bluuebunny/crossref_metadata_2025 huggingface dataset:
Does prucalopride reduce the dose of sodium phosphate in bowel preparation? A single‐blind, randomized, and prospective study
Authors: Hung Jui‐Sheng , Yi Chih‐Hsun , Liu Tso‐Tsai , Lei Wei‐Yi , Wong Ming‐Wun , Chen Chien‐Lin
Published: May 2019

Objective

Sodium phosphate solution (NaP) in oral form is well known and frequently used for good quality bowel cleansing before a colonoscopy, but it carries the potential risk of electrolyte disturbance and dehydration. Prucalopride mitigates severe constipation by promoting colon motility. We evaluated the hypothesis that prucalopride plus one single dose of 45 mL NaP could be used as an alternative bowel preparation.

Methods

Consenting adult patients undergoing a screening colonoscopy were randomized to receive 90 mL NaP (90‐NaP) in two split doses or prucalopride 2 mg plus 45 mL NaP (P‐NaP). Patients completed a questionnaire about adverse gastrointestinal symptoms and acceptability for bowel preparation. The effectiveness of colon preparation was evaluated according to the Ottawa bowel preparation scale.

Results

Bowel cleansing was achieved in 92 patients with 90‐NaP and in 97 patients with P‐NaP. There was no significant difference in bowel cleansing level and adverse gastrointestinal symptoms between the two groups. However, more patients in the P‐NaP group were willing to undertake the same regimen for a subsequent colonoscopy bowel preparation than those in 90‐NaP group (82/97; 85% vs 51/92; 55%, P < 0.001).

Conclusion

The combination of 2 mg prucalopride and 45 mL NaP appeared to provide the same level of bowel cleansing, but it was more acceptable than the 90 mL NaP in split doses.
Body mass index and glucocorticoid dose contribute to subclinical atherosclerosis in Korean patients with systemic lupus erythematosus: A prospective 4 year follow‐up study
Authors: Jung Ju‐Yang , Kim Hyoun‐Ah , Lee Hyun‐Young , Suh Chang‐Hee
Published: May 2019

Aim

Patients with systemic lupus erythematosus (SLE) have an increased risk of cardiovascular disease owing to an immunological abnormality, along with traditional risk factors. We found that carotid artery intima‐media thickness (cIMT) and plaque were associated with age, body mass index (BMI) and disease activity in a previous study 4 years ago. Our aim was to identify risk factors associated with progression of subclinical atherosclerosis in SLE.

Methods

We assessed cIMT and plaque using Doppler ultrasonography in 61 Korean women with SLE who were enrolled in the previous study 4 years ago.

Results

The mean cIMT of the patients was 0.39 ± 0.09 mm; 11 patients had carotid plaques, which was similar to the results of the previous study. Twenty‐one patients had increased cIMT, and new carotid plaque had developed in seven patients. Patients with increased cIMT had a lower BMI and took fewer non‐steroidal anti‐inflammatory drugs and higher 4 year cumulative glucocorticoid dose than patients without increased cIMT. The 4 year cumulative glucocorticoid dose was higher in patients with carotid plaque than in those without. On multivariate regression analysis, BMI (odds ratio [OR] = 0.67, P = 0.034) was associated with increased cIMT, and the 4 year cumulative glucocorticoid dose was associated with increased cIMT (OR = 6.994, P = 0.025) and carotid plaque (OR = 5.651, P = 0.031).

Conclusion

This prospective follow‐up study on cIMT and plaque in patients with SLE showed that low BMI and 4 year cumulative glucocorticoid dose were associated with the progression of subclinical atherosclerosis.
Capillaroscopy changes are associated with disease progression in patients with early systemic sclerosis: A prospective study
Authors: Zumstein Camargo Cintia , Kayser Cristiane
Published: May 2019

Aim

After the development of the 2013 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) classification criteria for systemic sclerosis (SSc), there are still a group of patients affected by early SSc who do not meet the new criteria. This study aimed to evaluate capillaroscopy changes and to identify predictors of progression to definite SSc in patients with early SSc over a 3‐year follow‐up.

Methods

In this prospective study, 44 patients with early SSc (LeRoy and Medsger 2001 criteria) were included. Clinical evaluation and widefield nailfold capillaroscopy were performed at baseline and after 3 years of follow‐up. At the end of follow‐up, the fulfilment of the 2013 ACR/EULAR criteria was also assessed.

Results

After 3 years, 34 patients with early SSc were re‐evaluated. Of these, eight patients (23.5%) developed definite SSc. Worsening of capillaroscopy parameters was observed in 55.9% of patients. An increase in the number of giant capillaries and worsening of the avascular score were more frequent in patients who developed SSc than in those who did not (P = 0.02; P = 0.002, respectively). By multivariate analysis, an active or a late pattern at baseline on capillaroscopy was an independent predictor for the development of definite SSc (odds ratio = 30.0, 95% CI 2.1‐421.1).

Conclusions

In this prospective study, worsening in capillaroscopy parameters was observed in early SSc patients. An active or a late pattern on capillaroscopy was an independent predictive risk factor for the development of SSc, suggesting that capillaroscopy might be a useful tool to identify patients with early SSc at risk of disease progression.
Partitioning intraspecific variation in seed dispersal potential using a low‐cost method for rapid estimation of samara terminal velocity
Authors: Wyse Sarah V. , Hulme Philip E. , Holland E. Penelope
Published: May 2019

Seed or samara terminal velocity is a key trait affecting the dispersal potential of wind‐dispersed plants. However, this trait is often represented in dispersal models by a single mean value per species. This is despite considerable variation in dispersal traits within species and individuals that may have implications for both phenotypic selection and rates of spread. Methodological constraints may have acted as a barrier for robust assessments of intraspecific variation in seed terminal velocity.

To quantify intraspecific variation in wind dispersal traits, we develop a low‐cost, time‐efficient method to measure the terminal velocity of a large number of samaras. We made three separate terminal velocity measurements for each of 750 Pinus radiata samaras, allowing partitioning of variation among individual cones, trees and source populations. We use the mechanistic WALD model to assess the potential influence of observed variation in samara terminal velocity on predicted dispersal kernels under a variety of realistic conditions.

We demonstrate a twofold range in samara terminal velocity within P. radiata, with the highest variation occurring within individual cones, and the lowest among cones within individual trees. We identify a potential influence of source population on terminal velocity. Our modelling results demonstrate that this within‐species variation is sufficient to affect the shape of the predicted dispersal kernels, particularly the kernel tails and therefore the likelihood of long‐distance dispersal events. The effect of samara terminal velocity on dispersal is especially pronounced under environmental conditions that enhance seed dispersal.

Our findings illustrate the scale of within‐species variation in a key dispersal trait, and the likely effect of this variation on dispersal distance. We suggest that the high level of variation observed within individual cones of P. radiata is likely to reduce the potential for phenotypic selection, and may either be indicative of a “bet‐hedging” strategy, or simply the result of the constraints of cone morphology on samara development. To obtain accurate dispersal models for wind‐dispersed species we highlight the necessity of capturing this variation for inclusion in future modelling approaches, and describe a device that can achieve such measurements easily and at low cost.
Anomalous Kv7 channel activity in human malignant hyperthermia syndrome unmasks a key role for H2S and persulfidation in skeletal muscle
Authors: Vellecco Valentina , Martelli Alma , Bibli Iris Sofia , Vallifuoco Marianna , Manzo Onorina L. , Panza Elisabetta , Citi Valentina , Calderone Vincenzo , de Dominicis Gianfranco , Cozzolino Caterina , Basso Elisabetta M. , Mariniello Martina , Fleming Ingrid , Mancini Antonio , Bucci Mariarosaria , Cirino Giuseppe
Published: May 2019

Background and Purpose

Human malignant hyperthermia (MH) syndrome is induced by volatile anaesthetics and involves increased levels of cystathionine β‐synthase (CBS)‐derived H2S within skeletal muscle. This increase contributes to skeletal muscle hypercontractility. Kv7 channels, expressed in skeletal muscle, may be a molecular target for H2S. Here, we have investigated the role of Kv7 channels in MH.

Experimental Approach

Skeletal muscle biopsies were obtained from MH‐susceptible (MHS) and MH‐negative (MHN) patients. Immunohistochemistry, RT‐PCR, Western blot, and in vitro contracture test (IVCT) were carried out. Development and characterization of primary human skeletal muscle cells (PHSKMC) and evaluation of cell membrane potential were also performed. The persulfidation state of Kv7 channels and polysulfide levels were measured.

Key Results

Kv7 channels were similarly expressed in MHN and MHS biopsies. The IVCT revealed an anomalous contractility of MHS biopsies following exposure to the Kv7 channel opener retigabine. Incubation of negative biopsies with NaHS, prior to retigabine addition, led to an MHS‐like positive response. MHS‐derived PHSKMC challenged with retigabine showed a paradoxical depolarizing effect, compared with the canonical hyperpolarizing effect. CBS expression and activity were increased in MHS biopsies, resulting in a major polysulfide bioavailability. Persulfidation of Kv7.4 channels was significantly higher in MHS than in MHN biopsies.

Conclusions and Implications

In skeletal muscle of MHS patients, CBS‐derived H2S induced persulfidation of Kv7 channels. This post‐translational modification switches the hyperpolarizing activity into depolarizing. This mechanism can contribute to the pathological skeletal muscle hypercontractility typical of MH syndrome.

Linked Articles

This article is part of a themed section on Hydrogen Sulfide in Biology & Medicine. To view the other articles in this section visithttp://onlinelibrary.wiley.com/doi/10.1111/bph.v177.4/issuetoc
Mechanisms and roles of mitophagy in neurodegenerative diseases
Authors: Wang Yan , Liu Na , Lu Bingwei
Published: May 2019

Mitochondria are double‐membrane‐encircled organelles existing in most eukaryotic cells and playing important roles in energy production, metabolism, Ca2+buffering, and cell signaling. Mitophagy is the selective degradation of mitochondria by autophagy. Mitophagy can effectively remove damaged or stressed mitochondria, which is essential for cellular health. Thanks to the implementation of genetics, cell biology, and proteomics approaches, we are beginning to understand the mechanisms of mitophagy, including the roles of ubiquitin‐dependent and receptor‐dependent signals on damaged mitochondria in triggering mitophagy. Mitochondrial dysfunction and defective mitophagy have been broadly associated with neurodegenerative diseases. This review is aimed at summarizing the mechanisms of mitophagy in higher organisms and the roles of mitophagy in the pathogenesis of neurodegenerative diseases. Although many studies have been devoted to elucidating the mitophagy process, a deeper understanding of the mechanisms leading to mitophagy defects in neurodegenerative diseases is required for the development of new therapeutic interventions, taking into account the multifactorial nature of diseases and the phenotypic heterogeneity of patients.
Effect of a single dose of insulin glargine/lixisenatide fixed ratio combination (iGlarLixi) on postprandial glucodynamic response in Japanese patients with type 2 diabetes mellitus: A phase I randomized trial
Authors: Inoue Megumi , Lorenz Martin , Muto Hideya , Wesch Roland , Hashimoto Yasuhiro
Published: May 2019

This report describes novel clinical data assessing the pharmacodynamics of insulin glargine/lixisenatide (iGlarLixi) compared with placebo and insulin glargine alone, to determine pharmacokinetics of lixisenatide, and to assess safety of iGlarLixi in Japanese people with type 2 diabetes mellitus (T2DM). In a single‐centre, open‐label, randomized, placebo‐controlled cross‐over study, participants received subcutaneous iGlarLixi 5 U/5 μg and 10 U/10 μg, placebo, and 5 U insulin glargine. The primary endpoint was area under the postprandial plasma glucose (PPG) curve (AUC0–2h). A total of 20 participants completed all study periods. iGlarLixi 5 U/5 μg and 10 U/10 μg reduced mean PPG dose‐dependently compared with placebo and insulin glargine 5 U. Both combinations significantly reduced PPG‐AUC0–2h dose‐dependently compared with placebo (least squares mean difference −7.48 mmol h/L for 5 U/5 μg, −10.75 mmol h/L for 10 U/10 μg; P < 0.0001). iGlarLixi 5 U/5 μg reduced PPG‐AUC0–2h significantly compared with insulin glargine 5 U (−0.76 mmol h/L; P < 0.0001). No symptomatic hypoglycaemia occurred during the study. iGlarLixi single subcutaneous injections significantly and dose‐dependently reduced PPG compared to placebo or insulin glargine in Japanese participants with T2DM. iGlarLixi was safe and well tolerated, and would be expected to provide the 24‐hour plasma glucose‐lowering effects of insulin glargine and the postprandial antihyperglycaemic effects of lixisenatide.
Epicardial and pericardial adipose tissues are associated with reduced diastolic and systolic function in type 2 diabetes
Authors: Christensen Regitse H. , Hansen Christian S. , von Scholten Bernt Johan , Jensen Magnus T. , Pedersen Bente K. , Schnohr Peter , Vilsbøll Tina , Rossing Peter , Jørgensen Peter G.
Published: May 2019

The aim of this study was to investigate the association of epicardial (EAT) and pericardial (PAT) adipose tissues with myocardial function in type 2 diabetes (T2D). EAT and PAT were measured by ultrasound in 770 patients with T2D and 234 age‐ and sex‐matched non‐diabetic controls. Echocardiography was performed, including tissue Doppler imaging and 2D speckle tracking. Patients with T2D versus controls had increased EAT (4.6 ± 1.8 mm vs. 3.4 ± 1.2 mm, P < 0.0001) and PAT (6.3 ± 2.8 mm vs. 5.3 ± 2.4 mm, P < 0.0001). EAT and PAT were associated with structural cardiac measures both in T2D patients and controls (all P < 0.043), but only in T2D patients with functional measures: PAT was associated with impaired global longitudinal strain [beta coefficient (SE)] [0.11% (0.04), P = 0.002], while EAT was associated with reduced diastolic function by lateral early diastolic myocardial velocity (e’lat) [−0.31 (0.05) cm/s, P = 0.001], mitral inflow velocities: peak early (E)/peak atrial (A) ratio [−0.02 (0.01), P = 0.001] and lateral E/e’lat [0.36 (0.10), P < 0.001]. However, no interaction was found between diabetes status and PAT (P = 0.75) or EAT (P = 0.45). Adipose tissue in intimate relation to the myocardium is higher in patients with T2D versus controls and is associated with functional myocardial measures in T2D.
Bariatric surgery is associated with a lower rate of death after myocardial infarction and stroke: A nationwide study
Authors: Aminian Ali , Aleassa Essa M. , Bhatt Deepak L. , Tu Chao , Khorgami Zhamak , Schauer Philip R. , Brethauer Stacy A. , Daigle Christopher R.
Published: May 2019

Aim

To assess the potential protective effect of bariatric surgery on mortality after myocardial infarction (MI) or cerebrovascular accident (CVA).

Materials and Methods

Using the National Inpatient Sample (2007‐2014), 2218 patients with a principal discharge diagnosis of acute MI and 2168 patients with ischaemic CVA who also had history of prior bariatric surgery were identified. Utilizing propensity scores, these patients were matched 1:5 with patients who had similar principal diagnoses but no history of bariatric surgery (controls). Control group‐1 included participants with obesity (BMI ≥ 35 kg/m2) only and participants in control group‐2 were matched according to post‐surgery BMI with the bariatric surgery group. The primary and secondary endpoints were in‐hospital all‐cause mortality and length of hospital stay, respectively. Outcomes after MI and CVA were separately compared among groups in multivariate regression models.

Results

A total of 48 300 (weighted) participants were included in the analysis. The distribution of covariates was well balanced after propensity matching. Mortality rates after MI were significantly lower in patients with a history of bariatric surgery compared with control group‐1 (1.85% vs 3.03%; odds ratio (OR), 0.61; 95% confidence interval (CI), 0.44‐0.86; P = 0.004) and with control group‐2 (2.00% vs 3.26%; OR, 0.62; 95% CI, 0.44‐0.88; P = 0.008). Similarly, in‐hospital mortality rates after CVA were significantly lower in patients with a history of bariatric surgery compared with control group‐1 (1.43% vs 2.74%; OR, 0.54; 95% CI, 0.37‐0.79; P = 0.001) and with control group‐2 (1.54% vs 2.59%; OR, 0.61; 95% CI, 0.41‐0.91; P = 0.015). Furthermore, length of stay was significantly shorter in the bariatric surgery group for all comparisons (P < 0.001).

Conclusion

Prior bariatric surgery is associated with significant protective effect on survival after MI and CVA.
Population‐level consequences of seismic surveys on fishes: An interdisciplinary challenge
Authors: Slabbekoorn Hans , Dalen John , de Haan Dick , Winter Hendrik V. , Radford Craig , Ainslie Michael A. , Heaney Kevin D. , van Kooten Tobias , Thomas Len , Harwood John
Published: May 2019

Offshore activities elevate ambient sound levels at sea, which may affect marine fauna. We reviewed the literature about impact of airgun acoustic exposure on fish in terms of damage, disturbance and detection and explored the nature of impact assessment at population level. We provided a conceptual framework for how to address this interdisciplinary challenge, and we listed potential tools for investigation. We focused on limitations in data currently available, and we stressed the potential benefits from cross‐species comparisons. Well‐replicated and controlled studies do not exist for hearing thresholds and dose–response curves for airgun acoustic exposure. We especially lack insight into behavioural changes for free‐ranging fish to actual seismic surveys and on lasting effects of behavioural changes in terms of time and energy budgets, missed feeding or mating opportunities, decreased performance in predator‐prey interactions, and chronic stress effects on growth, development and reproduction. We also lack insight into whether any of these effects could have population‐level consequences. General “population consequences of acoustic disturbance” (PCAD) models have been developed for marine mammals, but there has been little progress so far in other taxa. The acoustic world of fishes is quite different from human perception and imagination as fish perceive particle motion and sound pressure. Progress is therefore also required in understanding the nature and extent to which fishes extract acoustic information from their environment. We addressed the challenges and opportunities for upscaling individual impact to the population, community and ecosystem level and provided a guide to critical gaps in our knowledge.
Analysis of stresses and displacements in the vicinity of blunt V‐notches by considering higher order terms
Authors: Bahrami Bahador , Ayatollahi Majid R. , Mirzaei Amir Mohammad
Published: May 2019

Mode I asymptotic stress and displacement fields of blunt V‐notches are calculated based on the Muskhelishvili's approach. First, by using appropriate complex potential functions, the stress and displacement components in the polar coordinate system are determined. By applying proper mapping, the notch profile is built up, and then by utilizing the near‐field boundary conditions, free parameters are specified. Afterwards, the solution procedure available for the singular term is extended for higher order terms leading to asymptotic relations for stress and displacement fields. Subsequently, the coefficients of the asymptotic stress fields are computed by using a numerical procedure named “overdeterministic” technique. It is shown that the proposed method that considers the higher order terms yields very good results, whereas the methods based only on the singular term have significant errors. Finally, some parameters affecting the convergence of the numerical results are studied and discussed.
Field‐related quality management system for grass silage production
Authors: Pickert Jürgen , Brüning Dave , Mersch Ferdinand , Herrmann Antje , Weise Gerhard
Published: May 2019

A model for the prediction of the silage quality was tested in several large farms in northeast Germany. The model uses data and information on the fresh grass and the application of silage additives at ensiling to evaluate the “ensilability.” During clamp filling, the model analyses information on the filling performance, activity of compacting machines and hermitic covering of the clamp and evaluates the “ensiling technique.” Both “ensilability” and “ensiling technique” are assessed as “good,” “medium” or “bad” and pooled in “silage evaluation grades” 1–5. In the present model version, the predicted silage net energy lactation (NEL) and crude protein (CP) content is between 3% (for the best grade 1) and 15% (for the weakest grade 5) lower than the fresh grass NEL and CP content. In our experiments, all the grass silage production systems were characterized by “good” “ensilability” and “ensiling technique.” Under those circumstances, the experimental results indicated a closer numerical relation between fresh grass and measured silage NEL and CP content than between predicted silage and measured silage NEL and CP content. The results reveal that the model prediction calculation should be changed compared to the present version. If “ensilability” and “ensiling technique” are evaluated as “good,” the predicted silage NEL and CP content should be forecasted in a range between 0% and 3% decrease compared to fresh grass.
A New Interlaboratory Characterisation of Silicon, Rare Earth Elements and Twenty‐Two Other Trace Element Concentrations in the Natural River Water Certified Reference Material SLRS‐6 (NRC‐CNRC)
Authors: Yeghicheyan Delphine , Aubert Dominique , Bouhnik‐Le Coz Martine , Chmeleff Jérôme , Delpoux Sophie , Djouraev Irina , Granier Guy , Lacan François , Piro Jean‐Luc , Rousseau Tristan , Cloquet Christophe , Marquet Aurélie , Menniti Christophe , Pradoux Catherine , Freydier Rémi , Vieira da Silva‐Filho Emmanoel , Suchorski Krzysztof
Published: May 2019

The natural river water reference material SLRS‐6 (NRC‐CNRC) is the newest batch of a quality control material routinely used in many international environmental laboratories. This work presents a nine‐laboratory compilation of measurements of major and trace element concentrations and their related uncertainties, unavailable in the NRC‐CNRC certificate (B, Cs, Li, Ga, Ge, Hf, Nb, P, Rb, Rh, Re, S, Sc, Se, Si, Sn, Th, Ti, Tl, W, Y, Y, Zr and REEs). Measurements were mostly made using inductively coupled plasma‐mass spectrometry. The results are compared with equivalent data for the last batch of the material, SLRS‐5, measured simultaneously with SLRS‐6 in this study. In general, very low concentrations, close to the quantification limits, were found in the new batch. The Sr isotopic ratio is also reported.
Patterns of patient withdrawal from BCG treatment for bladder cancer: A retrospective time interval analysis
Authors: Alcorn Jason , Burton Rob , Topping Annie
Published: May 2019

The research aim of this research was to answer the questions of what were the patterns that have been recorded for the withdrawal from BCG treatment and what individual factors influenced the withdrawal? Bacillus Calmette‐Guerin (BCG) vaccine was first introduced at the turn of the 19th to 20th century and since the 1970s has become significant in the treatment of non‐muscle invasive bladder cancer (NMIBC). It is concerning to note that little is known about the patient experience of this intravesical treatment, which is particularly concerning. Despite over 50 years of clinical use, early withdrawal from treatment rates of between 32% and 86% have been reported in the literature. This study sought to estimate the rate of non‐completion of BCG regime in one English National Health Service Cancer Unit and identify factors that contributed to patients' decisions to withdraw. A retrospective observational time interval study of a consecutive sample 234 case records of patients who underwent intravesical BCG treatment in one English National Health Service Cancer Unit, using time to event analysis. The population for this review was from a large metropolitan area in England, including a large northern town and satellites where heavy industry had dominated. The overall withdrawal rate was 211 (90%) prior to completion of induction and maintenance regime. The majority, 107 (46%) withdrew from treatment within the first year. Age, number of side effects and symptoms and contact with CNS were all associated with withdrawal. The data has shown that age, side effects, contact details and information giving may be factors that contribute to a patient deciding whether they stay on treatment or withdraw from it.
Workplace resilience and emotional labour of Australian mental health nurses: Results of a national survey
Authors: Delgado Cynthia , Roche Michael , Fethney Judith , Foster Kim
Published: May 2019

Emotional labour is a form of adversity faced by mental health nurses in the context of their workplace interactions. Frequent exposure to emotional adversity can negatively impact mental health nurses’ biopsychosocial well‐being, workplace relationships, and performance. Workplace resilience is a dynamic interactive process within and between the person and their environment that promotes positive adaptation to adverse events and restores well‐being. Workplace resilience could be a protective process that helps mental health nurses positively adapt to workplace emotional adversity. This study aimed to investigate Australian mental health nurses’ workplace resilience and emotional labour and explore the relationship between them. A national cross‐sectional online survey comprising the Resilience at Work and Emotional Labour scales was completed by registered nurses (n = 482) working in a mental health role or setting across Australia. There was a strong negative relationship between resilience and the emotional labour strategy of surface acting. A positive association between resilience, frequency of emotional labour, and clinical supervision was also found. These findings point to a potential link between mental health nurses’ skills of cognitive reframing, and emotional and behavioural regulation needed to effectively manage their emotions and remain therapeutic in interpersonal interactions. Clinical supervision may be a key strategy in supporting mental health nurses’ resilience. Further investigation of workplace individuals’ internal and external resources, and organizational resources, supports, and strategies that can promote and strengthen mental health nurses’ well‐being is needed.
Holistic nursing competence scale: Turkish translation and psychometric testing
Authors: Aydin A. , Hiçdurmaz D.
Published: May 2019

Aim

This study aimed to culturally adapt and evaluate the reliability and validity of the Holistic Nursing Competence Scale for application in the Turkish context.

Background

Nurses are expected to assess well‐being of individuals by considering physical, social, psychological, cultural and spiritual dimensions to enhance adaptation to diseases. In Turkey, no tools have been developed to date for the evaluation of competencies in holistic nursing in the country.

Methods

The study was conducted with 288 nurses working in two hospitals in Ankara equipped with over 500 beds. A confirmatory factor analysis was performed in order to identify whether the items and the sub‐dimensions of the adapted scale complied with the original structure comprising 36 items and five sub‐scales, namely ‘general aptitude’, ‘staff education and management’, ‘ethically oriented practice’, ‘nursing care in a team’ and ‘professional development’. Cronbach's alpha value was used as an estimate for reliability analysis.

Results

Opinions of 11 experts were obtained for content validation of the scale, and the content validity index was 0.90. The adaptation was observed to be acceptable on the basis of structural equation model fit indices in confirmatory factor analysis. Cronbach's alpha value was estimated to be 0.97 and 0.90, respectively, for the complete scale.

Conclusion

The study identified the Turkish version of Holistic Nursing Competence Scale as a valid and reliable tool for the evaluation of competence in holistic nursing among nurses.

Implications for nursing and nursing policy

The instrument may now be utilized as a tool of measurement in nursing practice, as well as in education and research, for identifying the level of competence in the holistic nursing practices among the nurses in Turkey.
Predicting 1‐Year Mortality in Older Hospitalized Patients: External Validation of the HOMR Model
Authors: Curtin Denis , Dahly Darren L. , van Smeden Maarten , O'Donnell Desmond P. , Doyle David , Gallagher Paul , O'Mahony Denis
Published: May 2019

OBJECTIVES

Accurate prognostic information can enable patients and physicians to make better healthcare decisions. The Hospital‐patient One‐year Mortality Risk (HOMR) model accurately predicted mortality risk (concordance [C] statistic = .92) in adult hospitalized patients in a recent study in North America. We evaluated the performance of the HOMR model in a population of older inpatients in a large teaching hospital in Ireland.

DESIGN

Retrospective cohort study.

SETTING

Acute hospital.

PARTICIPANTS

Patients aged 65 years or older cared for by inpatient geriatric medicine services from January 1, 2013, to March 6, 2015 (n = 1654). After excluding those who died during the index hospitalization (n = 206) and those with missing data (n = 39), the analytical sample included 1409 patients.

MEASUREMENTS

Administrative data and information abstracted from hospital discharge reports were used to determine covariate values for each patient. One‐year mortality was determined from the hospital information system, local registries, or by contacting the patient's general practitioner. The linear predictor for each patient was calculated, and performance of the model was evaluated in terms of its overall performance, discrimination, and calibration. Recalibrated and revised models were also estimated and evaluated.

RESULTS

One‐year mortality rate after hospital discharge in this patient cohort was 18.6%. The unadjusted HOMR model had good discrimination (C statistic = .78; 95% confidence interval = .76‐.81) but was poorly calibrated and consistently overestimated mortality prediction. The model's performance was modestly improved by recalibration and revision (optimism corrected C statistic = .8).

CONCLUSION

The superior discriminative performance of the HOMR model reported previously was substantially attenuated in its application to our cohort of older hospitalized patients, who represent a specific subset of the original derivation cohort. Updating methods improved its performance in our cohort, but further validation, refinement, and clinical impact studies are required before use in routine clinical practice. J Am Geriatr Soc 1‐6, 2019.
Evidence‐Based Community Fall Prevention Programs at Senior Centers Near 10 US Academic Centers
Authors: Hamel Corey , Hekmatjah Natan , Hakakian Ben , Banooni Matthew , Lalezari Jonathan , Simino Matthew S. , Azizi Jacob , Zaghi David , Kamen Leon , Atanelov Levan
Published: May 2019

BACKGROUND/OBJECTIVES

The Centers for Disease Control and Prevention recommends that patients at risk of falling engage in evidence‐based community fall prevention programs (EBCFPPs). EBCFPPs are often delivered in senior centers (SCs). This is the first independent assessment of availability of EBCFPPs in SCs.

DESIGN

Cross‐sectional study of four types of EBCFPPs in the 25‐mile radius of 10 US academic centers (ACs).

SETTING

SCs.

PARTICIPANTS

SCs.

INTERVENTION

None.

MEASUREMENTS

Number and types of EBCFPPs offered at SCs.

RESULTS

Across the 10 ACs, 249 SCs were sampled. Of the SCs, 35% offered zero, 54% offered at least one, 9% offered at least two, and 2% offered at least three EBCFPPs. Tai Chi of any type was offered in 59.8%, A Matter of Balance was offered in 8.9%, Stepping On was offered in 8.0%, and Staying Active and Independent for Life was offered in 1.2% of SCs sampled. SCs near Columbia University offered all four of the programs, while those near the University of Utah, Johns Hopkins University, and Seattle University only offered three of the programs. In univariate analysis, the number of local SCs was significantly associated with quantity of EBCFPPs (odds ratio [OR] = 2.2; 95% confidence interval [CI] = 1.9‐2.6; P < .001), but not with diversity of EBCFPPs (OR = 1.0; 95% CI = 1.0‐1.1; P = .13). In multivariate regression, city, sex distribution, and average household income did not correlate with the overall number or the diversity of EBCFPPs, whereas locales with more SCs offered more EBCFPPs (OR = 2.2; 95% CI = 1.7‐2.9; P < .001).

CONCLUSIONS

A significant number of SCs still do not offer any EBCFPPs. From those that do, few offer a diversity of these programs. Opportunities exist to increase access to EBCFPPs in SCs.
Evaluating the Macroeconomic Effects of the ECB's Unconventional Monetary Policies
Authors: MOUABBI SARAH , SAHUC JEAN‐GUILLAUME
Published: May 2019

We quantify the macroeconomic effects of the European Central Bank's unconventional monetary policies using a dynamic stochastic general equilibrium model which includes a set of shadow interest rates. Extracted from the yield curve, these shadow rates provide unconstrained measures of the overall stance of monetary policy. Counterfactual analyses show that, without unconventional measures, the euro area would have suffered (i) a substantial loss of output since the Great Recession and (ii) a period of deflation from mid‐2015 to early 2017. Specifically, year‐on‐year inflation and GDP growth would have been on average about 0.61% and 1.09% below their actual levels over the period 2014Q1–17Q2, respectively.
Development of the basal hypothalamus through anisotropic growth
Authors: Fu Travis , Pearson Caroline , Towers Matthew , Placzek Marysia
Published: May 2019

The adult hypothalamus is subdivided into distinct domains: pre‐optic, anterior, tuberal and mammillary. Each domain harbours an array of neurones that act together to regulate homeostasis. The embryonic origins and the development of hypothalamic neurones, however, remain enigmatic. Here, we summarise recent studies in model organisms that challenge current views of hypothalamic development, which traditionally have attempted to map adult domains to correspondingly located embryonic domains. Instead, new studies indicate that hypothalamic neurones arise from progenitor cells that undergo anisotropic growth, expanding to a greater extent than other progenitors, and grow in different dimensions. We describe in particular how a multipotent Shh/Fgf10‐expressing progenitor population gives rise to progenitors throughout the basal hypothalamus that grow anisotropically and sequentially: first, a subset displaced rostrally give rise to anterior‐ventral/tuberal neuronal progenitors; then a subset displaced caudally give rise to mammillary neuronal progenitors; and, finally, a subset(s) displaced ventrally give rise to tuberal infundibular glial progenitors. As this occurs, stable populations of Shh+ive and Fgf10+ive progenitors form. We describe current understanding of the mechanisms that induce Shh+ive/Fgf10+ive progenitors and begin to direct their differentiation to anterior‐ventral/tuberal neuronal progenitors, mammillary neuronal progenitors and tuberal infundibular progenitors. Taken together, these studies suggest a new model for hypothalamic development that we term the “anisotropic growth model”. We discuss the implications of the model for understanding the origins of adult hypothalamic neurones.
The influence of flap design on sequelae and quality of life following surgical removal of impacted mandibular third molars: A split‐mouth randomised clinical trial
Authors: Şimşek Kaya Göksel , Yapıcı Yavuz Günay , Saruhan Nesrin
Published: May 2019

Background

Surgical removal of impacted mandibular third molar is one of the most frequently performed interventions in oral and maxillofacial surgery.

Objectives

To compare two different flap designs in terms of sequelae and quality of life following surgical removal of impacted third molars.

Methods

This prospective, randomised, split‐mouth clinical study involved patients referred for surgical removal of bilateral symmetrical impacted mandibular third molars. Envelope flap and modified triangular flap techniques were used. The effects of flap design on trismus, swelling, wound dehiscence, alveolar osteitis, haematoma, infection and quality of life were evaluated on post‐operative days 3 and 7. Pain levels were assessed on post‐operative days 1, 3 and 7.

Results

Significant differences were determined between the two groups in terms of trismus, pain and wound dehiscence scores on post‐operative day 3. However, on post‐operative day 7, this difference was observed only in trismus. Statistically significant differences were also determined between the two groups on post‐operative day 3 for social isolation and eating subscale scores as well as total quality of life score.

Conclusion

Based on the study findings, the modified triangular flap may be superior to the envelope flap in terms of pain, trismus, and wound dehiscence in the first 3 days after impacted third molar surgery and may have a better impact on quality of life during this process.
Data approximation strategies between generalized line scales and the influence of labels and spacing
Authors: Kershaw Jonathan C. , Running Cordelia A.
Published: May 2019

Comparing sensory data gathered using different line scales is challenging. We tested whether adding internal labels to a generalized visual analog scale (gVAS) would improve comparability to a typical generalized labeled magnitude scale (gLMS). Untrained participants evaluated cheeses using one of four randomly assigned scales. Normalization to a cross‐modal standard and/or two gLMS transformations were applied to the data. Response means and distributions were lower for the gLMS than the gVAS, but no difference in resolving power was detected. The presence of labels, with or without line markings, caused categorical‐like lumping of responses. Closer low‐end label spacing for gLMS increased influenced participants to mark near higher intensity labels when they were evaluating low‐intensity samples. Although normalization reduced differences between scales, neither transformation nor normalization was supported as appropriate gLMS/gVAS approximation strategies. This study supports previous observations that neither scale offers a systematic advantage and that participant usage differences limit direct scale comparisons.

Practical applications

Practitioners should exercise caution when comparing between gVAS and gLMS data, as neither normalization nor transformations make these equivalent. The value of qualitative information from internal labels generalized labeled magnitude scale (gLMS) and the expected intensity of samples should be considered when choosing a scale (generalized visual analog scale may be better for lower intensity samples, gLMS for high intensity). While all scales in this study provide valid information regarding sample intensity, the impact of scale on statistical assumptions, most notably the non‐normal distribution of residuals from gLMS data, should also be considered and corrected when necessary.
In ovo injection of branched‐chain amino acids: Embryonic development, hatchability and hatching quality of turkey poults
Authors: Kop‐Bozbay Canan , Ocak Nuh
Published: May 2019

In this study, the influence of a branched‐chain amino acid blend (BCAA composed of 3 l‐leucine:1 l‐valine:2 l‐isoleucine) injected into the amniotic fluid was evaluated for embryonic growth, yolk‐sac (YS) utilization and development of gastrointestinal tract (GIT) and skeletal muscles of turkey embryos from day 24 of incubation (24E) to hatching, together with hatchability, poult quality and liver L* (lightness), a* (redness) and b* (yellowness) values at hatch. At day 22 of incubation, embryonated eggs (n = 240) were assigned to three treatments, that is, eggs were not injected (control, NC) or injected with 1.5 ml sterile solution with 0.9% salt (SA) or 0.2% BCAA blend (BCAAb). These solutions were injected manually into the amniotic fluid of the embryonated eggs. To determine weights and lengths (where appropriate) of the studied organs and tissues, four embryonated eggs and poults per treatment were selected at 24E and at hatch. While the BCAAb decreased the YS and embryo weight, hatchability and the liver L* value, it increased the weight and quality of poults and the weights of breast and thigh muscles at hatch. In conclusion, the in ovo feeding of the BCAA blend negatively affected hatchability but positively affected hatching weight and poult quality by improving development of skeletal muscles and by regulating energy metabolism.
Effect of dietary nutmeg oil on heat‐stress tolerance‐related parameters in Korean native chicken reared under hot temperature
Authors: Hartanto Slamet , Ko Han Seo , Jee Seung Hwan , Kang Ji Ung , Seo Jee Soo , Kang Yu Hyun , Kim Hee Na , Ohh Sang Jip
Published: May 2019

This study investigated the effect of dietary nutmeg oil (NO) on growth performance, blood parameters, lipid peroxidation and heat shock protein (HSP) 70 expression in Korean native chicken (KNC) reared under hot temperature. We allocated 273 meat‐type KNCs (Hanhyup‐3, 4‐week‐old, body weight [BW] = 539.93 ± 1.75 g) to the following three treatments with seven replicate pens (13 birds/pen) per treatment. Three treatment diets were as follows: (a) Control, basal diet without NO supplementation; (b) NO 250; and (c) NO 500, basal diet supplemented with 250 and 500 ppm NO respectively. Diets and water were provided ad libitum throughout the 6‐week feeding trial. During overall period (0–6 weeks), no differences (p > 0.05) were observed in BW gain (BWG), feed intake (FI) and feed conversion rate (FCR) among treatments. However, the FI at 0–3 weeks decreased (p < 0.05) quadratically with increasing NO levels. Most blood parameters did not differ (p > 0.05) among treatments, although the monocyte level of the NO 500 group was considerably lower (p > 0.05) than that of the other groups. Furthermore, dietary NO did not affect serum triglyceride, cholesterol, total protein, albumin, calcium, phosphorus and alanine aminotransferase (ALT) levels (p > 0.05); however, it linearly decreased serum aspartate aminotransferase (AST) level (p < 0.05). Additionally, serum malondialdehyde (MDA) concentration decreased (p < 0.05) and heart MDA concentration was lower (p = 0.08) with increasing dietary NO supplementation. After a 3‐hr heat (35°C) challenge, the rectal temperature (RT) reduced (p < 0.05) linearly with increasing NO levels. Dietary NO did not affect liver HSP70 (p > 0.05) gene expression. In conclusion, NO potentially enhanced the ability of chickens to alleviate heat stress. Furthermore, our findings suggest that lipid oxidation inhibition by dietary NO likely mediated the enhanced heat‐stress tolerance of the chickens.
Snakes as a model for measuring skull preparation errors in geometric morphometrics
Authors: Souto N. M. , Murta‐Fonseca R. A. , Machado A. S. , Lopes R. T. , Fernandes D. S.
Published: May 2019

Researchers often use skulls prepared by different techniques in geometric morphometrics (GM). The main goal of this paper was to compare and measure errors in GM analyses using snake skulls prepared with two of these techniques (microCT Scan and chemical maceration). We evaluate if analyses employing skulls with both types of preparation may generate biased results or if this parameter is negligible. Thirty‐four heads of Liophis miliaris merremi were first scanned and subsequently prepared following the techniques of chemical maceration. We used 37 and 18 landmarks for dorsal and ventral views of skulls respectively. To evaluate shape differences between the same skull assessed by microCT Scan and chemical maceration, we performed discriminant analyses, Hotelling's T2 and cross‐validation tests. Discriminant analyses showed significant differences between preparation techniques for both views. However, all the differences between dried and microCT scanned skulls were smaller than those between individuals of the same taxon, which means that such differences are within the range of intraspecific variation. The results support the use of specimens prepared according to both techniques in studies of GM.
Slow looking: “reading picturebooks takes time”
Authors: Pantaleo Sylvia
Published: May 2019

One of the main purposes of the classroom‐based research featured in this article was to develop 9‐year‐old students' visual meaning‐making skills and competences by focusing specifically on elements of visual art and design in picturebooks. The complexity of the picturebook format requires and rewards slow looking by readers/viewers. However, students need to receive instruction about and have opportunities for engaging in slow looking in order to develop the disposition to do so. The discussion of slow looking is situated in four frameworks that focus on the centrality of careful observation of images. Descriptions of some of the pedagogy delivered during the study that featured students engaging in slow looking and visual analysis are followed by examples of students' written work that reveals their close observation of and analytical thinking about elements of visual art and design in picturebook artwork.
External validation of the modified PAGE‐B score in Asian chronic hepatitis B patients receiving antiviral therapy
Authors: Lee Hye Won , Kim Seung Up , Park Jun Yong , Kim Do Young , Ahn Sang Hoon , Han Kwang‐Hyub , Kim Beom Kyung
Published: May 2019

Background and Aims

The modified PAGE‐B (mPAGE‐B) score comprising age, gender, platelet count and albumin was recently proposed to predict hepatocellular carcinoma (HCC) risk among chronic hepatitis B (CHB) patients undergoing antivirals. Here, in the independent cohort, we externally validated the predictive performance of the mPAGE‐B score and compared it with those of conventional HCC prediction models.

Methods

We consecutively recruited CHB patients treated with lamivudine, entecavir or tenofovir as the first‐line antiviral regimen. Patients with decompensated cirrhosis or HCC at baseline were excluded. Predictive performances of the mPAGE‐B score and other models were assessed with comparison.

Results

Among 1330 patients, 9.6% developed HCC during follow‐up. The mPAGE‐B score provided the highest Harrell's c‐index (0.769), followed by the GAG‐HCC (0.751), PAGE (0.744), REACH‐B (0.686) and CU‐HCC (0.618) scores. The mPAGE‐B score showed the similar performance to the PAGE‐B and GAG‐HCC scores and the better performance than the REACH‐B and CU‐HCC scores. Cumulative HCC probabilities at 5‐ and 7‐years were 0.0% and 0.0% in low‐risk group (mPAGE‐B score ≤ 8), 6.1% and 10.8% in intermediate‐risk group (mPAGE‐B score 9‐12) and 18.7% and 26.7% in high‐risk group (mPAGE‐B score ≥ 13) respectively (both P < 0.001 between adjacent two groups). C‐indices of the mPAGE‐B score were 0.785 and 0.724 among subgroups treated with entecavir or tenofovir (n = 1011) and with lamivudine (n = 319), respectively, which are overall similar to those of the PAGE‐B score.

Conclusion

The mPAGE‐B score showed acceptable predictive performances. Compared to the PAGE‐B score, addition of albumin as a constituent provided the marginal benefit.