bluuebunny/crossref_metadata_2025 huggingface dataset:
Premenstrual Dysphoric Disorder
Authors: Freeman Ellen W.
Published: October 2015

This chapter examines premenstrual dysphoric disorder (PMDD) and the less restricted condition of clinically significant premenstrual syndrome (PMS). PMDD is distinguished from a clinical diagnosis of PMS by the number of specific symptoms required for a PMDD diagnosis. Both are characterized by changes in mood as well as behavioral and physical symptoms that occur in relation to regular menstrual cycles and impair functioning. Circulating levels of the reproductive hormones are in the normal range, but some women may be vulnerable to the normal fluctuations of one or more of these hormones. The chapter presents the epidemiology, diagnosis, and treatments of PMDD/PMS based on evidence in randomized clinical trials. There is no one treatment that entirely fits this complex disorder, but the weight of current evidence supports treatments aimed at modifying serotonin transmission or suppressing ovulation. The chapter concludes with suggestions for further research to increase our knowledge of the causes and treatments of menstrually related disorders.
Ultrasonography for the diagnosis of patients with clinically suspected skin and soft tissue infections: a systematic review of the literature
Authors: Alsaawi Abdulmohsen , Alrajhi Khaled , Alshehri Abdussalam , Ababtain Abdalmohsen , Alsolamy Sami
Published: October 2015

Background

In patients presenting with skin and soft tissue infections (SSTI), the use of ultrasound may lead to a more accurate distinction between cellulitis and abscess compared with clinical assessment alone.

Objectives

This systematic review aims to determine the diagnostic accuracy of ultrasound for detecting skin abscesses. In addition, it aims to assess the impact of using ultrasound on management decisions in patients with SSTI.

Methods

We searched relevant electronic databases for primary studies including MEDLINE, EMBASE, and CINAHL. We searched conference proceedings, checked references of retrieved articles, and contacted field experts. Two reviewers assessed the quality of each full-text publication using a modified QUADAS-2 tool.

Results

Five studies (n=710) fulfilled our inclusion criteria. Four studies compared the diagnostic accuracy of ultrasound with clinical examination alone (n=584). Most studies reported an improvement in diagnostic accuracy. The sensitivity of ultrasound ranged from 89 to 98% and the specificity ranged from 64 to 88%. However, the sensitivity of clinical assessment ranged from 75 to 90% and the specificity ranged from 55 to 83%; most of these results did not reach statistical significance. Sensitivity was further improved in cases of indeterminate clinical assessment. Two studies (n=176) examined the impact of ultrasound on management decisions. Use of ultrasound has led to significant and appropriate changes in management decisions in 16 to 39% of patients.

Conclusion

The use of ultrasound could potentially improve diagnostic accuracy and lead to improved management decisions in patients with SSTI, especially in cases of indeterminate clinical assessment. Most of our findings did not achieve statistical significance. Further research is required to confirm these findings.
Management of Postembolization Syndrome Following Hepatic Transarterial Chemoembolization for Primary or Metastatic Liver Cancer
Authors: Blackburn Helen , West Sandra
Published: October 2015

Background:

Transarterial chemoembolization (TACE) is an established treatment in managing liver primary neoplasms or liver metastases. Postembolization syndrome (PES) is a common adverse event defined as fever without associated sepsis, pain in the right upper quadrant, and nausea and/or vomiting.

Objective:

This integrative review aims to identify effective management strategies for PES or one of its characterizing symptoms (fever, pain, and nausea and/or vomiting).

Methods:

Searches of electronic databases MEDLINE, EMBASE, and CINAHL were conducted. Fifteen articles were identified for inclusion. Seven addressed all symptoms of PES, and 8 studies focused on individual symptoms of PES.

Results:

Interventions identified are intra-arterial lidocaine, oral and intravenous analgesics, steroids, wrist-ankle acupuncture, antibiotics, and 5-HT3 receptor antagonists. Findings are explicated according to individual symptoms of PES. Intra-arterial lidocaine, steroids, and a 5-HT3 receptor antagonist are found to offer potential benefit in the management of PES symptoms.

Conclusion:

A number of interventions have shown potential benefit in the management of PES. A systemic approach using combination therapy is necessary to effectively manage characterizing symptoms. Further research is needed to determine the impact of primary disease site, TACE technique, and chemotherapeutic agent on PES.

Implications for Practice:

Oncology nurses are uniquely placed to undertake thorough patient assessment after TACE and implement early intervention to effectively manage PES.
Structure solution and refinement of stacking-faulted NiCl(OH)
Authors: Bette Sebastian , Dinnebier Robert E. , Freyer Daniela
Published: October 2015

Two samples of pure NiCl(OH) were produced by hydrothermal synthesis and characterized by chemical analysis, IR spectroscopy, high-resolution laboratory X-ray powder diffraction and scanning electron microscopy. Layers composed of edge-sharing distorted NiCl6x(OH)6−6xoctahedra were identified as the main building blocks of the crystal structure. NiCl(OH) is isostructural to CoOOH and crystallizes in space groupR\overline{{3}}m[a= 3.2606 (1),c= 17.0062 (9) Å]. Each sample exhibits faults in the stacking pattern of the layers. Crystal intergrowth of (AγB)(BαC)(CβA) and (AγB)(AγB) [C6 like, β-Ni(OH)2related] stacked layers was identified as the main feature of the microstructure of NiCl(OH) byDIFFaXsimulations. A recursion routine for creating distinct stacking patterns of rigid-body-like layers in real space with distinct faults (global optimization) and a Rietveld-compatible approach (local optimization) was realized and implemented in a macro for the programTOPASfor the first time. This routine enables a recursive creation of supercells containing (AγB)(BαC)(CβA), (AγB)(AγB) and (CβA)(BαC)(AγB) stacking patterns, according to user-defined transition probabilities. Hence it is an enhancement of the few previously published Rietveld-compatible approaches. This routine was applied successfully to create and adapt a detailed microstructure model to the measured data of two stacking-faulted NiCl(OH) samples. The obtained microstructure models were supported by high-resolution scanning electron microscopy images.
Estimating the effect of entrepreneur education on graduates’ intention to be entrepreneurs
Authors: Mohamad Noorkartina , Lim Hock-Eam , Yusof Norhafezah , Soon Jan-Jan
Published: October 2015

Purpose

– Previous studies on the effect of entrepreneur education are not comprehensive. Thus, estimating the effect of entrepreneur education is imperative. According to the Malaysian Ministry of Education (MoE), only 1.7 percent (as of 2013) of university graduates are self-employed, that is managing one’s own business or known as graduate entrepreneurs. Consequently, a huge gap exists between what is targeted by the government (5.5 percent by 2015) and the reality (a small number of graduate entrepreneurs). The purpose of this paper is to analyze the factors influencing a graduate’s choice to be entrepreneur, particularly the effects of different entrepreneur education, either formal or informal.

Design/methodology/approach

– A total of 2,300 graduates from Universiti Utara Malaysia participated in this study.

Findings

– The findings showed that the majority of the respondents are consistent in terms of their intent to become entrepreneurs.

Research limitations/implications

– Due to time and resource constraints, the data are limited to only one university in Malaysia. It is suggested that future studies include more universities, especially entrepreneurial universities. Although it is believe that public universities’ undergraduates population are highly homogeneous, it is good that the findings of the present study to be further validated by future studies using larger sample that consists of varies of public universities.

Practical implications

– This paper supports government policies in terms of cultivating educated entrepreneur such as promoting the entrepreneurship education among higher institutions of education (MoE, 2007). However, there are negative relationships among higher academic achievement of graduates toward their intention to be entrepreneurs. It is indicated that high academic achievements are negatively related to becoming entrepreneurs. Thus, it is suggested that entrepreneurship education in terms of both formal and informal education be implemented into the curriculum in order to cultivate entrepreneurial intentions.

Originality/value

– There is still much more to be learned to fully understand the processes that leading to the decision to become an entrepreneur. Nevertheless, the results presented in this paper provide some understanding of the factors influencing the decision to become an entrepreneur among university students and graduates using a convenience sample. Thus, the results are exploratory and subjected to validation by future studies using more representative samples. Nevertheless, the study makes a contribution to the effort to predict and develop entrepreneurs in the country.
Sustainability: what the entrepreneurship educators think
Authors: Wyness Lynne , Jones Paul , Klapper Rita
Published: October 2015

Purpose

– The purpose of this paper is to consider the understanding and presence of sustainability within entrepreneurship education. The extant literature on sustainability within the entrepreneurship discipline remains extremely limited. Previously, sustainability within an entrepreneurship context has related to economic viability as opposed to sustainability in its broadest sense. This study explores, through a survey of entrepreneurship educators, three key research questions, namely, how entrepreneurship educators believe that entrepreneurs can contribute to solving sustainability problems. Second, to what extent education about sustainability is integrated within existing entrepreneurship curricula. Finally, what considerations are being made to include sustainability within future programmes.

Design/methodology/approach

– This study represented part of a larger university project exploring the associations between the sustainability and entrepreneurship disciplines. This part of the study involved a web-based survey from entrepreneurship academics drawn from Australia, New Zealand, UK, and the USA which provided 54 completed questionnaires.

Findings

– The study uncovered much good practice led by “champions” within the entrepreneurship discipline. However, embedded sustainability practice was typically limited and it was more typically regarded as an “add-on” to traditional entrepreneurial teaching.

Practical implications

– The study proposes three ways in which sustainability might be more meaningfully integrated into entrepreneurship programmes. First, the QAA (2012) guidelines for enterprise and entrepreneurship need to be reconsidered to encapsulate the sustainability agenda. Second, for entrepreneurship educators to reconsider their pedagogical approaches to encapsulate systems thinking as more holistic educational perspective. Finally, the authors call for entrepreneurship educators to revise their programmes to embed the core facets of social, environmental, economic, and more recently ethical sustainability.

Originality/value

– The study offers a novel insight into entrepreneurship educators attitudes to sustainability and their approach to it within their curricula. This study provides an initial benchmark regarding the levels of sustainability provision within entrepreneurship curricula which will be of interest to the entrepreneurship academic community, the sustainability community, and policy makers.
Toward a service ecosystem perspective at the base of the pyramid
Authors: Ben Letaifa Soumaya , Reynoso Javier
Published: October 2015

Purpose

– The purpose of this paper is to combine service-dominant logic premises with ecosystem characteristics in the base of the pyramid (BoP) environment, aiming to establish the foundations of a new service ecosystem framework for BoP contexts.

Design/methodology/approach

– This conceptual paper is developed by connecting service logic with an ecosystem perspective, developing theoretical propositions for sustainable service ecosystems at the BoP, and identifying future research direction using this new framework.

Findings

– The paper first highlights main challenges faced in the BoP environment. It then constructs an ecosystem framework for BoP contexts composed by four theoretical propositions: first, need to shift from a top-down to a multi-actor BoP approach; second, need of social embeddedness for successful BoP initiatives; third, service co-creation for and with local communities with actors playing multiple social roles; and fourth, multi-actor and multi-dimensional value creation. Future research directions are identified related to these propositions.

Research limitations/implications

– Theoretical propositions integrating the service ecosystem framework need further exploration and confirmation with additional empirical studies.

Practical implications

– Proposed framework and propositions provide useful insights for practitioners from different types of organizations aiming to participate in BoP markets.

Social implications

– Understanding the need to integrate a service ecosystem perspective in BoP contexts is fundamental to better address the needs of all actors involved.

Originality/value

– The conceptual framework proposed offers a comprehensive, multi-dimensional, and multi-actor perspective on how to understand, and better address services in BoP contexts. Future research avenues identified offer a more inclusive agenda for increasing service knowledge at the BoP.
Service appropriation: how do customers make the service their own?
Authors: Mifsud Matthieu , Cases Anne-Sophie , N'Goala Gilles
Published: October 2015

Purpose

– The purpose of this paper is to propose a comprehensive framework for service appropriation, specifying the different facets of the phenomenon.

Design/methodology/approach

– A literature review summarizes views of the appropriation concept from various disciplines (human and social sciences, information systems, marketing), reinforced by an exploratory study in the health sector.

Findings

– Six underlying dimensions of service appropriation emerge: service knowledge; service consciousness; self-adaptation to service; service control; service creation; and psychological ownership of the service.

Research limitations/implications

– This paper is mainly conceptual and requires empirical testing in other domains to confirm the applicability of the proposed framework.

Practical implications

– This study offers insights into how service providers and managers should design services and integrate customers in the service coproduction process.

Originality/value

– The complementary view of appropriation in the context of services defines it as a cognitive, measurable state. The outcome of this approach is an original, integrative framework applied to services, not just spaces or immersive experiences.
Service alliances between unequals: the apple does not fall far from the better tree
Authors: Bleijerveld Jeroen F.J. , Gremler Dwayne D. , Lemmink Jos G.A.M.
Published: October 2015

Purpose

– Brand alliances take various forms, yet academic research has not investigated how value spillovers differ between partners. The purpose of this paper is to address psychological mechanisms to uncover consumers’ perceptions of a service alliance when a strong service brand partners with a weak one.

Design/methodology/approach

– An experiment used a 2 (perceived value of parent brand X: high vs low)×2 (perceived value of parent brand Y: high vs low)×2 (alliance contribution: equal vs unequal) full-factorial between-subjects design.

Findings

– Service alliance value is maximal when both parent brands have high perceived value but is lowest when both are of low perceived value. When their perceived value varies, the alliance value approximates the higher rather than the lower value parent. This effect increases with the relative size of a parent brand’s contribution to the alliance service. Alliances also enhance perceptions of the value of each parent brand.

Practical implications

– In an alliance between a strong and a weak service brand, the strong brand lifts the alliance, and consumers perceive high value. Companies should avoid service alliances with weaker brands that make major contributions.

Originality/value

– This study investigates how value spillovers vary across different forms of service alliances. Moreover most alliance research focusses on products while services (such as education) are more involved in alliances than ever.
Integrating spatially explicit indices of abundance and habitat quality: an applied example for greater sage‐grouse management
Authors: Coates Peter S. , Casazza Michael L. , Ricca Mark A. , Brussee Brianne E. , Blomberg Erik J. , Gustafson K. Benjamin , Overton Cory T. , Davis Dawn M. , Niell Lara E. , Espinosa Shawn P. , Gardner Scott C. , Delehanty David J.
Published: October 2015

Predictive species distributional models are a cornerstone of wildlife conservation planning. Constructing such models requires robust underpinning science that integrates formerly disparate data types to achieve effective species management.

Greater sage‐grouse Centrocercus urophasianus, hereafter ‘sage‐grouse’ populations are declining throughout sagebrush‐steppe ecosystems in North America, particularly within the Great Basin, which heightens the need for novel management tools that maximize the use of available information.

Herein, we improve upon existing species distribution models by combining information about sage‐grouse habitat quality, distribution and abundance from multiple data sources. To measure habitat, we created spatially explicit maps depicting habitat selection indices (HSI) informed by >35 500 independent telemetry locations from >1600 sage‐grouse collected over 15 years across much of the Great Basin. These indices were derived from models that accounted for selection at different spatial scales and seasons. A region‐wide HSI was calculated using the HSI surfaces modelled for 12 independent subregions and then demarcated into distinct habitat quality classes.

We also employed a novel index to describe landscape patterns of sage‐grouse abundance and space use (AUI). The AUI is a probabilistic composite of the following: (i) breeding density patterns based on the spatial configuration of breeding leks and associated trends in male attendance; and (ii) year‐round patterns of space use indexed by the decreasing probability of use with increasing distance to leks. The continuous AUI surface was then reclassified into two classes representing high and low/no use and abundance.

Synthesis and applications. Using the example of sage‐grouse, we demonstrate how the joint application of indices of habitat selection, abundance and space use derived from multiple data sources yields a composite map that can guide effective allocation of management intensity across multiple spatial scales. As applied to sage‐grouse, the composite map identifies spatially explicit management categories within sagebrush steppe that are most critical to sustaining sage‐grouse populations as well as those areas where changes in land use would likely have minimal impact. Importantly, collaborative efforts among stakeholders guide which intersections of habitat selection indices and abundance and space use classes are used to define management categories. Because sage‐grouse are an umbrella species, our joint‐index modelling approach can help target effective conservation for other sagebrush obligate species and can be readily applied to species in other ecosystems with similar life histories, such as central‐placed breeding.
The relationship between C‐reactive protein rs3091244 polymorphism and ankylosing spondylitis
Authors: Akbal Ayla , Reşorlu Hatice , Gökmen Ferhat , Savaş Yılmaz , Zateri Çoşkun , Sargin Betül , Bozkurt Emre , Sılan Fatma , Özdemir Öztürk
Published: October 2015

Aims

Previous studies have shown thatC‐reactive protein(CRP) gene polymorphism can be related to inflammatory changes. The present study aimed to examine the association betweenCRPgene polymorphism and clinical and laboratory findings in ankylosing spondylitis (AS) patients.

Materials and methods

A total of 80 patients, 40 withASand 40 controls, were included in the study. Diagnosis ofASwas made according to Assessment inASInternational Working Group criteria. Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Metrology Index and Bath Ankylosing Spondylitis Radiology Index scores were evaluated.CRPgene C, A and T alleles were evaluated and were determined using the analysis of melting curves after real time polymerase chain reaction. The odds ratios were calculated for all alleles and haploids of theCRPgene. We investigated the relationship between theCRPpolymorphism and clinical and laboratory findings.

Results

A, C, T allele frequencies in the control group were 15%, 57.5% and 27.5%. The allele frequencies in theASgroup were 38%, 68.8% and 26.2%. While C and T allele frequencies were shown to be similar in the two groups, A allele frequency was higher in theASgroup compared to the control group. TheCCwild allele was 42.5% in the control group and 47.5% in theASgroup (P= 1.0). Odds ratios for the C allele were 1.6, for theCChaploid 1.2 and for theCThaploid 3.7. Chest expansion and finger‐to‐ground distance was better in theCRPgene polymorphism group compared to the no polymorphism group.

Conclusion

The presence of theCRPgeneCCwild haploid and C allele in patients may indicate an increased risk forAS.
Association of tocilizumab treatment with changes in measures of regional left ventricular function in rheumatoid arthritis, as assessed by cardiac magnetic resonance imaging
Authors: Kobayashi Yasuyuki , Kobayashi Hitomi , Giles Jon T. , Hirano Masaharu , Nakajima Yasuo , Takei Masami
Published: October 2015

Objective

The goal of this study was to determine whether the powerful anti‐inflammatory effect of anti‐interleukin‐6 with tocilizumab (TCZ) might lead to a reduction in left ventricular (LV) dysfunction in patients with rheumatoid arthritis (RA).

Methods

Consecutive RA patients with active disease and healthy control subjects without a clinical diagnosis of cardiovascular disease were enrolled. The RA patients each had inadequate clinical response to non‐biologic disease‐modifying anti‐rheumatic drugs and were prescribed TCZ therapy. All subjects underwent baseline evaluation of LV function, as measured by cardiac magnetic resonance imaging (CMRI). Peak systolic regional radial strain (Err, %) was calculated by feature tracking of cine CMRI. After baseline (BL) CMRI measurements, treatment with TCZ was initiated, and patients were followed for 52 weeks. We compared peak Err of RA patients at BL and at 52 weeks.

Results

Thirteen RA patients (mean age 52.6 ± 5.4 years) were assessed at BL and at 52 weeks, and these patients were compared with 10 non‐RA controls (mean age 55.7 ± 4.6 years). Disease Activity Score of 28 joints – erythrocyte sedimentation rate and Simple Disease Activity Index were significantly lower in RA patients at 52 weeks than at BL. Mean peak Err at BL in RA patients was significantly lower than in normal subjects (P = 0.03). Mean peak Err was significantly higher at 52 weeks than at BL (P = 0.028) in RA patients.

Conclusion

We showed that TCZ was associated with left ventricular dysfunction in RA patients which correlated with a reduction in RA disease activity.
Population pharmacokinetics of nalmefene in healthy subjects and its relation to μ‐opioid receptor occupancy
Authors: Kyhl Lars‐Erik Broksoe , Li Shen , Faerch Kirstine Ullitz , Soegaard Birgitte , Larsen Frank , Areberg Johan
Published: October 2015

Aims

The aims of this study were to develop a population pharmacokinetic (PK) model to describe the PK of nalmefene in healthy subjects and to relate the exposure of nalmefene to the μ‐opioid receptor occupancy by simulations in the target population.

Methods

Data from nine phase I studies (243 subjects) with extensive blood sampling were pooled and used for the population PK model building. Data from four other phase I studies (85 subjects) were pooled and used as an external validation dataset. Eight subjects from an imaging study contributed occupancy data and the pharmacokinetic/pharmacodynamic (PK/PD) relationship was modelled. Combining the population PK model and the PK/PD relationship enabled simulations to predict μ‐opioid occupancy.

Results

A two compartment model with first order absorption best described the nalmefene PK data. The typical subject in the population was estimated to have a systemic clearance of 60.4 l h−1 and a central volume of distribution of 266 l. Absolute oral bioavailability was estimated to 41% without food intake and with food about 53%. Simulation of the μ‐opioid receptor occupancy shows that the 95% confidence bound is within or above 60–90% occupancy for up to 22–24 h after a single dose of 20 mg nalmefene.

Conclusions

A robust population PK model for nalmefene was developed. Based on the concentration–occupancy model the μ‐opioid receptor occupancy after a single 20 mg dose of nalmefene is predicted to be above the target therapeutic occupancy for about 24 h in about 95% of the target population.
Mitochondrial Replacement: Ethics and Identity
Authors: Wrigley Anthony , Wilkinson Stephen , Appleby John B.
Published: October 2015

Mitochondrial replacement techniques (MRTs) have the potential to allow prospective parents who are at risk of passing on debilitating or even life‐threatening mitochondrial disorders to have healthy children to whom they are genetically related. Ethical concerns have however been raised about these techniques. This article focuses on one aspect of the ethical debate, the question of whether there is any moral difference between the two types of MRT proposed: Pronuclear Transfer (PNT) and Maternal Spindle Transfer (MST). It examines how questions of identity impact on the ethical evaluation of each technique and argues that there is an important difference between the two. PNT, it is argued, is a form of therapy based on embryo modification while MST is, instead, an instance of selective reproduction. The article's main ethical conclusion is that, in some circumstances, there is a stronger obligation to use PNT than MST.
The Ethics of Fertility Preservation for Paediatric Cancer Patients: From Offer to Rebuttable Presumption
Authors: McDougall Rosalind
Published: October 2015

Given advances in the science of fertility preservation and the link between fertility choices and wellbeing, it is time to reframe our ethical thinking around fertility preservation procedures for children and young people with cancer. The current framing of fertility preservation as a possible offer may no longer be universally appropriate. There is an increasingly pressing need to discuss the ethics of failing to preserve fertility, particularly for patient groups for whom established techniques exist. I argue that the starting point for deliberating about a particular patient should be a rebuttable presumption that fertility preservation ought to be attempted. Consideration of the harms applicable to that specific patient may then override this presumption. I outline the benefits of attempting fertility preservation; these justify a presumption in favour of the treatment. I then discuss the potential harms associated with fertility preservation procedures, which may justify failing to attempt fertility preservation in an individual patient's particular case. Moving from a framework of offer to one of rebuttable presumption in favour of fertility preservation would have significant implications for medical practice, healthcare organizations and the state.
Morally Relevant Similarities and Differences Between Children and Dementia Patients as Research Subjects: Representation in Legal Documents and Ethical Guidelines
Authors: Jongsma Karin , Bos Wendy , van de Vathorst Suzanne
Published: October 2015

Children and adults with dementia are vulnerable populations. Both groups are also relatively seldom included in biomedical research. However, including them in clinical trials is necessary, since both groups are in need of scientific innovation and new therapies. Their dependence and limited decision‐making capacities increase their vulnerability, necessitating extra precautions when including them in clinical trials. Beside these similarities there are also many differences between the groups. The most obvious one is that children have an entire life ahead of them and will become persons with certain ideals and preferences, while adults with dementia have lived a life in which they have expressed their ideals and preferences. Some of the available research guidelines recognize these differences, setting one list of specific requirements for groups of incapacitated adults and another list for children. Other documents, however, do not differentiate and only set requirements for subjects unable to consent as a single category of subjects.

In this article we analyse to what extent the similarities and differences between the two groups are represented in legal documents and ethical guidelines. The article presents an overview and an analysis of the requirements for doing research with children and dementia patients. We conclude with suggestions about how to better incorporate the morally relevant aspects of these two groups in legislation and ethical guidelines.
Impact of age‐related macular degeneration in patients with glaucoma: understanding the patients' perspective
Authors: Skalicky Simon E , Fenwick Eva , Martin Keith R , Crowston Jonathan , Goldberg Ivan , McCluskey Peter
Published: October 2015

Background

The aim of the study is to measure the impact of age‐related macular degeneration on vision‐related activity limitation and preference‐based status for glaucoma patients.

Design

This was a cross‐sectional study.

Participants

Two‐hundred glaucoma patients of whom 73 had age‐related macular degeneration were included in the research.

Methods

Sociodemographic information, visual field parameters and visual acuity were collected. Age‐related macular degeneration was scored using the Age‐Related Eye Disease Study system.

Main Outcome Measures

The Rasch‐analysed Glaucoma Activity Limitation‐9 and the Visual Function Questionnaire Utility Index measured vision‐related activity limitation and preference‐based status, respectively. Regression models determined factors predictive of vision‐related activity limitation and preference‐based status. Differential item functioning compared Glaucoma Activity Limitation‐9 item difficulty for those with and without age‐related macular degeneration.

Results

Mean age was 73.7 (±10.1) years. Lower better eye mean deviation (β: 1.42, 95% confidence interval: 1.24–1.63, P < 0.001) and age‐related macular degeneration (β: 1.26 95% confidence interval: 1.10–1.44, P = 0.001) were independently associated with worse vision‐related activity limitation. Worse eye visual acuity (β: 0.978, 95% confidence interval: 0.961–0.996, P = 0.018), high risk age‐related macular degeneration (β: 0.981, 95% confidence interval: 0.965–0.998, P = 0.028) and severe glaucoma (β: 0.982, 95% confidence interval: 0.966–0.998, P = 0.032) were independently associated with worse preference‐based status. Glaucoma patients with age‐related macular degeneration found using stairs, walking on uneven ground and judging distances of foot to step/curb significantly more difficult than those without age‐related macular degeneration.

Conclusions

Vision‐related activity limitation and preference‐based status are negatively impacted by severe glaucoma and age‐related macular degeneration. Patients with both conditions perceive increased difficulty walking safely compared with patients with glaucoma alone.
Transcrestal Sinus Lift Using Platelet Concentrates in Association to Short Implant Placement: A Retrospective Study of Augmented Bone Height Remodeling
Authors: Anitua Eduardo , Flores Javier , Alkhraisat Mohammad Hamdan
Published: October 2015

Background

No evidence has been reported yet about dimensional changes in maxillary sinuses grafted with autologous platelet concentrate.

Purpose

This study aimed to analyze the augmented height alterations around short implants (length ≤ 8.5 mm) placed after transcrestal sinus lift surgery in association with plasma rich in growth factors.

Materials and Methods

A retrospective design was used. Patients with atrophic posterior maxilla were treated by inserting short implants in combination with transalveolar maxillary sinus floor augmentation. Radiographic bone level alterations over time were assessed on panoramic radiographs.

Results

Transalveolar sinus augmentation was performed to place 41 implants in 26 patients with a residual bone height of 4.7 ± 1.3 mm. The alveolar bone height was increased by 3.7 ± 1.7 mm and 4.2 ± 2.0 mm after 12 ± 3 months and 35 ± 11 months of surgery, respectively, whereas the apical augmented height (beyond the implant) apex was stable around 34 implants during the follow‐up. It was increasing around seven implants that were not covered by the endo‐sinus augmented height at the 1‐year follow‐up.

Conclusions

Transalveolar sinus floor augmentation in association with plasma rich in growth factors and short implants resulted in a stable augmented height gain after 3 years follow‐up. Atrophic posterior maxilla could be treated by transalveolar sinus lift in association with plasma rich in growth factors and the placement of short implants.
Anthropogenic areas as incidental substitutes for original habitat
Authors: Martínez‐Abraín Alejandro , Jiménez Juan
Published: October 2015

One speaks of ecological substitutes when an introduced species performs, to some extent, the ecosystem function of an extirpated native species. We suggest that a similar case exists for habitats. Species evolve within ecosystems, but habitats can be destroyed or modified by natural and human‐made causes. Sometimes habitat alteration forces animals to move to or remain in a suboptimal habitat type. In that case, the habitat is considered a refuge, and the species is called a refugee. Typically refugee species have lower population growth rates than in their original habitats. Human action may lead to the unintended generation of artificial or semiartificial habitat types that functionally resemble the essential features of the original habitat and thus allow a population growth rate of the same magnitude or higher than in the original habitat. We call such areas substitution habitats and define them as human‐made habitats within the focal species range that by chance are partial substitutes for the species’ original habitat. We call species occupying a substitution habitat adopted species. These are 2 new terms in conservation biology. Examples of substitution habitats are dams for European otters, wheat and rice fields for many steppeland and aquatic birds, and urban areas for storks, falcons, and swifts. Although substitution habitats can bring about increased resilience against the agents of global change, the conservation of original habitat types remains a conservation priority.
Post‐trial obligations in the Declaration of Helsinki 2013: classification, reconstruction and interpretation
Authors: Mastroleo Ignacio
Published: October 2015

The general aim of this article is to give a critical interpretation of post‐trial obligations towards individual research participants in the Declaration of Helsinki 2013. Transitioning research participants to the appropriate health care when a research study ends is a global problem. The publication of a new version of the Declaration of Helsinki is a great opportunity to discuss it. In my view, the Declaration of Helsinki 2013 identifies at least two clearly different types of post‐trial obligations, specifically, access to care after research and access to information after research. The agents entitled to receive post‐trial access are the individual participants in research studies. The Declaration identifies the sponsors, researchers and host country governments as the main agents responsible for complying with the post‐trial obligations mentioned above. To justify this interpretation of post‐trial obligations, I first introduce a classification of post‐trial obligations and illustrate its application with examples from post‐trial ethics literature. I then make a brief reconstruction of the formulations of post‐trial obligations of the Declaration of Helsinki from 2000 to 2008 to correlate the changes with some of the most salient ethical arguments. Finally I advance a critical interpretation of the latest formulation of post‐trial obligations. I defend the view that paragraph 34 of ‘Post‐trial provisions’ is an improved formulation by comparison with earlier versions, especially for identifying responsible agents and abandoning ambiguous ‘fair benefit’ language. However, I criticize the disappearance of ‘access to other appropriate care’ present in the Declaration since 2004 and the narrow scope given to obligations of access to information after research.
A pilot study of factors associated with glycaemic control in adults with Type 1 diabetes mellitus on insulin pump therapy
Authors: Wen W. , Frampton R. , Wright K. , Fattore S. , Shadbolt B. , Perampalam S.
Published: October 2015

Aims

To identify the knowledge and management factors associated with glycaemic control among adults with Type 1 diabetes mellitus treated with insulin pump therapy.

Methods

A cross‐sectional study of adults with Type 1 diabetes mellitus on insulin pump therapy for at least 12 months (n = 50, 18–70 years old) was undertaken between December 2013 and May 2014. A new questionnaire was developed to evaluate participants’ knowledge and management related to insulin pump therapy, and were correlated with insulin pump data, HbA1c and frequency of hypoglycaemia.

Results

Participants who changed their insulin pump settings when indicated had significantly better glycaemic control than those who did not (P = 0.04). Multivariate logistic regression analysis found that better overall insulin pump therapy management was a significant predictor of better glycaemic control (odds ratio 4.45, 95% confidence interval 1.61–12.3; P = 0.004) after adjusting for potential confounders including age, gender, duration of diabetes and insulin pump therapy. However, overall insulin pump therapy knowledge was not a significant predictor of glycaemic control (P = 0.058). There was no significant association between frequency of hypoglycaemia and insulin pump therapy knowledge or management.

Conclusions

We identified some key knowledge and management factors associated with glycaemic control in adults with Type 1 diabetes mellitus on insulin pump therapy using a newly designed questionnaire. The pilot study assessed the clinical utility of this evaluation tool, which may facilitate provision of targeted education to insulin pump therapy users to achieve optimal glycaemic control.
A meta‐analysis of rate ratios for nocturnal confirmed hypoglycaemia with insulin degludec vs. insulin glargine using different definitions for hypoglycaemia
Authors: Heller S. , Mathieu C. , Kapur R. , Wolden M. L. , Zinman B.
Published: October 2015

Aims

A prospective meta‐analysis of phase 3 trials showed lower rates of nocturnal hypoglycaemia with insulin degludec vs. insulin glargine. We investigated the consistency of the results across different definitions of hypoglycaemia.

Methods

This post‐hoc, patient‐level meta‐analysis included six randomized, controlled, 26‐ or 52‐week phase 3a trials in insulin‐naïve participants with Type 2 diabetes mellitus (Type 2 diabetesinsulin naïve), participants with Type 2 diabetes mellitus using basal−bolus therapy (Type 2 diabetesBB) and those with Type 1 diabetes mellitus. We used three definitions of hypoglycaemia and different timescales for the nocturnal period. Rates were analysed for the entire core trial period, the ‘maintenance period’ only, and the extension trial set population. Analyses utilized a negative binomial regression model.

Results

In Type 2 diabetesinsulin naïve participants, risk of nocturnal hypoglycaemia was significantly lower with insulin degludec vs. insulin glargine for all hypoglycaemia definitions and trial periods. Risk was also lower for the timescale 21.59–05.59, but not 00.01–07.59. For Type 2 diabetesBB, nocturnal hypoglycaemia rates were lower with insulin degludec vs. insulin glargine across all definitions, timescales and trial periods, with one exception. For individuals with Type 1 diabetes mellitus, nocturnal hypoglycaemia risk was significantly lower with insulin degludec during the maintenance period for the original definition (plasma glucose < 3.1 mmol/l, timescale 00.01–05.59) and in the extension trial set population for all hypoglycaemia definitions except for the nocturnal timescale 00.01–07.59.

Conclusions

Compared with insulin glargine, insulin degludec is associated with lower rates of nocturnal hypoglycaemia in people with Type 2 diabetes mellitus, and similar or lower rates in Type 1 diabetes mellitus, across different definitions.
Annotations on a Scandal: Desire, Transgression, and the Filmic Fantasy of Pedagogy
Authors: Stillwaggon James , Jelinek David
Published: October 2015

From Socrates to Jean Brodie, we have become accustomed to teachers serving as placeholders for transgressive and powerful desires in our cultural imaginary. Evidenced by recent scholarship on teachers in film, however, as well as by the 2006 film Notes on a Scandal, the way we ought to feel about teachers acting on their transgressive motivations, realizing the cultural fantasies that shadow desire and break from social norms, is less clear. In this article James Stillwaggon and David Jelinek frame the problematic erotics of school films in terms of the fantasy of the subject presumed to know and the transgressive bliss of jouissance. Stillwaggon and Jelinek analyze Notes on a Scandal as a breakdown and reversal of the tradition of school films to which it is indebted and work from it toward an understanding of the unrecognized and often conflicted cultural commitments that shape teaching.
Incestuous marriages in late Carolingian Ravenna: the causa Deusdedit (878–81)
Authors: Betti Maddalena
Published: October 2015

During the ninth century and especially after Lothar II's divorce, the Carolingian reformers turned their attention to the definition of legitimate Christian marriage, promoting and spreading precise rules to discipline the marital strategies of aristocracies in the Carolingian world. Legislation against incestuous marriages became progressively more radical, extending the scope of incest not only to consanguinity, but also to affinity and spiritual kinship. This article examines the effects of the new prescriptions in late Carolingian Ravenna through an analysis of Pope John VIII's letters concerning the so‐called causa Deusdedit, a controversial trial for incestuous marriage.
Does metabolic syndrome impact cognition and emotion in Alzheimer's disease?
Authors: Willette A.
Published: October 2015

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A synthesis of the effect of grazing exclusion on carbon dynamics in grasslands in China
Authors: Hu Zhongmin , Li Shenggong , Guo Qun , Niu Shuli , He Nianpeng , Li Linghao , Yu Guirui
Published: October 2015

Grazing exclusion (GE) is considered to be an effective approach to restore degraded grasslands and to improve their carbon (C) sequestration. However, the C dynamics and related controlling factors in grasslands with GE have not been well characterized. This synthesis examines the dynamics of soil C content and vegetation biomass with the recovery age through synthesizing results of 51 sites in grasslands in China. The results illustrate increases in soil C content and vegetation biomass with GE at most sites. Generally, both soil C content and vegetation biomass arrive at steady state after 15 years of GE. In comparison, the rates of increase in above‐ and belowground biomass declined exponentially with the age of GE, whereas soil C content declined in a milder (linear) way, implying a lagged response of soil C to the inputs from plant biomass. Mean annual precipitation (MAP) and the rate of soil nitrogen (N) change were the main factors affecting the rate of soil C content change. MAP played a major role at the early stage, whereas the rate of soil N change was the major contributor at the middle and late stages. Our results imply that the national grassland restoration projects in China may be more beneficial for C sequestration in humid regions with high MAP. In addition, increased soil N supply to grasslands with GE at the latter recovery stage may enhance ecosystem C sequestration capacity.
Influence of Alluvial Morphology on Upscaled Hydraulic Conductivity
Authors: Jha Sanjeev Kumar , Mariethoz Gregoire , Mathews George , Vial John , Kelly Bryce F.J.
Published: October 2015

The hydraulic conductivity of aquifers is a key parameter controlling the interactions between resource exploitation activities, such as unconventional gas production and natural groundwater systems. Furthermore, this parameter is often poorly constrained by typical data used for regional groundwater modeling and calibration studies performed as part of impact assessments. In this study, a systematic investigation is performed to understand the correspondence between the lithological descriptions of channel‐type formation and the bulk effective hydraulic conductivities at a larger scale (Kxeff, Kyeff, and Kzeff in the direction of channel cross section, along the channel and in the vertical directions, respectively). This will inform decisions on what additional data gathering and modeling of the geological system can be performed to allow the critical bulk properties to be more accurately predicted. The systems studied are conceptualized as stacked meandering channels formed in an alluvial plain, and are represented as two facies. Such systems are often studied using very detailed numerical models. The main factors that may influence Kxeff, Kyeff, and Kzeff are the proportion of the facies representing connected channels, the aspect ratio of the channels, and the difference in hydraulic conductivity between facies. Our results show that in most cases, Kzeff is only weakly dependent on the orientations of channelized structures, with the main effects coming from channel aspect ratio and facies proportion.