bluuebunny/crossref_metadata_2025 huggingface dataset:
Antimicrobial stewardship: a Canadian perspective
Authors: Rennert-May Elissa , Conly John
Published: August 2016

Purpose

– The purpose of this paper is to explore the current state of antimicrobial stewardship implementation and development within Canada at both a federal and provincial level.

Design/methodology/approach

– Narrative review.

Findings

– There have been several prominent conferences and reports in Canada regarding the development and implementation of antimicrobial stewardship programs over the past two decades. However, despite the knowledge that there is a need for standardization of programs across Canada with accurate mechanisms and infrastructure in place for implementation and evaluation of these programs, there is still a lack of consistency across the country. In addition pharmacy information regarding inpatient and outpatient antimicrobial use is not uniformly reliable. Recently, the Public Health Agency of Canada using the Pan-Canadian Public Health Network as a vehicle organized a task group to help facilitate the working relationships among the provincial, territorial and federal governments in terms of implementing antimicrobial stewardship programs. This network has the potential to enhance and standardize programs across the country.

Originality/value

– This paper looks at Canadian policy regarding antimicrobial stewardship at a federal as well as provincial level. Historic conferences, reports and discussions are highlighted emphasizing the progressive changes over the past two decades and highlight many of the challenges that Canada continues to face.
Antimicrobial stewardship in Tanzania
Authors: Eliakimu Eliudi
Published: August 2016

Purpose

– Worldwide situation analysis on antimicrobial resistance (AMR) released in 2015 by the World Health Organisation (WHO) has revealed inadequate capability to respond to AMR in African region. Report of antibiotics use and resistance in Tanzania revealed rising levels of healthcare associatedMethicilin Resistant Staphylococcus aureusinfections; while other studies have reported high prevalence of Expanded Spectrum Beta-Lactamase (ESBL). The purpose of this paper is to review the current situation of antimicrobial stewardship (AMS) in Tanzania using strengths, weaknesses, opportunities and challenges (SWOC) analysis.

Design/methodology/approach

– General literature review was done on use of antimicrobials in Google Scholar, websites of key organisations including WHO, and grey literature. Conceptual framework designed by the authors was used to inform SWOC analysis of the Tanzanian health sector.

Findings

– The SWOC analysis has revealed much strength in the Tanzanian health sector indicating that increasing investments in laboratory services, in medicines Regulatory Authority and Pharmacy Council, and strengthening management teams at all levels of service delivery, including Medicines and Therapeutics Committees; and strengthening advocacy on rational use of antimicrobials both in humans and livestock will improve AMS.

Research limitations/implications

– This is a general literature review. No interview of experts or use of questionnaires was used. However, based on the literature found and author’s experience in the health sector, the information contained is valid for consideration in making policy decisions about AMR in Tanzania.

Practical implications

– Designing policy interventions to prevent development of AMR to commonly used antimicrobials.

Social implications

– Improving social wellbeing in the community through prevention of morbidity and mortality resulting from multi-resistant pathogens.

Originality/value

– This is the authors original idea backed by available literature.
UK initiatives to reduce antimicrobial resistant infections, 2013-2018
Authors: Hopkins Susan
Published: August 2016

Purpose

– The purpose of this paper is to highlight the local, national and global actions from the UK to reduce the impact of antimicrobial resistance (AMR) on human health.

Design/methodology/approach

– Synthesis of UK government policy, surveillance and research on AMR.

Findings

– Activities that are taking place by the UK government, public health and professional organisations are highlighted.

Originality/value

– This paper describes the development and areas for action of the UK AMR strategy. It highlights the many interventions that are being delivered to reduce antibiotic use and antimicrobial resistant infections.
IJHG review
Authors: MacVane Phipps Fiona
Published: August 2016

Purpose

– The purpose of this paper is to provide an overview and commentary on the articles contained in the current issue of the journal.

Design/methodology/approach

– The review is prepared by the review editor to highlight key points within each paper.

Findings

– Enables readers to scan content and select articles of most interest or relevance to their needs.

Originality/value

– The IJHG is the only Emerald journal with a review section of this type and therefore makes a unique contribution to the content of the journal.
Next‐generation tropical forests: reforestation type affects recruitment of species and functional diversity in a human‐dominated landscape
Authors: Wills Jarrah , Herbohn John , Moreno Maria Opelia Maranguit , Avela Mayet S. , Firn Jennifer
Published: August 2016

In tropical countries where little natural forest remains, such as the Philippines, small‐holder monocultures and mixed‐species plantations potentially provide conservation values by providing habitat for local fauna and recruiting diverse understorey species. However, little information exists as to whether monocultures offer a framework to kick‐start understorey species recruitment and how this compares to mixtures.

In this study, species and trait diversity were measured within the understories of three different forest types on the Island of Leyte, Philippines: mixed‐species forests (known as ‘Rainforestation Farming’), Swietenia macrophylla monocultures and regenerating selectively logged forests. All plants less than 2 m in height were identified, and dispersal type, fruit type, seed and fruit size were extracted from literature and online data bases.

We found that overall seedling richness and diversity were lower within the monoculture forests compared with the regenerating selectively logged forests, with the Rainforestation forests showing intermediate seedling diversity, including trait diversity. Monoculture understories had a higher proportion of large fruited domesticated species that are likely dispersed by people and significantly lower wind‐dispersed native seedlings than the other forest types. Higher understorey diversity was generally negatively correlated with soil nutrients and positively correlated with increased leaf area index, that is more canopy cover.

Our results confirm that mixed‐species plantations and regenerating selectively logged forests recruit higher species diversity, but we also found evidence that monocultures can recruit diverse species in the understorey. However, monoculture understories were depauperate of native wind‐dispersed traits that are often important emergent species in tropical rain forests.

Synthesis and applications. Overall, our results show that just having trees in a cleared landscape provides conservation value, but if monocultures are used as less costly and technically simpler solutions for initiating recruitment, then wind‐dispersed native species (e.g. species from the Dipterocarpaceae family) in addition to other limited functional traits (e.g. large‐seeded species) should be planted to enhance long‐term survival of ecologically significant native tree populations.
Assembly dynamics of a forest bird community depend on disturbance intensity and foraging guild
Authors: Kroll Andrew J. , Verschuyl Jake , Giovanini Jack , Betts Matthew G.
Published: August 2016

Tree plantations occur globally and are often promoted as a strategy to supply wood products for an expanding human population while reducing pressure on natural forests. Herbicides can accelerate growth of crop trees by suppressing competing vegetation, but little information is available about potential trade‐offs with early seral biodiversity resulting from more intensive management.

Using data collected over 5 years immediately following stand‐replacing disturbance (clear‐felling), we used a large‐scale experiment to test how environmental filtering influences dynamics of avian community assembly. We evaluated avian responses to three levels of plant cover reduction (light, moderate and intensive herbicide applications) in relation to a control without herbicide. Under the environmental filtering hypothesis, we expected reduced avian species richness and higher turnover as broadleaf plant cover decreases with increasing management intensity. We predicted that the most intensive treatments would exert strong negative effects on leaf‐gleaning insectivores, including several species of conservation concern due to long‐term population declines.

Richness of leaf‐gleaning bird species was reduced by 23–52% over the 5 years on moderate (standard practice) vs. control treatments, but effects were substantially smaller for the non‐leaf‐gleaner guild in years 1–4 (8–25%) and disappeared by year 5 (0%). Both leaf‐gleaner and non‐leaf‐gleaner functional groups continued to colonize moderate and intensive treatments at higher probabilities than the control in Year 5 (range: 0·17–0·29), likely due to rapid vegetation recovery after herbicide applications ceased. Planted conifers were >35% taller and >70% larger in diameter in the two most intensive treatments, leading to substantially more wood volume produced per unit area than on stands without herbicide applications.

Synthesis and applications. Under current management regimes, stand‐level trade‐offs between conservation of avian diversity and production of wood commodities may be less severe than previously recognized. However, in landscapes where biodiversity conservation rather than wood production is the primary goal, managers can adjust the trade‐off by making relatively small reductions in herbicide use that should have positive impacts on richness of leaf‐gleaning insectivorous birds.
Systemic RNAi in western corn rootworm, Diabrotica virgifera virgifera, does not involve transitive pathways
Authors: Li Huarong , Bowling Andrew J. , Gandra Premchand , Rangasamy Murugesan , Pence Heather E. , McEwan Robert E. , Khajuria Chitvan , Siegfried Blair D. , Narva Kenneth E.
Published: August 2016

Western corn rootworm (WCR, Diabrotica virgifera virgifera LeConte) is highly sensitive to orally delivered double‐stranded RNA (dsRNA). RNAi in WCR is systemic and spreads throughout the insect body. This raises the question whether transitive RNAi is a mechanism that functions in WCR to amplify the RNAi response via production of secondary siRNA. Secondary siRNA production is achieved through RNA‐dependent RNA polymerase (RdRP) activity in other eukaryotic organisms, but RdRP has not been identified in WCR and any other insects. This study visualized the spread of the RNAi‐mediated knockdown of Dv v‐ATPase C mRNA throughout the WCR gut and other tissues using high‐sensitivity branched DNA in situ hybridization. Furthermore, we did not detect either secondary siRNA production or transitive RNAi in WCR through siRNA sequence profile analysis. Nucleotide mismatched sequences introduced into either the sense or antisense strand of v‐ATPase C dsRNAs were maintained in siRNAs derived from WCR fed with the mismatched dsRNAs in a strand specific manner. The distribution of all siRNAs was restricted to within the original target sequence regions, which may indicate the lack of new dsRNA synthesis leading to production of secondary siRNA. Thus, the systemic spread of RNAi in WCR may be derived from the original dsRNA molecules taken up from the gut lumen. These results indicate that the initial dsRNA dose is important for a lethal systemic RNAi response in WCR and have implications in developing effective dsRNA traits to control WCR and in resistance management to prolong the durability of RNAi trait technology.
Safety of atorvastatin in Asian patients within clinical trials
Authors: Chan Juliana C. N. , Kong Alice P. S. , Bao Weihang , Fayyad Rana , Laskey Rachel
Published: August 2016

Introduction

Data on statin safety in Asian patients are limited compared with evidence from Western populations.

Aim

This study assessed atorvastatin safety among Asian patients enrolled in 58 randomized clinical trials.

Methods

Data from 52 short‐term trials (median exposure 4–72 weeks) and six long‐term cardiovascular outcomes trials (median exposure 3.1–4.9 years) conducted across the atorvastatin 10–80‐mg dose range were analyzed retrospectively to assess the incidence of safety endpoints.

Results

A total of 77 952 patients were identified (49 974 received atorvastatin), among whom 3191 were Asian (2519 received atorvastatin). In the short‐term trials, the incidence of all‐causality adverse events (AEs) and serious AEs (SAEs) in Asian patients treated with atorvastatin was similar to or lower than that observed with other statins or placebo, and discontinuations due to treatment‐related AEs/SAEs were infrequent (2.0% across all doses). These observations were confirmed in the long‐term trials. Treatment‐related SAEs were rare (n = 4) among Asian patients receiving atorvastatin. No cases of rhabdomyolysis were observed in atorvastatin‐treated Asian patients, and the incidence of myalgia was 1.8% in the short‐term studies and 6.7% in the long‐term trials. Elevations (>3× the upper limit of normal) in liver transaminases were observed in ~2% of Asian patients receiving atorvastatin; renal AEs occurred in <2%.

Conclusion

The incidence of AEs/SAEs with atorvastatin 10–40‐mg in patients of Asian origin was low and comparable to placebo. Further evaluation of atorvastatin 80‐mg is required owing to the limited number of Asian patients (n = 281; 11.2%) who received this dose.
Long‐lasting response to third‐line crizotinib treatment in a patient with non‐small cell lung cancer with brain metastases and poor performance status
Authors: Li De‐lan , Chen Xin‐ru , Ma Shu‐xiang , Chen Li‐kun
Published: August 2016

Identification of the anaplastic lymphoma kinase (ALK) gene has refined the classification of non‐small cell lung cancer (NSCLC) and promoted research on molecularly targeted drugs such as crizotinib, an ALK inhibitor with good efficacy, in ALK‐rearranged NSCLC. At present, few studies have reported the efficacy of crizotinib in patients with ALK‐rearranged NSCLC with brain metastases. In a patient with NSCLC harboring ALK‐rearrangement who had brain metastases and poor performance status (PS), we obtained a durable response with crizotinib administered following multi‐line chemotherapy regimens.
Safety of Computer Interpretation of Normal Triage Electrocardiograms
Authors: Hughes Katie E. , Lewis Scott M. , Katz Laurence , Jones Jonathan
Published: August 2016

Objectives

Frequent interruptions within the emergency department may lead to errors that negatively impact patient care. The immediate review of electrocardiograms (ECGs) obtained from triage patients is one source of interruption. Limiting triage ECGs requiring immediate attending review to those interpreted by the computer as abnormal may be one way to reduce interruption. We hypothesize that triage ECGs interpreted by the computer as “normal ECG” are unlikely to have clinical significance that would affect triage care.

Methods

All triage ECGs performed at the University of North Carolina were collected between November 14, 2014, and March 3, 2015, according to a standard nursing triage protocol using GE machines running Marquette 12SL software. Triage ECGs with a computer interpretation of “normal ECG” were compared to an attending cardiologist's final interpretation. Triage ECGs for which the cardiologist's interpretation differed from the computer interpretation of normal ECG were presented to two emergency physicians (EPs) blinded to the goals of the study. The physicians were asked to evaluate the ECG for clinical significance. Clinical significance was defined as any change from normal that would alter triage care. Triage ECGs were considered true negatives if either the cardiologist agreed with the normal computer interpretation or if both EPs agreed that the ECG did not show clinical significance.

Results

A total of 855 triage ECGs were collected over 16 weeks. A total of 222 (26%) were interpreted by the computer as normal. The negative predictive value for a triage ECGs interpreted by the computer as “normal” was calculated to be 99% (95% confidence interval = 97% to 99%). Of the ECGs with a computer interpretation of normal ECG, 13 had an interpretation by an attending cardiologist other than normal. Two attending EPs reviewed these triage ECGs. One of the 13 ECGs was found to have clinical significance that would alter triage care by one of the EPs. The stated triage intervention was “bed immediately.”

Conclusions

Our data suggest that triage ECGs identified by the computer as normal are unlikely to have clinical significance that would change triage care. Eliminating physician review of triage ECGs with a computer interpretation of normal may be a safe way to improve patient care by decreasing physician interruptions.
Goal‐directed Focused Ultrasound Milestones Revised: A Multiorganizational Consensus
Authors: Nelson Mathew , Abdi Amin , Adhikari Srikar , Boniface Michael , Bramante Robert M. , Egan Daniel J. , Matthew Fields J. , Leo Megan M. , Liteplo Andrew S. , Liu Rachel , Nomura Jason T. , Pigott David C. , Raio Christopher C. , Ruskis Jennifer , Strony Robert , Thom Chris , Lewiss Resa E.
Published: August 2016

In 2012 the Accreditation Council for Graduate Medical Education and the American Board of Emergency Medicine released the emergency medicine milestones. The Patient Care 12 (PC12) subcompetency delineates staged and progressive accomplishment in emergency ultrasound. While valuable as an initial framework for ultrasound resident education, there are limitations to PC12. This consensus paper provides a revised description of criteria to define the subcompetency. A multiorganizational task force was formed between the American College of Emergency Physicians Ultrasound Section, the Council of Emergency Medicine Residency Directors, and the Academy of Emergency Ultrasound of the Society for Academic Emergency Medicine. Representatives from each organization created this consensus document and revision.
Bone mineral density in women treated for various types of gynecological cancer
Authors: Lee Suk Woo , Yeo Seung Geun , Oh In‐Hwan , Yeo Joon Hyung , Park Dong Choon
Published: August 2016

Aim

Patients with gynecologic cancer frequently experience bone loss due to cancer treatments, including bilateral oophorectomy, chemotherapy and radiotherapy. This study evaluated treatment‐associated changes in bone mineral density (BMD) in women with gynecologic cancer and compared changes among patients with different types of gynecologic cancer.

Methods

BMD of the lumbar spine and femur was retrospectively analyzed using dual‐energy X‐ray absorptiometry in 118 women who underwent treatment for gynecological cancers and 132 women without gynecologic cancers. The cohort included 55 women with cervical cancer who underwent surgery followed by adjuvant chemotherapy and/or radiation therapy, 33 with endometrial cancer (EC) who underwent surgery followed by adjuvant radiation therapy and 30 with ovarian cancer who underwent bilateral oophorectomy followed by adjuvant platinum‐based chemotherapy. Lumbar spine and femoral neck BMD were assessed at baseline and 12 months after treatment. Areal BMD, expressed as grams of mineral/cm2 scanned, was compared with that in young healthy women (T‐score).

Results

Demographic characteristics and pretreatment BMDs, including T‐scores, did not differ among cancer types. After adjustment for factors that can affect T‐score, cancer type affected change in T‐score 12 months after treatment. After adjustment for pretreatment age, parity, BMI and T‐score, T‐score 12 months after treatment was significantly lower in the EC than in the other groups.

Conclusions

Women treated for gynecological cancer, particularly those with EC who undergo bilateral oophorectomy followed by adjuvant radiation therapy or chemotherapy, should be managed in a timely manner to prevent or minimize bone loss.
Continuous Pringle maneuver does not affect outcomes of patients with hepatocellular carcinoma after curative resection
Authors: Xu Wei , Xu Haifeng , Yang Huayu , Liao Wenjun , Ge Penglei , Ren Jinjun , Sang Xinting , Lu Xin , Zhong Shouxian , Mao Yilei
Published: August 2016

Aim

To investigate whether the use of continuous Pringle maneuver (PM) adversely impacts the outcome of patients with hepatocellular carcinoma (HCC).

Methods

From January 1989 to January 2011, 586 HCC patients who underwent curative resection in Peking Union Medical College Hospital were identified from the database. Continuous PM was performed in 290 patients (PM group), including 163 patients with a hepatic inflow occlusion time of <15 min (PM‐1 group) and 127 with 15–30 min (PM‐2 group). An additional 296 patients underwent partial hepatectomy without inflow occlusion (occlusion‐free, OF group).

Results

The PM group showed less estimated blood loss during hepatectomy than the OF group (P = 0.005) and the two groups experienced similar incidence of perioperative complications. There were no significant differences in either overall survival or disease‐free survival (DFS) between the PM and OF groups (P = 0.117 and 0.291, respectively), and between the PM‐1 and PM‐2 groups (P = 0.344 and 0.103, respectively). Hepatic inflow occlusion and occlusion time were not independent risk factors for OS or DFS.

Conclusions

Continuous PM effectively reduces intraoperative bleeding and does not adversely impact the outcomes of HCC patients. It remains a valuable tool in hepatic resection, even difficult, complicated resections requiring prolonged clamping times.
Gene expression of MAGE‐A3 and PRAME tumor antigens and EGFR mutational status in Taiwanese non–small cell lung cancer patients
Authors: Pan Szu‐Hua , Su Kang‐Yi , Spiessens Bart , Kusuma Nicole , Delahaye Nicolas F , Gruselle Olivier , Myo Aung , de Creus An , Louahed Jamila , Chang Gee‐Cheng , Yu Sung‐Liang , Yang Pan‐Chyr
Published: August 2016

Aim

To determine the frequency of expression of the tumor‐associated antigens (TAAs) melanoma‐associated antigen A3 (MAGE‐A3) and preferentially expressed antigen of melanoma (PRAME) and the rate of EGFR mutations in a Taiwanese non–small cell lung cancer (NSCLC) population including only adenocarcinomas and squamous cell carcinomas. Furthermore, to investigate associations between TAA expression and EGFR mutations and to evaluate these TAAs as prognostic markers for overall survival. The occurrence of single nucleotide polymorphisms in MAGEA3 and PRAME was also assessed.

Methods

Archival fresh‐frozen tumor tissue specimens were tested by quantitative reverse transcription polymerase chain reaction assays to detect MAGE‐A3 and PRAME expression. EGFR mutations were detected by mass spectroscopy and single nucleotide polymorphisms by gene sequencing.

Results

Of the 156 adenocarcinomas examined, 3.3% expressed MAGE‐A3, 32.2% expressed PRAME and 62.8% had EGFR mutations. Of the 128 squamous cell carcinomas, 29.8% expressed MAGE‐A3, 59.2% expressed PRAME and 20.5% harbored EGFR mutations. TAA expression was similar across subgroups determined by patient or tumor characteristics. There was no association between TAA expression and EGFR mutation status and TAA expression was found not to be a prognostic marker for survival. Single nucleotide polymorphisms were identified, one of which with a possible impact on MAGE‐A3 expression.

Conclusions

In this NSCLC population, expression of MAGE‐A3 and PRAME was more frequent in squamous cell carcinomas than in adenocarcinomas tumors. EGFR mutations were not associated with TAA expression for either histology and were three times more frequent in adenocarcinomas than in squamous cell carcinomas tumors.
Predictive value of maternal serum NF‐κB p65 and sTREM‐1 for subclinical chorioamnionitis in premature rupture of membranes
Authors: Wang Fan , Wang Yuhuan , Wang Rongyue , Qiu Haifan , Chen Lulu
Published: August 2016

Problem

The aim of this study was to investigate the levels of nuclear factor kappa B‐p65 (NF‐κB p65) and soluble triggering receptor expressed on myeloid cells‐1 (sTREM‐1) in maternal blood with premature rupture of membranes (PROM) and to assess their values for prediction of subclinical chorioamnionitis.

Method

NF‐κB p65 and sTREM‐1 levels were measured in maternal blood and cord blood by fluorescence quantitative RT‐PCR assay. According to the placental membranes pathological examination, pregnant women with PROM were divided into chorioamnionitis group (n=28) and non‐chorioamnionitis group (n=22).

Results

In the PROM group,the NF‐κB p65 and sTREM‐1 levels in maternal blood were significantly higher in women with chorioamnionitis than women without chorioamnionitis (P<.05). The cutoff value of maternal NF‐κB p65, sTREM‐1, C‐reactive protein (CRP), and WBC level were 6.73, 2.93, 6.75 mg/L, and 10.8×109/L, respectively, through analysis of the area under the ROC curve (AUC). The optimal combination test was detection of maternal blood NF‐κB p65 and CRP levels, which resulted in a sensitivity of 89.3% and a specificity of 72.7% for the prediction of subclinical chorioamnionitis.

Conclusion

Combined measurements of maternal NF‐κB p65 and CRP levels may be used as early biological indicators that predict subclinical chorioamnionitis in premature rupture of membranes.
Fundus autofluorescence lifetimes are increased in non‐proliferative diabetic retinopathy
Authors: Schmidt Johanna , Peters Sven , Sauer Lydia , Schweitzer Dietrich , Klemm Matthias , Augsten Regine , Müller Nicolle , Hammer Martin
Published: August 2016

Purpose

To discriminate non‐proliferative diabetic retinopathy (NPDR) patients from healthy controls by fluorescence lifetime imaging ophthalmoscopy (FLIO).

Methods

A prototype FLIO (Heidelberg‐Engineering, Heidelberg, Germany) was used to examine the retina of 33 patients and 28 controls. As increased fluorescence of the diabetic lens is known, the lenses of 34 patients and 24 controls were investigated as well. Time‐resolved decay was detected in two spectral channels (ch1: 498–560 nm, ch2: 560–720 nm) and approximated by a series of three exponential functions yielding in lifetimes (τ1, τ2, τ3), amplitudes (α1, α2, α3) and their amplitude‐weighted means (τm).

Results

Significant differences between patients and controls were found for all fundus lifetime components (τm, τ1‐τ3) as for the amplitude α3 in both spectral channels. Channel 1 showed the largest differences: the average of mean fluorescence lifetime τm in the macula was 259 ± 137 ps in the patients versus 147 ± 69 ps in the controls.

A logistic regression model allowed discrimination between study and control group with a sensitivity of 90.09% and a specificity of 71.4% (area under the curve: 0.865).

Significantly shorter τm in the patients group than in the control group was detected in channel 2 in the crystalline lens (1587 ± 326 ps versus 1854 ± 384 ps, p = 0.006).

Conclusions

Fundus Fluorescence lifetimes are significantly increased in NPDR while lens lifetimes are shorter in the patient group. Lifetime changes might be indicative for the accumulation of advanced glycation end products (AGEs) which enables detection of the disease with high sensitivity and specificity possibly bearing diagnostic merit.
Role of artificial tears in reducing the recurrence of pterygium after surgery: a prospective randomized controlled trial
Authors: Kampitak Kosol , Leelawongtawun Wichai , Leeamornsiri Supinda , Suphachearaphan Wannisa
Published: August 2016

Purpose

To determine whether artificial tears can reduce recurrence of pterygium after surgery.

Methods

A total of 128 primary pterygium cases after excision were randomized into two groups according to postoperative drugs: 64 cases received topical dexamethasone (control group), and 64 cases received topical dexamethasone and hydroxypropyl methylcellulose (treatment group). The pterygium was removed with amniotic membrane graft technique in all cases. Recurrence was observed within 6 months after surgery, and survival analysis was used to evaluate the difference between groups.

Results

There were no significant differences in age and gender of patients, size of pterygium, Schirmer's test results and tear breakup time between both groups (p > 0.05). Recurrence rate in the treatment group (16%) was significantly less than the control group (33%), p = 0.018 (log‐rank test).

Conclusion

Using artificial tears as an adjunctive drug could lower pterygium recurrence after excision.
Evaluation of circumferential angle closure using iridotrabecular contact index after laser iridotomy by swept‐source optical coherence tomography
Authors: Cho Hyun‐kyung , Ahn Dongsub , Kee Changwon
Published: August 2016

Purpose

To investigate the quantitative changes of circumferential angle closure after laser iridotomy (LI) using the iridotrabecular contact (ITC) index by Swept‐Source optical coherence tomography (OCT).

Methods

In this prospective observational study conducted in a hospital setting, 42 eyes of 36 patients (five males, 31 females) who underwent LI were included. The mean age was 65.00 ± 8.13 years old and the diagnosis included primary angle closure (PAC, 21 eyes), PAC suspect (16 eyes) and PAC glaucoma (five eyes). Optical coherence tomography (OCT) images were obtained pre‐LI and at 1 week post‐LI. In each image frame, the scleral spur (SS) and the ITC end‐point were marked, from which the ITC index was calculated as a percentage of the angle closure across 360°. Measurements inspected before and after LI included: central anterior chamber depth (ACD), anterior chamber volume (ACV), lens vault (LV), nasal and temporal angle opening distance (AOD), angle recess area (ARA), trabecular‐iris space area (TISA), trabecular‐iris angle (TIA) at 500 μm and 750 μm from the SS and intraocular pressure (IOP).

Results

The ITC index and IOP decreased significantly after LI from 71.52 ± 26.29 to 35.31 ± 27.19 and from 20.64 ± 12.72 mmHg to 14.02 ± 3.49 mmHg, respectively (p < 0.001 and p < 0.001). Central ACD (1.94 ± 0.31 mm pre‐LI) and LV (1.13 ± 0.32 mm pre‐LI) did not show a significant change after LI (all p > 0.05), but ACV increased significantly after LI (p < 0.001). Most of the angle parameters except for nasal TIAs increased significantly after LI (all p < 0.05).

Conclusion

The ITC index from patients with shallow anterior chamber angle showed a significant decrease after LI, but part of the angle closure was not relieved after LI. Other mechanisms besides pupillary block may play a role together in causing angle closure.
Translating child development research into practice: Can teachers foster children's theory of mind in primary school?
Authors: Bianco Federica , Lecce Serena
Published: August 2016

Background

Translating research findings into practice should be one of the objectives of developmental psychology. Recently, research demonstrated the existence of individual differences in theory of mind (ToM) during middle childhood that are crucial for children's academic and social adjustment.

Aims

This study aims to transfer the results of recent experimental studies on ToM interventions into primary‐school teachers’ practices. It examines whether a ToM training programme, based on conversations about mental states, can be effective under real‐world school conditions and if it can be translated in such a way that it becomes suitable for primary‐school teachers.

Sample

Seventy‐two 8‐ to 9‐year‐old children took part in the study. A total of four classes were recruited and randomly assigned to the experimental (34 children, 18 boys) or to the control condition (38 children, 18 boys).

Methods

The ToM group and the control group were matched at pre‐test for age, ToM, socio‐economic background, verbal ability, working memory, and planning. Teachers were trained in four teacher‐training sessions; the classroom‐training programme was delivered by teachers in four sessions (each 50 min long). Children were assessed before the intervention, after the end of the programme, and 2 months later.

Results

The ToM group improved ToM skills significantly more than the control group both in the short and in the long term.

Conclusions

Teachers can successfully promote their pupils’ ToM development during their regular teaching hours. Results are discussed in the light of the importance of ToM promotion for children's school adjustment.
Gestation‐specific changes in maternal thyroglobulin during pregnancy and lactation in an iodine‐sufficient region in China: a longitudinal study
Authors: Zhang Xiaowen , Li Chenyan , Mao Jinyuan , Wang Weiwei , Xie Xiaochen , Peng Shiqiao , Wang Zhaojun , Han Cheng , Zhang Xiaomei , Wang Danyang , Fan Chenling , Shan Zhongyan , Teng Weiping
Published: August 2016

Objectives

To describe the changes in thyroglobulin (Tg) based upon gestational and postpartum concentrations in healthy pregnant women from an iodine‐sufficient region in China, and to evaluate the use of Tg as a biomarker for iodine‐sufficient pregnant women.

Design

A longitudinal study of Tg change in normal pregnant women from an iodine‐sufficient region.

Patients and measurements

Blood and urine samples were obtained from 133 pregnant women. Urinary iodine concentration (UIC) was measured using an ammonium persulfate method. Serum iodine concentration was required by inductively coupled plasma mass spectrometry (ICP‐MS). Serum thyroid‐stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), total thyroxine (TT4), total triiodothyronine (TT3), antithyroid peroxidase antibody (TPOAb), antithyroglobulin antibody (TgAb) and Tg were measured using an electrochemiluminescence immunoassay.

Results

Thyroglobulin concentrations were higher in early pregnancy (pregnancy at 8 weeks vs nonpregnancy: 11·42 ng/ml vs 8·8 ng/ml, P < 0·01) and maintained a stable level, and then increased greatly at the 36th week. After delivery, Tg decreased to nonpregnant levels. During pregnancy, maternal Tg was not correlated with thyroid function, UIC or urine iodine–creatinine ratio (UI/Cr). Cord blood Tg was much higher compared to maternal Tg levels at the 36w (57·34 vs 14·86 ng/ml, P < 0·001) and correlated positively with cord FT4 (r = 0·256, P < 0·05), cord TT4 (r = 0·263, P < 0·05) and maternal UI/Cr at 36w (r = −0·214, P < 0·05).

Conclusions

Our work demonstrates that Tg is elevated during pregnancy, and the effect of pregnancy should be taken into consideration when Tg is used as a biomarker for the iodine status. Cord blood Tg is much higher than maternal Tg levels at the 36w and is correlated with maternal iodine status.
Predictors of specialist avifaunal decline in coastal marshes
Authors: Correll Maureen D. , Wiest Whitney A. , Hodgman Thomas P. , Shriver W. Gregory , Elphick Chris S. , McGill Brian J. , O'Brien Kathleen M. , Olsen Brian J.
Published: August 2016

Coastal marshes are one of the world's most productive ecosystems. Consequently, they have been heavily used by humans for centuries, resulting in ecosystem loss. Direct human modifications such as road crossings and ditches and climatic stressors such as sea‐level rise and extreme storm events have the potential to further degrade the quantity and quality of marsh along coastlines. We used an 18‐year marsh‐bird database to generate population trends for 5 avian species (Rallus crepitans, Tringa semipalmata semipalmata, Ammodramus nelsonii subvirgatus, Ammodramus caudacutus,andAmmodramus maritimus) that breed almost exclusively in tidal marshes, and are potentially vulnerable to marsh degradation and loss as a result of anthropogenic change. We generated community and species trends across 3 spatial scales and explored possible drivers of the changes we observed, including marsh ditching, tidal restriction through road crossings, local rates of sea‐level rise, and potential for extreme flooding events. The specialist community showed negative trends in tidally restricted marshes (−2.4% annually from 1998 to 2012) but was stable in unrestricted marshes across the same period. At the species level, we found negative population trends in 3 of the 5 specialist species, ranging from −4.2% to 9.0% annually. We suggest that tidal restriction may accelerate degradation of tidal marsh resilience to sea‐level rise by limiting sediment supply necessary for marsh accretion, resulting in specialist habitat loss in tidally restricted marshes. Based on our findings, we predict a collapse of the global population of Saltmarsh Sparrows (A. caudacutus) within the next 50 years and suggest that immediate conservation action is needed to prevent extinction of this species. We also suggest mitigation actions to restore sediment supply to coastal marshes to help sustain this ecosystem into the future.
Impact of fetal growth restriction on neurodevelopmental outcome at 2 years for extremely preterm infants: a single institution study
Authors: El Ayoubi Mayass , Patkai Juliana , Bordarier Cécile , Desfrere Luc , Moriette Guy , Jarreau Pierre‐Henri , Zeitlin Jennifer
Published: August 2016

Aim

We evaluated the impact of fetal growth restriction on neurodevelopmental outcomes at 2 years corrected age for infants born before 27 weeks gestational age.

Method

Data on infants born before 27 weeks gestational age between 1999 and 2008 (n=463), admitted to a tertiary neonatal unit in Paris, were used to compare neurological outcomes at 2 years for infants with birthweight lower than the 10th centile and birthweight of at least the 10th centile, using intrauterine reference curves. Outcomes were cerebral palsy (CP) and the Brunet‐Lézine assessment of cognitive development, which provides age‐corrected overall and domain‐specific (global and fine motor skills, language and social interaction) developmental quotients. Models were adjusted for perinatal and social factors.

Results

Seventy‐two percent of infants were discharged alive. Eighty‐three percent (n=268) were evaluated at 2 years. Six percent had CP. Fetal growth restriction was not associated with the risk of CP. After adjustment, children with a birthweight lower than the 10th centile had a global developmental quotient 4.7 points lower than those with birthweight of at least the 10th centile (p<0.001); differences were greatest for fine motor and social skills (−4.7, p=0.053 and −7.3, p<0.001 respectively).

Interpretation

In extremely preterm children, fetal growth restriction was associated with poorer neurodevelopmental outcomes at 2 years, but not with CP.
Participation trajectories: impact of school transitions on children and adolescents with cerebral palsy
Authors: Imms Christine , Adair Brooke
Published: August 2016

Aim

To describe participation trajectories, and impact of school transitions on those trajectories, of children with cerebral palsy (CP).

Method

This population‐based longitudinal study assessed participation in activities outside school of children with CP born in 1994/1995. Eligible children contributed data between two and five occasions over 9 years, and had parents with sufficient English proficiency to complete the measures: the Children's Assessment of Participation and Enjoyment, and the Preferences for Activities of Children. Linear mixed models were used to assess the relationships between participation and age and the impact of transition.

Results

At study commencement (2006), 233 children with CP born in 1994/1995 were registered in Victoria; 93 (51 males, 42 females; mean age 11y 2mo, age range 10–12y) contributed longitudinal data. Participation diversity and intensity decreased over time for recreational, active physical, and self‐improvement activities (p<0.009). Social participation increased over time: diversity, intensity, and frequency (p<0.007). All of the identified slopes were generally small (β≤0.11, 1‐point change every 9y) except for recreational diversity scores (β=−0.29). Transition from primary and secondary school had little impact on participation.

Interpretation

Findings of increased social participation over time are encouraging. Declining participation in other activity types suggests that action is needed to ensure that meaningful recreation and leisure activities are maintained as adolescents with CP transition to adulthood.
Should mirror movements modify therapeutic strategies for unilateral spastic cerebral palsy?
Authors: Staudt Martin
Published: August 2016

This commentary is on the original article by Zielinski et al. on pages 152–159 of this issue.
Epilepsy as the ‘echo’ of acute stroke in children
Authors: Rivkin Michael J
Published: August 2016

This commentary is on the original article by Fox et al. on pages 38–44 of this issue.
A THEORY OF TURNOVER AND WAGE DYNAMICS
Authors: Li Jin , Yu Jun
Published: August 2016

We develop a model of turnover and wage dynamics with insurance, match‐specific productivity, and long‐term contracting. The model predicts that wages are downward rigid within firms but can decrease when workers are fired. We apply the model to study the impact of business cycles on subsequent wages and job mobility. Workers hired during a boom have persistent higher future wages if staying with the same firm. However, these boom hires are more likely to be terminated and have shorter employment spells. (JEL C73, D23, D82, J33)
Relationship between impulsivity traits and awareness of motor intention
Authors: Giovannelli F. , Mastrolorenzo B. , Rossi A. , Gavazzi G. , Righi S. , Zaccara G. , Viggiano M. P. , Cincotta M.
Published: August 2016

Deficient voluntary control of behaviour and impulsivity are key aspects of impulse control disorders. The objective of the present study was to evaluate the relationship between behavioural measures of impulsivity and the awareness of voluntary action. Seventy‐four healthy volunteers completed the Barratt Impulsiveness Scale (BIS), a questionnaire used to measure impulsive personality traits, and a go/no‐go task. Moreover, all participants performed a behavioural task based on the Libet's clock paradigm in which they were requested to report the time of a self‐initiated movement (M‐judgement) or the time they first feel their intention to move (W‐judgement). A positive relationship between the time in which subjects reported the intention to move (W‐judgement) and impulsivity measures emerged. Namely, the higher was the score in the attentional and motor impulsivity subscales of the BIS and the number of inhibitory failure responses in the go/no‐go task, the lower was the difference between the W‐judgement and the actual movement (i.e. the awareness of intention to move was closer to the voluntary movement execution). In contrast, no relationship emerged with M‐judgement. The present findings suggest that impulsivity is related to a delayed awareness of voluntary action. We hypothesize that in impulse control disorders, the short interval between conscious intention and actual movement may interfere with processes underlying the conscious ‘veto’ of the impending action.
Reducing the time interval between concussion and voluntary exercise restores motor impairment, short‐term memory, and alterations to gene expression
Authors: Mychasiuk Richelle , Hehar Harleen , Ma Irene , Candy Sydney , Esser Michael J.
Published: August 2016

Despite the most common form of brain injury, there has been little progress in the prognosis and treatment of concussion/mild traumatic brain injury (mTBI). Current ‘return‐to‐play’ guidelines are conservative, deterring the initiation of physical and social activity until patients are asymptomatic; but the effects of post‐injury exercise have not been adequately investigated. Therefore, this study examined the effects of voluntary exercise on concussion recovery. Using a translational rodent model of concussion, we examined the influence of exercise on injury‐associated behaviours that comprise post‐concussive syndrome (PCS) and gene expression changes (bdnf, dnmt1, Igf‐1, pgc1‐a, Tert) in prefrontal cortex and hippocampus. In addition, as we have previously demonstrated telomere length (TL) to be a reliable predictor of mTBI prognosis, TL was also examined. The results suggest that exercise initiated within 1–3 days post‐concussion significantly improved motor and cognitive functioning, but had limited efficacy treating emotional impairments. What is more, when deprived of social interaction and exercise, a combination similar to clinical recommendations for rest until symptom resolution, animals did not recover and exhibited impairments similar to typical mTBI animals. Exercise aided in restoration of mTBI‐induced modifications to gene expression in both brain regions. An inverse relationship between the exercise return interval and TL was identified, indicating greater recovery with acute exercise reinstatement. Although additional strategies may need to be employed for emotional functioning, these findings support re‐evaluation of ‘return‐to‐play’ guidelines, suggesting that exercise is valuable for the treatment of concussion.
Contribution of color signals to ocular following responses
Authors: Matsuura Kiyoto , Kawano Kenji , Inaba Naoko , Miura Kenichiro
Published: August 2016

Ocular following responses (OFRs) are elicited at ultra‐short latencies (< 60 ms) by sudden movements of the visual scene. In this study, we investigated the roles of color signals in OFRs in monkeys. To make physiologically isoluminant sinusoidal color gratings, we estimated the physiologically isoluminant points using OFRs and found that the physiologically isoluminant points were nearly independent of the spatiotemporal frequency of the gratings. We recorded OFRs induced by the motion of physiologically isoluminant color gratings and found that OFRs elicited by the motion of color gratings had different spatiotemporal frequency tuning from those elicited by the motion of luminance gratings. Additionally, OFRs to isoluminant color gratings had smaller peak responses, suggesting that color signals weakly contribute to OFRs compared with luminance signals. OFRs to the motion of stimuli composed of luminance and color signals were also examined. We found that color signals largely contributed to OFRs under low luminance signals regardless of whether color signals moved in the same or opposite direction to luminance signals. These results provide evidence of the multichannel visual computations underlying motor responses. We conclude that, in everyday situations, color information contributes cooperatively with luminance information to the generation of ocular tracking behaviors.