bluuebunny/crossref_metadata_2025 huggingface dataset:
Dietary and fluid restriction perceptions of patients undergoing haemodialysis: an exploratory study
Authors: Hong Leting Isabella , Wang Wenru , Chan Ee Yuee , Mohamed Fatimah , Chen Hui‐Chen
Published: January 2017

Aims and objectives

To explore the perspectives of patients undergoing haemodialysis in Singapore on an imposed dietary and fluid restriction regime.

Background

Adherence to prescribed dietary and fluid restriction constructs the fundamental basis of self‐care with improved morbidity and mortality. However, most patients have struggled to adhere in this aspect. Existing studies have presented limited understanding on the facilitators and barriers of dietary and fluid adherence among haemodialysis patients.

Design

An exploratory qualitative study.

Methods

A purposive sample of 14 patients undergoing haemodialysis was recruited from a renal unit of a tertiary hospital in Singapore. Data were collected through face‐to‐face individual interviews and subsequently analysed by thematic analysis.

Results

Four themes emerged: (1) Pessimism, (2) Existing struggles, (3) Perceived quality of support, and (4) Immensity of self‐discipline.

Conclusions

The imposed dietary and fluid restriction is a constant struggle and a cause of suffering among haemodialysis patients in Singapore. Nonetheless, they are generally submissive to their fluid restrictions for the sake of survival or to meet the expectations of their loved ones. The imposed dietary restrictions are generally neglected.

Relevance to clinical practice

The findings from this study can provide useful information in reviewing existing educational strategies, policies and nursing care. This is especially important because most patients exhibit high reliance on healthcare professionals.
The heart is a representation of life: an exploration of illness beliefs in couples living with atrial fibrillation
Authors: Dalteg Tomas , Sandberg Jonas , Malm Dan , Sandgren Anna , Benzein Eva
Published: January 2017

Aims and objectives

To explore illness beliefs in couples where one spouse has atrial fibrillation.

Background

Beliefs are the lenses through which we view the world, guiding our behaviour and constructing our lives. Couples evolve an ecology of beliefs from their interaction whereby their actions and choices arise from their beliefs. Atrial fibrillation is a common cardiac arrhythmia that has implications for both patients and partners. A couple's illness beliefs play an important role in convalescence and illness management, and no previous studies have explored illness beliefs in couples living with atrial fibrillation.

Design

A qualitative hermeneutic design.

Methods

Data collection constituted in‐depth interviews with nine couples (patient and partner together). Hermeneutic philosophy as described by Gadamer was used to interpret and to understand illness beliefs in couples living with atrial fibrillation.

Results

The findings revealed both core illness beliefs and secondary illness beliefs. From the core illness belief ‘The heart is a representation of life’, two secondary illness beliefs were derived: atrial fibrillation is a threat to life and atrial fibrillation can and must be explained. From the core illness belief ‘Change is an integral part of life’, two secondary illness beliefs were derived: atrial fibrillation is a disruption in our lives and atrial fibrillation will not interfere with our lives. Finally, from the core illness belief ‘Adaptation is fundamental in life’, two secondary illness beliefs were derived: atrial fibrillation entails adjustment in daily life and atrial fibrillation entails confidence in and adherence to professional care.

Conclusion

Couples’ interaction has developed mutual illness beliefs regarding atrial fibrillation that guide them in their daily lives and influence their decisions. The adoption of a family‐centred perspective in cardiovascular care settings is warranted.
Capital Account Liberalization and Aggregate Productivity: The Role of Firm Capital Allocation
Authors: LARRAIN MAURICIO , STUMPNER SEBASTIAN
Published: January 2017

We study the effects of capital account liberalization on firm capital allocation and aggregate productivity in 10 Eastern European countries. Using a large firm‐level data set, we show that capital account liberalization decreases the dispersion in the return to capital across firms, particularly in sectors more dependent on external finance. We provide evidence that capital account liberalization improves capital allocation by allowing financially constrained firms to demand more capital and produce at a more efficient level. Finally, using a model of misallocation we document that capital account liberalization increases aggregate productivity through more efficient capital allocation by 10% to 16%.
The Convergence and Divergence of Job Discretion Between Occupations and Institutional Regimes in Europe from 1995 to 2010
Authors: Holman David , Rafferty Anthony
Published: January 2017

Drawing on technical change and institutional theories, this paper examines the convergence and divergence of job discretion between occupations and institutional regimes in Europe from 1995–2010. Latent growth modelling of a pseudo‐panel data set derived from the European Working Conditions Survey reveals that significantly different rates of change have led to an increasing polarization of job discretion between occupations and between Nordic and other European countries. Across occupations the findings are in keeping with routine‐biased technical change rather than skill‐biased technical change theories and suggest that the effects of technical change on job discretion depend largely on whether technology substitutes or complements job tasks. Across countries, the results are in line with employment regime theory, which suggests that institutional differences (particularly employment policies and trade union influence) are driving cross‐national variation in job discretion. Overall, a more comprehensive empirical and theoretical understanding is provided of factors shaping change in a key aspect of job quality, namely job discretion.
Increased circulating CXCR5+CD4+ T follicular helper‐like cells in oral lichen planus
Authors: Tan Ya‐Qin , Li Qing , Zhang Jing , Du Ge‐Fei , Lu Rui , Zhou Gang
Published: January 2017

Background

CD4+ T‐helper cell is crucial for the inflammatory autoimmune condition of oral lichen planus (OLP). Recently, the pathogenetic functions of T follicular helper (Tfh) cells, a subtype of CD4+ T‐helper cells, have been revealed in autoimmune diseases for their pivotal regulation on humoral immunity. To explore the potential pathophysiological role of Tfh cells in OLP, the expression of circulating Tfh‐like cells and its correlations with IL‐21 and B cells were investigated.

Methods

The frequencies of CXCR5+ CD4+ Tfh‐like cells and CD19+ B cells were analyzed in peripheral blood of patients with OLP and controls by flow cytometry, respectively. Besides, the serum IL‐21 concentration was measured using ELISA technology. Furthermore, the correlations of CXCR5+ CD4+ Tfh‐like cells with CD19+ B cells and serum IL‐21 expression levels were evaluated.

Results

This study showed significant increased circulating Tfh‐like cells (P < 0.05) and B cells (P < 0.0001), as well as decreased serum IL‐21 expression (P < 0.001) in OLP. Besides, the frequency of Tfh‐like cells exhibited negative correlation with B cells in OLP (r = −0.435, P < 0.05). In particular, the proportion of CXCR5+ CD4+ Tfh‐like cells in peripheral blood mononuclear cells of erosive OLP was higher than non‐erosive OLP and controls (P = 0.012 and 0.021, respectively).

Conclusions

Increased circulating Tfh‐like cells may be involved in the pathogenesis of OLP through abnormal modulation on B‐cell proliferation and IL‐21 production, and associated with different clinical forms of OLP.
Dysregulation of AKT1, a miR‐138 target gene, is involved in the migration and invasion of tongue squamous cell carcinoma
Authors: Ji Muyuan , Wang Wei , Yan Wangxiang , Chen Dan , Ding Xueqiang , Wang Anxun
Published: January 2017

Background

AKT1, also known as PKBα, is abnormally expressed in various malignancies. In this study, we aimed to evaluate the role of AKT1 in the tongue squamous cell carcinoma (TSCC) and further clarify the mechanisms of AKT1 in the migration and invasion of TSCC.

Methods

At first, immunohistochemistry (IHC) was conducted to detect the expression of AKT1 in TSCC. Then, we determined the role of AKT1 in the migration and invasion of TSCC and further investigated whether AKT1 was the target gene of miR‐138 using dual luciferase reporter assays and Western blot.

Results

Immunohistochemistry results suggested that AKT1 dysregulation was a frequent event in TSCC, and upregulation of AKT1 was correlated with lymph node metastasis and associated with reduced overall survival. UM1 cells with higher migratory and invasive abilities had more robust AKT1 protein expression than UM2 cells with lower migratory and invasive abilities. The migration and invasion abilities were inhibited in UM1 cells upon AKT1 knockdown, meanwhile resulted in a decline of metastasis‐related proteins (vimentin, slug, and pERK1/2), and upregulation of E‐cadherin. Luciferase assays revealed that AKT1 was directly targeted by miR‐138, and ectopic transfection of miR‐138 reduced the expression of AKT1 protein.

Conclusions

Our results confirm that upregulation of AKT1, a miR‐138 target gene, is a frequent event in TSCC and contributes to the aggressive behaviors and poor prognosis of TSCC.
Oral cancer screening for high‐risk individuals in the primary healthcare setting using an active approach
Authors: Pivovar Allana , Gonçalves Dos Santos Zilá Ferreira Dias , Torres‐Pereira Cassius Carvalho
Published: January 2017

Background

Oral squamous cell carcinoma (OSCC) is considered a major public health problem. The diagnosis often occurs in advanced stages, causing high morbidity and mortality, and therefore, prevention strategies should be advocated. This study aimed to investigate a model of OSCC screening for high‐risk individuals in the Family Health Strategy's (FHS) scenario.

Methods

Participants were men between 50 and 65 years of age registered in a primary healthcare electronic database and resident in an area with low socioeconomic status in the city of Curitiba (Paraná/Brazil). With the support of an electronic map application, dentistry students visited subjects at their homes.

Results

From the 16 391 registered subjects, 981 were men aged between 50 and 65. From 608 available subjects, 233 (38.3%) were identified as smokers and former smokers and 202 (86.6%) were examined. There was a prevalence of 57 (28.2%) potentially malignant lesions and one confirmed case of squamous cell carcinoma. Actual smoking habits, low‐income wage, and absence from clinical appointments were the key predictors of leukoplakia in this study sample.

Conclusion

This study offers evidence of the possibility of applying a high‐risk‐oriented approach as a secondary prevention measure in the FHS in Brazil or other developing countries.
Use of ultrasound by registered nurses—a systematic literature review
Authors: Steinwandel Ulrich , Gibson Nicholas P , Rippey James Charles , Towell Amanda , Rosman Johan
Published: January 2017

Background

In Western Australia (WA), most stable patients undergoing haemodialysis receive treatment in a satellite setting where no doctors are on‐site during treatment hours, so nurses must make critical decisions about fluid removal. Some patients regularly experience adverse events during dialysis (intradialytic), often due to excessive ultrafiltration goals, with intradialytic hypotension being particularly challenging. Ultrasound of the inferior vena cava has been previously demonstrated being a rapid and non‐invasive method for volume assessment on haemodialysis patients, thus could hold valuable information for the treating nurse.

Aim

This paper examines the existing literature in regards to the use of ultrasound measurements of the inferior vena cava in patients on haemodialysis for objective assessment of their intravascular volume status by renal nurses.

Method

A systematic literature review was performed within medical and nursing databases including CINAHL Plus with Full Text, SCOPUS, Web of Science and MEDLINE.

Results

Renal nurses are conscious of the significance of intradialytic hypotension and have only limited options for its prevention. Ultrasound of the inferior vena cava could add another objective dimension for intravascular volume assessment and prevention of intradialytic hypotension, but to date renal nurses have not been using this technique.

Conclusions

Ultrasound of the inferior vena cava has the potential to assist in defining the ultrafiltration goal for that particular dialysis session, thus reducing the risk of intradialytic hypotension. Additionally, it has potential to change current renal nursing practice when added to clinical nursing assessment methods. Further studies are required to validate this assessment tool carried out by a renal nurse compared with a skilled ultrasonographer.
Case studies of industrial applications of the “M+N” classification method with larger M and N for visual and manual inspections
Authors: Kuesten Carla , Hou Amy , Wu Jenny , Bi Jian
Published: January 2017

In recent sensory literature, Bi and Kuesten (2015a.Food Quality and Preference, 43, 47–52; 2015b.Journal of Sensory Studies, 30, 461–471) have proposed the “M + N” classification method with larger M and N (>3) for discrimination testing based on Fisher's exact test. Industry studies using the method are shared in this article to illustrate application of the method. The tests and measures are taken for non‐fatiguing visual and manual inspections conducted across a variety of product categories. Further, within the examples provided, a validation between labs is documented and results of the method are compared to results from other methods (2‐Alternative Choice and 2‐Alternative Forced Choice) based on common conventional sensory measurement Thurstoniand′. Estimations are given of Intraclass Correlation Coefficient and Cronbach's coefficient alpha for evaluation of panel performance in the test using the “M + N” classification method with larger M and N (only for M = N > 3).

Practical applications

Sorting methods are popular and often used for rapid investigation of product quality, product differences, or consumer perception and are used to help guide product maintenance and/or development efforts. The “M + N” classification method with larger M and N, a type of sorting technique, can be applied for sensory discrimination and perceptual tests with generation of various indices, including Thurstonian discriminal distance delta (ord′) thereby offering the ability to compare results with other sensory discrimination methods.
‘Too Lowly to Reach God Without a Mediator’: John Calvin's Supralapsarian Eschatological Narrative
Authors: van Driel Edwin Chr.
Published: January 2017

In this essay I offer a novel interpretation of Calvin's eschatological imagination and the ways the latter shapes Calvin's overall theological narrative. In addition to his explicit, infralapsarian eschatology, which circles around the reconciling work of the incarnate Christ, Calvin also has an implicit, supralapsarian eschatology, according to which human beings were created for an upward journey toward God, mediated by the non‐incarnate divine Word. Tracing the contours of this eschatology sheds new light on Calvin's account of mediation, incarnation, and expiation, his understanding of the end of Christ's mediatory work, and the contemporary discussion about Calvin and deification.
The pentatricopeptide repeat protein EMP9 is required for mitochondrial ccmB and rps4 transcript editing, mitochondrial complex biogenesis and seed development in maize
Authors: Yang Yan‐Zhuo , Ding Shuo , Wang Hong‐Chun , Sun Feng , Huang Wen‐Long , Song Shu , Xu Chunhui , Tan Bao‐Cai
Published: January 2017

Pentatricopeptide repeat (PPR) proteins comprise a large family of sequence‐specific RNA binding proteins in land plants. Because of its large family size and frequent embryo lethality in the mutants, molecular functions and physiological roles of many PPR proteins are unknown. Through characterization of an empty pericarp9 (emp9) mutant in maize (Zea mays), we defined the functions of EMP9 in mitochondrial RNA editing, respiratory complex formation and seed development.

Mu insertions in different regions of Emp9 facilitated dissection of the domain functions of the EMP9. Through genetic and functional analyses of multiple alleles, we showed that deletions of two N‐terminal PPR motifs and partial E+ domain do not eliminate the editing function of EMP9.

Emp9 encodes an E+ subclass PPR protein that is localized in mitochondria. Loss of EMP9 function abolishes the C‐to‐U editing of ccmB‐43 and rps4‐335 sites in mitochondria. The loss of editing at ccmB‐43 and rps4‐335 affects the maturation of cytochrome c and impairs the biogenesis of mitochondrial respiratory complexes, particularly complex III.

This work extends our understanding of PPR‐E+ protein in editing function and seed development, and provides insights into the molecular function of mitochondrial CcmB protein in higher plants.
Video‐based eye tracking for neuropsychiatric assessment
Authors: Adhikari Sam , Stark David E.
Published: January 2017

This paper presents a video‐based eye‐tracking method, ideally deployed via a mobile device or laptop‐based webcam, as a tool for measuring brain function. Eye movements and pupillary motility are tightly regulated by brain circuits, are subtly perturbed by many disease states, and are measurable using video‐based methods. Quantitative measurement of eye movement by readily available webcams may enable early detection and diagnosis, as well as remote/serial monitoring, of neurological and neuropsychiatric disorders. We successfully extracted computational and semantic features for 14 testing sessions, comprising 42 individual video blocks and approximately 17,000 image frames generated across several days of testing. Here, we demonstrate the feasibility of collecting video‐based eye‐tracking data from a standard webcam in order to assess psychomotor function. Furthermore, we were able to demonstrate through systematic analysis of this data set that eye‐tracking features (in particular, radial and tangential variance on a circular visual‐tracking paradigm) predict performance on well‐validated psychomotor tests.
Elderly with remaining teeth report less frailty and better quality of life than edentulous elderly: a cross‐sectional study
Authors: Hoeksema AR , Spoorenberg SLW , Peters LL , Meijer HJA , Raghoebar GM , Vissink A , Wynia K , Visser A
Published: January 2017

Objective

To assess oral status and self‐reported oral health in community‐living elderly and to determine differences between relevant subgroups of oral status (remaining teeth, edentulous, implant‐retained overdentures) and case complexity (robust, frail, complex care needs).

Subjects and methods

In this cross‐sectional descriptive study, 1325 Dutch community‐living elderly (≥75 years of age) were asked to complete validated questionnaires on frailty, activities of daily living (ADL), complexity of care needs, and QoL. Data on oral status, self‐reported oral health, dental care, general health, and medication use were assessed. Differences between relevant subgroups were determined.

Results

Data of 1026 (77%) elderly (median 80 years, IQR 77–84) were analyzed: 39% had remaining teeth, 51% were edentulous, and 10% had implant‐supported overdentures. Elderly with complex care needs (n = 225, 22%) and frail elderly (n = 217, 21%) were more often edentulous and reported more oral problems than robust elderly (n = 584, 57%). Elderly persons with remaining teeth were less frail, had better QoL and ADL, and used fewer medicines than edentulous elderly. Elderly with implant‐supported overdentures performed better on frailty and QoL than edentulous elderly with conventional dentures.

Conclusion

Community‐living elderly commonly suffer from oral health problems, in particular elderly with complex care needs. QoL, ADL, and general health are higher among community‐living elderly with remaining teeth and implant‐supported overdentures than in edentulous elderly.
Fitness in invasive social wasps: the role of variation in viral load, immune response and paternity in predicting nest size and reproductive output
Authors: Dobelmann Jana , Loope Kevin J. , Wilson‐Rankin Erin , Quinn Oliver , Baty James W. , Gruber Monica A. M. , Lester Philip J.
Published: January 2017

Within any one habitat, the relative fitness of organisms in a population can vary substantially. Social insects like the common wasp are among the most successful invasive animals, but show enormous variation in nest size and other fitness‐related traits. Some of this variation may be caused by pathogens such as viruses that can have serious consequences in social insects, which range from reduced productivity to colony death. Both individual immune responses and colony‐level traits such as genetic diversity are likely to influence effects of pathogen infections on colony fitness. Here we investigate how infections with Kashmir Bee Virus (KBV), immune response and intracolony genetic diversity (due to queen polyandry) affect nest size in the invasive common wasp Vespula vulgaris. We show that KBV is highly prevalent in wasps and expression of antiviral immune genes is significantly increased with higher viral loads across individuals. Patriline membership within a nest did not influence KBV susceptibility or immune response. A permutational MANCOVA revealed that polyandry, viral load and expression of the immune gene Dicer were significant predictors of variation in nest size. High intracolony genetic diversity due to polyandry has previously been hypothesized to improve colony‐level resistance to parasites and pathogens. Consistent with this hypothesis, we observed genetically diverse colonies to be significantly larger and to produce more queens, although this effect was not driven by the pathogen we investigated. Invasive wasps clearly suffer from pathogens and expend resources, as indicated here by elevated immune gene expression, toward reducing pathogen‐impact on colony fitness.
Imaging in pediatric renal transplantation
Authors: Damasio Maria Beatrice , Ording Muller Lil‐Sofie , Piaggio Giorgio , Marks Stephen D. , Riccabona Michael
Published: January 2017

Renal transplantation is the therapy of choice in children with ESKD. Radiological investigations are required in both pre‐ and post‐transplant assessment, although there is paucity of both consensus‐based statements and evidence‐based imaging guidelines in pediatric renal transplantation. The phases of pediatric ESKD management that require imaging are pretransplantation recipient assessment and post‐transplantation surveillance for detection of potential complications. We present suggestions for imaging algorithms for both pre‐ and post‐transplant assessment in pediatric renal transplant recipients.
Probing the Electronic Structure of Bacteriochlorophyll Radical Ions—A Theoretical Study of the Effect of Substituents on Hyperfine Parameters
Authors: Sinnecker Sebastian , Lubitz Wolfgang
Published: January 2017

In reaction centers (RCs) of photosynthesis, a light‐induced charge separation takes place creating radical cations and anions of the participating cofactors. In photosynthetic bacteria, different bacteriochlorophylls (BChl) are involved in this process. Information about the electronic structure of theBChl radical cations and anions can be obtained by measuring the electron spin density distributionviathe electron–nuclear hyperfine interaction usingEPRandENDORtechniques. In this communication, we report isotropic hyperfine coupling constants (hfcs) of theBChlbandgradical cations and anions, calculated by density functional theory, and compare them with the more common radical ions ofBChlaand with available experimental data. The observed differences in the computed hyperfine data are discussed in view of a possible distinction between these species byEPR/ENDORmethods. In addition,14N nuclear quadrupole coupling constants (nqcs) computed forBChla,b,g, and also for Chlain their charge neutral, radical cation and radical anion states are presented. These nqcs are compared with experimental values obtained byESEEMspectroscopy on several different radical ions.
Proteomic Analyses of Changes in Synechococcus sp. PCC7942 Following UV‐C Stress
Authors: Peng Xi , Yang Jie , Gao Yang
Published: January 2017

UV‐C's effects on the physiological and biochemical processes of cyanobacteria have been well characterized. However, the molecular mechanisms of cyanobacteria's tolerance to UV‐C still need further investigation. This research attempts to decode the variation in protein abundances in cyanobacteria after UV‐C stress. Different expression levels of proteins in the cytoplasm of Synechococcus sp. PCC7942 under UV‐C stress were investigated using a comparative proteomic approach. In total, 47 UV‐C‐regulated proteins were identified by MALDI‐TOF analysis and classified by Gene Ontology (GO). After studying their pathways, the proteins were mainly enriched in the groups of protein folding, inorganic ion transport and energy production. By focusing on these areas, this study reveals the correlation between UV‐C stress‐responsive proteins and the physiological changes of Synechococcus sp. PCC7942 under UV‐C radiation. These findings may open up new areas for further exploration in the homeostatic mechanisms associated with cyanobacteria responses to UV‐C radiation.
Ejaculation does not contribute to the stress response to electroejaculation in sheep
Authors: Abril‐Sánchez S , Freitas‐de‐Melo A , Damián JP , Giriboni J , Villagrá‐García A , Ungerfeld R
Published: January 2017

Contents

Electroejaculation procedures (EEPs) provoke stress; nevertheless, ejaculation produces physiological changes similar as those usually used to measure stress responses. The application of EEP to animals that cannot ejaculate—as ewes—may be useful to discriminate the responses induced by ejaculation from those provoked by EEP. The aim was to determine the stress response to EEP in rams and ewes. The EEPs were applied to 10 rams and 10 ewes during the non‐breeding season, and the number of vocalizations, the heart rate, rectal temperature, serum cortisol concentration, biochemical and haematological parameters were measured. Overall, EEP provoked increases in cortisol concentration, glycaemia, rectal temperature and concentration of creatine kinase (all them: p < .0001) as well as relative concentration of granulocytes (p = .003) and absolute granulocyte concentration (p = .0002) in both, rams and ewes. Heart rate, relative concentration of lymphocytes (p = .001), haematocrit (p = .02) and haemoglobin (p = .045) decreased in animals from both genders after EEP. Besides, cortisol (p < .0001), rectal temperature (p = .002) and glycaemia (p = .001) were greater in ewes than rams, and creatine kinase also tended to be greater in ewes than rams (p = .054). On the other hand, the number of animals that vocalized (p = .006), white blood cells (p = .02) and absolute lymphocytes (p = .02) were greater in rams than ewes. The general trends show a similar pattern of stress responses in animals from both genders. Therefore, we concluded that ejaculation does not contribute to the stress response provoked by the EEP. This procedure also provokes muscular damage and probably pain.
Transporting bovine oocytes in a medium supplemented with different macromolecules and antioxidants: Effects on nuclear and cytoplasmic maturation and embryonic development in vitro
Authors: Ambrogi M , Dall'Acqua PC , Rocha‐Frigoni NAS , Leão BCS , Mingoti GZ
Published: January 2017

Contents

We investigated whether supplementing the medium used to transport bovine oocytes with different macromolecules [foetal calf serum (FCS) or bovine serum albumin (BSA)] or a mixture of antioxidants (cysteine, cysteamine and catalase) affects their nuclear and cytoplasmic maturation and thereby affects their subsequent embryonic development and cryotolerance. Oocytes were transported for 6 hr in a portable incubator and then subjected to standard in vitro maturation (IVM) for 18 hr. The oocytes in the control groups were cultured (standard IVM) for 24 hr in medium containing 10% FCS (Control FCS) or 10% FCS and the antioxidant mixture (Control FCS+Antiox). The intracellular concentrations of reactive oxygen species (ROS) at the end of IVM period were lower in the oocytes subjected to simulated transport in the presence of a macromolecular supplement or the antioxidant mixture than that of the control group (FCS: 0.62 and BSA: 0.66 vs. Control FCS: 1.00, p < .05; and Transp: 0.58 and Transp Antiox: 0.70 vs. Control FCS: 1.00, p < .05). After IVM, the mitochondrial membrane potentials of the transported oocytes were lower than those of the non‐transported oocytes (FCS: 0.41 and BSA: 0.57 vs. Control FCS: 1.00, p < .05; and Transp: 0.48 and Transp Antiox: 0.51 vs. Control FCS: 1.00 and Control Antiox: 0.84, p < .05). The blastocyst formation rates (36.9% average) and the re‐expansion rates of vitrified‐warmed blastocysts (53%, average) were unaffected (p > .05) by the treatments. In conclusion, supplementing the medium in which bovine oocytes are transported with antioxidants or different macromolecules did not affect their in vitro production of embryos or their cryotolerance.
A Bayesian Approach to Integrated Ecological and Human Health Risk Assessment for the South River, Virginia Mercury‐Contaminated Site
Authors: Harris Meagan J. , Stinson Jonah , Landis Wayne G.
Published: January 2017

We conducted a regional‐scale integrated ecological and human health risk assessment by applying the relative risk model with Bayesian networks (BN‐RRM) to a case study of the South River, Virginia mercury‐contaminated site. Risk to four ecological services of the South River (human health, water quality, recreation, and the recreational fishery) was evaluated using a multiple stressor–multiple endpoint approach. These four ecological services were selected as endpoints based on stakeholder feedback and prioritized management goals for the river. The BN‐RRM approach allowed for the calculation of relative risk to 14 biotic, human health, recreation, and water quality endpoints from chemical and ecological stressors in five risk regions of the South River. Results indicated that water quality and the recreational fishery were the ecological services at highest risk in the South River. Human health risk for users of the South River was low relative to the risk to other endpoints. Risk to recreation in the South River was moderate with little spatial variability among the five risk regions. Sensitivity and uncertainty analysis identified stressors and other parameters that influence risk for each endpoint in each risk region. This research demonstrates a probabilistic approach to integrated ecological and human health risk assessment that considers the effects of chemical and ecological stressors across the landscape.
On the Measurement of the Overall Degree of Income Stratification between Groups
Authors: Allanson Paul
Published: January 2017

This paper proposes a new class of indices that measure overall stratification between groups in a population and can be decomposed as population‐weighted averages of pairwise indices. The indices capture not only the extent to which groups form well‐defined strata in the income distribution but also the scale of the resultant differences in equally distributed equivalent incomes between them, where these two factors play the same role as identification and alienation respectively in the measurement of polarization. The properties of the class as a whole are investigated as well as those of selected members of it: zeroth and first power indices may be interpreted as measuring the overall incidence and depth of stratification respectively, while second and higher power indices members are directly sensitive to the severity of stratification between groups. An illustrative application provides an empirical analysis of global income stratification by regions in 1993.
Peripheralisation: A Politics of Place, Affect, Perception and Representation
Authors: Willett Joanie , Lang Thilo
Published: January 2017

Recently scholars have started to consider the persistence of peripheries in relation to how they are represented by others outside of the region. Drawing on Foucauldian knowledge/power processes and forms of ‘internal colonialism’, powerful core regions construct and reconstruct knowledge about peripheries as a weaker ‘other’. However this denies agency to passive, peripheral ‘victims’, compromising their capacity to contest their peripherality. We challenge this using Deleuze and Guattari's assemblages and the concepts of affect and perception to develop a conceptualisation of power which allows agency to weaker entities. This enables us to develop better tools for improving peripheral development. We use an innovative Public Engagement research method and a case‐study of Cornwall in the South West of the UK to consider an alternative model with regards to how ideas become accepted and adopted. We claim that analyses of the relationships between core and peripheral regions need to understand the complex cultural assemblages behind regional identities, because this helps us to explore the sites of possibility which offer space for development.
Serum sCD30: A promising biomarker for predicting the risk of bacterial infection after kidney transplantation
Authors: Fernández‐Ruiz Mario , Parra Patricia , López‐Medrano Francisco , Ruiz‐Merlo Tamara , González Esther , Polanco Natalia , Origüen Julia , San Juan Rafael , Andrés Amado , Aguado José María
Published: January 2017

Background

The transmembrane glycoprotein CD30 contributes to regulate the balance between Th1 and Th2 responses. Previous studies have reported conflicting results on the utility of its soluble form (sCD30) to predict post‐transplant infection.

Methods

Serum sCD30 was measured by a commercial ELISA assay at baseline and post‐transplant months 1, 3, and 6 in 100 kidney transplant (KT) recipients (279 monitoring points). The impact of sCD30 levels on the incidence of overall, bacterial and opportunistic infection during the first 12 months after transplantation was assessed by Cox regression.

Results

There were no differences in serum sCD30 according to the occurrence of overall or opportunistic infection. However, sCD30 levels were higher in patients with bacterial infection compared to those without at baseline (P=.038) and months 1 (P<.0001), 3 (P=.043), and 6 after transplantation (P=.006). Patients with baseline sCD30 levels ≥13.5 ng/mL had lower 12‐month bacterial infection‐free survival (35.0% vs 80.0%; P<.0001). After adjusting for potential confounders, baseline sCD30 levels ≥13.5 ng/mL remained as an independent risk factor for bacterial infection (adjusted hazard ratio [aHR]: 4.65; 95% confidence interval [CI]: 2.05‐10.53; <.001). Analogously, sCD30 levels ≥6.0 ng/mL at month 1 acted as a risk factor for subsequent bacterial infection (aHR: 5.29; 95% CI: 1.11‐25.14; P=.036).

Conclusion

Higher serum sCD30 levels were associated with an increased risk of bacterial infection after KT. We hypothesize that this biomarker reflects a Th2‐polarized T‐cell response, which exerts a detrimental effect on the immunity against bacterial pathogens.
Use of magnesium sulfate in preterm deliveries for neuroprotection of the neonate
Authors: Usman Sana , Foo Lin , Tay Jasmine , Bennett Phillip R , Lees Christoph
Published: January 2017

Key content

The prevalence of preterm birth is increasing and owing to advances in neonatal care, more infants are surviving. However, in parallel with this, the incidence of cerebral palsy (CP) is also rising.

Magnesium sulfate (MgSO4) is currently recommended for use in women who are at risk of giving birth at less than 30–32 weeks of gestation for neuroprotection of their infants. The exact mechanism of action remains unclear.

Meta‐analyses report encouraging results that are consistent with a modest but tangible benefit for the use of MgSO4, and suggest a number needed to treat (NNT) to prevent one in 46 cases of CP in infants born preterm before 30 weeks of gestation and one in 63 cases of CP in infants born preterm before 34 weeks of gestation.

Learning objectives

To gain an understanding of the risk of neurodisability in infants delivered preterm.

To become familiar with the main studies assessing the use of MgSO4for neuroprotection in preterm deliveries.

To become aware of the relevant international guidelines.

Ethical issues

Concerns have been raised regarding the higher number of perinatal deaths reported with the use of MgSO4in the MagNET study. This was not substantiated in the Cochrane review.

Given that MgSO4is a safe, readily available and inexpensive drug, even if there were only to be modest benefits from its use, the risk–benefit ratio is in favour of its use.
Surgical management of heavy menstrual bleeding: part 1
Authors: Saraswat Lucky , Cooper Kevin
Published: January 2017

Key content

Heavy menstrual bleeding affects one in five premenopausal women and significantly impairs quality of life.

Management options for heavy menstrual bleeding are diverse and include a variety of medical and surgical treatments.

Surgical treatment options are endometrial ablation, hysterectomy and myomectomy.

Treatment choice for heavy menstrual bleeding should take into account the underlying pathology, the woman's preferences and fertility needs.

Learning objectives

To review the first‐ and second‐generation endometrial ablation techniques and evaluate the role of outpatient ablation.

To discuss efficacy, safety, acceptability and cost‐effectiveness of various ablation techniques for the treatment of heavy menstrual bleeding in premenopausal women.

Ethical issues

Is it justified to offer endometrial ablation as a first choice surgical option for the management of heavy menstrual bleeding?

Would a move to second‐generation ablation techniques result in loss of operative hysteroscopic skills that may be required for treating intrauterine pathology?

With the rising trend of women having more than one caesarean section is it safe to use blind global ablative techniques?
Effect of obesity on assisted reproductive treatment outcomes and its management: a literature review
Authors: Khairy Mohammed , Rajkhowa Madhurima
Published: January 2017

Key content

Obesity is associated with infertility and poor obstetric outcomes.

The current trends of advanced maternal age and rising obesity rates contribute indirectly to the growing demand for fertility treatment and assisted reproduction treatment (ART), posing clinical and ethical dilemmas for fertility service providers.

The live‐birth rate, after ART, is significantly lower in obese women than non‐obese women, possibly due to impaired oocyte quality and/or defective endometrial receptivity. Poor ART outcomes correlate positively with the severity of obesity.

Management of obesity‐related infertility should include diet, exercise, cognitive behavioural interventions and possibly adjunctive pharmacotherapy. Bariatric surgery may benefit morbidly obese women who struggle to lose weight otherwise.

Randomised controlled trials are required to clarify the effects of various therapeutic interventions for obesity on ART outcomes.

Learning objectives

To understand the association of obesity and infertility with ART outcomes.

To learn the principles of obesity‐related infertility management.

Ethical issues

To understand the ethical challenges in the provision of ART for obese women and to inform the stance of professional bodies, such as the British Fertility Society and the European Society of Human Reproduction and Embryology.
Potency and stability of compounded formulations of chlorambucil, melphalan and cyclophosphamide
Authors: Burton J. H. , Knych H. K. , Stanley S. D. , Rebhun R. B.
Published: January 2017

Background

Oral chemotherapy agents are frequently compounded in veterinary medicine however, the potency of some formulations have been shown to vary from that of Food and Drug Administration (FDA)‐approved products.

Aims

The objective of this study was to evaluate the potency and stability of three compounded oral chemotherapeutics commonly prescribed to be administered over time.

Materials & Methods

Compounded chlorambucil 1 mg, cyclophosphamide 5 mg and melphalan 1 mg were obtained and for potency tested upon receipt and 6 weeks later.

Results

Potency ranged from 71 to 104% for chlorambucil and 58 to 109% for melphalan; 1/4 and 2/4 samples were <90% of labelled strength at baseline and 6 weeks, respectively, for both drugs. Potency of cyclophosphamide ranged from 92 to 107% with all samples +/−10% of labelled strength at all time points.

Discussion/Conclusion

These results demonstrate variability of compounded chemotherapy products, and highlight the need to consider both potency and stability when prescribing orally compounded chemotherapy.
Disorders of micturition in small animal patients: clinical significance, etiologies, and management strategies
Authors: Langfitt Eric , Prittie Jennifer E. , Buriko Yekaterina , Calabro Janine M.
Published: January 2017

Objectives

To review the physiology of micturition, the pathophysiology of micturition disorders, and current pharmacological agents used to treat these disorders. To discuss different urinary catheterization techniques, along with the risks of catheter‐associated urinary tract infections attributed with these techniques.

Etiology

Many critically ill veterinary patients are at risk of developing a number of neurological and non neurological micturition‐related disorders.

Diagnosis

Micturition disorders can be diagnosed based on physical examination findings, urinary voiding contrast studies, urethral pressure profiles, and diagnostic testing such as urinalysis and urine cultures.

Therapy

Therapy can be either pharmacological, involvement of urinary catheterization, surgical, or a combination of all the above. The goal of the treatment is to correct the underlying causes resulting in the micturition‐related disorder, and if possible, allow the patient to regain their normal physiological micturition behavior.

Prognosis

Depending on the underlying disease process and duration of the micturition disorder, the prognosis can be variable. In many instances, near‐normal or normal function can return, but in severe cases, the patient may not regain its normal, appropriate micturition response.
Hypothermia and targeted temperature management in cats and dogs
Authors: Brodeur Andrea , Wright Annie , Cortes Yonaira
Published: January 2017

Objective

To review current knowledge surrounding the effects, treatment, and prognosis of hypothermia in people, dogs, and cats, as well as the application of therapeutic hypothermia in clinical medicine.

Etiology

Hypothermia may be a primary or secondary condition, and may be due to environmental exposure, illness, medications, anesthesia, or trauma. Hypothermia has been applied therapeutically in human medicine for a variety of conditions, including postcardiac arrest. In veterinary medicine, the technique has been applied in cardiac surgeries requiring bypass and in a patient with intractable seizures.

Diagnosis

Hypothermia can be diagnosed based on presenting temperature or clinical signs, and appropriate diagnosis may require nontraditional thermometers.

Therapy

Rewarming is the primary treatment for accidental hypothermia, with intensity ranging from passive surface rewarming to extracorporeal rewarming. The goal is to return the core temperature to a level that restores normal physiologic function of all body processes. Other supportive therapies such as intravenous fluids are typically indicated, and if cardiopulmonary arrest is present, prolonged resuscitation may be required. In cases of secondary hypothermia, reversal of the underlying cause is important.

Prognosis

There are few prognostic indicators in human and veterinary patients with hypothermia. Even the most severely affected individuals, including those presenting in cardiopulmonary arrest, have potential for complete recovery with appropriate therapy. Therapeutic hypothermia has been shown to improve outcome in people following cardiac arrest. Further studies are needed to examine this application in veterinary medicine, as well as appropriate therapy and prognosis for cases of spontaneous hypothermia.
Characterization of buffy coat‐derived granulocytes for clinical use: a comparison with granulocyte colony‐stimulating factor/dexamethasone‐pretreated donor‐derived products
Authors: van de Geer A. , Gazendam R. P. , Tool A. T. J. , van Hamme J. L. , de Korte D. , van den Berg T. K. , Zeerleder S. S. , Kuijpers T. W.
Published: January 2017

Background and objectives

Buffy coat‐derived granulocytes have been described as an alternative to the apheresis product from donors pretreated with dexamethasone and granulocyte colony‐stimulating factor (G‐CSF). The latter is – dependent on the local and national settings – obtained following a demanding and time‐consuming procedure, which is undesirable in critically ill septic patients. In contrast, buffy coat‐derived products have a large volume and are often heavily contaminated with red cells and platelets. We developed a new pooled buffy coat‐derived product with high purity and small volume, and performed a comprehensive functional characterization of these granulocytes.

Materials and methods

We pooled ten buffy coats following the production of platelet concentrates. Saline 0·9% was added to decrease the viscosity and the product was split into plasma, red cells and a ‘super’ buffy coat. Functional data of the granulocytes were compared to those obtained with granulocytes from healthy controls and G‐CSF/dexamethasone‐pretreated donors.

Results

Buffy coat‐derived granulocytes showed adhesion, chemotaxis, reactive oxygen species production, degranulation, NETosis and in vitro killing of Staphylococcus aureus, Escherichia coli and Aspergillus species comparable to control and G‐CSF/dexamethasone‐derived granulocytes. Candida killing was superior compared to G‐CSF/dexamethasone‐derived granulocytes. Immunophenotyping was normal; especially no signs of activation in the buffy coat‐derived granulocytes were seen. Viability was reduced. Buffy coats are readily available in the regular blood production process and would take away the concerns around the apheresis product.

Conclusion

The product described appears a promising alternative for transfusion purposes.
HLA‐stripped platelets: preclinical developments and clinical outlooks
Authors: Meinke S. , Karlström C. , Gryfelt G. , Wikman A. , Höglund P.
Published: January 2017

Antibodies to foreign HLA class I can form in patients exposed to allogeneic cells, for example during blood transfusion. During platelet transfusions, these anti‐HLA class I antibodies can bind to transfused platelets and mediate their destruction, causing platelet refractoriness. Providing HLA‐matched platelets is a therapeutic option for immunized patients. However, sometimes HLA‐matched donors cannot be found or are too few, leading to suboptimal treatment and risks of bleedings. An alternative is to strip standard platelets of HLA class I using a brief incubation at low pH. Such HLA‐stripping results in a reduction in HLA class I expression at the surface, followed by loss of reactivity to HLA class I‐specific antibodies. HLA‐stripped platelets therefore have therapeutic potential in platelet refractory patients. In this article, we summarize our recent work on HLA stripping of platelets and discuss how the HLA‐stripping process affects platelet function and interactions with cells of the immune system. We also review earlier clinical case studies in which HLA‐stripped platelets have been used In patients, and discuss concerns and considerations that should be taken into account when testing their efficacy in platelet refractory patients in clinical trials.