models generated by 20B. fragilisreference strains (10cfiA-positive and 10cfiA-negative) in the ClinProTools software to identify 404B. fragilis(71cfiA-positive and 333cfiA-negative) clinical isolates. The ability of the CarbaNP assay to detect IS-mediated activation of thecfiAgene was assessed and the results obtained by molecular analysis were used as reference methods.

Results

The support vector machine model generated by ClinProTools was found to be the most reliable algorithm for differentiation ofcfiA-positive andcfiA-negativeB. fragilissubgroups. Using the direct transfer method, all but onecfiA-negative isolates were correctly identified to the two subgroups by the model. The correct identification of thecfiA-negative isolate was obtained upon retesting by the extraction method. Of the 81cfiA-positive isolates, PCR and sequencing showed that 30 had an IS element providing the promoter for activation ofcfiA. With regard to the presence of the IS element, the CarbaNP test in thecfiAupstream region had 100% sensitivity, 80.4% specificity, 75.0% positive predictive value and 100% negative predictive value.

Conclusions

The combination of MALDI-TOF MS and the CarbaNP assay can be applied in diagnostic clinical laboratory for rapid identification ofB. fragiliswith IS element-activatedcfiAgene.
Predictors of false-positive stroke thrombectomy transfers
Authors: Yi Julia , Zielinski Danielle , Ouyang Bichun , Conners James , Dafer Rima , Chen Michael
Published: March 2017

Background

Most patients with large vessel occlusion (LVO) stroke need to be transferred to receive thrombectomy. To save time, the decision to transfer often relies on clinical scales as a surrogate for LVO rather than imaging. However, clinical scales have been associated with high levels of diagnostic error. The aim of this study is to define the susceptibility to overdiagnosis of our current transfer decision process by measuring the rate of non-treatment transfers, the most common reasons for no treatment and potential predictors.

Methods

Clinical and transfer data on consecutive patients transferred to a single endovascular capable centre for possible thrombectomy via stroke code activation were retrospectively reviewed. Whether patients underwent the procedure, why they did not undergo the procedure, and other clinical and logistical predictors were recorded. χ2tests and multivariate logistic regression analysis were performed.

Results

From 2015 to 2016, 105/192 transferred patients (54%) did not undergo thrombectomy and the most common reason was absence of a LVO found on CTA after transfer (71/104 (68%)). 14/16 (88%) with a National Institutes of Health Stroke Scale (NIHSS) score <10 did not undergo thrombectomy while 41/78 (52%) with a NIHSS>20 underwent thrombectomy (p<0.001). Helicopter use was associated with no treatment (p=0.004) while arrival within 5 hours was associated with treatment (p<0.001).

Conclusions

Clinical scales appear to overdiagnose LVO and may be responsible for the majority of our stroke code transfers not undergoing thrombectomy. Primary stroke centres therefore have reason to develop the capability to rapidly acquire and interpret a CTA in patients with suspected LVO prior to transfer. Such efforts may reduce the costs associated with unnecessary thrombectomy transfers.
Nuclear structure study of two-neutron halo nucleus 19B in microscopic cluster model
Authors: Salih Fitri Hakeem M. , Lee Chun Hao , Radiman Shahidan , Khoo Kok Siong
Published: March 2017

The structure nucleus [Formula: see text] is investigated in the Microscopic Cluster Model, using three-body model [Formula: see text]. This model is used to investigate neutron halo features such as binding energy of neutron valence, root-mean-square (rms) of radius and core deformation. All the features are studied in configuration-T and -Y. In this study, theoretical framework is used in the MATLAB software to run the computational calculations. The results are compared with the experimental data.
Deconfinement of electric charges in hydrogen-bonded ferroelectrics
Authors: Huang Bo-Jie , Chern Chyh-Hong
Published: March 2017

In addition to the gauge charges, a new charge degree of freedom is identified in the deconfined phase in the lattice Ising gauge theory. While applying to the hydrogen-bonded ferroelectrics, the new charge is essentially the electric charge, leading to the divergent dielectric susceptibility. The new degree of freedom paves an experimentally accessible way to identify the deconfined phase in the lattice Ising gauge theory.
Enumeration of ribbon 2-knots presented by virtual arcs with up to four crossings
Authors: Kanenobu Taizo , Komatsu Seiya
Published: March 2017

We enumerate ribbon 2-knots presented by virtual arc diagrams with up to four classical crossings. We use a linear Gauss diagram for a virtual arc diagram.
The properties of generalized offset linear canonical Hilbert transform and its applications
Authors: Xu Shuiqing , Feng Li , Chai Yi , Hu Youqiang , Huang Lei
Published: March 2017

The Hilbert transform is tightly associated with the Fourier transform. As the offset linear canonical transform (OLCT) has been shown to be useful and powerful in signal processing and optics, the concept of generalized Hilbert transform associated with the OLCT has been proposed in the literature. However, some basic results for the generalized Hilbert transform still remain unknown. Therefore, in this paper, theories and properties of the generalized Hilbert transform have been considered. First, we introduce some basic properties of the generalized Hilbert transform. Then, an important theorem for the generalized analytic signal is presented. Subsequently, the generalized Bedrosian theorem for the generalized Hilbert transform is formulated. In addition, a generalized secure single-sideband (SSB) modulation system is also presented. Finally, the simulations are carried out to verify the validity and correctness of the proposed results.
Boundary conditions and Green function approach of the spin–orbit interaction in the graphitic nanocone
Authors: Smotlacha Jan , Pincak Richard
Published: March 2017

The boundary effects affecting the Hamiltonian for the nanocone with curvature-induced spin–orbit coupling were considered and the corresponding electronic structure was calculated. These boundary effects include the spin–orbit coupling, the electron mass acquisition and the Coulomb interaction. Different numbers of the pentagonal defects in the tip were considered. The matrix and analytical form of the Green function approach was used for the verification of our results and the increase of their precision in the case of the spin–orbit coupling.
An age-structured model of the human papillomavirus dynamics and optimal vaccine control
Authors: Al-Arydah Mo’tassem , Malik Tufail
Published: March 2017

We formulate an age-structured model based on a system of nonlinear partial differential equations to assist the early and catch up female vaccination programs for human papillomavirus (HPV) types 6 and 11. Since these HPV types do not induce permanent immunity, the model, which stratifies the population based on age and gender, has a susceptible-infectious-susceptible (SIS) structure. We calculate the effective reproduction number [Formula: see text] for the model and describe the local-asymptotic stability of the disease-free equilibrium using [Formula: see text]. We prove the existence of an endemic equilibrium for [Formula: see text] for the no vaccine case. However, analysis of the model for the vaccine case reveals that it undergoes the phenomenon of backward bifurcation. To support our theoretical results, we estimate the age and time solution with the given data for Toronto population, when an early and catch up female vaccine program is adopted, and when there is no vaccine. We show that early and catch up female vaccine program eliminates the infection in both male and female populations over a period of 30 years. Finally, we introduce the optimal control to an age-dependent model based on ordinary differential equations and solve it numerically to obtain the most cost-effective method for introducing the catch up vaccine into the population.
Detection of human elastase isoforms by the ScheBo Pancreatic Elastase 1 Test
Authors: Tóth Anna Zsófia , Szabó András , Hegyi Eszter , Hegyi Péter , Sahin-Tóth Miklós
Published: March 2017

Determination of fecal pancreatic elastase content by ELISA is a reliable, noninvasive clinical test for assessing exocrine pancreatic function. Despite the widespread use of commercial tests, their exact molecular targets remain poorly characterized. This study was undertaken to clarify which human pancreatic elastase isoforms are detected by the ScheBo Pancreatic Elastase 1 Stool Test and whether naturally occurring genetic variants influence the performance of this test. Using recombinantly expressed and purified human pancreatic proteinases, we found that the test specifically measured chymotrypsin-like elastases (CELA) 3A and 3B (CELA3A and CELA3B), while CELA2A was not detected. Inactive proelastases, active elastases, and autolyzed forms were detected with identical efficiency. CELA3B elicited approximately four times higher ELISA signal than CELA3A, and we identified Glu154in CELA3B as the critical determinant of detection. Common genetic variants of CELA3A and CELA3B had no effect on test performance, with the exception of the CELA3B variant W79R, which increased detection by 1.4-fold. Finally, none of the human trypsin and chymotrypsin isoforms were detected. We conclude that the ScheBo Pancreatic Elastase 1 Stool Test is specific for human CELA3A and CELA3B, with most of the ELISA signal attributable to CELA3B.

NEW & NOTEWORTHY The ScheBo Pancreatic Elastase 1 Stool Test is widely used to assess pancreatic exocrine function, yet its molecular targets have been poorly defined. We demonstrate that, among the human pancreatic proteinases, the test measures the elastase isoform CELA3B and, to a lesser extent, CELA3A. Genetic variants of the human CELA3 isoforms have no significant effect on test performance.
Ursodeoxycholic acid and lithocholic acid exert anti-inflammatory actions in the colon
Authors: Ward Joseph B. J. , Lajczak Natalia K. , Kelly Orlaith B. , O’Dwyer Aoife M. , Giddam Ashwini K. , Ní Gabhann Joan , Franco Placido , Tambuwala Murtaza M. , Jefferies Caroline A. , Keely Simon , Roda Aldo , Keely Stephen J.
Published: March 2017

Inflammatory bowel diseases (IBD) comprise a group of common and debilitating chronic intestinal disorders for which currently available therapies are often unsatisfactory. The naturally occurring secondary bile acid, ursodeoxycholic acid (UDCA), has well-established anti-inflammatory and cytoprotective actions and may therefore be effective in treating IBD. We aimed to investigate regulation of colonic inflammatory responses by UDCA and to determine the potential impact of bacterial metabolism on its therapeutic actions. The anti-inflammatory efficacy of UDCA, a nonmetabolizable analog, 6α-methyl-UDCA (6-MUDCA), and its primary colonic metabolite lithocholic acid (LCA) was assessed in the murine dextran sodium sulfate (DSS) model of mucosal injury. The effects of bile acids on cytokine (TNF-α, IL-6, Il-1β, and IFN-γ) release from cultured colonic epithelial cells and mouse colonic tissue in vivo were investigated. Luminal bile acids were measured by gas chromatography-mass spectrometry. UDCA attenuated release of proinflammatory cytokines from colonic epithelial cells in vitro and was protective against the development of colonic inflammation in vivo. In contrast, although 6-MUDCA mimicked the effects of UDCA on epithelial cytokine release in vitro, it was ineffective in preventing inflammation in the DSS model. In UDCA-treated mice, LCA became the most common colonic bile acid. Finally, LCA treatment more potently inhibited epithelial cytokine release and protected against DSS-induced mucosal inflammation than did UDCA. These studies identify a new role for the primary metabolite of UDCA, LCA, in preventing colonic inflammation and suggest that microbial metabolism of UDCA is necessary for the full expression of its protective actions.

NEW & NOTEWORTHY On the basis of its cytoprotective and anti-inflammatory actions, the secondary bile acid ursodeoxycholic acid (UDCA) has well-established uses in both traditional and Western medicine. We identify a new role for the primary metabolite of UDCA, lithocholic acid, as a potent inhibitor of intestinal inflammatory responses, and we present data to suggest that microbial metabolism of UDCA is necessary for the full expression of its protective effects against colonic inflammation.
Old and new models for studying host-microbe interactions in health and disease:C. difficileas an example
Authors: Young Vincent B.
Published: March 2017

There has been an explosion of interest in studying the indigenous microbiota, which plays an important role in human health and disease. Traditionally, the study of microbes in relationship to human health involved consideration of individual microbial species that caused classical infectious diseases. With the interest in the human microbiome, an appreciation of the influence that complex communities of microbes can have on their environment has developed. When considering either individual pathogenic microbes or a symbiotic microbial community, researchers have employed a variety of model systems with which they can study the host-microbe interaction. With the use of studies of infections with the toxin-producing bacterium Clostridium difficile as a model for both a pathogen and beneficial bacterial communities as an example, this review will summarize and compare various model systems that can be used to gain insight into the host-microbe interaction.