bluuebunny/crossref_metadata_2025 huggingface dataset:
Revisiting the lectotype of Rhamnus micranthus (Rhamnaceae)
Authors: GARWOOD NANCY C.
Published: November 2016

The lectotypes of Rhamnus micranthus, the basionym of Trema micrantha, proposed by Wijnands (1983), Howard (1988) and Jarvis (2007) are incomplete or incorrect. The source of the problem is discussed and a new lectotype is here designated.
Census of Cnidaria (Medusozoa) and Ctenophora from South American marine waters
Authors: OLIVEIRA OTTO M. P. , MIRANDA THAÍS P. , ARAUJO ENILMA M. , AYÓN PATRICIA , CEDEÑO-POSSO CRISTINA M. , CEPEDA-MERCADO AMANCAY A. , CÓRDOVA PABLO , CUNHA AMANDA F. , GENZANO GABRIEL N. , HADDAD MARIA ANGÉLICA , MIANZAN HERMES W. , MIGOTTO ALVARO E. , MIRANDA LUCÍLIA S. , MORANDINI ANDRÉ C. , NAGATA RENATO M. , NASCIMENTO KARINE B. , JÚNIOR MIODELI NOGUEIRA , PALMA SERGIO , QUIÑONES JAVIER , RODRIGUEZ CAROLINA S. , SCARABINO FABRIZIO , SCHIARITI AGUSTÍN , STAMPAR SÉRGIO N. , TRONOLONE VALQUÍRIA B. , MARQUES ANTONIO C.
Published: November 2016

We have compiled available records in the literature for medusozoan cnidarians and ctenophores of South America. New records of species are also included. Each entry (i.e., identified species or still as yet not determined species referred to as “sp.” in the literature) includes a synonymy list for South America, taxonomical remarks, notes on habit, and information on geographical occurrence. We have listed 800 unique determined species, in 958 morphotype entries: 5 cubozoans, 905 hydrozoans, 25 scyphozoans, 3 staurozoans, and 20 ctenophores. Concerning nomenclatural and taxonomical decisions, two authors of this census (Miranda, T.P. & Marques, A.C.) propose Podocoryna quitus as a nomen novum for the junior homonym Hydractinia reticulata (Fraser, 1938a); Euphysa monotentaculata Zamponi, 1983b as a new junior synonym of Euphysa aurata Forbes, 1848; and Plumularia spiralis Milstein, 1976 as a new junior synonym of Plumularia setacea (Linnaeus, 1758). Finally, we also reassign Plumularia oligopyxis Kirchenpauer, 1876 as Kirchenpaueria oligopyxis (Kirchenpauer, 1876) and Sertularella margaritacea Allman, 1885 as Symplectoscyphus margaritaceus (Allman, 1885).
Regional Sea Level Changes for the Twentieth and the Twenty-First Centuries Induced by the Regional Variability in Greenland Ice Sheet Surface Mass Loss
Authors: Meyssignac B. , Fettweis X. , Chevrier R. , Spada G.
Published: November 2016

Surface mass balance (SMB) variations of the Greenland ice sheet (GrIS) have been identified as an important contributor to contemporary and projected global mean sea level variations, but their impact on the regional sea level change pattern is still poorly known. This study proposes estimates of GrIS SMB over 1900–2100 based on the output of 32 atmosphere–ocean general circulation models and Earth system models involved in phase 5 of the Climate Model Intercomparison Project (CMIP5). It is based on a downscaling technique calibrated against the Modèle Atmosphérique Régional (MAR) regional climate model and it provides an ensemble of 32 Greenland SMB estimates for each Greenland major drainage basin. Because the GrIS SMB does not respond uniformly to greenhouse gas (GHG) emissions, the southern part of the GrIS is more sensitive to climate warming. This study shows that this part should be in imbalance in the twenty-first century sooner than the northern part. This regional variability significantly affects the associated relative sea level pattern over the entire ocean and particularly along the U.S. East Coast and the northern coast of Europe. This highlights the necessity of taking into account GrIS regional SMB changes to evaluate accurately relative sea level changes in future projections.
Hedgehog Pathway–Mediated Vascular Alterations Following Trigeminal Nerve Injury
Authors: Moreau N. , Dieb W. , Mauborgne A. , Bourgoin S. , Villanueva L. , Pohl M. , Boucher Y.
Published: November 2016

Whereas neurovascular interactions in spinal neuropathic pain models have been well characterized, little attention has been given to such neurovascular interactions in orofacial neuropathic pain models. This study investigated in male Sprague-Dawley rats the vascular changes following chronic constriction injury (CCI) of the infraorbital nerve (IoN), a broadly validated preclinical model of orofacial neuropathic pain. Following IoN-CCI, an early downregulation of tight junction proteins Claudin-1 and Claudin-5 was observed within the endoneurium and perineurium, associated with increased local accumulation of sodium fluorescein (NaFlu) within the IoN parenchyma, as compared with sham animals. These events were evidence of local blood-nerve barrier disruption and increased vascular permeability. A significant upregulation of immunocytes (CD3, CD11b) and innate immunity (TLR2, TLR4) mRNA markers was also observed, suggestive of increased local inflammation. Finally, a significant downregulation of Hedgehog pathway readouts Patched-1 and Gli-1 was observed within the IoN after CCI and local injections of cyclopamine, a Hedgehog pathway inhibitor, replicated in naïve rats the molecular, vascular, and behavioral changes observed following IoN-CCI. These results suggest a major role of Hedgehog pathway inhibition in mediating local increased endoneurial and perineurial vascular permeability following trigeminal nerve injury, thus facilitating immunocytes infiltration, neuroinflammation development, and neuropathic pain-like aversive behavior.
Wireless bi-directional data link for smart temperature recording
Authors: Wu Nan , Liu Chengguo , Zhang Bin , Zhou Shuai , Zhang Jingwei , Wu Zhi P
Published: November 2016

In application systems of the Internet of Things (IoT), real-time monitoring and control of the systems need to be realized with wireless communications from machine to machine (M2M), especially under harsh application scenarios. The data link of the M2M communication has also a critical effect on the system in the application. In this paper, a wireless bi-directional data link for smart temperature recording is reported. The radio frequency hardware employed consists of NRF24L01 wireless transceivers, RFX2401 amplifiers and matching network sand antennas. The microcontroller unit (MCU) is based on the STM32F103VET6 chip, which controls the NRF24L01 by a four-pin serial peripheral interface (SPI) to realize the bi-directional data link, and the sensor data are sampled with 12-bit analogue-to-digital converters (ADCs). The communication is realized as the interrupt request (IRQ) signal of the NRF24L01 changes periodically. A look-up table and a linear optimization method are also implemented to improve the accuracy of ADC data. The bi-directional data link is then applied to a wired heating control system. The results show that temperature data can be transmitted and received over a distance up to 320 m in an open environment and 52 m in an indoor complex environment with the hardware implemented. The real-time temperature data can be displayed on a computer or a handheld device. Wireless M2M communication and control are thus demonstrated.
The Influence of Varying Cost Formats on Preferences
Authors: Jiang Charles Changchuan , Fraenkel Liana
Published: November 2016

Background. Numerous studies have found that cost strongly influences patients’ decision making. The objective of this study was to explore the impact of varying cost formats on patients’ preferences. Methods. Mechanical Turk workers completed a choice-based conjoint (CBC) survey. The CBC survey was designed to examine stated preferences for the use of second-line agents to treat diabetes across 5 attributes: route of administration, efficacy, risk of low blood sugar, frequency of checking blood sugar levels, and cost. We developed 7 versions of the CBC survey that were identical except for the cost attribute. We described cost in terms of: Affordability, Monthly Co-pay, Dollar Sign Rating, How Expensive, or How Cheap compared with other medications, Working Hours Equivalent (per mo) and Percent of Monthly Income. The resulting part-worth utilities were used to calculate the relative importance of cost and to estimate treatment preferences for exenatide, a sulfonylurea, and insulin. Results. The relative impact of cost varied significantly across the 7 formats. Cost had the greatest influence on participants’ decisions when framed in terms of Affordability [mean (SD) relative importance, 37.3 (0.9)] and the lowest influence when framed in terms of How Cheap (compared with other drugs) [12.1 (0.9)]. A sulfonylurea was strongly preferred across 4 of the 7 formats. Preference for insulin, the most effective, albeit riskiest, option was low across all cost formats. Conclusions. The format used to describe cost affects how the attribute impacts patients’ preferences. Individuals are most cost-sensitive when cost is framed in terms of affordability and least cost-sensitive when cost is described in terms of how cheap the medication is compared with others.
Abundant water, abundant knowledge: Cognitive patterns for policy changes in Brussels’ water management system
Authors: Dotti Nicola Francesco
Published: November 2016

Knowledge plays an essential key role in the policymaking process for interpreting the available information, defining policy issues at stake and evaluating possible solutions – especially in complex policy issues like water management. However, for city-regions, knowledge is often a scarce resource due to the small size of the policy community, context-specific issues, limited availability of resources and experts, as well as the challenge of addressing complex issues that are often supra-local. This paper explores which patterns of local knowledge promote policy change and learning. Starting from the ‘policy paradigm’ concept, a cognitive–evolutionary approach is applied to analyse Brussels’ water management policy, which aims to address the major challenge of flooding. The variety of knowledge by local actors, the role of the policy paradigm of the local policymaking community in vetting information and evaluating alternative solutions, and the importance of local governments for retaining knowledge, are the main dimensions to understanding policy change and learning. City-regions benefit from direct contacts between actors facilitating exchange of knowledge, while supra-local decisions (e.g. EU directives) and local accidents can also trigger major changes. Based on my findings, policymakers tend to rely on technocratic patterns using already available knowledge, mainly whether decentralisation reshapes the policymaking community. While a technocratic pattern determines only minor changes and institutional instability undermines policy learning, policy entrepreneurs and participative patterns can promote major changes and learning if they are able to engage in dialogue with the dominant policy paradigm.
Assessing Support Network Stability With Transition-Age Foster Youth
Authors: Blakeslee Jennifer E. , Keller Thomas E.
Published: November 2016

Objective:

This study uses the Support Network Assessment for Practice (SNAP) approach to measure the support provided to young people transitioning from foster care.

Methods:

The SNAP was administered on two occasions, approximately 7 months apart, to a cohort of transition-age foster youth ( n = 27). Analyses investigated measurement reliability and sensitivity to change for network-level characteristics as well as baseline factors associated with relationship stability.

Results:

Most network-level indicators had strong test–retest correlations, and differences in mean scores over time also were detected, suggesting measurement sensitivity to change. Respondents were able to explain most observed changes in their networks, further suggesting reliable measurement. Stable relationships were those reported as stronger and providing more multifaceted support and those with family members and/or parent figures.

Discussion:

The SNAP approach could be used to facilitate planning around support needs for youth transitioning out of foster care and to evaluate efforts to enhance support networks.
Moving Toward a Better Balance
Authors: Zhou Joanne , Bortz Walter , Fredericson Michael
Published: November 2016

Stanford Medical School has created a class in lifestyle medicine that any student in the university can attend for credit. It is based on the foundational principles of lifestyle medicine and also informs students about topics such as Chinese medicine, naturopathic medicine, and wearable devices. The popularity of the course at Stanford speaks to the growing interest in the field of lifestyle medicine for medical students, undergraduate students, business students, and even engineers.
Religio: The ties that bind
Authors: Wilcox Melissa M
Published: November 2016

In this response essay, I borrow a page from Jack Halberstam to explore the ties that bind—ligates, as in re-ligio—the two sibling fields of sociology and religious studies.
Clarifying immunoglobulin gene usage in systemic and localized immunoglobulin light-chain amyloidosis by mass spectrometry
Authors: Kourelis Taxiarchis V. , Dasari Surendra , Theis Jason D. , Ramirez-Alvarado Marina , Kurtin Paul J. , Gertz Morie A. , Zeldenrust Steven R. , Zenka Roman M. , Dogan Ahmet , Dispenzieri Angela
Published: November 2016

Key Points

Mass spectrometry is a high-throughput, low-resource technique that can identify immunoglobulin variable region gene from tissue specimens. IGVL gene usage is restricted and different between systemic and localized AL and only partially explains organ tropism in this disease.
Formal analysis of subnet-based failure recovery algorithm in wireless sensor and actor and network
Authors: Afzaal Hamra , Zafar Nazir Ahmad
Published: November 2016

Wireless sensor and actor networks (WSANs) have various applications in safety and mission critical systems. Sensors are used for sensing the information whereas actors for taking intelligent decisions. Developing and modeling algorithms for WSANs have raised several research issues which have captured attention of the research community. Maintaining inter-actor connectivity or failure recovery is a critical issue in WSANs because these are deployed in harsh and inhospitable environment which may result into physical damage to actors loosing inter-actor connectivity. In case of failure of inter-actor connectivity, the topology of the network may be affected that might be inefficient to recover. Therefore an efficient subnet-based failure recovery algorithm (SFRA) is proposed in this work. It is assumed the partitioning of WSAN into subnets which localizes the failure recovery procedure at subnet level achieving objective of efficiency. Moreover, algorithm is hybrid as it assumes pre-failure planning and post-failure recovery. The proposed model is presented as a graph-based model to represent static part of the network topology. The graph model is transformed into a formal model using Vienna development method-specification language (VDM-SL). The static model is described by defining formal specification of subnets, network topology, sensors, actors and gateways as composite objects. The state space of the WSANs is described in the form of functions and operations as dynamic part of the model. Invariants are defined over the data types in static model for ensuring safety criteria and pre/post conditions are defined in functions and operations for changing state space of the system. The proposed model is validated and verified using VDM-SL Toolbox.
Understanding Phenotypes of Obstructive Sleep Apnea: Applications in Anesthesia, Surgery, and Perioperative Medicine
Authors: Subramani Yamini , Singh Mandeep , Wong Jean , Kushida Clete A. , Malhotra Atul , Chung Frances
Published: November 2016

Obstructive sleep apnea (OSA) is a prevalent sleep-disordered breathing with potential long-term major neurocognitive and cardiovascular sequelae. The pathophysiology of OSA varies between individuals and is composed of different underlying mechanisms. Several components including the upper airway anatomy, effectiveness of the upper airway dilator muscles such as the genioglossus, arousal threshold of the individual, and inherent stability of the respiratory control system determine the pathogenesis of OSA. Their recognition may have implications for the perioperative health care team. For example, OSA patients with a high arousal threshold are likely to be sensitive to sedatives and narcotics with a higher risk of respiratory arrest in the perioperative period. Supplemental oxygen therapy can help to stabilize breathing in OSA patients with inherent respiratory instability. Avoidance of supine position can minimize airway obstruction in patients with a predisposition to upper airway collapse in this posture. In this review, the clinically relevant endotypes and phenotypes of OSA are described. Continuous positive airway pressure (CPAP) therapy is the treatment of choice for most patients with OSA but tolerance and adherence can be a problem. Patient-centered individualized approaches to OSA management will be the focus of future research into developing potential treatment options that will help decrease the disease burden and improve treatment effectiveness.
Trends in Tramadol: Pharmacology, Metabolism, and Misuse
Authors: Miotto Karen , Cho Arthur K. , Khalil Mohamed A. , Blanco Kirsten , Sasaki Jun D. , Rawson Richard
Published: November 2016

Tramadol is a unique analgesic medication, available in variety of formulations, with both monoaminergic reuptake inhibitory and opioid receptor agonist activity increasingly prescribed worldwide as an alternative for high-affinity opioid medication in the treatment of acute and chronic pain. It is a prodrug that is metabolized by cytochrome P450 (CYP) enzymes CYP2D6 and CYP3A4 to its more potent opioid analgesic metabolites, particularly the O-demethylation product M1. The opioid analgesic potency of a given dose of tramadol is influenced by an individual’s CYP genetics, with poor metabolizers experiencing little conversion to the active M1 opioid metabolite and individuals with a high metabolic profile, or ultra-metabolizers, experiencing the greatest opioid analgesic effects. The importance of the CYP metabolism has led to the adoption of computer clinical decision support with pharmacogenomics tools guiding tramadol treatment in major medical centers. Tramadol’s simultaneous opioid agonist action and serotonin (5-HT) and norepinephrine reuptake inhibitory effects result in a unique side effect profile and important drug interactions that must be considered. Abrupt cessation of tramadol increases the risk for both opioid and serotonin–norepinephrine reuptake inhibitor withdrawal syndromes. This review provides updated important information on the pharmacology, pharmacokinetics, CYP genetic polymorphisms, drug interactions, toxicity, withdrawal, and illicit use of tramadol.
Essential Oil Yield in Rosewood (Aniba Rosaeodora Ducke): Initial Application of Rapid Prediction by near Infrared Spectroscopy Based on Wood Spectra
Authors: Amusant Nadine , Beauchène Jacques , Digeon Alexis , Chaix Gilles
Published: November 2016

Rosewood ( Aniba rosaeodora) essential oil is a valuable ingredient that has long been used in the perfume and cosmetic industries. The main rosewood timber quality parameters are its essential oil yield and quality. A hydrodistillation method has been developed for yield determination, but it is time consuming. Here we tested the applicability of near infrared (NIR) spectroscopy for determining essential oil yield directly from wood powder. Essential oil from 139 wood powders was extracted via hydrodistillation. The measurements were based on the ratio between the extracted essential oil mass and the oven-dried wood mass and were correlated with the wood powder NIR spectra. The calibration model statistical findings demonstrated that NIR could be a fast and feasible alternative method for selecting trees with a high essential oil yield potential. NIR-based predictions obtained in an independent validation set indicated a high correlation ( r2 = 0.92) with laboratory essential oil yield measurements. This NIR model could help wood managers in selecting trees with a high essential oil yield potential and in developing sustainable rosewood management strategies.
Prediction of Colour Change of Thermally Modified Wood by near Infrared Spectroscopy
Authors: Tong Li , Zhang Wenbo , Lu Wei
Published: November 2016

Colour changes of untreated and thermally modified (120°C, 180°C and 220°C) southern pine wood are predicted by near infrared spectroscopy (NIR). Colour change information originating from thermal chemical decomposition was assessed by NIR spectroscopy while wood surface colour change values in the CIE1976 L*a*b* system were determined with a colour measurement instrument. Calibration models were built using partial least squares and corresponding cross-validation. A close relationship between colour change values and NIR spectra of thermally modified wood allowed for easy clustering. The proposed colour prediction model for thermally modified wood produced very high R2 values (above 0.90) and was well suited to NIR spectra acquired from wood tangential surfaces, suggesting that the method can provide effective, online quality control.
Monitoring the Chemistry and Monosaccharide Ratio of Eucalyptus Dunnii Wood by near Infrared Spectroscopy
Authors: Zhou Chengfeng , Jiang Wei , Via Brian K. , Chetty P.M. , Swain Tammy
Published: November 2016

Determination of wood chemical components such as extrac tives, lignin and car bohydrate content by conventional wet chemistry is time consuming and sometimes hazardous. Near infrared reflectance (NIR) spectroscopy coupled with multivariate calibration was utilised to offer a fast alternative to wet chemistry methods. In this study, 70 Eucalyptus dunnii wood samples were collected to investigate the correlation and modelling potential of using NIR spectra to predict extractives, lignin, carbohydrate content and ash which were determined with classical methods (extractives, ash and lignin) and high-performance liquid chromatography (sugars). Partial least squares regression was used for multivariate calibration. An evaluation of the results found that ash, extractives and lignin could be predicted with the strongest prediction diagnostics while mannose and glucose-to-mannose ratio models exhibited the lowest performance. The robust ability to predict glucose-to-xylose ratio ( r2 = 0.87) provided a unique way to utilise NIR to monitor biomass quality and could be helpful for the improvement of ethanol and other forest products. The large range in glucose-to-xylose ratio (2.0 to 4.0), as determined through NIR, suggests that using xylose content to estimate total hemicellulose content may be unsuitable, though this type of ratio assumption and analysis is common for softwoods.
Information Technology and the Ambidexterity Hypotheses: An Analysis in Product Development
Authors: Revilla Elena , Prieto Isabel Maria , Rodríguez Beatriz
Published: November 2016

This paper explores ambidexterity, defined as the capacity to simultaneously achieve exploration and exploitation activities at a product development level. Building on the knowledge-based view literature, it is argued that information technology -defined by a combination of convergent and divergent dimensions- may facilitate ambidexterity in the context of product development. Furthermore, ambidexterity mediates the relationship between information technology and performance. Data collected from 80 product development projects supports our hypotheses. Most importantly, the study presents evidence that ambidexterity mediates the relationship between the information technology that encourages exploration and exploitation and subsequent performance in product development.
Pay-for-performance in resource-constrained settings: Lessons learned from Thailand’s Quality and Outcomes Framework
Authors: Khampang Roongnapa , Tantivess Sripen , Teerawattananon Yot , Chootipongchaivat Sarocha , Pattanapesaj Juntana , Butchon Rukmanee , Malathong Natthida , Cluzeau Francoise , Foskett-Tharby Rachel , Gill Paramjit
Published: November 2016

Introduction. Many countries have introduced pay-for-performance (P4P) models to encourage health providers and institutions to provide good quality of care. In 2013, the National Health Security Office of Thailand introduced P4P, based on the UK Quality and Outcomes Framework (QOF), as a mandatory programme for primary care providers. This study aims to review the first year of the Thai QOF policy, focusing on the key features of its formulation and implementation stages. Methods.This study used a mix of data collection approaches, such as literature review, in-depth interviews with QOF managers, and focus-group discussions with health officers and practitioners. Data were collected between June and August 2015 and transcribed and analysed using qualitative content analysis (interpretation of the content of text data through the systematic classification process of identifying themes or patterns). Two consultation meetings were organised to verify the preliminary findings. Results. Based on the UK model, the Thai QOF was formulated without formal consultation with key stakeholders. Additionally, programme managers adopted a ‘learning by doing’ approach, since Thai authorities were already aware of health system limitations, such as insufficient human and financial resources and unreliable databases. There were also problems with QOF implementation, as follows: 1) deducting the budget from the annual payment for ambulatory care made the policy unjustified because providers did not receive full subsidisation of their service delivery; 2) lack of key stakeholder engagement resulted in miscommunication, and subsequently misunderstanding and inadequate coordination, for the translation of QOF policy into action; and 3) the unreliability of the IT system led to inaccurately-reported data on service delivery, thereby adversely affecting performance. Conclusion.There is still room for improvement in formulating and implementing the Thai QOF programme. Policy makers and programme implementers at both the national and international levels can benefit from this study for ensuring effective policy transfer and implementation of future QOF programmes.
Pathogenic mycobacteria achieve cellular persistence by inhibiting the Niemann-Pick Type C disease cellular pathway
Authors: Fineran Paul , Lloyd-Evans Emyr , Lack Nathan A. , Platt Nick , Davis Lianne C. , Morgan Anthony J. , Höglinger Doris , Tatituri Raju Venkata V. , Clark Simon , Williams Ian M. , Tynan Patricia , Al Eisa Nada , Nazarova Evgeniya , Williams Ann , Galione Antony , Ory Daniel S. , Besra Gurdyal S. , Russell David G. , Brenner Michael B. , Sim Edith , Platt Frances M.
Published: November 2016

Background. Tuberculosis remains a major global health concern. The ability to prevent phagosome-lysosome fusion is a key mechanism by which intracellular mycobacteria, includingMycobacterium tuberculosis, achieve long-term persistence within host cells. The mechanisms underpinning this key intracellular pro-survival strategy remain incompletely understood. Host macrophages infected with persistent mycobacteria share phenotypic similarities with cells taken from patients suffering from Niemann-Pick Disease Type C (NPC), a rare lysosomal storage disease in which endocytic trafficking defects and lipid accumulation within the lysosome lead to cell dysfunction and cell death. We investigated whether these shared phenotypes reflected an underlying mechanistic connection between mycobacterial intracellular persistence and the host cell pathway dysfunctional in NPC. Methods. The induction of NPC phenotypes in macrophages from wild-type mice or obtained from healthy human donors was assessed via infection with mycobacteria and subsequent measurement of lipid levels and intracellular calcium homeostasis. The effect of NPC therapeutics on intracellular mycobacterial load was also assessed. Results. Macrophages infected with persistent intracellular mycobacteria phenocopied NPC cells, exhibiting accumulation of multiple lipid types, reduced lysosomal Ca2+levels, and defects in intracellular trafficking. These NPC phenotypes could also be induced using only lipids/glycomycolates from the mycobacterial cell wall. These data suggest that persistent intracellular mycobacteria inhibit the NPC pathway, likely via inhibition of the NPC1 protein, and subsequently induce altered acidic store Ca2+homeostasis. Reduced lysosomal calcium levels may provide a mechanistic explanation for the reduced levels of phagosome-lysosome fusion in mycobacterial infection. Treatments capable of correcting defects in NPC mutant cells via modulation of host cell calcium were of benefit in promoting clearance of mycobacteria from infected host cells. Conclusion. These findings provide a novel mechanistic explanation for mycobacterial intracellular persistence, and suggest that targeting interactions between the mycobacteria and host cell pathways may provide a novel avenue for development of anti-TB therapies.
Why Do Adults Engage in Cyberbullying on Social Media? An Integration of Online Disinhibition and Deindividuation Effects with the Social Structure and Social Learning Model
Authors: Lowry Paul Benjamin , Zhang Jun , Wang Chuang , Siponen Mikko
Published: November 2016

The dramatic increase in social media use has challenged traditional social structures and shifted a great deal of interpersonal communication from the physical world to cyberspace. Much of this social media communication has been positive: Anyone around the world who has access to the Internet has the potential to communicate with and attract a massive global audience. Unfortunately, such ubiquitous communication can be also used for negative purposes such as cyberbullying, which is the focus of this paper. Previous research on cyberbullying, consisting of 135 articles, has improved the understanding of why individuals—mostly adolescents—engage in cyberbullying. However, our study addresses two key gaps in this literature: (1) how the information technology (IT) artifact fosters/inhibits cyberbullying and (2) why people are socialized to engage in cyberbullying. To address these gaps, we propose the social media cyberbullying model (SMCBM), which modifies Akers’ [Akers RL (2011) Social Learning and Social Structure: A General Theory of Crime and Deviance, 2nd ed. (Transaction Publishers, New Brunswick, NJ)] social structure and social learning model. Because Akers developed his model for crimes in the physical world, we add a rich conceptualization of anonymity composed of five subconstructs as a key social media structural variable in the SMCBM to account for the IT artifact. We tested the SMCBM with 1,003 adults who have engaged in cyberbullying. The empirical findings support the SMCBM. Heavy social media use combined with anonymity facilitates the social learning process of cyberbullying in social media in a way that fosters cyberbullying. Our results indicate new directions for cyberbullying research and implications for anticyberbullying practices.
How support workers can improve nutritional status of patients with dementia
Authors: Dhillon Rupinder Kaur
Published: November 2016

A significant number (approximately 34%) of dementia patients in care homes in the UK are suffering from malnutrition, while 56% are at risk of malnutrition. Support workers play a very important role in providing care around mealtimes and they are interested in ensuring clients have sufficient nutritional intake.

Research-based feeding strategies can be very helpful for support workers working with dementia patients by enhancing their knowledge and confidence level to provide feeding assistance to care home residents with or without dementia.

This article will equip support workers with knowledge and strategies that can enhance their role in improving the nutritional status of this vulnerable client group and make their role more rewarding.
Care Certificate Standards 3: duty of care; and 4: equality and diversity
Authors: Peate Ian
Published: November 2016

This second article in the series addresses duty of care and equality and diversity; these are the third and fourth standards of the Care Certificate.

The Care Certificate offers HCAs and APs, in a variety of care settings, the knowledge required to provide safe, compassionate care. The 15 standards associated with the Care Certificate can be used by HCAs and APs and their employers to assess competence as associated with the standards that are outlined in the Care Certificate.

This article discusses two topics: duty of care, and your role and responsibilities in that regard; and the important issue of ensuring that in the workplace there is equality and agreed ways of working that incorporate the diversity and range of needs in health and care settings ( Mullen, 2014 ).

Standards 3 and 4 concentrate on the important issues of duty of care and equality and diversity (respectively) and the impact these have on your role and the care and support you offer people, with an emphasis on safety and effectiveness. Lifelong learning is seen as a key component of working in an effective manner, with the patient at the heart of all that is done.
Redeployment of clinical support to assist junior doctors: A cost analysis
Authors: Chan Gareth , Rewbury Rebecca , Groves Nick , Kalidasan Varadarajan
Published: November 2016

Junior doctors' working hours are regulated by the current New Deal Junior Doctors' contract and European Working Time Directive. Failure to adhere to these requirements results in substantial financial penalties for the employing organisation. Working hours in general surgery are the most frequent sources of such infringements, affecting patient safety, workforce morale and the attractiveness of a surgical career. In this article, we present our data analysing the financial metrics of a 6-month workforce modernisation pilot study introducing a novel clinical and administrative support role of the ‘clinical assistant’ into a busy tertiary general surgical unit; which had a persistent history of working hour non-compliance. We present our results on a successful ‘spend to save’ pilot, which resulted in a significant reduction in working hours negating all financial penalties, while delivering on additional soft metrics including career development and workforce morale.
Locating areas with high use of critical care
Authors: Beeknoo Neeraj , Jones Rod
Published: November 2016

Admissions over a three-year period to the general surgical and medical critical care unit at King's College University Hospital were allocated to the output area of residence for each patient. Each output area contains around 300 people of roughly similar social and demographic characteristics. Output area social grouping (output area classification) and deprivation (index of multiple deprivation) are shown to effect critical care admission rates. The admission rate doubles between the least and most deprived areas (excluding the effect of social group), however there is in excess of a 10-fold variation between the various deprivation-banded output area classification social groups. Particular social groups also show differing proportions of patients admitted to the critical care unit for different conditions such as sepsis or drug overdose. Having identified small areas with high risk of critical care admission should enable primary care organisations to target admission avoidance and/or appropriate end-of-life care.
Minitracheostomy: the benefits for patient care
Authors: Nelson Sara
Published: November 2016

Sputum retention is a potentialcomplication following thoracic surgery. This article describes minitracheostomy, a technique that is commonly used in thoracic units to clear secretions, examines its advantages and disadvantages and recommends its more widespread use in district general hospitals.
Caring for patients with enterocutaneous fistulae
Authors: Phillips Jenny , Walton Margaret
Published: November 2016

Fistulae are distressing for both patients and staff. The management of fistulae presents a challenge to the nurse in terms of providing care for the psychological and physiological needs of the patient. This article describes the causes of fistulae and examines the nursing priorities and how to achieve them.
Caring for a homosexual man undergoing a colostomy formation
Authors: Corless Rosemary
Published: November 2016

Chris was admitted to hospital with a 2-week history of abdominal pain which had increased in frequency and severity; it radiated from his sides to his back and was exacerbated upon eating and drinking. Consequently, he suffered a reduced appetite, weight loss and constipation. The possible diagnoses were cholelithiasis, constipation or partial obstruction. His past medical history revealed a heart attack 2 years previously and a femoral popliteal bypass graft due to peripheral vascular disease. During his assessment, it became apparent just how anxious Chris was about the strain that this admission had placed on his relationship with his partner Dave. As he later wrote: ‘The effect on Dave was terrible and how he coped I'll never know’. It was clear that both partners needed support.
Rights to healthcare and the role of the nurse practitioner
Authors: Dimond Bridgit
Published: November 2016

With the recent developments in healthcare now coming into effect, it is necessary to consider rights to healthcare, the balance of supply and demand and the role of the nurse practitioner as patient advocate.
Health visiting in a well-baby clinic
Authors: Gillespie Jacynth , Hanny Annette , Rote Sandra
Published: November 2016

This article highlights the changes that were implemented after research was carried out into health visiting practice in a well-baby clinic. The study was the result of collaboration between practitioners and nurses working in the academic field.
Advances in the clinical practice of psychiatric nursing
Authors: Thomas Ben
Published: November 2016

Understanding mental health needs forms the basis of psychiatric nursing care. Analysis of these needs and knowing what resources are available determines the clinical practice of psychiatric nursing.
Mental health nursing: getting the message across
Authors: Thomas Ben
Published: November 2016

If you are ill, you expect to be treated and cared for by skilled professional staff who know what they are doing, i.e. staff who have been trained for the job. In the UK these fundamental principles are becoming increasingly more difficult to achieve. Nowhere is this more evident than in mental health nursing.
Developing a community-based leg ulcer clinic
Authors: Russell Gill , Bowles Alison
Published: November 2016

Mr Smith was one of the first patients to attend our leg ulcer clinic. He also turned out to be one of our biggest challenges as his leg ulcers affected both legs and covered large areas. Looking at his medical history we first thought we may be fighting a losing battle. He had suffered shrapnel wounds to his lower limbs during the war and had had operations on both legs to reconstruct his fractured bones with plates. He had been admitted to hospital several times with chronic liver disease, and had a history of varicose veins but had never received treatment for them. However, with our new-found enthusiasm and motivation we were determined, with Mr Smith's cooperation, to improve or heal his leg ulcers.
Poverty: a challenge for nursing in the 1990s
Authors: Morris Mervyn
Published: November 2016

How seriously is poverty considered in nursing practice? This article aims to provide an introduction to poverty in the UK today for all nurses, midwives and health visitors.
Outpatient nurses must adapt to survive
Authors: Marsden Edwin
Published: November 2016

Outpatient nursing has long been considered a clinical backwater. However, recent critical reports, the NHS reforms and other trends in healthcare are likely to change this. Outpatient nurses must move quickly to develop a new role for themselves or the opportunity will be lost. They should aim to make the best possible use of their nursing skills, given that outpatients need nursing care.
Care of a child with hypospadias: ethical issues in practice
Authors: Rose Pat
Published: November 2016

Care study

John, a 6-year old, was undergoing his sixth hospital admission (Table 1). He had been born with hypospadias, a congenital malformation of the genitalia resulting in the urethral orifice being found on the ventral surface of the penile shaft. In John's case it was at the base of the penis. With this condition, chordee (ventral curvature of the penis) often occurs due to the presence of fibrous tissue (Fig. 1). Surgery may be performed in stages to release the chordee and progressively extend the length of the urethra (Waley and Wong, 1991). The purpose of the surgery is threefold: to enable the child to void urine in the standing position; to improve the cosmetic appearance of the genitalia; and to produce an adequate organ for sexual activity.
Education and staffing in the ICU: past, present and future
Authors: Ball Carol
Published: November 2016

This article discusses the history of intensive care education in the UK and the impact of recent developments and their effect on the education of nurses in intensive care units.
What is a registered nurse?
Authors: Castledine George
Published: November 2016

Among the recent changes announced by the UKCC is one that has received little publicity: the use of the title of registered nurse. Previously when there was a change in title, such as when the abbreviation SRN was replaced by RGN, there was considerable resistance to the change. Are nurses nowadays becoming less concerned about such issues, or has the current proposal been overshadowed by the recent discussions and publicity surrounding the new Code of Professional Conduct and the Scope of Professional Practice documents (see BJN Vol 1 (6): 296?
How to choose the right applicant: 2
Authors: Fish Jane
Published: November 2016

Deciding which candidate to appoint requires considerable discussion and skill. Giving feedback to the unsuccessful candidate should be carefully considered.
Capillary blood glucose monitoring
Authors: Guilding Lucy M
Published: November 2016

The complications associated with inaccurate capillary blood glucose monitoring and poor control of diabetes are well known. This article explores the research identifying potential causes of inaccurate testing, examines ways of minimizing error and investigates quality control issues.
Correspondence
Authors: Newbold David , Thomas Nicola , Morgan D A , Bienfait Crowhurst
Published: November 2016

Casual dismissal of quality of life studies

Defining poverty

Hypochlorite solutions

Panic disorders
People should not have to resort to assisted suicide
Authors: Scott Helen
Published: November 2016

Following the recent case of Reginald Crew, the 74-year-old man with motor neurone disease (MND) who was given a lethal dose of oral medication by the orga niza tion Dignitas in Switzerland, it is not surprising th at there has been a renewed upsurge of interest in assisted suicide or active euthanasia. Mr Crew wanted to die because he had ‘had enough’ and ‘couldn't live another six or seven months’.
Autonomy, privacy and informed consent 3: elderly care perspective
Authors: Scott P Anne , Välimäki Maritta , Leino-Kilpi Helena , Dassen Theo , Gasull Maria , Lemonidou Cryssoula , Arndt Marianne
Published: November 2016

Despite the growing Interest In clinical healthcare ethics, there Is a dearth of empirical studies Investigating the ethical elements of day-to-day clinical practice from the perspective of either patients or staff. This article, the third In a four-part series, reports the results of a Scottish study that formed part of a multl-slte comparative study funded by the European Commission. It explores patient autonomy, privacy and Informed consent In the care of elderly people In long-stay care facilities (I.e. nursing homes and continuing care units). A convenience sample of 101 elderly residents and their nurses (n=160) participated In the study. Data were collected by means of a selfcompletion questionnaire for staff and a structured Interview schedule for elderly residents. Results Indicate marked differences between staff's and residents' responses on three of the four dimensions explored: Informatlon-glvlng, and opportunity to participate In declslon-maklng about care and consent. There was much closer agreement between staff's and residents' responses regarding protection of patient privacy. From the results of this study there Is Indication of a clear need for further empirical studies exploring Issues of patient autonomy, privacy and Informed consent In the day-to-day nursing care of older people. Rndlngs to date suggest there Is stili a slgnfflcant need to educate staff concemlng ethical awareness and sensitivity to the dignity and rights of patients.
Increased Trimethylamine N-Oxide Portends High Mortality Risk Independent of Glycemic Control in Patients with Type 2 Diabetes Mellitus
Authors: Tang W H Wilson , Wang Zeneng , Li Xinmin S , Fan Yiying , Li Daniel S , Wu Yuping , Hazen Stanley L
Published: November 2016

BACKGROUND

Recent studies show a mechanistic link between intestinal microbial metabolism of dietary phosphatidylcholine and coronary artery disease pathogenesis. Concentrations of a proatherogenic gut microbe-generated metabolite, trimethylamine N-oxide (TMAO), predict increased incident cardiovascular disease risks in multiple cohorts. TMAO concentrations are increased in patients with type 2 diabetes mellitus (T2DM), but their prognostic value and relation to glycemic control are unclear.

METHODS

We examined the relationship between fasting TMAO and 2 of its nutrient precursors, choline and betaine, vs 3-year major adverse cardiac events and 5-year mortality in 1216 stable patients with T2DM who underwent elective diagnostic coronary angiography.

RESULTS

TMAO [4.4 μmol/L (interquartile range 2.8–7.7 μmol/L) vs 3.6 (2.3–5.7 μmol/L); P < 0.001] and choline concentrations were higher in individuals with T2DM vs healthy controls. Within T2DM patients, higher plasma TMAO was associated with a significant 3.0-fold increased 3-year major adverse cardiac event risk (P < 0.001) and a 3.6-fold increased 5-year mortality risk (P < 0.001). Following adjustments for traditional risk factors and high-sensitivity C-reactive protein, glycohemoglobin, and estimated glomerular filtration rate, increased TMAO concentrations remained predictive of both major adverse cardiac events and mortality risks in T2DM patients [e.g., quartiles 4 vs 1, hazard ratio 2.05 (95% CI, 1.31–3.20), P < 0.001; and 2.07 (95% CI, 1.37–3.14), P < 0.001, respectively].

CONCLUSIONS

Fasting plasma concentrations of the proatherogenic gut microbe-generated metabolite TMAO are higher in diabetic patients and portend higher major adverse cardiac events and mortality risks independent of traditional risk factors, renal function, and relationship to glycemic control.
Debate - Trafficking as a Floating Signifier: The view from Brazil
Authors: Davida Grupo
Published: November 2016

The fact that the United Nations (UN) Trafficking Protocol is not an autochthonous product of the Brazilian political system has resulted in its being brought into that system as a ‘floating signifier’: something that does not point to any actual object or agreed upon meaning.[1] People who wish to criminalise prostitution have attempted to bend the Protocol in that direction while prostitutes’ rights groups have used it to critique current Brazilian laws, emphasising the need to distinguish migration for voluntary, consensual sex work from trafficking. Groups concerned with organ trafficking (a crime for which there are practically no proven cases in Brazil) have managed to push their banner to the fore in the trafficking debate. Meanwhile, Brazil’s long-established and relatively successful anti-slave labour movement has been loath to ‘change their brand’, having already gained a considerable degree of institutionalisation prior to Brazil’s ratification of the Protocol in 2004.[1] C Lévi-Strauss, ‘Introduction à l'oeuvre de Marcel Mauss’ in Mauss, Sociologie et Anthropologie, Paris, 1950.