bluuebunny/crossref_metadata_2025 huggingface dataset:
Receipt and use of spoken and written over-the-counter medicine information: insights into Australian and UK consumers’ experiences
Authors: Tong Vivien , Raynor David K , Aslani Parisa
Published: May 2017

Objectives

To explore Australian and UK consumers’ receipt and use of spoken and written medicine information and examine the role of leaflets for consumers of over-the-counter (OTC) medicines.

Methods

Semistructured interviews were conducted with 37 Australian and 39 UK consumers to explore information received with their most recent OTC medicine purchase, and how information was used at different times post-purchase. Interviews were audio-recorded, transcribed verbatim and thematically analysed.

Key findings

Similarities were evident between the key themes identified from Australian and UK consumers’ experiences. Consumers infrequently sought spoken information and reported that pharmacy staff provided minimal spoken information for OTC medicines. Leaflets were not always received or wanted and had a less salient role as an information source for repeat OTC purchases. Consumers tended not to read OTC labels or leaflets. Product familiarity led to consumers tending not to seek information on labels or leaflets. When labels were consulted, directions for use were commonly read. However, OTC medicine information in general was infrequently revisited.

Conclusions

As familiarity is not an infallible proxy for safe and effective medication use, strategies to promote the value and use of these OTC medicine information sources are important and needed. Minimal spoken information provision coupled with limited written information use may adversely impact medication safety in self-management.
Machine learning reveals a non‐canonical mode of peptide binding to MHC class II molecules
Authors: Andreatta Massimo , Jurtz Vanessa I. , Kaever Thomas , Sette Alessandro , Peters Bjoern , Nielsen Morten
Published: May 2017

MHC class II molecules play a fundamental role in the cellular immune system: they load short peptide fragments derived from extracellular proteins and present them on the cell surface. It is currently thought that the peptide binds lying more or less flat in the MHC groove, with a fixed distance of nine amino acids between the first and last residue in contact with the MHCII. While confirming that the great majority of peptides bind to the MHC using this canonical mode, we report evidence for an alternative, less common mode of interaction. A fraction of observed ligands were shown to have an unconventional spacing of the anchor residues that directly interact with the MHC, which could only be accommodated to the canonical MHC motif either by imposing a more stretched out peptide backbone (an 8mer core) or by the peptide bulging out of the MHC groove (a 10mer core). We estimated that on average 2% of peptides bind with a core deletion, and 0·45% with a core insertion, but the frequency of such non‐canonical cores was as high as 10% for certain MHCII molecules. A mutational analysis and experimental validation of a number of these anomalous ligands demonstrated that they could only fit to their MHC binding motif with a non‐canonical binding core of length different from nine. This previously undescribed mode of peptide binding to MHCII molecules gives a more complete picture of peptide presentation by MHCII and allows us to model more accurately this event.
Transition to motherhood in women with an infant with special care needs
Authors: Korukcu O. , Deliktaş A. , Kukulu K.
Published: May 2017

Background

Mothers of infants with special care needs experience multiple transitions, as their babies are diagnosed with congenital anomalies and hospitalized during their transition to motherhood.

Aim

To examine the transition to motherhood in mothers of infants with special care needs, under the guidance of Meleis's Theory of Transition.

Methods

A descriptive qualitative approach was used. We followed a semi‐structured form prepared in accordance with Meleis's Theory of Transition's concepts. The sample of the study consisted of eight mothers of infants with congenital anomalies in a neonatal intensive care unit of a university hospital in Turkey. Interview transcripts were analysed using the content analysis method.

Results

After the interviews, transition to motherhood was obtained in three themes: facilitating and inhibiting, nursing therapeutic and response patterns. It was determined that mothers who can breastfeed their baby and touch them have a better adaptation to the transition process. Mothers' touching and breastfeeding their infants were accepted as turning points in their transition process.

Conclusion

It could be helpful for nurses to use Meleis's Theory of Transition in order understand the process of transition to motherhood for mothers of infants with special care needs.

Implications for nursing and health policy

This study highlights a necessity to prepare an orientation programme for families who will have a baby with a congenital anomaly. Such a programme, developed with multidisciplinary approaches, may help mothers having a baby with a congenital abnormally to adapt to their babies' situation and need for post‐partum care.
Investigation of the sintering mechanisms of GDC pellets obtained by the compaction of nanostructured oxide microspheres
Authors: Caisso Marie , Boulesteix Rémy , Picart Sébastien , Maître Alexandre , Delahaye Thibaud , Ayral André
Published: May 2017

The sintering behavior of green pellets obtained from nanostructured Ce0.8Gd0.2O1.9 submillimetric microspheres is studied in the present paper. Corresponding shrinkage rate curve shows a two‐step densification in dynamic conditions, with the presence of two successive extrema, at 1200 K and 1500 K. To fully understand this non‐common densification behavior, an iterative study was performed. Multiple characterizations point out multiscale organization of the matter with temperature giving rise to differential sintering stages of two different particle size classes. Concerning 1200 K‐first shrinkage rate maximum, it corresponds to the densification of nanometric aggregates of crystallites into submicrometric pre‐sintered aggregates, resulting in a specific porous microstructure with residual open porosity. As‐generated porosity combined with submicron size of pre‐sintered aggregates thus prevent from a homogeneous sintering illustrated by a single maximum shrinkage rate. Finally, the second maximum shrinkage rate at 1500 K can then be associated to optimal temperature for submicrometric particles sintering.
A systematic review of the evidence regarding cognitive therapy skills that assist cognitive behavioural therapy in adults who have an intellectual disability
Authors: Cooney Patricia , Tunney Conall , O'Reilly Gary
Published: May 2017

Background

Cognitive behavioural therapy (CBT) is being increasingly adapted for use with people who have an intellectual disability. However, it remains unclear whether inherent cognitive deficits that are present in adults who have an intellectual disability preclude the use of cognitive‐based therapies. This review aims to systematically examine “cognitive therapy skills” in adults who have an intellectual disability that assist engagement in CBT.

Method

Two authors independently reviewed titles and abstracts of articles located through electronic database searching.

Results

Outcomes of the 18 studies selected for full‐text review are mixed and limited by a moderately high risk of bias.

Conclusions

The authors suggest eleven findings from research areas of emotion recognition, cognitive mediation, discriminating between thoughts, feelings and behaviours, linking events and emotions that have implications for the design of CBT programmes and future research for this population.
Prevalence and potential factors associated with overweight and obesity status in adults with intellectual developmental disorders
Authors: Ranjan Sobhana , Nasser Jennifer A. , Fisher Kathleen
Published: May 2017

Background

The prevalence of being overweight and obese is increasing not just in the general population but also in individuals with intellectual disability (ID). Therefore, a need to identify factors contributing to overweight/obesity arises as this population is escalating.

Materials and Methods

This narrative review article summarizes pertinent research focusing on prevalence and the potential factors associated with overweight and obesity in adults with intellectual disability during the past decade.

Results

Prevalence of being overweight and obese among adults with intellectual disability is reportedly 28%‐71% and 17%‐43%, respectively. Factors increasing the susceptibility of being overweight or obese have been identified as female gender, increasing age, having a certain diagnosis, mild intellectual disability, as well as living independently/with family, consuming certain prescription medications, and non‐participation in physical activities.

Conclusion

Identification of the potential risk factors associated with being overweight and obese in this population will help tackle the challenges faced by this growing adult population with intellectual disability.
Providing end‐of‐life care in disability community living services: An organizational capacity‐building model using a public health approach
Authors: Grindrod Andrea , Rumbold Bruce
Published: May 2017

Background

There is broad consensus within the disability field that the end‐of‐life care offered to people with intellectual disabilities should be of a quality consistent with that advocated by contemporary palliative care. In practice, however, various barriers are encountered when applying palliative care strategies to the end‐of‐life care of people with intellectual disabilities, particularly those in disability community living services.

Methods

A mixed‐methods approach was used. Quantitative data were gathered through a survey of disability support staff working in government‐managed community living services in the Australian state of Victoria.

These quantitative data informed the collection of qualitative data through focus groups and research interviews. A public health palliative care framework provided the basis for developing an organizational change model from the consolidated data.

Results

There is a strong relationship between organizational structure and culture, and both influence end‐of‐life practice in community living services.

Barriers to good practice arise from the differing attitudes of paid carers involved, and from uncoordinated approaches reflecting misaligned service systems in the disability and palliative care fields. Organizational reorientation is crucial to achieving sustainable change that will support healthy dying.

Conclusions

End‐of‐life care requires the collaboration of disability and palliative care services, but for care to achieve palliative care goals, the collaboration must be led by disability services. We outline here an organizational model we have developed from public health principles to manage end‐of‐life care in community living services.
Fibroblast growth factor 2 protects against renal ischaemia/reperfusion injury by attenuating mitochondrial damage and proinflammatory signalling
Authors: Tan Xiao‐Hua , Zheng Xiao‐Meng , Yu Li‐Xia , He Jian , Zhu Hong‐Mei , Ge Xiu‐Ping , Ren Xiao‐Li , Ye Fa‐Qing , Bellusci Saverio , Xiao Jian , Li Xiao‐Kun , Zhang Jin‐San
Published: May 2017

Ischaemia‐reperfusion injury (I/RI) is a common cause of acute kidney injury (AKI). The molecular basis underlying I/RI‐induced renal pathogenesis and measures to prevent or reverse this pathologic process remains to be resolved. Basic fibroblast growth factor (FGF2) is reported to have protective roles of myocardial infarction as well as in several other I/R related disorders. Herein we present evidence that FGF2 exhibits robust protective effect against renal histological and functional damages in a rat I/RI model. FGF2 treatment greatly alleviated I/R‐induced acute renal dysfunction and largely blunted I/R‐induced elevation in serum creatinine and blood urea nitrogen, and also the number of TUNEL‐positive tubular cells in the kidney. Mechanistically, FGF2 substantially ameliorated renal I/RI by mitigating several mitochondria damaging parameters including pro‐apoptotic alteration of Bcl2/Bax expression, caspase‐3 activation, loss of mitochondrial membrane potential and KATP channel integrity. Of note, the protective effect of FGF2 was significantly compromised by the KATP channel blocker 5‐HD. Interestingly, I/RI alone resulted in mild activation of FGFR, whereas FGF2 treatment led to more robust receptor activation. More significantly, post‐I/RI administration of FGF2 also exhibited robust protection against I/RI by reducing cell apoptosis, inhibiting the release of damage‐associated molecular pattern molecule HMBG1 and activation of its downstream inflammatory cytokines such as IL‐1α, IL‐6 and TNF α. Taken together, our data suggest that FGF2 offers effective protection against I/RI and improves animal survival by attenuating mitochondrial damage and HMGB1‐mediated inflammatory response. Therefore, FGF2 has the potential to be used for the prevention and treatment of I/RI‐induced AKI.
Reproductive biology of black seabream Acanthopagrus schlegelii, threadfin porgy Evynnis cardinalis and red pargo Pagrus major in the northern South China Sea with consideration of fishery status and management needs
Authors: Law C. S. W. , Sadovy de Mitcheson Y.
Published: May 2017

The reproductive biology of three commercially significant seabream species (family: Sparidae) Acanthopagrus schlegelii, Evynnis cardinalis and Pagrus major, taken from Hong Kong and adjacent northern South China Sea (SCS) waters, were investigated for their sexual patterns, spawning seasons, length at maturity and exploitation in relation to their conservation and management status. Histological analysis showed E. cardinalis and P. major to be functionally gonochoristic, the latter having a bisexual juvenile stage and being a rudimentary hermaphrodite. Acanthopagrus schlegelii is a protandric hermaphrodite. Standard length (LS) at 50% sex change for A. schlegelii is 291 mm. LS at 50% female maturity for E. cardinalis and P. major are 117 and 332 mm, respectively. For all three species, the spawning period falls between November and March. The study highlights geographical differences in reproductive biology among the species and a paucity of fishery or other population‐related data. While heavy fishing pressure, life‐history characteristics and absence of effective management throughout the geographic ranges of these species make them susceptible to overfishing, they nonetheless appear to be generally more resilient than many other taxa that comprise the multi‐species fisheries of the region, possibly due to their relatively rapid sexual maturation and spatial movement patterns. Overall, however, little is known of the biology, fishing history and current fishery status of sparids in general in the northern SCS and the current study is one of the first to examine such aspects of this family in the region and to consider appropriate management options.
A noninvasive diagnosis of hepatic fibrosis by BioFibroScore® in chronic hepatitis C patients
Authors: Liu Chen‐Hua , Liu Chun‐Jen , Hong Chun‐Ming , Su Tung‐Hung , Yang Hung‐Chih , Chen Kuei‐Ming , Huang Yi‐Ping , Yeh Yu‐Ming , Tien Hui‐Lan , Liu Yuan‐Chih , Kao Jia‐Horng , Chen Ding‐Shinn , Chen Pei‐Jer
Published: May 2017

Background and Aims

The diagnostic accuracy of a novel serological panel (BioFibroScore®) to predict hepatic fibrosis in patients with chronic hepatitis C virus (HCV) infection is unknown.

Methods

Three markers of BioFibroScore, including urokinase plasminogen activator, matrix metalloproteinase‐9, and beta‐2 microglobulin, were retrospectively evaluated in 635 HCV‐infected patients who received percutaneous liver biopsy and FibroScan®. The formula of BioFibroScore to predict the severity of hepatic fibrosis was developed by adaptive boosting algorithm. The diagnostic accuracy of hepatic fibrosis was assessed both for BioFibroScore and FibroScan, taking METAVIR fibrosis score as the reference standard.

Results

Urokinase plasminogen activator and beta‐2 microglobulin were positively and matrix metalloproteinase‐9 was negatively associated with the severity of hepatic fibrosis. Thirty‐five (5.5%) patients had failed FibroScan assessment. By adaptive boosting model for BioFibroScore and the established reference ranges for FibroScan, 85.7% and 89.0% of the patients had an identical result for F0‐1, F2, F3, and F4, as compared with liver biopsy. The concordance rate between BioFibroScore and FibroScan was 80.7%. BioFibroScore overestimated and underestimated the stage of hepatic fibrosis in 8.3% and 6.0% patients, and most patients had one stage error. Among patients with failed FibroScan assessment, 82.9% of them were correctly diagnosed by BioFibroScore. Bootstrap analysis for BioFibroScore showed the diagnostic accuracy was 80.9–88.4%.

Conclusions

BioFibroScore is accurate to assess the stage of hepatic fibrosis in HCV‐infected patients. Applying this noninvasive test can substantially reduce the need for invasive liver biopsy and can play a role for fibrosis evaluation when FibroScan assessment was unavailable or unreliable.
Patients' help‐seeking experiences and delaying in breast cancer diagnosis: A qualitative study
Authors: Oshiro Mariko , Kamizato Midori
Published: May 2017

Aim

To identify the influencing factors in help‐seeking behavior by comparing delayers with non‐delayers in Japanese female patients with breast cancer.

Methods

This is a descriptive qualitative study. A total of 21 female patients with breast cancer (nine delayers and 12 non‐delayers) who were at least 3 months to 5 years postdiagnosis were recruited from two hospitals in Okinawa, Japan. Semistructured interviews were carried out and the results were analyzed by using a qualitative inductive approach.

Results

The comparison between the delayers and non‐delayers showed eight barriers to help‐seeking behavior that were unique to the delayers: (i) the appearance of symptoms that cannot be definitely linked to breast cancer; (ii) anxiety and fear; (iii) the necessity to prioritize the immediate needs of daily life; (iv) non‐disclosure of the situation; (v) the view that medical care is a nuisance; (vi) a desire to surrender to the natural course of things; (vii) confidence that they would not develop cancer; and (viii) inaccessibility of medical facilities. A common trigger for help‐seeking that was identified in both the delayers and the non‐delayers was the presence of other persons who encouraged seeking a provider evaluation.

Conclusion

The barriers to help‐seeking that were found in this study (namely, the emotional reaction and difficult living conditions) are common worldwide. The Japanese patients with breast cancer in the sample tended to emphasize their relationship with family and friends in their help‐seeking behavior, which is a common content in Japanese and other Asian cultures. Therefore, health professionals should assess the social conditions of their patients.
Role of AMPA receptors in homocysteine‐NMDA receptor‐induced crosstalk between ERK and p38 MAPK
Authors: Poddar Ranjana , Chen Alexandria , Winter Lucas , Rajagopal Sathyanarayanan , Paul Surojit
Published: May 2017

Homocysteine, a metabolite of the methionine cycle has been reported to play a role in neurotoxicity through activation of N‐methyl‐d‐aspartate receptors (NMDAR)‐mediated signaling pathway. The proposed mechanisms associated with homocysteine‐NMDAR‐induced neurotoxicity involve a unique signaling pathway that triggers a crosstalk between extracellular signal‐regulated kinase (ERK) and p38 MAPKs, where activation of p38 MAPK is downstream of and dependent on ERK MAPK. However, the molecular basis of the ERK MAPK‐mediated p38 MAPK activation is not understood. This study investigates whether α‐Amino‐3‐hydroxy‐5‐methyl‐4‐isoxazolepropionic acid receptors (AMPARs) play a role in facilitating the ERK MAPK‐mediated p38 MAPK activation. Using surface biotinylation and immunoblotting approaches we show that treatment with homocysteine leads to a decrease in surface expression of GluA2‐AMPAR subunit in neurons, but have no effect on the surface expression of GluA1‐AMPAR subunit. Inhibition of NMDAR activation with D‐AP5 or ERK MAPK phosphorylation with PD98059 attenuates homocysteine‐induced decrease in surface expression of GluA2‐AMPAR subunit. The decrease in surface expression of GluA2‐AMPAR subunit is associated with p38 MAPK phosphorylation, which is inhibited by 1‐napthyl acetyl spermine trihydrochloride (NASPM), a selective antagonist of GluA2‐lacking Ca2+‐permeable AMPARs. These results suggest that homocysteine‐NMDAR‐mediated ERK MAPK phosphorylation leads to a decrease in surface expression of GluA2‐AMPAR subunit resulting in Ca2+ influx through the GluA2‐lacking Ca2+‐permeable AMPARs and p38 MAPK phosphorylation. Cell death assays further show that inhibition of AMPAR activity with 2,3‐dioxo‐6‐nitro‐1,2,3,4,tetrahydrobenzoquinoxaline‐7‐sulfonamide (NBQX)/6‐cyano‐7‐nitroquinoxaline‐2,3, ‐dione (CNQX) or GluA2‐lacking Ca2+‐permeable AMPAR activity with NASPM attenuates homocysteine‐induced neurotoxicity. We have identified an important mechanism involved in homocysteine‐induced neurotoxicity that highlights the intermediary role of GluA2‐lacking Ca2+‐permeable AMPARs in the crosstalk between ERK and p38 MAPKs.

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Influence of frailty on the quality of life patients qualified for pacemaker implantation
Authors: Mlynarska Agnieszka , Mlynarski Rafal , Golba Krzysztof S.
Published: May 2017

Aims and objectives

An important question is whether frailty syndrome affects the assessment of quality of life or whether frailty syndrome may reduce the benefits of a cardiac pacemaker implantation.

Background

Frailty syndrome is known risk factor for quality of life evaluation after selected cardiology invasive procedures.

Design

The study was designed as single‐centre prospective study.

Methods

The study included 171 patients aged ≥60 years who were qualified for pacemaker implantation. Quality of life was evaluated twice—before and 6 months after implantation using MLHF questionnaire. A frailty syndrome evaluation using the Tilburg Frailty Indicator (TFI) was performed prior to pacemaker implantation. A DDDR pacemaker was implanted in each patient.

Results

Frailty syndrome was identified in half of the patients with indications for cardiac pacemaker implantation. There was an improvement in quality of life in the six months after pacemaker implantation in all of the robust and frailty syndrome‐affected patients that were included into the study—in general, physical and emotional domains.

Conclusion

Implantation of cardiac pacemaker influences the compensation quality of life evaluation in patients with sinus node dysfunction. Presence of frailty influences worse quality of life of patients when evaluated before cardiac pacemaker implantation.

Relevance to clinical practice

Frailty should be evaluated in all older patients qualified for pacemaker implantation to evaluate high‐risk group, optimise therapeutic approach and to intense education activities for patients and family.
The important role of positioning in nasogastric tube insertion in unconscious patients: A prospective, randomised, double‐blind study
Authors: Zhao Wangmiao , Ge Chunyan , Zhang Wanzeng , Sun Zhaosheng , Li Xiaowei
Published: May 2017

Aims and objectives

To investigate whether positioning the body in a lateral decubitus position will facilitate nasogastric tube insertion in unconscious patients.

Background

Inserting a nasogastric tube into unconscious patients can be challenging because these patients cannot cooperate with the operator. The piriform sinus and arytenoid cartilage are the most commonly reported impaction sites. However, we found that the first impaction site was the backward displaced tongue when inserting a nasogastric tube in unconscious patients who often exhibited glossoptosis. Performing an intubation in the lateral decubitus position could make this procedure easy.

Design

This prospective, double‐blind, parallel, randomised controlled trial was conducted in Hengshui City, Hebei Province, China.

Methods

A total of 110 cases of unconscious patients were enrolled. The patients were randomly assigned to a conventional group (group C) or a lateral decubitus position group (group L). In group C, the nasogastric tube was inserted while the patients were in a supine position using the conventional technique, and in group L, the tube was inserted in a lateral decubitus position or further tilting the body to a prone decubitus position 20–30°. We discussed reasonable intubation methods in unconscious patients by comparing the success rate on first insertion, the overall success rate, the intubation time and the complication rates between the two groups.

Results

Group L had a higher success rate on first insertion and overall success rate than group C (p < .05). The intubation time in group L was shorter than that in group C (p < .001), and the complication rate in group L was lower than that in group C (p < .05). The differences were statistically significant.

Conclusions

The backward displaced tongue blocks the pharyngeal passage. Nasogastric tube insertions in the lateral decubitus position are recommended in unconscious patients because of the higher success rate, reduced intubation time and lower complication rate.

Relevance to clinical practice

This study provides an effective method for nasogastric tube insertions in unconscious patients.
Inpatient dependency in activities of daily living predicts informal caregiver strain: A cross‐sectional study
Authors: Pérez Mármol José Manuel , Flores Antigüedad María Luz , Castro Sánchez Adelaida María , Tapia Haro Rosa María , García Ríos María del Carmen , Aguilar Ferrándiz María Encarnación
Published: May 2017

Aims and Objectives

To investigate what factors influence caregiver strain in informal caregivers just before inpatients are discharged.

Background

Previous research has investigated the risk factors related to the burden on caregivers in different clinical contexts. However, the findings from studies analysing these factors just before inpatients are discharged are uncertain.

Design

A cross‐sectional study design.

Methods

The study involved 100 inpatients and 100 informal caregivers from seven different hospital units. Sociodemographic, clinical, functional and cognitive factors of inpatients–caregivers, and caregiver strains were recorded. Descriptive, bivariate correlation and multiple regression analyses were performed.

Results

Caregivers of inpatients at risk of ulcers had significantly higher scores of strain. Dependency in activities of daily living scores and cognitive status scores were statistically inversely proportional to caregiver strain. Almost 27% of total variance of caregiver strain was due to dependency in activities of daily living.

Conclusions

Caregiver strain was mainly associated with those situations in which the hospitalised patients presented the risk of ulcers, dependency and cognitive disorders, with dependency in activities of daily living being the factor that most influenced informal caregiver strain.

Relevance to clinical practice

Dependency in activities of daily living, among other risk factors, should be evaluated at an early stage, monitored and controlled by hospital nursing staff. These strategies could protect and promote the well‐being and quality of life of informal caregivers during patient hospitalisation and after discharge.
Owner assessment of the outcome of tibial plateau levelling osteotomy without meniscal evaluation for treatment of naturally occurring cranial cruciate ligament rupture: 130 cases (2009 to 2013)
Authors: Bureau S.
Published: May 2017

Objective

To evaluate long‐term surgical outcome and chronic pain in dogs suffering from naturally occurring cranial cruciate ligament rupture treated by tibial plateau levelling osteotomy without meniscal evaluation.

Materials and Methods

In this retrospective clinical study, data from surgical records of dogs with cranial cruciate ligament rupture that underwent tibial plateau levelling osteotomy without meniscal evaluation between August 2009 and November 2013 were reviewed. An owner questionnaire was used to evaluate the long‐term outcome and the prevalence of chronic pain.

Results

107 dogs were included in this study. The long‐term follow‐up ranged from 1 to 4·5 years (mean 2·5 years). Four dogs developed acute lameness 4 to 21 months after surgery after having shown improvement. Dog behavior was assessed to be normal in 93% of cases and the level of activity was estimated to be normal for 88% of cases. Persistent lameness was reported after surgery in 6% of dogs and might have resulted from undiagnosed meniscal lesions.

Clinical Significance

Considering the low incidence of persistent lameness after surgery and the limits of diagnosis and treatment, the need for routine meniscal examination during tibial plateau levelling osteotomy is questionable.
Tropical specialist vs. climate generalist: Diversification and demographic history of sister species of Carlia skinks from northwestern Australia
Authors: Afonso Silva Ana C. , Bragg Jason G. , Potter Sally , Fernandes Carlos , Coelho Maria Manuela , Moritz Craig
Published: May 2017

Species endemic to the tropical regions are expected to be vulnerable to future climate change due in part to their relatively narrow climatic niches. In addition, these species are more likely to have responded strongly to past climatic change, and this can be explored through phylogeographic analyses. To test the hypothesis that tropical specialists are more sensitive to climate change than climate generalists, we generated and analyse sequence data from mtDNA and ~2500 exons to compare scales of historical persistence and population fluctuation in two sister species of Australian rainbow skinks: the tropical specialist Carlia johnstonei and the climate generalist C. triacantha. We expect the tropical specialist species to have deeper and finer‐scale phylogeographic structure and stronger demographic fluctuations relative to the closely related climate generalist species, which should have had more stable populations through periods of harsh climate in the late Quaternary. Within C. johnstonei, we find that some populations from the northern Kimberley islands are highly divergent from mainland populations. In C. triacantha, one major clade occurs across the deserts and into the mesic Top End, and another occurs primarily in the Kimberley with scattered records eastwards. Where their ranges overlap in the Kimberley, both mitochondrial DNA and nuclear DNA suggest stronger phylogeographic structure and range expansion within the tropical specialist, whereas the climate generalist has minimal structuring and no evidence of recent past range expansion. These results are consistent with the hypothesis that tropical specialists are more sensitive to past climatic change.
Determination of genetic relatedness from low‐coverage human genome sequences using pedigree simulations
Authors: Martin Michael D. , Jay Flora , Castellano Sergi , Slatkin Montgomery
Published: May 2017

We develop and evaluate methods for inferring relatedness among individuals from low‐coverage DNA sequences of their genomes, with particular emphasis on sequences obtained from fossil remains. We suggest the major factors complicating the determination of relatedness among ancient individuals are sequencing depth, the number of overlapping sites, the sequencing error rate and the presence of contamination from present‐day genetic sources. We develop a theoretical model that facilitates the exploration of these factors and their relative effects, via measurement of pairwise genetic distances, without calling genotypes, and determine the power to infer relatedness under various scenarios of varying sequencing depth, present‐day contamination and sequencing error. The model is validated by a simulation study as well as the analysis of aligned sequences from present‐day human genomes. We then apply the method to the recently published genome sequences of ancient Europeans, developing a statistical treatment to determine confidence in assigned relatedness that is, in some cases, more precise than previously reported. As the majority of ancient specimens are from animals, this method would be applicable to investigate kinship in nonhuman remains. The developed software grups (Genetic Relatedness Using Pedigree Simulations) is implemented in Python and freely available.
Cardiac‐diabetes self‐management program for Australians and Taiwanese: A randomized blocked design study
Authors: Wu Chiung‐Jung (Jo) , Sung Huei‐Chuan , Chang Anne M. , Atherton John , Kostner Karam , McPhail Steven M.
Published: May 2017

Cardiac disease and type 2 diabetes are prevalent diseases globally. Cardiac rehabilitation and diabetes self‐management programs empower patients' self‐management to improve their health outcomes. However, inappropriate delivery modes and continuing low participation rates indicate some programs are less than optimal. A previous study demonstrated the feasibility of incorporating telephone and text messages into a cardiac‐diabetes self‐management program in Australia; however, the program did not specifically address patients' cultural backgrounds. This current study used a randomized blocked design to evaluate short‐term efficacy of the cardiac‐diabetes self‐management program incorporating telephone and text‐messaging across different cultural contexts in Australia and Taiwan in comparison to usual care. No significant differences between groups were observed for outcomes of self‐care behavior, self efficacy, knowledge and health‐related quality of life, with patients in both groups demonstrating improvements. Patient‐reported outcomes indicated some evidence of an interaction effect between country of origin and group allocation. Findings indicated an improved tendency of outcome measures between the baseline and follow‐up assessments within usual care and intervention groups. Further research is required to clarify components of the program work for each cultural group.
Rapid radiations of both kiwifruit hybrid lineages and their parents shed light on a two‐layer mode of species diversification
Authors: Liu Yifei , Li Dawei , Zhang Qiong , Song Chi , Zhong Caihong , Zhang Xudong , Wang Ying , Yao Xiaohong , Wang Zupeng , Zeng Shaohua , Wang Ying , Guo Yangtao , Wang Shuaibin , Li Xinwei , Li Li , Liu Chunyan , McCann Honour C. , He Weiming , Niu Yan , Chen Min , Du Liuwen , Gong Junjie , Datson Paul M. , Hilario Elena , Huang Hongwen
Published: May 2017

Reticulate speciation caused by interspecific hybridization is now recognized as an important mechanism in the creation of biological diversity. However, depicting the patterns of phylogenetic networks for lineages that have undergone interspecific gene flow is challenging.

Here we sequenced 25 taxa representing natural diversity in the genus Actinidia with an average mapping depth of 26× on the reference genome to reconstruct their reticulate history.

We found evidence, including significant gene tree discordance, cytonuclear conflicts, and changes in genome‐wide heterozygosity across taxa, collectively supporting extensive reticulation in the genus. Furthermore, at least two separate parental species pairs were involved in the repeated origin of the hybrid lineages, in some of which a further phase of syngameon was triggered. On the basis of the elucidated hybridization relationships, we obtained a highly resolved backbone phylogeny consisting of taxa exhibiting no evidence of hybrid origin. The backbone taxa have distinct demographic histories and are the product of recent rounds of rapid radiations via sorting of ancestral variation under variable climatic and ecological conditions.

Our results suggest a mode for consecutive plant diversification through two layers of radiations, consisting of the rapid evolution of backbone lineages and the formation of hybrid swarms derived from these lineages.
Phenotypic selection varies with pollination intensity across populations ofSabatia angularis
Authors: Emel Sarah L. , Franks Steven J. , Spigler Rachel B.
Published: May 2017

Pollinators are considered primary selective agents acting on plant traits, and thus variation in the strength of the plant–pollinator interaction might drive variation in the opportunity for selection and selection intensity across plant populations. Here, we examine whether these critical evolutionary parameters covary with pollination intensity across wild populations of the biennialSabatia angularis.

We quantified pollination intensity in each of nineS. angularispopulations as mean stigmatic pollen load per population. For female fitness and three components, fruit number, fruit set (proportion of flowers setting fruit) and number of seeds per fruit, we evaluated whether the opportunity for selection varied with pollination intensity. We used phenotypic selection analyses to test for interactions between pollination intensity and selection gradients for five floral traits, including flowering phenology.

The opportunity for selection via fruit set and seeds per fruit declined significantly with increasing pollen receipt, as expected. We demonstrated significant directional selection on multiple traits across populations. We also found that selection intensity for all traits depended on pollination intensity.

Consistent with general theory about the relationship between biotic interaction strength and the intensity of selection, our study suggests that variation in pollination intensity drives variation in selection acrossS. angularispopulations.
Generalized modeling of empirical social‐ecological systems
Authors: Lade Steven J. , Niiranen Susa
Published: May 2017

Modeling social‐ecological systems is difficult due to the complexity of ecosystems and of individual and collective human behavior. Key components of the social‐ecological system are often over‐simplified or omitted. Generalized modeling is a dynamical systems approach that can overcome some of these challenges. It can rigorously analyze qualitative system dynamics such as regime shifts despite incomplete knowledge of the model's constituent processes. Here, we review generalized modeling and use a recent study on the Baltic Sea cod fishery's boom and collapse to demonstrate its application to modeling the dynamics of empirical social‐ecological systems. These empirical applications demand new methods of analysis suited to larger, more complicated generalized models. Generalized modeling is a promising tool for rapidly developing mathematically rigorous, process‐based understanding of a social‐ecological system's dynamics despite limited knowledge of the system.
The use of piezoelectric surgical debridement in the management of bisphosphonate osteonecrosis of the jaw: a case report
Authors: Ghurye S. , Kwok J. , Thakrar P. , Patel V.
Published: May 2017

The management of bisphosphonate related osteonecrosis of the jaw (BRONJ) poses many challenges to the clinician as there remains no established guaranteed treatment. Currently, guidance from the American Association of Oral and Maxillofacial Surgeons advises a conservative approach for the management of BRONJ. Predominantly this means medical management, however, this is not always successful. Invasive surgical debridement is often feared due to the real risk of inducing further necrosis. In repetitive acute infections or longterm chronic infections the clinician is left with a difficult situation to manage. This report presents a case of a 58 year old female with a complex medical and drug history with BRONJ. Routine management strategies were unsuccessful in treating BRONJ, leading to surgical intervention via piezoelectric surgical debridement.
Coexistence of a permanent form of a junctional reciprocating tachycardia and coronary sinus aneurysm: A case report
Authors: Shimizu Yuki , Inaba Osamu , Goya Masahiko , Hirao Kenzo
Published: May 2017

A 58‐year‐old man with a long R‐P' narrow QRS tachycardia underwent an electrophysiological study. The tachycardia was diagnosed as a permanent form of junctional reciprocating tachycardia (PJRT), and the earliest atrial activation site during tachycardia was coronary sinus (CS) ostium. Radiofrequency ablation at the site was initially not successful because the tip impedance and temperature were unstable. After changing of the ablation catheter to that with contact force sensor, the accessory pathway was immediately ablated and the PJRT was no longer induced. A retrograde CS angiogram revealed a fusiform aneurysm, which was located at the earliest activation site during the tachycardia.
Elevated intrathoracic CO2 pressure during thoracoscopic surgery decreases regional cerebral oxygen saturation in neonates and infants—A pilot study
Authors: Neunhoeffer Felix , Warmann Steven W. , Hofbeck Michael , Müller Alisa , Fideler Frank , Seitz Guido , Schuhmann Martin U. , Kirschner Hans‐Joachim , Kumpf Matthias , Fuchs Jörg
Published: May 2017

Background

Intraoperative hypercapnia and acidosis are risk factors during thoracoscopy in neonates and infants.

Methods

In a prospective pilot study, we evaluated the effects of thoracoscopy in neonates and infants on cerebral microcirculation, oxygen saturation, and oxygen consumption. Regional cerebral oxygen saturation and blood flow were measured noninvasively using a new device combining laser Doppler flowmetry and white light spectrometry. Additionally, cerebral fractional tissue oxygen extraction and approximated oxygen consumption were calculated.

Fifteen neonates and infants undergoing thoracoscopy were studied using the above‐mentioned method. The chest was insufflated with carbon dioxide with a pressure of 2‐6 mm Hg. Single lung ventilation was not used. As control group served 15 neonates and infants undergoing abdominal surgery.

Results

Data are presented as median and range. The 95% confidence intervals for differences of means (95% CI) are given for the mean difference from baseline values.

We observed a correlation between intrathoracic pressure exceeding 4 mm Hg and transient decrease in regional cerebral oxygen saturation of 12.7% (95% CI: 9.7–17.2, P<.001). Peripheral oxygen saturation was normal at the same time.

Intraoperative increase in arterial paCO2 (median maximum value: 48.8 mm Hg, range: [36.5‐65.4]; 95% CI: −16.0 to −3.0, P=.002) and decrease in arterial pH (median minimum value: 7.3, range: [7.2‐7.4]; 95% CI: 0.04‐0.12, P=.008) were observed during thoracoscopy with both parameters recovering at the end of the procedure.

Periods of regional cerebral oxygen saturation below 20% from baseline were significantly more frequent during thoracoscopy as compared to the control group (median maximum value: 1.3%min/h, range: [0.0‐66.2] vs median maximum value: 0.0%min/h, range: [0.0‐4.0]; 95% CI: −16.6 to −1.1, P=.028).

Conclusion

We suggest that thoracoscopic surgery in neonates and infants, although generally safe, may be associated with a decrease in regional cerebral oxygen saturation correlating with the applied intrathoracic pressure. According to our data an inflation pressure >4 mm Hg should be avoided during thoracoscopic surgery.
Cartesian Imperativism
Authors: Gottlieb Joseph , Parvizian Saja
Published: May 2017

We propose a novel reading of Descartes' views on the nature of pain, thirst, and hunger:imperativism. According to imperativism, rather than (exclusively) having intentional contents individuated by a set of correctness conditions specifying the way the worldis, pain thirst, and hunger have contents individuated bysatisfaction conditions, which specify the way the worldoughtto be. Unlike representationalist treatments, the imperativist reading satisfies the unique health‐preserving role Descartes sets out for pain, thirst, and hunger, without inflating his austere metaphysics ofres extensa.
Ultraviolet radiation accelerates NRas‐mutant melanomagenesis: A cooperative effect blocked by sunscreen
Authors: Hennessey Rebecca C. , Holderbaum Andrea M. , Bonilla Anamaria , Delaney Conor , Gillahan James E. , Tober Kathleen L. , Oberyszyn Tatiana M. , Zippin Jonathan H. , Burd Christin E.
Published: May 2017

To mitigate melanoma risk, sunscreen use is widely advocated; yet, the ability of sunscreens to prevent melanoma remains controversial. Here, we test the tenet that sunscreens limit melanoma risk by blocking ultraviolet radiation (UV)‐induced DNA damage using murine models that recapitulate the genetics and spontaneous evolution of human melanoma. We find that a single, non‐erythematous dose of UV dramatically accelerates melanoma onset and increases tumor multiplicity in mice carrying an endogenous, melanocyte‐specific NRas61R allele. By contrast, transient UV exposure does not alter tumor onset in mice lacking p16INK4a or harboring an NRas12D allele. To block the rapid onset of melanoma cooperatively caused by UV and NRas61R, we employed a variety of aerosol sunscreens. While all sunscreens delayed melanoma formation and blocked UV‐induced DNA damage, differences in aerosol output (i.e., amount applied/cm2) caused variability in the cancer preventative efficacy of products with identical sunburn protection factor (SPF) ratings.
Regulatory T cells and CTLA‐4 in idiopathic nephrotic syndrome
Authors: Tsuji Shoji , Kimata Takahisa , Yamanouchi Sohsaku , Kitao Tetsuya , Kino Jiro , Suruda Chikushi , Kaneko Kazunari
Published: May 2017

The pathogenesis of idiopathic nephrotic syndrome (INS) remains unknown. Recently, it was postulated that suppression of regulatory T cells (Treg) leads to massive proteinuria in INS, although there is some controversy. Considering the important role of cytotoxic T‐lymphocyte‐associated protein 4 (CTLA‐4) in Treg‐mediated immune suppression, the aim of this study was therefore to clarify the involvement of Treg and CTLA‐4 in the pathogenesis of INS. Fifteen patients with INS were enrolled. Their blood was sampled twice, once at onset and once at remission induced by glucocorticoid. Although median Treg number was significantly lower at onset than in healthy children, it increased at remission. Similarly, serum CTLA‐4 concentration significantly increased at remission compared with onset. Furthermore, a positive significant correlation was observed between Treg number and serum CTLA‐4 level. This suggests that Treg and CTLA‐4 are involved in the induction of remission in INS.
Inter‐prefecture disparity in under‐5 mortality: 115 year trend in Japan
Authors: Nagata Chie , Moriichi Akinori , Morisaki Naho , Gai‐Tobe Ruoyan , Ishiguro Akira , Mori Rintaro
Published: May 2017

Background

Child poverty is a growing, serious issue in Japan, where various social disparities are increasing. Numerous reports have focused on the relationship between social inequity and health, but few studies have assessed how the overall magnitude of disparities in child health has changed in the course of drastic social and economic transitions from 1899 to more recent times. In this study, we assessed the trend of the under‐5 mortality rate (U5MR) and its inter‐prefecture disparity in Japan.

Methods

This is a secondary analysis of Japan's vital statistics data from 1899 to 2014 (115 years), which covers a core period of modern Japan. We calculated the U5MR of each prefecture and its Theil index by year to assess the trend of inter‐prefecture disparity in child health from 1899 to 2014.

Results

The U5MR monotonically decreased from 238 per 1,000 births in 1899 to 3 in 2014. The Theil index of the U5MR increased in the post‐war period, peaked in 1962 (0.027) and gradually reduced to <0.01 in the 1970s. In the 2000s, however, even though U5MR continued to decrease, the Theil index started to increase, and in 2014 (0.013) it exceeded that in 1970 and was more similar to that before World War II.

Conclusions

The disparities in child health appear to be widening, and may serve as a warning to today's society that increasing socioeconomic gradients may lead to rising health inequity among children. Further investigations into the causes, mechanisms, and possible interventions are needed.