bluuebunny/crossref_metadata_2025 huggingface dataset:
Toward a global geroethics – gerontology and the theory of the good human life
Authors: Ehni Hans‐Joerg , Kadi Selma , Schermer Maartje , Venkatapuram Sridhar
Published: April 2018

Gerontologists have proposed different concepts for ageing well such as ‘successful ageing’, ‘active ageing’, and ‘healthy ageing’. These conceptions are primarily focused on maintaining health and preventing disease. But they also raise the questions: what is a good life in old age and how can it be achieved? While medical in origin, these concepts and strategies for ageing well also contain ethical advice for individuals and societies on how to act regarding ageing and old age. This connection between gerontology and ethics is overlooked by both schools of thought. We thus develop this research programme for a systematic geroethics in four steps. First, we analyze ‘successful ageing’ as put forward by Rowe and Kahn as a paradigmatic example of a gerontological conception of ageing well. Then, in a second step, we move from criticisms within gerontology to an ethical perspective; in particular, we want to clarify the problem of the claim of universal validity of conceptions of the good life. In a third constructive step, we explain how the ‘capabilities approach’ could be applied in this context as a normative foundation for the implicit normative assumptions of gerontological conceptions of ageing well, such as a particular choice of functionings, the ethical relevance of human agency, and the resulting claims of individuals towards society. Finally, using a concept developed by the German philosopher Ursula Wolf, we systematically develop the different aspects of the connection between ageing well and the theory of the good life in their full complexity and show their interconnectedness.
A Psychoanalysis of Being: An Approach to Donald Winnicott
Authors: Caldwell Lesley
Published: April 2018

This paper offers a brief résumé of Winnicott's approach to psychoanalysis through a reading that emphasizes his interest in the capacity to be as a fundamental acquisition of human subjectivity. This interest continued throughout his life. The paper argues that it is closely related to his interest in analytic communication and the emphasis in his paper ‘Communicating and not‐communicating leading to a study of certain opposites’ of the importance clinically of the patient's right not to communicate and the analyst's acceptance of it. It refers briefly to the richness of the arena opened up by his idea of the incommunicado self and its implications for both theory and practice. Three clinical vignettes are included to demonstrate Winnicott's way of working.
Endoplasmic reticulum stress‐mediated autophagy protects against β,β‐dimethylacrylshikonin‐induced apoptosis in lung adenocarcinoma cells
Authors: Wang Haibing , Zhang Gaochenxi
Published: April 2018

β,β‐Dimethylacrylshikonin (DMAS) is an anti‐cancer compound extracted from the roots of Lithospermum erythrorhizon. The present study aims to investigate the effects of DMAS on human lung adenocarcinoma cells in vitro and explore the mechanisms of its anti‐cancer action. We showed that DMAS markedly inhibited cell viability in a dose‐ and time‐dependent way, and induced apoptosis as well as autophagy in human lung adenocarcinoma cells. Furthermore, we found that DMAS stimulated endoplasmic reticulum stress and mediated autophagy through the PERK‐eIF2α‐ATF4‐CHOP and IRE1‐TRAF2‐JNK axes of the unfolded protein response in human lung adenocarcinoma cells. We also showed that the autophagy induced by DMAS played a prosurvival role in human lung adenocarcinoma cells and attenuated the apoptotic cascade. Collectively, combined treatment of DMAS and pharmacological autophagy inhibitors could offer an effective therapeutic strategy for lung adenocarcinoma treatment.
Improving the echocardiographic assessment of pulmonary pressure using the tricuspid regurgitant signal—The “chin” vs the “beard”
Authors: Kyranis Stephen J. , Latona Jilani , Platts David , Kelly Natalie , Savage Michael , Brown Martin , Hamilton‐Craig Christian , Scalia Gregory M. , Burstow Darryl
Published: April 2018

Aim

Transthoracic echocardiography (TTE) is a fundamental investigation for the noninvasive assessment of pulmonary hemodynamics and right heart function. The aim of this study was to assess the correlation and agreement of Doppler calculation of right ventricular systolic pressure (RVSP) and pulmonary vascular resistance (PVR) using “chin” and “beard” measurements of tricuspid regurgitant velocity (TRVmax), with invasive pulmonary artery systolic pressure (PASP) andPVR.

Methods

One hundred patients undergoing right heart catheterisation (RHC) and near simultaneous transthoracic echocardiography were studied.TRVmaxwas recorded for “chin” measurement (distinct peakTRVmaxsignal) and where available (63 patients), “beard” measurement (higher indistinct peakTRVmaxsignal).

Results

MeasurableTRVsignal was obtained in 96 patients. MeanRVSPchin54.7 ± 22.7 mm Hg andRVSPbeard68.6 = 23 ± 26.3 mm Hg (P < .001). There was strong correlation between bothRVSPchinandRVSPbeardwith invasivePASP(Pearson'sr = .9,R2 = 0.82,P < .001 ‐r = .88,R = .78,P < .001, respectively.). Bland‐Altman analysis forRVSPchinandRVSPbeardshowed a mean bias of −0.5 mm Hg (95% limits of agreement −21.4 to 20.5 mm Hg) and −10.7 (95%LOA−35.5 to 14.2 mm Hg), respectively. Receiver operator characteristics ofTRVmax“chin” and “beard” for diagnosis of pulmonary hypertension was assessed with optimal cut‐offs being 2.8 m/s (sensitivity 93%, specificity 87%) and 3.2 m/s (sensitivity 91%, specificity 82%), respectively. There was similar correlation betweenPVRchinandPVRbeard(r = .87,R2 = 0.75,P < .001 andr = .86,R2 = 0.74,P < .001, respectively). At higherPVR, there was overestimation of calculatedPVRusingPVRbeard.

Conclusion

The accuracy of noninvasive measurement of right heart pressures is increased using the “chin” in estimation of bothRVSPandPVR.
Hypoplastic posterior mitral valve leaflet: A case report and review of the literature
Authors: Pourafkari Leili , Baghbani‐Oskouei Aidin , Toufan Mehrnoush , Ghaffari Samad , Nader Nader D.
Published: April 2018

Hypoplasia of the mitral leaflets is rarely reported in adults. We reported a 45‐year‐old man presented to us with palpitation, dyspnea, and severe mitral regurgitation. In echocardiographic examination, an immobile hypoplastic posterior mitral leaflet (PML) was detected. A review of clinical and echocardiographic findings of all reported cases revealed that mitral regurgitation was the most common finding associated with PML hypoplasia/uni‐leaflet mitral valve. PML hypoplasia is rare and often an incidental diagnosis during echocardiography, which could be relatively well tolerated since adulthood and carries a good prognosis.
From evidence to action: Applying gender mainstreaming to pay gaps in the Welsh public sector
Authors: Parken Alison , Ashworth Rachel
Published: April 2018

Progress on reducing gender disparities remains painfully slow, despite efforts to identify the determinants of gender pay gaps and specify size and shape. Recent studies highlight the need for a more nuanced account of the way that public policy shapes organizational responses and insights into the types of organizational practices that diminish pay disparities. In response, this research reports on an action research intervention in three large Welsh public organizations, subject to a unique statutory equality duty. Data demonstrate how an evidence‐based gender mainstreaming approach facilitated the development of a ‘no blame’ strategy, which legitimized organizational proactivity through collaborative and empowering change management processes. The research contributes to the study of gender pay gaps by demonstrating that gender mainstreaming, with facilitative local conditions and supportive public policy, shapes action on gender segregation, with particular success in women's low‐paid employment. Conclusions highlight theoretical and policy implications arising from the research.
An approach on the potential use of probiotics in the treatment of skin conditions: acne and atopic dermatitis
Authors: Mottin Vitória H. M. , Suyenaga Edna S.
Published: April 2018

Acne and Atopic Dermatitis (AD) are chronic inflammatory skin conditions with severe impact on a patient's life. Current treatments are related to adverse effects and do not represent a definitive cure. The present paper reviews the alterations in skin microbiome, specifically in acne and AD, and aims in searching for potential treatments based on benefic microorganisms, called probiotics. The review was made through bibliographic search of the main databases (Science Direct, PubMed, Scielo, Medline) between September 2015 and June 2016. Acne lesions create an environment that facilitates the excess growth of Propionibacterium acnes (P. acnes). AD is related to an increase in the proportion of Staphylococcus aureus (S. aureus) during flare‐ups. Some microorganisms have been shown to act not only in the prevention but also in the competition for pathogenic microorganisms and beneficially affect the inflammatory process present in these conditions. Despite the high variety of tested bacteria, Staphylococcus, Streptococcus, Lactococcus, Lactobacillus, and Enterococcus are the ones which showed the highest potential to control acne, and Vitreoscilla filiformis (V. filiformis), Staphylococcus epidermidis (S. epidermidis), and species of Lactobacillus and Bifidobacterium in the treatment of AD. Many of these studies were in vitro, and more detailed research should be performed in order to prove the real efficacy and safety of probiotics in these situations. An interesting alternative seems to be the use of Bacteriocin‐like inhibitory substances produced by probiotics, responsible for their antimicrobial activity.
Heart rate variability parameters in children with ventricular preexcitation
Authors: Koca Serhat , Pac Feyza Aysenur , Mihcioglu Ajda , Eris Deniz , Cay Serkan , Ozeke Ozcan
Published: April 2018

Introduction

The autonomic nervous system has a regulatory effect on cardiac electrophysiology and arrhythmogenesis. We aimed to assess cardiac autonomic status using heart rate variability (HRV) parameters in children with ventricular preexcitation.

Methods

The electrocardiography, Holter monitoring, transesophageal electrophysiological study (TEEPS), and invasive electrophysiological study (EPS) results of ventricular preexcitation patients obtained over a 7‐year period in our clinic were evaluated. According to the TEEPS results, patients’ accessory pathway conduction was classified as adverse (n = 40) or nonadverse (n = 25). The HRV parameters of patients were compared according to tachycardia inducibility that assessed by TEEPS and EPS. Also, HRV parameters were compared in patients with adverse and nonadverse pathway conduction. Further, the HRV parameters of preexcitation patients were compared with those of healthy controls.

Results

LF/HF, the best measure of sympathovagal balance, was statistically higher in patients with adverse conduction than in patients without adverse conduction and controls (P  =  0.001). The LF/HF ratio was higher in ventricular preexcitation patients with inducible tachycardia than those without in EPS (P  =  0.001). In addition, the LF/HF ratio was higher in symptomatic ventricular preexcitation patients than asymptomatic ones (P  =  0.001). No difference in HRV parameters was found between preexcitation patients and controls.

Conclusion

Autonomic tonus in patients with ventricular preexcitation may affect accessory pathway conduction properties, tachycardia inducibility, and symptomology. The indicator of sympathovagal balance, LF/HF ratio, increased in ventricular preexcitation patients with inducible tachycardia and those that were symptomatic.
Utilization of cold pressed chia seed oil waste in a low‐fat salad dressing as natural fat replacer
Authors: Akcicek Alican , Karasu Salih
Published: April 2018

The main aim of this study is to develop a low‐fat salad dressing by using cold‐press chia seed oil waste powder (CCWP). Formulation optimization was conducted by response surface methodology (RSM) based on the rheological and microstructural properties. All of the samples exhibited non‐Newtonian flow behavior, and storage modulus (G′) value was higher than loss modulus (G″) in the whole frequency range. The consistency coefficient (K) value of the samples was significantly affected by formulation (p < .05) and found as 0.552–15.87 Pa·sn. The optimum stabilizer, oil, emulsifier, and CCWP content are 0.33, 10, 1.12, and 2%, respectively. The samples formulated by CCWP showed a high G′ and zeta (ζ) potential values at a low oil and emulsifier content. The samples prepared with optimum formulation exhibited high stability and comparable recovery properties with commercial samples. This study suggested that CCWP could be used in a low‐fat salad dressing as a fat replacer.

Practical applications

The trend in the consumption of low‐fat dressing and mayonnaise has increased in recent years due to some health problem from the overconsumption of fat. For the food industry, however, it can be a problem to develop reduced fat content emulsions without significant changes in texture, rheological, and organoleptic characteristics. Natural and commercial types of the fat replacers are used to develop rheological and sensory properties of the low‐fat emulsions. Several types of commercial fat replacers are used in the food industry to produce the desirable mouthfeel properties. However, the trend in finding the natural source of fat replacers has increased and alternatives should be improved to meet consumer expectancy. Chia seed waste obtained from the oil industry can be considered as a natural source of fat replacer due to its high polysaccharide and protein content. In this study, the potential use of CCWP was studied as a natural fat replacer.
Do‐Not‐Resuscitate Orders in Older Adults During Hospitalization: A Propensity Score–Matched Analysis
Authors: Patel Karishma , Sinvani Liron , Patel Vidhi , Kozikowski Andrzej , Smilios Christopher , Akerman Meredith , Kiszko Kinga , Maiti Sutapa , Hajizadeh Negin , Wolf‐Klein Gisele , Pekmezaris Renee
Published: April 2018

Objectives

To explore the effect of the presence and timing of a do‐not‐resuscitate (DNR) order on short‐term clinical outcomes, including mortality.

Design

Retrospective cohort study with propensity score matching to enable direct comparison of DNR and no‐DNR groups.

Setting

Large, academic tertiary‐care center.

Participants

Hospitalized medical patients aged 65 and older.

Measurements

Primary outcome was in‐hospital mortality. Secondary outcomes included discharge disposition, length of stay, 30‐day readmission, restraints, bladder catheters, and bedrest order.

Results

Before propensity score matching, the DNR group (n=1,347) was significantly older (85.8 vs 79.6, p<.001) and had more comorbidities (3.0 vs 2.5, p<.001) than the no‐DNR group (n=9,182). After propensity score matching, the DNR group had significantly longer stays (9.7 vs 6.0 days, p<.001), were more likely to be discharged to hospice (6.5% vs 0.7%, p<.001), and to die (12.2% vs 0.8%, p<.001). There was a significant difference in length of stay between those who had a DNR order written within 24 hours of admission (early DNR) and those who had a DNR order written more than 24 hours after admission (late DNR) (median 6 vs 10 days, p<.001). Individuals with early DNR were less likely to spend time in intensive care (10.6% vs 17.3%, p=.004), receive a palliative care consultation (8.2% vs 12.0%, p=.02), be restrained (5.8% vs 11.6%, p<.001), have an order for nothing by mouth (50.1% vs 56.0%, p=.03), have a bladder catheter (31.7% vs 40.9%, p<.001), or die in the hospital (10.2% vs 15.47%, p=.004) and more likely to be discharged home (65.5% vs 58.2%, p=.01).

Conclusion

Our study underscores the strong association between presence of a DNR order and mortality. Further studies are necessary to better understand the presence and timing of DNR orders in hospitalized older adults.
Evaluation of the Cincinnati Veterans Affairs Medical Center Hospital‐in‐Home Program
Authors: Cai Shubing , Grubbs Andrew , Makineni Rajesh , Kinosian Bruce , Phibbs Ciaran S. , Intrator Orna
Published: April 2018

Objectives

To examine hospital readmissions, costs, mortality, and nursing home admissions of veterans who received Hospital‐in‐Home (HIH) services.

Design

Retrospective cohort study.

Setting

Cincinnati Veterans Affairs Medical Center (VAMC).

Participants

Study cohort included veterans who received HIH services as an alternative to inpatient care between October 1, 2012, and November 30, 2015, and non‐HIH veterans who were hospitalized for similar conditions in the Cincinnati VAMC during the same period. We identified 138 veterans who used HIH services and 694 non‐HIH veterans.

Intervention

HIH veterans received hospital‐equivalent care at home. Non‐HIH veterans received traditional inpatient services in the Cincinnati VAMC.

Measurements

Total costs of care for treating an acute episode (HIH services vs inpatient) and likelihood of hospital readmission, death, or nursing home admission within 30 days of discharge from HIH services or hospitalization.

Results

Average per person costs were $7,792 for HIH services and $10,960 for traditional inpatient care (P<0.001). HIH veterans were less likely to use a nursing home within 30 days of discharge (3.1%) than non‐HIH veterans (12.6%) (P<0.001). Thirty‐day readmission rates and mortality were not statistically different between HIH and non‐HIH veterans.

Conclusion

The substitutive HIH model implemented in the Cincinnati VAMC delivered acute services in veterans' homes at lower cost and with lower likelihood of postdischarge nursing home use. Broader implementation of this innovative delivery model may benefit older adults in need of care while reducing healthcare system costs.
Delivery of therapeutics for deep-seated ocular conditions – status quo
Authors: Nguyen Hubert , Eng Shawn , Ngo Thanh , Dass Crispin R
Published: April 2018

Objectives

There is a need for research into designing effective pharmaceutical systems for delivering therapeutic drugs to the posterior of the eye for glaucoma-related pathology, macular degeneration, diabetic retinopathy, macular oedema, retinitis and choroiditis. Conventionally, eye drops have been extensively utilised for topical drug delivery to the anterior segment of the eye, but are less effective for delivery of therapeutics to the back of the eye due to significant barriers hampering drug penetration into the target intraocular tissue. This review explores some of the current and novel delivery systems employed to deliver therapeutics to the back of the eye such as those using liposomes, ocular implants, in situ gels, and nanoparticles, and how they can overcome some of these limitations.

Key findings

Issues such as blinking, precorneal fluid drainage, tear dilution and turnover, conjunctiva and nasal drug absorption, the corneal epithelium, vitreous drug clearance, and the blood–ocular barriers are reviewed and discussed.

Further studies are needed to address their shortcomings such as drug compatibility and stability, economic viability and patient compliance.
Being and Love: Schleiermacher, Aquinas and Augustine
Authors: Soskice Janet Martin
Published: April 2018

This article makes the case for speaking not of divine “attributes” but of divine “names.” There are good scriptural grounds for advancing the thesis that love is not just another divine name, but the name which designates God's very nature, i.e. who God is. Schleiermacher made that case. This essay argues that “Love,” as a divine name, should be paired with “being” (which is also, for theologians like Augustine and Aquinas, a “biblical” name), since God does not “have” love or being, but is love and is “being itself.”
Unravelling the Predictive Power of Telematics Data in Car Insurance Pricing
Authors: Verbelen Roel , Antonio Katrien , Claeskens Gerda
Published: April 2018

A data set from a Belgian telematics product aimed at young drivers is used to identify how car insurance premiums can be designed based on the telematics data collected by a black box installed in the vehicle. In traditional pricing models for car insurance, the premium depends on self-reported rating variables (e.g. age and postal code) which capture characteristics of the policy(holder) and the insured vehicle and are often only indirectly related to the accident risk. Using telematics technology enables tailor-made car insurance pricing based on the driving behaviour of the policyholder. We develop a statistical modelling approach using generalized additive models and compositional predictors to quantify and interpret the effect of telematics variables on the expected claim frequency. We find that such variables increase the predictive power and render the use of gender as a rating variable redundant.
Dimensions of Religion Associated with Suicide Attempt and Suicide Ideation in Depressed, Religiously Affiliated Patients
Authors: Jongkind Matthias , van den Brink Bart , Schaap‐Jonker Hanneke , van der Velde Nathan , Braam Arjan W.
Published: April 2018

There is substantial evidence to support the claim that religion can protect against suicide ideation, suicide attempts, and completed suicide. There is also evidence that religion does not always protect against suicidality. More insight is needed into the relationship between suicidal parameters and dimensions of religion. A total of 155 in‐ and outpatients with major depression from a Christian Mental Health Care institution were included. The following religious factors were assessed: religious service attendance, frequency of prayer, religious salience, type of God representation, and moral objections to suicide (MOS). Multiple regression analyses were computed. MOS have a unique and prominent (negative) association with suicide ideation and the lifetime history of suicide attempts, even after controlling for demographic features and severity of depression. The type of God representation is an independent statistical predictor of the severity of suicide ideation. A positive‐supportive God representation is negatively correlated with suicide ideation. A passive‐distressing God representation has a positive correlation with suicide ideation. High MOS and a positive‐supportive God representation in Christian patients with depression are negatively correlated with suicide ideation. Both are likely to be important markers for assessment and further development of therapeutic strategies.
It's not Economic Interventionism, Stupid! Reassessing the Political Economy of Radical Right‐wing Populist Parties
Authors: Otjes Simon , Ivaldi Gilles , Jupskås Anders Ravik , Mazzoleni Oscar
Published: April 2018

This paper engages in a comparative analysis of the economic positions of radical right‐wing populist parties in Western Europe. Following Ennser‐Jedenastik (), we argue that those parties’ political economy is best captured in terms of the nativist, populist and authoritarian features of their core ideology, each of which produces a specific set of economic policies independent from the issue of government intervention in the economy. On basis of an analysis of the election manifestos of seven radical right‐wing populist parties in Western Europe in the period 2005‐2015, we argue that those parties share similarities in their economic nativism, authoritarianism and populism, whilst their positions on the traditional role of the state in the economy are more diverse. The findings indicate also a unified ‘nativist’ response to the global financial crisis both in terms of welfare chauvinism and economic protectionism. We discuss the role of internal and external factors in explaining the economic profile of radical right‐wing populist parties.
Identifying soil management zones in a sugarcane field using proximal sensed electromagnetic induction and gamma‐ray spectrometry data
Authors: Dennerley C. , Huang J. , Nielson R. , Sefton M. , Triantafilis J.
Published: April 2018

Spatial variation in soils is required to supply ameliorants and fertilisers in the Australian sugarcane industry. However, traditional approaches are cost‐prohibitive. We investigated how a digital soil mapping (DSM) approach could be used to identify management zones. First, ancillary data including electromagnetic induction and gamma‐ray spectrometry data were collected. Using fuzzy k‐means (FKM) clustering, two to six management zones were identified. A similar approach was used to cluster percentage yield variations (2014, 2015 and 2016). Using restricted maximum likelihood analysis of topsoil (0–0.3 m) and subsoil (0.6–0.9 m) physical (e.g. clay) and chemical (e.g. exchangeable sodium percentage [ESP], and exchangeable calcium and magnesium) properties, three zones were found to minimise the mean squared prediction error (). By comparison, the three zones obtained using the percentage yield variation only minimised for subsoil ESP, which suggested it had some influence on sugarcane yield and productivity. Different rates of gypsum were required to manage the moderately sodic topsoil ESP for each zone. This was similarly the case with lime to overcome deficiencies in exchangeable calcium and magnesium. The results were consistent with yield variance, suggesting the smaller yield in some zones was due to topsoil sodicity and strongly sodic subsoil with a greater clay content. We concluded that the DSM approach was successful in identifying soil management zones and can be used to improve soil structural stability and fertility. The zones also had ramifications for strip trials to determine yield increases by comparing variable rate applications of gypsum and lime.
Potential to predict depth‐specific soil–water content beneath an olive tree using electromagnetic conductivity imaging
Authors: Martinez G. , Huang J. , Vanderlinden K. , Giráldez J. V. , Triantafilis J.
Published: April 2018

Efficient monitoring of soil moisture is becoming increasingly important. To understand soil–plant–water dynamics, we evaluate the potential of using a multiple‐coil‐array electromagnetic induction instrument and inversion software to map soil moisture beneath an olive tree. On twelve different days, we collected apparent electrical conductivity (ECa) data using a DUALEM‐21S and the volumetric soil moisture (θ) using a bank of soil moisture sensors on opposite sides of the tree. Using EM4Soil, we inverted the ECa data on five of the days and established a site‐specific calibration between estimates of true electrical conductivity (σ) and θ. The strongest calibration relationship between σ and θ (R2 = 0.65) was obtained for a full‐solution, S2 algorithm and damping factor of 1.2. A leave one out cross‐validation (LOOCV) showed the calibration was robust, with a root mean square error (RMSE) of 0.046 m3/m3, a mean error (ME) of 0.001 m3/m3 and a Lin's concordance of 0.72. We subsequently evaluated the calibration relationship on the seven remaining days and over a drying period of 120 days. This approach provides information about the temporal evolution of θ by a LOOCV of validation with a RMSE of 0.037, ME of −0.003 and a Lin's concordance of 0.54. Improvement could be achieved by aligning the DUALEM‐21S in the same orientation as the sensors, with time‐lapse inversion also being advantageous.
Port efficiency and Brazilian exports: A quantitative assessment of the impact of turnaround time
Authors: Sant’ Anna Vinícios P. , Kannebley Júnior Sérgio
Published: April 2018

This paper estimates the impact of vessels turnaround time on Brazilian exports. To achieve this goal, we use a difference gravity equation in order to explore the time variation in port procedures for 16 Brazilian ports. This paper uses a unique database with local exports, taking into account the port used and products aggregated at the four‐digit Harmonized System (HS) level for the period between 2010 and 2012. The estimation results indicate that, in general, each additional hour of delay in port procedures represents costs to Brazilian exporters, which may lead to loss of competitiveness of domestic products abroad. According to the estimates, each additional relative hour of delay in the average port is equivalent to a reduction in relative local exports of ~2%. Moreover, a 10% relative reduction in vessel turnaround time can increase the proportional number of exported product categories by 1%. Therefore, our findings suggest that turnaround time has a statistically significant effect on the intensive and extensive margins of international trade.
Qualitative evaluation of an educational intervention to reduce medicolegal risks for medical doctors experiencing significantly more cases than their peers in the UK and Ireland
Authors: Jolly John , Bowie Paul , Price Julie , Mason Matt , Dinwoodie Mark
Published: April 2018

Objectives

The Medical Protection Society (MPS) is a leading protection organisation for healthcare professionals worldwide. In the UK and Ireland, a small minority of MPS members experience significantly more medicolegal cases than their peers and are invited to participate in a risk education (RE) remediation process. To understand more about this educational intervention, we sought to explore participating doctors’ views of their experiences of this process and identify self-reported performance improvements and what elements of the intervention could be improved.

Design

Qualitative semistructured telephone interviews with a convenience sample of doctors with significantly more medicolegal cases than their peers identified by MPS.

Setting

UK and Ireland MPS members.

Participants

A convenience sample of 20 general medical practitioners and hospital specialists from a total of 79 who completed the RE process (25.3% response rate), with a particular focus on the Member Risk Review programme, between November 2013 and October 2015.

Results

19 participants were male and 16 were based in general medical (office) practice. Three key themes were generated: personal and professional impacts and actions (eg, member has taken action to reduce clinical workload); comprehension and validity of RE interventions (eg, risks were related to wider patient management); and feedback and proposals (eg, the supportive nature of the educational interventions should be clear from the start). A number of recommendations were made by participants to improve the RE process and enhance the educational experience.

Conclusions

The RE process was largely valued by participants with many reporting that participation led to some positive professional behaviour changes and improvements in practice processes and personal well-being.
Chemoattractant receptor-homologous molecule expressed on Th2 cells (CRTH2) antagonists in asthma: a systematic review and meta-analysis protocol
Authors: Liu Wei , Min Jie , Jiang Hongli , Mao Bing
Published: April 2018

Introduction

More than 20 orally bioavailable chemoattractant receptor-homologous molecule expressed on Th2 cells (CRTH2) antagonists have moved forward to clinical development in recent years for the treatment of asthma. However, evidence from individual randomised controlled trials (RCTs) has demonstrated inconsistent results in their efficacy and safety.

Methods and analysis

PubMed/Medline, Embase, Web of Science, Cochrane Database of Systematic Reviews, Global Index Medicus, Cochrane Central Register of Controlled Trials and Scopus will be searched from inception to 30 December 2017 for eligible RCTs, with additional studies being identified by manual searches. The study eligibility, data extraction and quality appraisal will be performed by two independent reviewers. Studies deemed fit for inclusion will be assessed using Cochrane Collaboration risk of bias tool. To generate more accurate analyses, Grading of Recommendations Assessment, Development and Evaluation will be used to grade the evidence. We will use the χ2test and the I2statistic to assess heterogeneity. The metaregression and subgroup analyses will be undertaken in the presence of heterogeneity. The potential for publication bias will be examined using funnel plots.

Ethics and dissemination

The current study is based on published data, thus ethical approval is not a requirement. The results of this study will be reported in an open-access peer-reviewed publication or will be disseminated as conference proceedings. This systematic review will increase the understanding of the application of CRTH2 antagonists in patients with asthma, which may help to establish and identify specific gaps in the evidence informing a future agenda for asthma research, policy and practice.

Trial registration number

CRD42017079342.
Dielectric properties and conductivity of PVdF-co-HFP/LiClO4 polymer electrolytes
Authors: Ulutaş Kemal , Yahsi Ugur , Deligöz Hüseyin , Tav Cumali , Yılmaztürk Serpil , Yılmazoğlu Mesut , Erdemci Gonca , Coşkun Bilgehan , Yakut Şahin , Değer Deniz
Published: April 2018

In this study, it was aimed to prepare a series of PVdF-co-HFP based electrolytes with different LiClO4 loadings and to investigate their chemical and electrical properties in detail. For this purpose, PVdF-co-HFP based electrolytes with different LiClO4 loadings (1–20 weight %) were prepared using solution casting method. X-ray diffraction (XRD), differential scanning calorimetry, and thermogravimetric (TGA) –differential thermal and dielectric spectroscopy analysis of PVdF-co-HFP/LiClO4 were performed to characterize their structural, thermal, and dielectric properties, respectively. XRD results showed that the diffraction peaks of PVdF-co-HFP/LiClO4 electrolytes broadened and decreased with LiClO4. TGA patterns exhibited that PVdF-co-HFP/LiClO4 electrolytes with 20 wt % of LiClO4 had the lowest thermal stability and it degraded above 473 K, which is highly applicable for solid polymer electrolytes. Dielectric constant, dielectric loss, and conductivities were calculated by measuring capacitance and dielectric loss factor of PVdF-co-HFP/LiClO4 in the range from 10 mHz to 20 MHz frequencies at room temperature. In consequence, conductivities of PVdF-co-HFP/LiClO4 increased significantly with frequency for low loading of LiClO4 while they only slightly changed with higher LiClO4 addition. On the other hand, dielectric constant values of PVdF-co-HFP/LiClO4 films decreased with frequency whereas they rose with LiClO4 addition. The dielectric studies showed an increase in dielectric constant and dielectric loss with decreasing frequency. This result was attributed to high contribution of charge accumulation at the electrode–electrolyte interface. The electrolyte showed the maximum conductivity of 8 × 10−2 S/cm at room temperature.
Thermal acclimation of fast-growing Japanese Quails (Coturnix japonica) exhibit decreased oxidative stress and increased muscle fiber diameters after acute heat challenges
Authors: Jimenez Ana Gabriela , Dias Jennifer , Nguyen Tram , Reilly Brigid , Anthony Nicholas
Published: April 2018

Many predict dire consequences of increasing temperatures; however, high temperatures in early life may aid animals during extreme thermal events later in life. The underlying physiological mechanisms have not been elucidated. We examined whether developing in warmer temperatures would physiologically benefit adult Japanese Quails (Coturnix japonica Temminck and Schlegel, 1849) by exploring changes in oxidative stress and muscle structure in two quail lines — one selected for control growth and another for fast growth and after acute heat challenges. We used a factorial design to administer four treatment combinations to each line: an initial period of either heat-stress acclimation (3 h every other day to 37 °C) or no acclimation, and after 5 weeks, either an acute heat-stress challenge (8 h at 39 °C) or no challenge. We found that control quails had significantly higher citrate synthase activity than fast-growing quails. Fast-growing quails had higher hydroxyl scavenging capacity than control quails. Peroxyl scavenging capacity decreased in both lines after an acute heat challenge, regardless of acclimation. Finally, fast-growing quails had larger muscle fiber diameters than control quails, and acclimated birds that experienced an acute heat challenge had larger muscle fibers than those that did not experience a heat challenge. Thus, fast-growing quails may physiologically benefit from developing in warmer temperatures.
DIGITISING PRODUCT PORTFOLIOS
Authors: ECHTERFELD JULIAN , GAUSMEIER JÜRGEN
Published: April 2018

Digitisation leads to far-reaching changes of products in all industries and has a massive impact on the global innovation landscape. For manufacturing companies, it is crucial to strategically align their product portfolio with digitisation and bring out a continuous stream of digital product innovations in order to strengthen their market position and remain competitive. The paper at hand, presents a methodology for digitising product portfolios. The methodology takes into account a company’s current digital position, possible future scenarios, digitisation strategies for the portfolio derived from the scenarios as well as concrete digitisation measures for each product group of the portfolio. The result is a portfolio roadmap which shows the planned development of the portfolio in the light of digitisation.
The Way We Walked with Immunology
Authors: Ishizaka Kimishige
Published: April 2018

It has been a little more than 50 years since we discovered IgE, a key molecule for the allergic response and a target for treating allergies and severe asthma. Here, I trace my career, from the kindling of my interest in immunochemistry to groundbreaking discoveries in the biology and chemistry of immunoglobulins. I describe my service to the broader community of immunologists and my role in shaping departments and research institutes. My course starts in Japan and includes Southern California, Baltimore, and Denver.
CD4 Helper and CD8 Cytotoxic T Cell Differentiation
Authors: Taniuchi Ichiro
Published: April 2018

A fundamental question in developmental immunology is how bipotential thymocyte precursors generate both CD4+helper and CD8+cytotoxic T cell lineages. The MHC specificity of αβ T cell receptors (TCRs) on precursors is closely correlated with cell fate–determining processes, prompting studies to characterize how variations in TCR signaling are linked with genetic programs establishing lineage-specific gene expression signatures, such as exclusive CD4 or CD8 expression. The key transcription factors ThPOK and Runx3 have been identified as mediating development of helper and cytotoxic T cell lineages, respectively. Together with increasing knowledge of epigenetic regulators, these findings have advanced our understanding of the transcription factor network regulating the CD4/CD8 dichotomy. It has also become apparent that CD4+T cells retain developmental plasticity, allowing them to acquire cytotoxic activity in the periphery. Despite such advances, further studies are necessary to identify the molecular links between TCR signaling and the nuclear machinery regulating expression of ThPOK and Runx3.
Workshop report: “Using Social Media and Smartphone Applications in Practical Lessons to Enhance Student Learning” in Búzios, Brazil (August 6–8, 2017)
Authors: Lellis-Santos Camilo , Halpin Patricia A.
Published: April 2018

Cost-effective student engagement poses a challenge for instructors, especially those who may not be familiar with new technologies and mobile devices. In this workshop, participants, experienced and discussed two ways of using smartphones in physiology classes: to engage in an online learning environment for discussions, and to make physiological measurements. Participants signed up for individual Twitter accounts and learned how to tweet, retweet, message, use a URL shortener, and use hashtags. They then went on to locate articles on an assigned topic from the Twitter accounts of credible science sources ( American Journal of Physiology, The Scientist, CDC.gov, WHO.int) and applied their Twitter skills to discuss the science topic of current interest. Additionally, participants shared their knowledge about the use of smartphones as a tool for teaching; they discussed the foundations of smartphone-assisted learning and the concept of mobile-learning laboratories, which we refer to as MobLeLabs. Participants also performed an experiment that used an Axé dance video and smartphone applications to measure changes in heart rate and reaction time. Our report describes this international hands-on teaching workshop and highlights its outcomes.
Retrieval practice in the form of online homework improved information retention more when spaced 5 days rather than 1 day after class in two physiology courses
Authors: Cadaret Caitlin N. , Yates Dustin T.
Published: April 2018

Studies have shown that practicing temporally spaced retrieval of previously learned information via formal assessments increases student retention of the information. Our objective was to determine the impact of online homework administered as a first retrieval practice 1 or 5 days after introduction of physiology topics on long-term information retention. Students in two undergraduate courses, Anatomy and Physiology (ASCI 240) and Animal Physiological Systems (ASCI 340), were presented with information on a specific physiological system during each weekly laboratory and then completed an online homework assignment either 1 or 5 days later. Information retention was assessed via an in-class quiz the following week and by a comprehensive final exam at semester’s end (4–13 wk later). Performance on homework assignments was generally similar between groups for both courses. Information retention at 1 wk did not differ due to timing of homework in either course. In both courses, however, students who received homework 5 days after class performed better on final exam questions relevant to that week’s topic compared with their day 1 counterparts. These findings indicate that the longer period between introducing physiology information in class and assigning the first retrieval practice was more beneficial to long-term information retention than the shorter period, despite seemingly equivalent benefits in the shorter term. Since information is typically forgotten over time, we speculate that the longer interval necessitates greater retrieval effort in much the same way as built-in desirable difficulties, thus allowing for stronger conceptual connections and deeper comprehension.
Before and after Esophageal Surgery: Which Information Is Needed from the Functional Laboratory
Authors: Gockel Ines , Rabe Sebastian Murad , Niebisch Stefan
Published: April 2018

Background: Indications for benign esophageal surgery and postoperative follow-up need to be highly elaborated with differentiated and structured algorithms, based on objective functional workup in the esophageal laboratory. Functional outcome is of utmost interest and has to be driven by the need for comprehensive but purposeful diagnostic methods. Methods: Preoperative diagnostic workup procedures by the functional laboratory include 24-h pH-monitoring, impedance testing, and high-resolution manometry (HRM) - in addition to upper gastrointestinal endoscopy and barium swallow/timed barium esophagogram. Results: The most frequent indications for benign esophageal surgery are gastroesophageal reflux disease and achalasia; quite rare indications are esophageal diverticula and benign tumors. Esophageal motility testing in addition to 24-h pH-monitoring is crucial before antireflux surgery (ARS) in order to rule out ineffective esophageal motility and to tailor the wrap. With respect to achalasia surgery, the exact type of achalasia (I-III) has to be labeled according to the Chicago classification, and other motility disorders have to be excluded. The postoperative functional evaluation in the early phase (6 months) after either ARS or Heller's myotomy serves as the new baseline motility testing in case of later occurring disturbances in the follow-up. Conclusion: A complete and proper preoperative esophageal function assessment is crucial in order to rule out a primary motility disorder and to avoid postoperative functional complications.
Mitophagy Plays a Protective Role in Iodinated Contrast-Induced Acute Renal Tubular Epithelial Cells Injury
Authors: Lei Rong , Zhao Fei , Tang Cheng-Yuan , Luo Min , Yang Shi-Kun , Cheng Wei , Li Xu-Wei , Duan Shao-Bin
Published: April 2018

Background/Aims: Contrast induced-acute kidney injury (CI-AKI) is one of the most common causes of acute kidney injury (AKI) in hospitalized patients. Mitophagy, the selective elimination of mitochondria via autophagy, is an important mechanism of mitochondrial quality control in physiological and pathological conditions. In this study, we aimed to determine effects of iohexol and iodixanol on mitochondrial reactive oxygen species (ROS), mitophagy and the potential role of mitophagy in CI-AKI cell models. Methods: Cell viability was measured by cell counting kit-8. Cell apoptosis, mitochondrial ROS and mitochondrial membrane potential were detected by western blot, MitoSOX fluorescence and TMRE staining respectively. Mitophagy was detected by the colocalization of LC3-FITC with MitoTracker Red, western blot and electronic microscope. Results: The results showed that mitophagy was induced in human renal tubular cells (HK-2 cells) under different concentrations of iodinated contrast media. Mitochondrial ROS displayed increased expression after the treatment. Rapamycin (Rap) enhanced mitophagy and alleviated contrast media induced HK-2 cells injury. In contrast, autophagy inhibitor 3-methyladenine (3-MA) down-regulated mitophagy and aggravated cells injury. Conclusions: Together, our finding indicates that iohexol and iodixanol contribute to the generation of mitochondrial ROS and mitophagy. The enhancement of mitophagy can effectively protect the kidney from iodinated contrast (iohexol)-induced renal tubular epithelial cells injury.
LPS Exposure in Early Life Protects Against Mucus Hypersecretion in Ovalbumin-Induced Asthma by Down-Regulation of the IL-13 and JAK-STAT6 Pathways
Authors: Ding Fengxia , Liu Bo , Zou Wenjing , Tian Daiyin , Li Qubei , Dai Jihong , Luo Zhengxiu , Fu Zhou
Published: April 2018

Background/Aims: Previous studies have shown that lipopolysaccharide (LPS) exposure may have a protective effect on asthma by reducing airway hyper-responsiveness, airway inflammation and serum IgE levels. However, there are few studies investigating the effect of LPS on mucous secretion in asthma. In this study, we evaluate the relationship between LPS pre-treatment in infant mice and airway mucus hypersecretion in an OVA (ovalbumin)-induced asthma model, and further explore the mechanisms behind this effect. Methods: Mice were pre-treated with LPS by intranasal instillation (i.n.) from the 3rd day of life for 10 consecutive days before the OVA-induced asthma model was established. In order to detect mucus secretion, periodic acid-Schiff (PAS) staining was carried out, and the expression of Muc5ac was detected. The IL-13 levels in Bronchoalveolar lavage fluid (BALF) and lung tissue were also detected. In vitro, the expression of Muc5ac mRNA and protein was quantified in IL-13-stimulated 16HBE cells with or without LPS pre-treatment. In addition, proteins in the JAK2/STAT6 pathway, transcription factors (forkhead box transcription factor A2 (FOXA2), activation protein-1(AP-1), NF-κB), and the levels of reactive oxygen species (ROS) were also measured in vivo and in vitro. Results: LPS pre-treatment reduced mucus secretion, as demonstrated by decreased PAS staining and muc5ac expression. Further exploration of the underlying mechanisms of this phenomenon revealed that LPS pre-treatment decreased the production of IL-13, IL-13 induced ROS synthesis was reduced, and the JAK2/STAT6 pathway was inhibited. Decreased stat6 increased transcription factor FOXA2, and the relatively increased FOXA2 further decreased the level of Muc5ac and mucous hypersecretion in OVA-induced asthma. Conclusions: LPS pre-treatment ameliorated mucus hypersecretion in an OVA-induced asthma model by inhibition of IL-13 production and by further inhibiting the JAK2/STAT6 pathway and ROS activity, and up-regulating expression of FOXA2.