bluuebunny/crossref_metadata_2025 huggingface dataset:
Taphonomic analysis of small mammal bone remains preyed upon by wildcats (Carnivora: Felidae) from the central Monte Desert (Mendoza, Argentina)
Authors: López José Manuel , Rosi María I. , Tabeni Solana , Bender Benjamín , Chiavazza Horacio
Published: November 2016

The present study analysed the taphonomic characteristics of small mammal bone accumulations produced by small felids in an area from the central Monte Desert (Mendoza, Argentina). In order to provide criteria to identify the role that these predators had in the formation of zooarchaeological assemblages, the anatomical representation, bone breakage patterns and degrees of digestive corrosion were evaluated. The main taphonomic results are: low average values for the relative abundance of skeletal elements; greater representation of mandibles, maxillae, isolated incisors, humeri and femora than the remaining elements; preponderance of cranial elements with high proportion of isolated teeth; elevated frequencies of proximal limb bones compared with distal parts; high degree of breakage in all skeletal elements and digestive corrosion on almost all diagnostic bones (mainly moderate and heavy). The values of the studied taphonomic variables indicate that small felids in this area made severe alterations to the bones of their prey (mainly rodents), attributable to the category of extreme modifier, while preserving enough skeletal elements to allow their taphonomic characterization. Tooth marks or grooves on bone surfaces produced by scratching and chewing were not detected. The low relative abundance of skeletal elements, the high degree of breakage and the elevated frequency of elements with digestion traces represent general taphonomic patterns that fall within those reported for other South American small carnivores.
Screening for ALK abnormalities in central nervous system metastases of non‐small‐cell lung cancer
Authors: Nicoś Marcin , Jarosz Bożena , Krawczyk Paweł , Wojas‐Krawczyk Kamila , Kucharczyk Tomasz , Sawicki Marek , Pankowski Juliusz , Trojanowski Tomasz , Milanowski Janusz
Published: November 2016

Anaplastic lymphoma kinase (ALK) gene rearrangement was reported in 3%–7% of primary non‐small‐cell lung cancer (NSCLC) and its presence is commonly associated with adenocarcinoma (AD) type and non‐smoking history. ALK tyrosine kinase inhibitors (TKIs) such as crizotinib, alectinib and ceritinib showed efficiency in patients with primary NSCLC harboring ALK gene rearrangement. Moreover, response to ALK TKIs was observed in central nervous system (CNS) metastatic lesions of NSCLC. However, there are no reports concerning the frequency of ALK rearrangement in CNS metastases. We assessed the frequency of ALK abnormalities in 145 formalin fixed paraffin embedded (FFPE) tissue samples from CNS metastases of NSCLC using immunohistochemical (IHC) automated staining (BenchMark GX, Ventana, USA) and fluorescence in situ hybridization (FISH) technique (Abbot Molecular, USA). The studied group was heterogeneous in terms of histopathology and smoking status. ALK abnormalities were detected in 4.8% (7/145) of CNS metastases. ALK abnormalities were observed in six AD (7.5%; 6/80) and in single patients with adenosuqamous lung carcinoma. Analysis of clinical and demographic factors indicated that expression of abnormal ALK was significantly more frequently observed (P = 0.0002; χ2 = 16.783) in former‐smokers. Comparison of IHC and FISH results showed some discrepancies, which were caused by unspecific staining of macrophages and glial/nerve cells, which constitute the background of CNS tissues. Their results indicate high frequency of ALK gene rearrangement in CNS metastatic sites of NSCLC that are in line with prior studies concerning evaluation of the presence of ALK abnormalities in such patients. However, they showed that assessment of ALK by IHC and FISH methods in CNS tissues require additional standardizations.
The politics of refusal: Aboriginal sovereignty and the Northern Gateway pipeline
Authors: Wood Patricia Burke , Rossiter David A.
Published: November 2016

Key Messages

Claims of Aboriginal sovereignty over territory crossed by proposed pipeline are substantive and practised, and well‐grounded in Canadian law.

Aboriginal presentations to the Joint Review Panel are examples of a politics of refusal based in Aboriginal knowledge, governance, experience, and perspective, rather than merely a response to a specific proposal.

Geographic research on natural resource development would benefit from more incorporation of Aboriginal theory.
Innovations in Practice: A case control and follow‐up study of ‘hard to reach’ young people who suffered from multiple complex mental disorders
Authors: Camilleri Nigel , Newbury‐Birch Dorothy , McArdle Paul , Stocken Deborah D. , Thick Tony , Le Couteur Ann
Published: November 2016

Background

Innovations Project (IP) was a new multidisciplinary team based within an inner city, walk‐in health centre, North East England (throughout 2011). The aim was to describe the social and mental disorders of the hard to reach young people (HTRYP) from the IP and compare with a matched sample who attended a Community Mental Health Team (CMHT) and follow‐up both samples 24 months after discharge.

Methods

A retrospective review of clinical case notes of YP who attended the IP and CMHT. A 24‐month (postdischarge) follow‐up evaluation of the mental state and social function of the YP in both groups using Health of the Nation Outcome Scales for Child and Adolescent Mental Health (HoNOSCA) and Children's Global Assessment Scale (CGAS).

Results

Thirty‐six referrals were accepted over a one‐year period by the IP, 31 met criteria for the HTRYP, 15 were offered individually tailored therapy. The HTRYP who were more deprived compared to the CMHT matched sample (n = 115), experienced a higher median number of mental disorders (n = 3 compared to CMHT n = 1), higher severity scores and lower levels of social function (HTRYP HoNOSCA mean: 19.1 (95% CI 15.9–22.2) and CMHT mean: 11.2 (95% CI 2.0–23.0) p = <.001, and HTRYP CGAS mean: 51.0 (95% CI 46.0–56.2) and CMHT mean: 58.9 (95% CI 52.9–64.8), p = .05). The HTRYP made significantly greater improvement compared to CMHTYP; (HoNOSCA p = <.001 and CGAS p = <.002) at discharge. A total of 13 HTRYP and 9 CMHT YP attended the follow‐up review at 24 months. There was substantial variability in terms of social function between the YP within each sample.

Conclusions

The term ‘HTR’ describes a state that may be often temporary, as opposed to lifelong. A bespoke service offering a developmental theoretical framework, regular reviews and an individualised care plan, was able to engage and had the potential to reduce morbidity suffered by HTRYP.
Synthesis, cytotoxic activity, and 2D‐ and 3D‐QSAR studies of 19‐carboxyl‐modified novel isosteviol derivatives as potential anticancer agents
Authors: Liu Cong‐Jun , Zhang Tao , Yu Shu‐Ling , Dai Xing‐Jie , Wu Ya , Tao Jing‐Chao
Published: November 2016

Two series of novel acylthiosemicarbazide and oxadiazole fused‐isosteviol derivatives were synthesized based on the 19‐carboxyl modification. The target compounds were evaluated for their cytotoxicities against three cancer cell lines (HCT‐116, HGC‐27, and JEKO‐1) using an MTT assay. Lead compounds from the acylthiosemicarbazides (4) showed IC50 values in the lower micromolar range. For example, compounds (4i, 4l, 4m, 4r, and 4s) exhibited significant inhibitory activities against the three cell lines with IC50 values of 0.95–3.36 μm. Furthermore, 2D‐HQSAR and 3D‐topomer CoMFA analyses were established, which could be used to develop second generation of isosteviol derivatives as anticancer agents.
Ustekinumab in der Therapie der Pustulosis palmoplantaris – Eine Fallserie mit neun Patienten
Authors: Buder Valeska , Herberger Katharina , Jacobi Arnd , Augustin Matthias , Radtke Marc Alexander
Published: November 2016

Hintergrund

Die Pustulosis palmoplantaris ist eine chronisch entzündliche Hauterkrankung, die mit bedeutenden Einschränkungen der Lebensqualität und der Belastbarkeit einhergeht. Aufgrund von Zulassungsbeschränkungen und einem häufig therapierefraktären Verlauf sind die Behandlungsmöglichkeiten limitiert.

Patienten und Methodik

Nach zuvor frustranen Therapien erhielten 9 Patienten mit Pustulosis palmoplantaris nach Ausschluss einer latenten Tuberkulose Ustekinumab (45 mg Ustekinumab bei < 100 kg Körpergewicht [KG], 90 mg Ustekinumab > 100 kg KG) in Woche 0, 4, 12 und 24. Reguläre Visiten erfolgten nach 4 und 12 Wochen, im weiteren Verlauf alle 12 Wochen.

Ergebnisse

Das Durchschnittsalter bei Therapiebeginn betrug 48 Jahre. Drei Patienten waren männlich. Bei n  =  4 Patienten (44,4 %) wurde eine Verbesserung um 75 % des Palmoplantar‐Psoriasis‐Area‐Severity‐Index (PPPASI) erreicht. Insgesamt verbesserte sich der PPPASI nach 24 Wochen durchschnittlich um 71,6 %. Eine komplette Abheilung zeigte sich bei n  =  2 Patienten nach 24 Wochen. Bis auf lokale Injektionsreaktionen und leichte Infekte wurden keine unerwünschten Wirkungen beobachtet.

Schlussfolgerungen

Die Fallserie ist ein weiterer Beleg für die Wirksamkeit und Verträglichkeit von Ustekinumab in der Therapie der Pustulosis palmoplantaris. Zur Beurteilung der Langzeitwirkung und ‐sicherheit sowie der Wirksamkeit einer intermittierenden Therapie sind kontrollierte Studiendaten sowie Beobachtungen im Rahmen von Patientenregistern notwendig.
Prognostic value of the area and density of lymphatic vessels in cutaneous squamous cell carcinoma
Authors: Krediet Jorien Tannette , Kanitakis Jean , Bob Adrienne , Schmitter Julia , Krediet Annelot Carine , Röwert Joachim , Stockfleth Eggert , Painsi Clemens , Hügel Rainer , Terhorst Dorothea , Lange‐Asschenfeldt Bernhard
Published: November 2016

Background and objectives

Cutaneous squamous cell carcinoma (SCC) is known for its capacity to metastasize via lymphatic vessels. In recent studies, the level of lymphangiogenesis has been reported as a potential prognostic factor for several skin tumors. The aim of this study was to quantify lymphangiogenesis in SCC using either computer‐assisted image analysis or the Chalkley count technique. Vascular parameters were evaluated and compared with respect to their predictive power for tumor metastasis.

Patient and methods

In this case‐control study, clinical and histological data of 15 metastatic and 15 nonmetastatic SCC patients were retrospectively analyzed. SCC samples were immunostained for the lymphatic endothelial marker D2–40 and the panvascular marker CD31, and analyzed using computer‐assisted morphometric image analyses within hot spots as well as the digitalized Chalkley counting method.

Results

Lymphatic vessel density, relative lymphatic vessel area, and lymphatic Chalkley count were significantly elevated in metastatic SCC. Tumor thickness was significantly higher in metastatic SCC, and had the highest predictive power for metastatic disease. Tumor thickness was a significant predictor of lymphangiogenic parameters.

Conclusions

Lymphangiogenesis is elevated in metastatic SCC but its extent is influenced by tumor thickness. Tumor thickness remains the most reliable predictive factor for metastatic disease.
Potential drug‐drug interactions and adverse drug reactions in dermatological inpatients
Authors: Koch Lukas , Kränke Birger , Aberer Werner
Published: November 2016

Objectives

To present information on the frequency of drug‐drug interactions and adverse drug reactions, and to provide assistance on how to minimize these major problems in the pharmacological treatment of dermatological inpatients.

Patients and methods

The medications given to 1,099 dermatological inpatients were retrospectively analyzed for drug‐drug interactions and adverse drug reactions using web‐based drug interaction software (Diagnosia® Check).

Results

We report an overall frequency of relevant drug‐drug interactions of 51.7 %, with an average of 3.2 interactions per affected inpatient. Drug combinations that should have been avoided were found in 5.7 % of the study population. Total drug count was the most important risk factor. Drug groups involved in the majority of interactions were analgesics, cardiovascular and antithrombotic agents, as well as antidepressants. The risk of developing adverse drug reactions was rated as “high” in 53.1 % of inpatients. The top five adverse reactions in this patient group were bleeding, constipation, anticholinergic effects, sedation, and orthostatic effects.

Conclusions

Potential drug‐drug interactions as well as adverse drug reactions are alarmingly common in dermatological inpatients. Every other patient is at risk of experiencing such interactions or adverse reactions, and every twentieth patient receives a drug combination that should not be administered. Increased alertness is a must in order to identify patients at risk.
Potenzielle Arzneimittelwechsel‐wirkungen und unerwünschte Arzneimittelwirkungen bei stationären dermatologischen Patienten
Authors: Koch Lukas , Kränke Birger , Aberer Werner
Published: November 2016

Ziele

Informationen zur Häufigkeit von Arzneimittelwechselwirkungen und unerwünschten Arzneimittelwirkungen zu präsentieren und Hilfestellung zu leisten, wie diese wichtigen Probleme in der pharmakologischen Behandlung stationärer dermatologischer Patienten minimiert werden können.

Patienten und Methoden

Die Medikation von 1 099 stationären dermatologischen Patienten wurde retrospektiv mittels einer Internet‐basierten Software für Medikamenteninteraktionen (Diagnosia® Check) auf Arzneimittelwechselwirkungen und unerwünschte Arzneimittelwirkungen analysiert.

Ergebnisse

Wir beschreiben eine Gesamthäufigkeit relevanter Arzneimittelwechselwirkungen von 51,7 % mit durchschnittlich 3,2 Interaktionen pro betroffenem stationären Patienten. Arzneimittelkombinationen, die gemieden werden sollten, wurden bei 5,7 % der Studienpopulation festgestellt. Der wichtigste Risikofaktor war die Gesamtzahl der verabreichten Medikamente. Die Arzneimittelgruppen, die bei der Mehrzahl der Wechselwirkungen beteiligt waren, waren Analgetika, Herz‐Kreislauf‐Medikamente und gerinnungshemmende Medikamente sowie Antidepressiva. Das Risiko unerwünschte Arzneimittelwirkungen auszubilden wurde bei 53,1 % der stationären Patienten als „hoch“ eingestuft. Die fünf wichtigsten unerwünschten Nebenwirkungen in dieser Patientengruppe waren Blutungen, Obstipation, anticholinerge Effekte, Sedierung und orthostatische Effekte.

Schlussfolgerungen

Potenzielle Arzneimittelwechselwirkungen sowie unerwünschte Arzneimittelwirkungen sind bei stationären dermatologischen Patienten alarmierend häufig. Bei jedem zweiten Patienten besteht die Gefahr, derartige Wechselwirkungen oder unerwünschte Nebenwirkungen zu erleiden und jeder zwanzigste Patient erhält eine Arzneimittelkombination, die nicht verabreicht werden sollte. Erhöhte Wachsamkeit ist erforderlich, um die gefährdeten Patienten zu erkennen.
Nagelbefall kann bei Patienten mit Psoriasis auf eine Enthesiopathie hinweisen
Authors: Castellanos‐González Maria , Joven Beatriz Esther , Sánchez Julio , Andrés‐Esteban Eva María , Vanaclocha‐Sebastián Francisco , Romero Pablo Ortiz , Díaz Raquel Rivera
Published: November 2016

Hintergrund

Obwohl subklinische Enthesiopathie ein gut etabliertes diagnostisches Merkmal der Psoriasisarthritis (PsA) ist, wird sie häufig übersehen, da viele Patienten asymptomatisch sind. Gäbe es klinische Hinweise auf das Vorliegen einer Enthesiopathie, würde dies den Klinikern die Möglichkeit eröffnen, eine PsA frühzeitig zu diagnostizieren.

Material und Methoden

Es wurde eine monozentrische prospektive Studie mit insgesamt 90 Psoriasis‐Patienten durchgeführt, um mittels Ultraschall das Vorliegen von Enthesenanomalien zu untersuchen und eine Korrelation mit dem Befall der Nägel festzustellen.

Ergebnisse

Enthesenanomalien wurden bei 23 Patienten (25,5 %) gefunden, von denen 19 (82,6 %) Nagelbefall aufwiesen. Bei 4 Patienten waren die Nägel nicht betroffen. Enthesiopathie lag bei 31,1 % (19/61) der Patienten mit Onychopathie vor, von den Patienten ohne Nagelbefall litten nur 13,8 % (4/29) an Enthesiopathie (p = 0,07). Zwischen dem Target‐NAPSI‐Score und dem Vorliegen einer Enthesiopathie bestand eine signifikante Korrelation. Eine signifikante Korrelation bestand darüber hinaus auch zwischen dem Vorliegen einer Enthesiopathie und der Anzahl der betroffenen Nägel (p = 0,035).

Schlussfolgerungen

Klinische Belege für eine Onychopathie können der Schlüssel für die frühe Diagnose einer Enthesiopathie bei Psoriasis‐Patienten sein.
Compression therapy in patients with venous leg ulcers
Authors: Dissemond Joachim , Assenheimer Bernd , Bültemann Anke , Gerber Veronika , Gretener Silvia , Kohler‐von Siebenthal Elisabeth , Koller Sonja , Kröger Knut , Kurz Peter , Läuchli Severin , Münter Christian , Panfil Eva‐Maria , Probst Sebastian , Protz Kerstin , Riepe Gunnar , Strohal Robert , Traber Jürg , Partsch Hugo
Published: November 2016

Wund‐D.A.CH. is the umbrella organization of the various wound care societies in German‐speaking countries. The present consensus paper on practical aspects pertinent to compression therapy in patients with venous leg ulcers was developed by experts from Germany, Austria, and Switzerland.

In Europe, venous leg ulcers rank among the most common causes of chronic wounds. Apart from conservative and interventional wound and vein treatment, compression therapy represents the basis of all other therapeutic strategies. To that end, there are currently a wide variety of materials and systems available. While especially short‐stretch bandages or multicomponent systems should be used in the initial decongestion phase, ulcer stocking systems are recommended for the subsequent maintenance phase. Another – to date, far less common – alternative are adaptive Velcro bandage systems. Medical compression stockings have proven particularly beneficial in the prevention of ulcer recurrence. The large number of treatment options currently available enables therapists to develop therapeutic concepts geared towards their patients’ individual needs and abilities, thus resulting in good acceptance and adherence.

Compression therapy plays a crucial role in the treatment of patients with venous leg ulcers. In recent years, a number of different treatment options have become available, their use and application differing among German‐speaking countries. The present expert consensus is therefore meant to outline concrete recommendations for routine implementation of compression therapy in patients with venous leg ulcers.
Endoscopic ultrasonography‐guided biopsy using a Franseen needle design: Initial assessment
Authors: Bang Ji Young , Hebert‐Magee Shantel , Hasan Muhammad K. , Navaneethan Udayakumar , Hawes Robert , Varadarajulu Shyam
Published: November 2016

Background and Aim

Recently, a 22‐gauge (G) needle with a Franseen tip design was developed for endoscopic ultrasonography‐guided fine‐needle biopsy (EUS‐FNB). The present study evaluated the performance of the Franseen biopsy needle in EUS‐guided tissue acquisition.

Methods

This is a retrospective study of patients who underwent EUS‐FNB using the Franseen needle. Lesions were sampled using either the Franseen needle only or after failed diagnostic fine‐needle aspiration (FNA). After rapid onsite evaluation (ROSE), two dedicated passes were carried out for histological assessment using the cell block technique. Main outcomes were: (i) rates of diagnostic adequacy for ROSE and histological diagnosis; and (ii) quality of histology as determined by total tissue area and tumor percentage in tissue.

Results

Thirty patients underwent EUS‐FNB of pancreatic or other masses over a 3‐month period. Twenty‐four lesions were sampled using the Franseen needle only and six after failed diagnostic FNA. Final diagnosis was pancreatic cancer in 12, gastrointestinal stromal cell tumor in five, other tumors in four and benign disease in nine. Diagnostic adequacy for ROSE was 96.6% and histological diagnosis was established in 96.7% of patients. Median tissue area was 2.9 mm2 (IQR = 0.68–8.71 mm2) and median tumor percentage in tissue was 73.9% (IQR = 44–97.6). Rates of technical success and adverse events were 96.7 and 3.3%, respectively.

Conclusion

Preliminary data suggest that the Franseen needle yields diagnostic material for ROSE and histology in >95% of patients.
Using fine‐scale spatial genetics of Norway rats to improve control efforts and reduce leptospirosis risk in urban slum environments
Authors: Richardson Jonathan L. , Burak Mary K. , Hernandez Christian , Shirvell James M. , Mariani Carol , Carvalho‐Pereira Ticiana S. A. , Pertile Arsinoê C. , Panti‐May Jesus A. , Pedra Gabriel G. , Serrano Soledad , Taylor Josh , Carvalho Mayara , Rodrigues Gorete , Costa Federico , Childs James E. , Ko Albert I. , Caccone Adalgisa
Published: November 2016

The Norway rat (Rattus norvegicus) is a key pest species globally and responsible for seasonal outbreaks of the zoonotic bacterial disease leptospirosis in the tropics. The city of Salvador, Brazil, has seen recent and dramatic increases in human population residing in slums, where conditions foster high rat density and increasing leptospirosis infection rates. Intervention campaigns have been used to drastically reduce rat numbers. In planning these interventions, it is important to define the eradication units ‐ the spatial scale at which rats constitute continuous populations and from where rats are likely recolonizing, post‐intervention. To provide this information, we applied spatial genetic analyses to 706 rats collected across Salvador and genotyped at 16 microsatellite loci. We performed spatially explicit analyses and estimated migration levels to identify distinct genetic units and landscape features associated with genetic divergence at different spatial scales, ranging from valleys within a slum community to city‐wide analyses. Clear genetic breaks exist between rats not only across Salvador but also between valleys of slums separated by <100 m—well within the dispersal capacity of rats. The genetic data indicate that valleys may be considered separate units and identified high‐traffic roads as strong impediments to rat movement. Migration data suggest that most (71–90%) movement is contained within valleys, with no clear source population contributing to migrant rats. We use these data to recommend eradication units and discuss the importance of carrying out individual‐based analyses at different spatial scales in urban landscapes.
Trade‐offs in transitions between indigenous and commercial fishing sectors: the Torres Strait tropical rock lobster fishery
Authors: Hutton T. , van Putten E.I. , Pascoe S.D. , Deng R.A. , Plagányi É.E. , Dennis D.
Published: November 2016

A bio‐economic model was developed to evaluate aspects of proposed quota‐based constraints vs the current effort control regulations for the tropical rock lobster, Panulirus ornatus, Fabricius, fishery in the Torres Strait (Australia/Papua New Guinea). The analysis integrates across biological, economic and social considerations. Model performance indicators have been chosen to reflect higher level policy objectives. The model simulation results indicate important trade‐offs. There is lower overall fleet total profit (across all the subfleets), lower fishery total value added and lower total employment if the fishery is quota‐constrained. This is due to an assumed rationalisation driven by incentives and current utilisation of capacity. The simulated re‐allocation of quota from the commercial non‐indigenous fleet allowing for greater potential indigenous fisher participation results in predicted increases in indigenous employment and would meet social objectives; however, due to limited capacity in the indigenous fleet, the simulated predicted lower catches led to lower total fishery profits and decreased total fishery value added within the supply chain. Investment in capacity could potentially offset this result.
When is a fisher (not) a fisher? Factors that influence the decision to report fishing as an occupation in rural Cambodia
Authors: Nasielski J. , Kc K. B. , Johnstone G. , Baran E.
Published: November 2016

In the developing world, the majority of people who fish in inland areas do so primarily for subsistence needs. This suggests that survey or census questionnaires which collect information concerning the occupations of respondents will underreport the number of people who fish, and corollary to this, misrepresent dependence on fishing as a support service for food and supplemental income. This study uses the results of a household survey conducted in 37 villages across Cambodia to quantify the amount of fishing that is done by inland fishers who do not report fishing as a primary or secondary occupation. The study also identifies the household characteristics which influence the decision of an individual who fishes to report fishing as an occupation. Fifty‐eight percent of households whose members engaged in fishing activities did not report fishing as an occupation. Individuals whose household owned farmland, earned off‐farm income and fished primarily for subsistence needs were significantly less likely to report fishing as an occupation. When assessing the importance of fishing to inland rural communities for the purposes of rural planning and policy development, relying solely on census‐style occupation or employment data will misrepresent the contributions of subsistence fishing to household welfare.
High antibiotic resistance of Helicobacter pylori and its effect on tailored and empiric eradication of the organism in Lower Silesia, Poland
Authors: Ferenc Stanisław , Gnus Jan , Kościelna Magdalena , Kinda Małgorzata , Yarka Andriy , Stewart Luke , Witkiewicz Wojciech
Published: November 2016

Background

At present, the resistance to antibiotics is considered the most important reason for Helicobacter pylori (HP) eradication failure. The aim of this study was to estimate the prevalence of antimicrobial resistance of HP strains and to evaluate tailored and empiric therapeutic regimens in patients with peptic ulcer disease associated with infection of this microorganism.

Materials and Methods

Between May 2011 and February 2013, 185 consecutive Polish patients with at least one positive Helicobacter pylori test (urease test, histopathologic examination, and/or culture) underwent eradication therapy. Those with positive culture were prescribed a tailored triple regimen, whereas those with no culture available received an empiric quadruple concomitant regimen or levofloxacin—containing triple therapy.

Results

There were no HP strains resistant to amoxicillin; however, 56.7% were resistant to metronidazole, 55.2% to clarithromycin, and 5.9% to levofloxacin. Dual resistance was detected in 32.8% of individuals. Tailored and empiric therapies achieve cure rates, respectively, 95.5% and 86.6% by intention‐to‐treat and 95.5% and 91.3% by per‐protocol analysis (P > 0.05).

Conclusions

Antibiotic resistance is notably high in Poland currently, but both tailored and empiric therapies can achieve acceptable cure rates equal to or higher than 90%.
Intraductal papillary mucinous neoplasms of the pancreas: reporting clinically relevant features
Authors: Del Chiaro Marco , Verbeke Caroline
Published: November 2016

Intraductal papillary mucinous neoplasms (IPMNs) of the pancreas can exhibit a wide spectrum of macroscopic and microscopic appearances. This not only causes occasional difficulties for the reporting pathologist in distinguishing these tumours from other lesions, but is also relevant clinically. As evidence accumulates, it becomes clear that multiple macroscopic and histological features of these neoplasms are relevant to the risk for malignant transformation and, consequently, of prime importance for clinical patient management. The need for detailed reporting is therefore increasing. This review discusses the panoply of gross and microscopic features of IPMN as well as the recommendations from recent consensus meetings regarding the pathology reporting on this tumour entity.
People, processes, and systems: An observational study of the role of technology in rural youth mental health services
Authors: Orlowski Simone , Lawn Sharon , Matthews Ben , Venning Anthony , Jones Gabrielle , Winsall Megan , Antezana Gaston , Bidargaddi Niranjan , Musiat Peter
Published: November 2016

The merits of technology‐based mental health service reform have been widely debated among academics, practitioners, and policy makers. The design of new technologies must first be predicated on a detailed appreciation of how the mental health system works before it can be improved or changed through the introduction of new products and services. Further work is required to better understand the nature of face‐to‐face mental health work and to translate this knowledge to computer scientists and system designers responsible for creating technology‐based solutions. Intensive observation of day‐to‐day work within two rural youth mental health services in South Australia, Australia, was undertaken to understand how technology could be designed and implemented to enhance young people's engagement with services and improve their experience of help seeking. Data were analysed through a lens of complexity theory. Results highlight the variety of professional roles and services that can comprise the mental health system. The level of interconnectedness evident in the system contrasted with high levels of service self‐organization and disjointed information flow. A mental health professional's work was guided by two main constructs: risk and engagement. Most clients presented with a profile of disability, disadvantage, and isolation, so complex client presentations and decision‐making were core practices. Clients (and frequently, their families) engaged with services in a crisis‐dependent manner, characterized by multiple disengagements and re‐engagements over time. While significant opportunities exist to integrate technology into existing youth mental health services, technologies for this space must be usable for a broad range of medical, psychological and cognitive disability, social disadvantage, and accommodate repeat cycles of engagement/disengagement over time.
The effectiveness of the COPE healthy lifestyles TEEN program: a school‐based intervention in middle school adolescents with 12‐month follow‐up
Authors: Ardic Aysun , Erdogan Semra
Published: November 2016

Aim

The goal of this study is to assess the applicability and long‐term effectiveness of the T‐COPE Healthy TEEN program on adolescent health.

Background

Obesity and mental health disorders are major public health problems in adolescents. In this context, including long‐term and multiple behavioural obesity prevention programs are becoming increasingly important.

Design

A quasi‐experimental design with pre‐test/post‐test control group and repeated measurements.

Methods

Eighty‐seven (45 in intervention group, 42 in control group) adolescents were included from two different middle schools in the intervention program. The data were analysed by using descriptive statistics, Pearson chi‐square, Fisher's exact test, Student‐t test, repeated measures of variance analysis and Cohen's d effect size.

Results

No significant difference was found between the intervention and control groups in terms of descriptive characteristics, behavioural and cognitive variables of the adolescents. Following the intervention, the adolescents in intervention groups showed improvements in nutritional behaviour, physical activity and stress management. These improvements concerned increased physical walking measured in the number of physical steps per week daily fruit and vegetable consumption and the daily quantity of water ingested. While their nutrition/physical activity knowledge significantly increased, their weight and anxiety symptoms significantly decreased. The effect of the program on body mass index, depression and health beliefs of the adolescents were not significant compared with the control group.

Conclusion

The applicability of the T‐COPE Healthy TEEN program on Turkish adolescents and its effectiveness on their health behaviours, nutrition and physical activity knowledge and stress management were revealed in this study.
Effectiveness of supporting intensive care units on implementing the guideline ‘End‐of‐life care in the intensive care unit, nursing care’: a cluster randomized controlled trial
Authors: Noome Marijke , Dijkstra Boukje M. , van Leeuwen Evert , Vloet Lilian C.M.
Published: November 2016

Aim

The aim of this study was to examine the effectiveness of supporting intensive care units on implementing the guidelines.

Background

Quality of care can be achieved through evidence‐based practice. Guidelines can facilitate evidence‐based practice, such as the guidelines ‘End‐of‐life care in the intensive care unit, nursing care’. Before intensive care nurses are able to use these guidelines, they needs to be implemented in clinical practice. Implementation is a complex process and may need support.

Design

Cluster randomized controlled trial.

Methods

Intensive care nurses of eight intensive care units in the intervention group followed a supportive programme that educated them on implementation, strategies, goals, project management and leadership. The intervention group focused on a stepwise approach to implement the guidelines. The control group (n = 5) implemented the guidelines independently or used the standard implementation plan supplementary to the guideline. The effectiveness of the programme was measured using questionnaires for nurses, interviews with nurses and a questionnaire for family of deceased patients, in the period from December 2014–December 2015.

Results

Overall, an increase in adherence to the guidelines was found in both groups. Overall, use of the guidelines in the intervention group was higher, but on some aspects the control group showed a higher score. Care for the patient and the overall nursing care scored significantly higher according to family in the intervention group.

Conclusion

The increase in adherence to the guidelines and the significantly higher satisfaction of family in the intervention group indicate that the supportive programme had a more positive effect.
Maternal Sensitivity in Mothers with Mild Intellectual Disabilities is Related to Experiences of Maltreatment and Predictive of Child Attachment: A Matched‐Comparison Study
Authors: Lindberg Lene , Fransson Mari , Forslund Tommie , Springer Lydia , Granqvist Pehr
Published: November 2016

Background

Scientific knowledge on the quality of caregiving/maternal sensitivity among mothers with mild intellectual disabilities (ID) is limited and subject to many methodological shortcomings, but seems to suggest that these mothers are less sensitive than mothers without intellectual disabilities.

Methods

In this matched‐comparison study (N = 48), the present authors observed maternal sensitivity for 20 min in four different laboratory play situations. The study also included semi‐structured interviews to assess maternal experiences of maltreatment and child attachment.

Results

The present authors found significantly lower sensitivity among mothers with intellectual disabilities than among a comparison group of mothers without intellectual disabilities. Among mothers with intellectual disabilities, low sensitivity was related to maternal experiences of maltreatment and predictive of disorganized child attachment. In the comparison group, high maternal sensitivity was related to partner presence and social support, and predictive of child intelligence.

Conclusions

The present authors highlight the importance of attending to intellectual disabilities mothers' history of receiving care to understand their capacity for giving adequate care.
Parents with Intellectual Disabilities Experiencing Challenging Child Routines: A Pilot Study Using Embedded Self‐Determination Practices
Authors: Knowles Christen , Blakely Allison , Hansen Sarah , Machalicek Wendy
Published: November 2016

Background

Practices to facilitate self‐determination have not received appropriate attention in research concerning parents with intellectual disabilities (ID). Likewise, parenting interventions for adults with intellectual disabilities have seldom observed both parent and child behavioural outcomes.

Methods

This study evaluated the effectiveness of a parenting intervention embedded with self‐determination facilitation practices for two dyads of a parent with intellectual disabilities and their young child. The interventions focused on increasing parents’ ability to correctly implement steps of a parenting routine while reducing occurrence of challenging child behaviour.

Results

The results of the study demonstrated two basic effects of correctly completed steps of the parenting routine and a reduction of challenging child behaviour. Parents also reported decreased feelings of stress during the routine following completion of the intervention.

Conclusions

Implications for future research and replication of this pilot study are discussed.
Good Enough Support? Exploring the Attitudes, Knowledge and Experiences of Practitioners in Social Services and Child Welfare Working with Mothers with Intellectual Disability
Authors: Strnadová Iva , Bernoldová Jana , Adamčíková Zdeňka , Klusáček Jan
Published: November 2016

Background

This study examined the attitudes, knowledge and experiences of practitioners in social services and child welfare working with mothers with intellectual disability.

Method

The authors used a national survey, which was completed by 329 participants. Descriptive statistics and frequency tables were generated, and the associations between variables and differences between various subgroups of the sample were made. The open questions were analysed using the processes involved in content analysis.

Results

The findings indicated that the participants had limited knowledge of available supports and services for mothers with intellectual disability. Furthermore, many participants believed that mothers with intellectual disability should have an abortion should they become pregnant. The findings show practitioners' stereotyped attitudes towards mothers with intellectual disability.

Conclusions

Workers in the area of social services and child welfare need access to training and professional development in the area of supporting mothers with intellectual disability.
Regulatory non‐coding RNAs in acute myocardial infarction
Authors: Guo Yuan , Luo Fei , Liu Qiong , Xu Danyan
Published: November 2016

Acute myocardial infarction (AMI) is one of the most common cardiovascular diseases that leads to high mortality and morbidity globally. Various therapeutic targets for AMI have been investigated in recent years, including the non‐coding RNAs (ncRNAs). NcRNAs, a class of RNA molecules that typically do not code proteins, are divided into several subgroups. Among them, microRNAs (miRNAs) are widely studied for their modulation of several pathological aspects of AMI, including cardiomyocyte apoptosis, inflammation, angiogenesis and fibrosis. It has emerged that long ncRNAs (lncRNAs) and circular RNAs (circRNAs) also regulate these processes via interesting mechanisms. However, the regulatory functions of ncRNAs in AMI and their underlying functional mechanisms have not been systematically described. In this review, we summarize the recent findings involving ncRNA actions in AMI and briefly describe the novel mechanisms of these ncRNAs, highlighting their potential application as therapeutic targets in AMI.
Delirium: A Survey of Healthcare Professionals’ Knowledge, Beliefs, and Practices
Authors: Sinvani Liron , Kozikowski Andrzej , Pekmezaris Renee , Akerman Meredith , Wolf‐Klein Gisele
Published: November 2016

Objectives

To evaluate knowledge, beliefs, and practices regarding delirium of physicians, nurse practitioners (NPs), and registered nurses (RNs).

Design

Anonymous cross‐sectional paper survey.

Setting

New York metropolitan area tertiary care hospital.

Participants

RNs, NPs, and physicians (N = 164).

Measurements

The survey assessed knowledge, beliefs, and practices regarding delirium and prior delirium or geriatric training.

Results

Of the 200 surveys distributed, 164 were completed (82% response rate). Of these, 61.7% were RNs, 13.6% were NPs, and 20.7% were physicians. Mean participant age was 36.3. The majority (80.1%) were female; 56.5% were white, 18.1% Asian, 8.7% Hispanic, 8.0% black, and 8.7% other. Of the seven potential barriers to delirium screening assessed, the three most frequently reported were lack of conceptual understanding of delirium (48.0%), similarity of delirium and dementia (41.4%), and the fluctuating nature of delirium (38.1%). Physicians were more likely than NPs and RNs to report being confident in identifying delirium (P = .002) and to score higher on the delirium knowledge assessment (P < .001). Participants who received geriatrics training were significantly more likely than those who did not to be confident in identifying delirium (P = .005) and to score higher on overall delirium knowledge assessment (P = .003).

Conclusion

Geriatric training is associated with more confidence in delirium screening and higher delirium knowledge scores. There is an urgent need to broaden the approach to delirium education of nurses and physicians caring for hospitalized older adults using comprehensive multidisciplinary geriatric educational models.
Association of Multimorbidity with Mortality and Healthcare Utilization in Chronic Kidney Disease
Authors: Bowling C. Barrett , Plantinga Laura , Phillips Lawrence S. , McClellan William , Echt Katharina , Chumbler Neale , McGwin Gerald , Vandenberg Ann , Allman Richard M. , Johnson Theodore M.
Published: November 2016

Objectives

Chronic kidney disease (CKD) almost universally occurs in individuals with other medical problems. However, few studies have described CKD‐related multimorbidity using a framework that identifies chronic conditions as concordant (having overlap in treatment goals) versus discordant (having opposing treatment recommendations) and unrelated (having no overlap, but contributing to complexity via different resource requirements).

Design

Retrospective cohort.

Setting

Veterans Affairs (VA) Medical Centers.

Participants

VA patients (n = 821,334) ages 18–100 years with at least one outpatient visit and incident CKD defined as an estimated glomerular filtration rate <60 mL/min/1.73 m2 for at least 3 months between January 1, 2005 and December 31, 2008 after excluding prevalent CKD.

Measurements

We determined the associations of number of chronic conditions (1, 2, 3, 4, 5, 6 or more) stratified by the presence of one or more discordant/unrelated conditions with mortality, hospitalizations and emergency department (ED) visits.

Results

There were 381,187 deaths over 6.8 median years of follow‐up. Higher risks of death, hospitalization and ED visits were associated with higher number of chronic conditions, among those with and without discordant/unrelated conditions. However, the magnitudes of the associations were consistently larger when at least one discordant/unrelated condition was present. For example, compared to patients with one concordant condition, patients with six or more concordant conditions had an age‐, race‐ and sex‐adjusted hazard ratio (HR) for mortality of 1.72 (95% CI 1.64–1.80) whereas those with six or more conditions, at least one of which was discordant/unrelated, had a HR of 2.05 (2.01–2.09) (P‐interaction <0.001).

Conclusions

The presence of one or more discordant/unrelated conditions was associated with increased risk for adverse health outcomes, beyond the effect of multimorbidity.
The effects of spaced retrieval training in improving hyperphagia of people living with dementia in residential settings
Authors: Hsu Chia‐Ning , Lin Li‐Chan , Wu Shiao‐Chi
Published: November 2016

Aims and objectives

To investigate the effectiveness of spaced retrieval for improving hyperphagia in patients with dementia in residential care settings.

Background

Although 10–30% of patients with dementia have hyperphagia, most studies have focused on eating difficulties. Only a few studies have focused on hyperphagia. Various memory problems cause hyperphagia in patients with dementia. Spaced retrieval, a cognitive technique for information learning, can be used as a training method to improve memory loss. Recent studies showed that patients who received the training successfully memorised information learned in the training and correctly applied it to their daily lives.

Study design

Single‐blind experiments were performed.

Methods

The 97 subjects with dementia were recruited from seven institutions. All research participants were stratified into three groups according to cognitive impairment severity and Hyperphagic Behavior Scale scores and then randomly assigned to the experimental and control groups. The experimental group received a six‐week one‐by‐one spaced retrieval training for hyperphagia behaviour. The control group received routine care.

Results

After the intervention, the frequency and severity of hyperphagia in the patients with dementia, and food intake were significantly lower in the experimental group than in the control group. However, body mass index did not significantly differ.

Conclusion

Our results suggest that the spaced retrieval training could decrease the frequency and severity of hyperphagia in patients with dementia. The content of this training programme is consistent with the normal manner of eating in daily life and is easy for patients to understand and perform. Therefore, it can be applied in residents’ daily lives.

Relevance to clinical practice

This study confirms the efficacy of the spaced retrieval training protocol for hyperphagia in patients with dementia. In future studies, the follow‐up duration can be increased to determine the long‐term effectiveness of the intervention.
The Effects of DWI‐Infarct Lesion Volume on DWI‐FLAIR Mismatch: Is There a Need for Size Stratification?
Authors: Payabvash Seyedmehdi , Taleb Shayandokht , Benson John C. , Rykken Jeffrey B. , Oswood Mark C. , McKinney Alexander M. , Hoffman Benjamin
Published: November 2016

BACKGROUND

The lack of fluid‐attenuated inversion‐recovery (FLAIR) hyperintensity in areas of diffusion‐weighted imaging (DWI) high signal, or DWI‐FLAIR mismatch, is a potential imaging biomarker for timing of stroke onset. We aimed to determine the effects of DWI infarct lesion volume on DWI‐FLAIR mismatch and its accuracy for identification of strokes within intravenous (IV) the thrombolytic therapy window.

METHODS

Acute ischemic stroke patients with magnetic resonance imaging scan within 12 hours of witnessed stroke were included. Two neuroradiologists independently reviewed DWI and FLAIR sequences for DWI‐FLAIR mismatch in areas of restricted diffusion compared to the contralateral normal side.

RESULTS

DWI‐FLAIR mismatch was identified in 21/82 (26%) patients. Infarct lesions with DWI‐FLAIR mismatch were scanned earlier (3.8 ± .3 vs. 7.5 ± .3 hours from onset, P < .001) and were smaller in size (8.9±2.3 vs. 43.1±11.9 mL, P = .007) compared to lesions without mismatch. Multivariate regression analysis showed a significant interaction between lesion volume and time‐from‐onset in relationship with the presence of DWI‐FLAIR mismatch (P = .045). The presence of DWI‐FLAIR mismatch had 56% sensitivity, 83% specificity, 48% positive predictive value (PPV), and 87% negative predictive value (NPV) for identification of infarction within 4.5 hours of symptom onset; while for infarct lesions >15 mL, the DWI‐FLAIR mismatch had 100% specificity and PPV for acute infarcts within 4.5 hours of onset.

CONCLUSION

The effects of stroke onset‐to‐scan time gap on DWI‐FLAIR mismatch are not the same for different DWI lesion volumes. At DWI lesion volumes >15 mL, the DWI‐FLAIR mismatch is highly specific for acute infarcts within IV thrombolytic therapy time, and can identify wake‐up stroke patients eligible for treatment.