bluuebunny/crossref_metadata_2025 huggingface dataset:
Late Quaternary aggradation rates and stratigraphic architecture of the southern Po Plain, Italy
Authors: Bruno Luigi , Amorosi Alessandro , Severi Paolo , Costagli Bianca
Published: December 2015

ThePoRiverBasin, where accumulation and preservation of thick sedimentary packages are enhanced by high rates of tectonic subsidence, represents an ideal site to assess the relations between vertical changes in stratigraphic architecture and sediment accumulation rates. Based on a large stratigraphic database, a markedly contrasting stratigraphy ofLatePleistocene andHolocene deposits is reconstructed from the subsurface of the modern alluvial and coastal plains. Laterally extensive fluvial channel bodies and related pedogenically modified muds of latest Pleistocene age are unconformably overlain byHolocene overbank fines, grading seaward into paralic and nearshore facies associations. In the interfluvial areas, a stiff paleosol, dating at about 12.5–10 cal kyBP, marks thePleistocene–Holocene boundary. Across this paleosol, aggradation rates (ARs) from 16 radiocarbon‐dated cores invariably show a sharp increase, from 0.1–0.9 mm year−1to 0.9–2.9 mm year−1. Comparatively lowerPleistocene values are inferred to reflect fluvial activity under a low‐accommodation (lowstand and early transgressive) regime, whereas higherARs during theHolocene are related to increasing accommodation under late transgressive and highstand conditions. Holocene sediment accumulation patterns vary significantly from site to site, and do not exhibit common trends. Very high accumulation rates (20–60 mm year−1) are indicated by fluvial channel or progradational delta facies, suggesting that extremely variable spatial distribution ofHoloceneARs was primarily controlled by autogenic processes, such as fluvial channel avulsion or delta lobe switching. ContrastingARbetween uppermostPleistocene andHolocene deposits also are reported from the interfluves of several coeval, alluvial‐coastal plain systems worldwide, suggesting a key control by allogenic processes. Sediment accumulation curves from adjacent incised valley fills show, instead, variable shapes as a function of the complex mechanisms of valley formation and filling.
The Caries Management System: are preventive effects sustained postclinical trial?
Authors: Evans R. Wendell , Clark Paula , Jia Nan
Published: December 2015

Objectives

To report, at two and 4 years post‐trial, on the potential legacy of a 3‐year randomized controlled clinical trial (RCT) of the Caries Management System (CMS) at private general dental practices. The CMS was designed to reduce caries risk and need for restorative care.

Methods

Nineteen dental practices located in city, urban, and rural locations in both fluoridated and nonfluoridated communities participated in the RCT. Eight practices were lost to follow‐up post‐trial; however, baseline mean DMFT balance between CMS and control practices was maintained. At the control practices, caries management following usual practice continued to be delivered. The patient outcome measure was the cumulative increment in the DMFT index score, and the practice outcome measures included the practice‐mean and practice‐median increments of patient DMFT index scores. In covariable analysis (patient‐level unit of analysis), as the patients were clustered by practices, mean DMFT increments were determined through multilevel modeling analysis. Practice‐mean DMFT increments (practice‐level unit of analysis) and practice‐median DMFT increments (also practice level) were determined through general linear modeling analysis of covariance. In addition, a multiple variable logistic regression analysis of caries risk status was conducted.

Results

The overall 4‐year post‐trial result (years 4–7) for CMS patients was a DMFT increment of 2.44 compared with 3.39 for control patients (P < 0.01), a difference equivalent to 28%. From the clinical trial baseline to the end of the post‐trial follow‐up period, the CMS and control increments were 6.13 and 8.66, respectively, a difference of 29% (P < 0.0001). Over the post‐trial period, the CMS and control practice‐mean DMFT increments were 2.16 and 3.10 (P = 0.055) and the respective increments from baseline to year 7 were 4.38 and 6.55 (P = 0.029), difference of 33%. The practice‐median DMFT increments during the 4‐year post‐trial period for CMS and control practices were 1.25 and 2.36 (P = 0.039), and the respective increments during the period from baseline to year 7 were 2.87 and 5.36 (P < 0.01), difference of 47%. Minimally elevated odds of being high risk were associated with baseline DMFT (OR = 1.17). Patients attending the CMS practices had lower odds of being high risk than those attending control practices (OR = 0.23, 95% CI = 0.06, 0.88).

Conclusion

In practices where adherence to the CMS protocols was maintained during the 4‐year post‐trial follow‐up period, patients continued to benefit from a reduced risk of caries and, therefore, experienced lower needs for restorative treatment.
Flatfoot and obesity in school‐age children: a cross‐sectional study
Authors: Sadeghi‐Demneh E. , Azadinia F. , Jafarian F. , Shamsi F. , Melvin J. M. A. , Jafarpishe M. , Rezaeian Z.
Published: December 2015

Childhood obesity exerts abnormally high stresses on developing foot structures which can lead to structural deformity of the foot. Screening for foot problems in children with overweight helps detect interior risks restricting normal lifestyle in these individuals. The purpose of this study was to investigate the effects of excess weight on the structure and function of the developing foot in students aged 7–14 years. A total of 667 participants were recruited for this cross‐sectional study via a multi‐level cluster sampling method (randomization was used within each cluster). All subjects (340 boys and 327 girls) attended primary and secondary schools in Isfahan City, Iran. The children's feet were evaluated using clinical assessments and footprint‐based measures whilst fully weight bearing. Significant differences were observed in the frequency of flatfoot between normal weight, overweight and obese groups (P < 0.001); participants who were more overweight had flatter feet. Children with higher weight also had a more pronated heel, less dorsiflexion range and higher reported pain within physical activity. This study indicated that childhood obesity is associated with structural foot and ankle deformities and activity‐related foot pain.
Participation as a leader in immersion weight loss treatment: a 1‐year follow‐up study
Authors: Anderson L. M. , Schaumberg K. , Anderson D. A. , Kirschenbaum D. S.
Published: December 2015

Non‐overweight individuals may follow aggressive weight management approaches alongside overweight/obese friends or family members; thus, research has begun to evaluate subsequent effects among non‐overweight populations. A prior study evaluated the short‐term effects of an immersion weight loss programme on healthy young adult staff leaders. Results indicated that participation seemed to benefit, not harm, the young adults. The current investigation examined 1‐year eating disorder and weight trajectories in this sample. The total sample (N = 244) consisted of staff leaders (44.3%) and demographically similar comparison participants who completed eating disorder and weight assessments across four time points: baseline, end of summer, 6‐week follow‐up and 1‐year follow‐up. Forty‐seven per cent of the original sample responded to all time points (staff leaders n = 60; comparison n = 55). Over the course of 1 year, risk trajectories did not differ between groups. Staff leaders did not report significant changes in body mass index, suggesting that they maintained healthy weight over the course of 1 year. Participation as an immersion weight loss programme leader appeared to be protective against weight gain, without increasing eating disorder risk, for healthy young adults. This provides further support for using weight management interventions across a wide range of individuals.
Eating behaviours are different in youth with obesity and severe obesity
Authors: Gross A. C. , Fox C. K. , Rudser K. D. , Foy A. M. H. , Kelly A. S.
Published: December 2015

The study purposes were to: (i) Investigate eating behaviours among patients in a paediatric weight management clinical practice and (ii) Compare eating behaviour phenotypes between children with severe obesity and obesity. This was a retrospective cross‐sectional study using data collected during clinical encounters. Participants were included if they were 2–12 years old, had a body mass index ≥95th percentile and if a parent or guardian completed the Child Eating Behaviour Questionnaire (CEBQ). Participants (n = 149) were children with severe obesity (n = 108) and obesity (n = 41). The mean Satiety Responsiveness score was significantly lower for children with severe obesity than for children with obesity. Girls with severe obesity had significantly higher Enjoyment of Food and significantly lower Satiety Responsiveness and Slowness in Eating than girls with obesity. The findings demonstrate the potential clinical utility of the CEBQ for informing tailored treatment strategies through identifying eating behaviour phenotypes.
High subcortical sacrectomy: a novel approach to facilitate complete resection of locally advanced and recurrent rectal cancer with high (S1–S2) sacral extension
Authors: Shaikh I. , Holloway I. , Aston W. , Littler S. , Burling D. , Antoniou A. , Jenkins J. T. ,   Complex Cancer Clinic St Mark's Hospital London
Published: December 2015

Aim

R0 resection of locally advanced or recurrent rectal cancer is the key determinant of outcome. Disease extension high on the sacrum has been considered a contraindication to surgery because of associated morbidity and difficulty in achieving complete pathological resection. Total sacrectomy has a high morbidity with poor function.

Method

We describe a novel technique of high subcortical sacrectomy (HiSS) to facilitate complete resection of disease extending to the upper sacrum at S1 and S2 to avoid high or total sacrectomy or a nonoperative approach to management. Details of patient demographics, radiology, operative details, postoperative histology, length of hospital stay and complications were entered into a prospectively maintained electronic patient database. All patients had had preoperative chemoradiotherapy.

Results

During 2013–2014, five patients, including three with advanced primary cancer and two with recurrent rectal cancer, underwent excision using this approach. All patients had an R0 resection. Four patients had a minor postoperative complication (Clavien–Dindo Grades I and II) and one had a major complication (Clavien–Dindo Grade IIIb). There was no mortality at 90 days, and four patients were disease free at a median of 18 months.

Conclusion

Patients with locally advanced and recurrent rectal cancer involving the upper sacrum may be rendered suitable for potentially curative radical resection with a modified approach to sacral resection. This pilot series suggests that this novel technique results in a high rate of complete pathological resection with acceptable morbidity in patients for whom the alternatives would have been an incomplete resection, a total sacrectomy or nonoperative management.
Transanal rectal resection: an initial experience of 20 cases
Authors: Buchs N. C. , Nicholson G. A. , Yeung T. , Mortensen N. J. , Cunningham C. , Jones O. M. , Guy R. , Hompes R.
Published: December 2015

Aim

Low anterior resection (LAR) can present a formidable surgical challenge, particularly for tumours located in the distal third of the rectum. Transanal total mesorectal excision (taTME) aims to overcome some of these difficulties. We report our initial experience with this technique.

Method

From June 2013 to September 2014, 20 selected patients underwent transanal rectal resection for various malignant and benign low rectal pathologies. All patients with rectal cancer were discussed at a multidisciplinary team meeting. Data were entered into a prospective managed international database.

Results

Of the 20 patients (14 male), seventeen (85%) had rectal cancer lying at a median distance of 2 cm (range 0–7) from the anorectal junction. The operations performed included LAR (16). Abdominoperineal excision (2) and completion proctectomy (2), all of which were performed by a minimally invasive approach with three conversions. The mean operation time was 315.3 min. There were six postoperative complications of which two (10%) were Clavien–Dindo Grade IIIb (pelvic haematoma and a late contained anastomotic leakage). The median length of stay was 7 days. The TME specimen was intact in 94.1% of cancer cases. The mean number of harvested lymph nodes was 23.2. There was only one positive circumferential resection margin (tumour deposit; R1 rate 5.9%). One patient developed a distant recurrence (median follow‐up 10 months, range 6–21).

Conclusion

TaTME was safe in this small series of patients. It is especially attractive in patients with a narrow and irradiated pelvis and a tumour in the lower third of the rectum. TaTME is technically demanding, but the good outcomes should prompt randomized studies and prospective registration of all taTME cases in an international registry.
Species richness representation within protected areas is associated with multiple interacting spatial features
Authors: Durán América Paz , Inger Richard , Cantú‐Salazar Lisette , Gaston Kevin J.
Published: December 2015

Aim

To assess the relative effects of the spatial features of protected areas (PAs), and their interactions, on species richness representation.

Location

Continental America and associated islands.

Methods

We used a novel dataset comprising species richness estimates for amphibians, birds and mammals for more than 400 PAs in the Western Hemisphere. Using spatial tools and remote sensing imagery, we calculated four spatial features for each PA: size, shape index, fragmentation level and proximity to the closest PA. The relative effect size of both PA spatial features and environmental covariates on levels of species richness, and how they interact, were assessed using generalized mixed effect models.

Results

Spatial features and environmental covariates explained about 61% of the variation in species richness within PAs, with the magnitude of the effect remaining similar among spatial features and taxonomic groups. While area had a positive effect on species richness, shape index and fragmentation had negative effects. Proximity had a significant positive effect only for mammals and a negative effect for all the taxa combined. PA spatial features showed significant interactions between them and with environmental covariates.

Main conclusions

We provide the first empirical evidence for the combined and interactive effects of terrestrial PA spatial features on predicting species richness. Our results suggest that the spatial features of PAs have an important effect on species richness and while the magnitude of this effect varies across taxonomic groups, its direction is consistent. Additionally, we show that the effect of one spatial design feature can be amplified or attenuated by that of another. These findings contribute towards a better understanding of the effect of spatial features on the performance of PAs and therefore how best to enhance the spatial configuration of existing and future PAs.
Towards an inpatient diabetes curriculum: medical student‐generated aims, objectives and methods for ward‐based learning of non‐critical, non‐perioperative inpatient diabetes care
Authors: Taylor C. G. , Atherley A. , Murphy M. M.
Published: December 2015

Aims

To create a summative document containing aims, objectives and methods that can be used for the training of healthcare professionals in inpatient diabetes care.

Methods

A four‐stage approach was introduced for the ward‐based teaching of inpatient diabetes care at the University of the West Indies, Cave Hill over the 2014–2015 academic year. Within this approach, 55 students (100%) submitted aims, objectives and methods to support two 2‐h, ward‐based sessions. This was guided by brief instructions and access to a copy of the Endocrine Society Clinical Practice Guideline on the management of non‐critical, non‐perioperative inpatient diabetes. Conceptual content analysis was used to convert submissions into a unifying document.

Results

Six themes emerged from students’ submissions: diagnosis; assessment and investigation of diabetes and its complications; planning individualized care and pharmacological management; hypoglycaemia management, including severe hypoglycaemia; patient education; discharge planning; and multidisciplinary teamwork. Students were primarily interested in patient management and treatment using higher‐level objectives and active learning methods.

Conclusions

This study produced comprehensive, student‐generated, and hence student‐centred, aims, objectives and methods for inpatient diabetes care with objectives appropriately set for higher cognitive levels of learning. This material can be used to guide teaching or for further development into a curriculum. This is the first known publication of content that could be used in a ward‐based inpatient diabetes curriculum.
Saxagliptin co‐therapy in C‐peptide negative Type 1 diabetes does not improve counter‐regulatory responses to hypoglycaemia
Authors: George P. S. , McCrimmon R. J.
Published: December 2015

Aims

To test the hypothesis that dipeptidyl peptidase‐4 inhibition in C‐peptide negative Type 1 diabetes would reduce glucose variability and exposure to hypoglycaemia and therefore may indirectly enhance counter‐regulatory responses to subsequent hypoglycaemia.

Methods

We conducted a 12‐week double‐blind, randomized, placebo‐controlled crossover study. The study was conducted in a tertiary hospital outpatient clinic, with additional studies performed in a clinical research centre. After obtaining informed consent, we recruited 14 subjects with moderately well controlled Type 1 diabetes (HbA1c 64 ± 2 mmol/mol) of long duration (20.5 ± 2.7 years). The subjects received 12 weeks' therapy with oral saxagliptin (5 mg) or placebo. Glucose variability, assessed via continuous glucose monitoring, together with frequency of hypoglycaemia, hypoglycaemia awareness and symptomatic, cognitive and counter‐regulatory hormone responses to experimental hypoglycaemia, were assessed. Additional outcome measures included HbA1c level, weight, total daily insulin dose and adverse events.

Results

Saxagliptin co‐therapy did not reduce glucose variability (low blood glucose index, average daily risk range), hypoglycaemia frequency or awareness and did not improve counter‐regulatory hormonal responses during experimental hypoglycaemia (area under the curve for adrenaline 25 775 vs. 24 454, for placebo vs saxagliptin, respectively; P = 0.76).

Conclusions

No additional benefit of dipeptidyl peptidase‐4 inhibition co‐therapy with saxagliptin in the management of Type 1 diabetes was observed.
Qualitative assessment of bone density at the distal articulating surface of the third metacarpal in Thoroughbred racehorses with and without condylar fracture
Authors: Loughridge A. B. , Hess A. M. , Parkin T. D. , Kawcak C. E.
Published: December 2015

Reasons for performing study

Changes in subchondral bone density, induced by the repetitive cyclical loading of exercise, may potentiate fatigue damage and the risk of fracture.

Objectives

To use computed tomography (CT) to characterise bone density patterns at the articular surface of the third metacarpal bone in racehorses with and without lateral condylar fractures.

Study Design

Case control

Methods

Computed tomographic images of the distal articulating surface of the third metacarpal bone were obtained from Thoroughbred racehorses subjected to euthanasia in theUK. Third metacarpal bones were divided into 3 groups based on lateral condyle status; fractured (FX, n = 42), nonfractured contralateral condyle (NFX, n = 42) and control condyles from horses subjected to euthanasia for reasons unrelated to the third metacarpal bone (control, n = 94). ColourCTimages were generated whereby each colour represented a range of pixel values and thus a relative range of bone density. A density value was calculated qualitatively by estimating the percentage of each colour within a specific region. Subchondral bone density was assessed in 6 regions from dorsal to palmar and 1 mm medial and lateral to the centre of the lateral parasagittal groove inNFXand control condyles and 1 mm medial and lateral to the fracture inFXcondyles.

Results

Bone density was significantly higher in theFXandNFXcondyles compared with control condyles for all 6 regions. A significantly higher bone density was observed inFXcondyles relative toNFXcondyles in the lateral middle and lateral palmar regions. Fractured condyles had increased heterogeneity in density among the 6 regions of interest compared with control andNFXcondyles.

Conclusions

Adjacent to the fracture, a focal increase in bone density and increased heterogeneity of density were characteristic of limbs with lateral condylar fractures compared with control andNFXcondyles. These differences may represent pathological changes in bone density that increase the risk for lateral condylar fractures in racehorses.
Physcomitrella patens DNA methyltransferase 2 is required for recovery from salt and osmotic stress
Authors: Arya Deepshikha , Kapoor Sanjay , Kapoor Meenu
Published: December 2015

DNA methyltransferase 2 (DNMT2) unlike other members of the cytosine DNA methyltransferase gene family has dual substrate specificity and it methylates cytosines in both the DNA and transfer RNA (tRNA). Its role in plants, however, has remained obscure to date. In this study, we demonstrate that DNMT2 from Physcomitrella patens accumulates in a temporal manner under salt and osmotic stress showing maximum accumulation during recovery, i.e. 24 h after plants are transferred to normal growth medium. Therefore, to study its role in stress tolerance, we generated PpDNMT2 targeted knockout plants (ppdnmt2ko). Mutant plants show increased sensitivity to salt and osmotic stress and are unable to recover even after 21 days of growth on optimal growth media. ppdnmt2ko, however, accumulate normal levels of dehydrin‐like and small heat shock protein encoding transcripts under stress but show dramatic reduction in levels of tRNAAsp‐GUC. The levels of tRNAAsp‐GUC, in contrast, increase ~ 25–30‐fold in ppdnmt2ko under non‐stress conditions and > 1200‐fold in wild‐type plants under stress. The role of PpDNMT2 in modulating biogenesis/stability of tRNAAsp‐GUC under salt and osmotic stress is discussed in the light of these observations.
Cloudy with a chance of sardines: forecasting sardine distributions using regional climate models
Authors: Kaplan Isaac C. , Williams Gregory D. , Bond Nicholas A. , Hermann Albert J. , Siedlecki Samantha A.
Published: December 2015

Despite the significant advances in making monthly or seasonal forecasts of weather, ocean hypoxia, harmful algal blooms and marine pathogens, few such forecasting efforts have extended to the ecology of upper trophic level marine species. Here, we test our ability to use short‐term (up to 9 months) predictions of ocean conditions to create a novel forecast of the spatial distribution of Pacific sardine, Sardinops sagax. Predictions of ocean conditions are derived using the output from the Climate Forecast System (CFS) model downscaled through the Regional Ocean Modeling System (ROMS). Using generalized additive models (GAMs), we estimated significant relationships between sardine presence in a test year (2009) and salinity and temperature. The model, fitted to 2009 data, had a moderate skill [area under the curve (AUC) = 0.67] in predicting 2009 sardine distributions, 5–8 months in advance. Preliminary tests indicate that the model also had the skill to predict sardine presence in August 2013 (AUC = 0.85) and August 2014 (AUC = 0.96), 4–5 months in advance. The approach could be used to provide fishery managers with an early warning of distributional shifts of this species, which migrates from the U.S.–Mexico border to as far north as British Columbia, Canada, in summers with warm water and other favorable ocean conditions. We expect seasonal and monthly forecasts of ocean conditions to be broadly useful for predicting spatial distributions of other pelagic and midwater species.
Migraine Triggers and Oxidative Stress: A Narrative Review and Synthesis
Authors: Borkum Jonathan M.
Published: December 2015

Background

Blau theorized that migraine triggers are exposures that in higher amounts would damage the brain. The recent discovery that the TRPA1 ion channel transduces oxidative stress and triggers neurogenic inflammation suggests that oxidative stress may be the common denominator underlying migraine triggers.

Objective

The aim of this review is to present and discuss the available literature on the capacity of common migraine triggers to generate oxidative stress in the brain.

Methods

A Medline search was conducted crossing the terms “oxidative stress” and “brain” with “alcohol,” “dehydration,” “water deprivation,” “monosodium glutamate,” “aspartame,” “tyramine,” “phenylethylamine,” “dietary nitrates,” “nitrosamines,” “noise,” “weather,” “air pollutants,” “hypoglycemia,” “hypoxia,” “infection,” “estrogen,” “circadian,” “sleep deprivation,” “information processing,” “psychosocial stress,” or “nitroglycerin and tolerance.” “Flavonoids” was crossed with “prooxidant.” The reference lists of the resulting articles were examined for further relevant studies. The focus was on empirical studies, in vitro and of animals, of individual triggers, indicating whether and/or by what mechanism they can generate oxidative stress.

Results

In all cases except pericranial pain, common migraine triggers are capable of generating oxidative stress. Depending on the trigger, mechanisms include a high rate of energy production by the mitochondria, toxicity or altered membrane properties of the mitochondria, calcium overload and excitotoxicity, neuroinflammation and activation of microglia, and activation of neuronal nicotinamide adenine dinucleotide phosphate (NADPH) oxidase. For some triggers, oxidants also arise as a byproduct of monoamine oxidase or cytochrome P450 processing, or from uncoupling of nitric oxide synthase.

Conclusions

Oxidative stress is a plausible unifying principle behind the types of migraine triggers encountered in clinical practice. The possible implications for prevention and for understanding the nature of the migraine attack are discussed.
Efficacy and safety of dapagliflozin in addition to insulin therapy in Japanese patients with type 2 diabetes: Results of the interim analysis of 16‐week double‐blind treatment period
Authors: Araki Eiichi , Onishi Yukiko , Asano Michiko , Kim Hyosung , Ekholm Ella , Johnsson Eva , Yajima Toshitaka
Published: December 2015

Introduction

Dapagliflozin treatment when added to insulin therapy in Japanese patients with type 2 diabetes remains to be evaluated.

Materials and Methods

This was a multicenter, randomized, double‐blind, parallel‐group, placebo‐controlled study to evaluate efficacy (at 16 weeks) and long‐term safety (at 52 weeks) of dapagliflozin in addition to insulin therapy. The interim analysis was carried out at week 16 to assess the efficacy and safety profiles. The patients receiving insulin (n = 182) were randomized to either dapagliflozin 5 mg or a placebo at a 2:1 ratio. The primary efficacy end‐point was the change in hemoglobin A1c (HbA1c) from baseline at week 16.

Results

Patients in the dapagliflozin group showed an adjusted decrease in HbA1c of −0.55% from baseline, whereas the placebo showed a marginal increase of 0.05%. The placebo‐corrected mean change of HbA1c from baseline to week 16 in dapagliflozin was −0.60% (P < 0.0001). In addition, the placebo‐corrected mean change of fasting plasma glucose and bodyweight from baseline to week 16 in the dapagliflozin group was −22.7 mg/dL (P < 0.0001) and −1.21 kg (P < 0.0001), respectively. The placebo‐corrected mean daily insulin dose in the dapagliflozin group was numerically decreased (treatment difference: −0.72 IU/day; P = 0.0743). No major episodes or discontinuations as a result of hypoglycemia were reported during the study period.

Conclusions

Dapagliflozin used as add‐on treatment to insulin therapy showed significantly greater reduction of HbA1c, fasting plasma glucose and bodyweight without severe hypoglycemia compared with the placebo at week 16. These results show the clinical benefit of prescribing dapagliflozin for Japanese patients with insufficient glycemic control even with insulin therapy.
The QATSDD critical appraisal tool: comments and critiques
Authors: Fenton Lara , Lauckner Heidi , Gilbert Robert
Published: December 2015

Rationale, aims and objectives

The aim of this research note is to reflect on the effectiveness of the QATSDD tool for its intended use in critical appraisals of synthesis work such as integrative reviews.

Methods

A seven‐member research team undertook a critical appraisal of qualitative and quantitative studies using the QATSDD.

Results and Conclusion

We believe that the tool can spur useful dialogue among researchers and increase in‐depth understanding of reviewed papers, including the strengths and limitations of the literature. To increase the clarity of the process, we suggest further definition of the language in each indicator and inclusion of explicit examples for each criterion. We would also like to see the authors outline clear parameters around the use of the tool, essentially stating that the tool should be used in synthesis work for studies of mixed methods or work that includes qualitative and quantitative research informed by a positivist paradigm. In the context of an appropriate team composition, the tool can be a useful mechanism for guiding people who are coming together to discuss the merits of studies across multiple methodologies and disciplines.
How to Get Better Care with Lower Costs? See the Person, Not the Patient
Authors: Westphal Erin C. , Alkema Gretchen , Seidel Rene , Chernof Bruce
Published: December 2015

The U.S. health system perceives people as “patients” almost exclusively as they enter and exit the healthcare system, but with this emphasis on context, have we lost sight of the people who should be in the foreground of care? Does such a view impede care effectiveness and efficiency? How can we shift our frame of reference moving forward? To foster this needed conceptual shift, a group of national thought‐leaders convened by the American Geriatrics Society (AGS) defined “person‐centered care” to reorient the perspective toward individuals remaining in the center of pursuing high‐quality care. This article explores how a person‐centered care approach can improve healthcare effectiveness and efficiency, particularly for older adults with heightened health and daily living needs, and healthcare costs. The process for supporting a person‐centered program is outlined, three critical indicators that define person‐centered quality are highlighted, and several models that embrace the person‐centered paradigm are briefly noted. Although there is no one‐size‐fits‐all schematic, how and why overall success entails fidelity to essential elements of person‐centered programs as the AGS expert panel identified is explained.
The visuospatial functions in children after cerebellar low‐grade astrocytoma surgery: A contribution to the pediatric neuropsychology of the cerebellum
Authors: Starowicz‐Filip Anna , Chrobak Adrian Andrzej , Milczarek Olga , Kwiatkowski Stanisław
Published: December 2015

The aim of this study was to specify whether cerebellar lesions cause visuospatial impairments in children. The study sample consisted of 40 children with low‐grade cerebellar astrocytoma, who underwent surgical treatment and 40 healthy controls matched with regard to age and sex. Visuospatial abilities were tested using the spatial WISC‐R subtests (Block Design and Object Assembly), Rey–Osterrieth Complex Figure, Benton Judgment of Line Orientation Test, PEBL Mental Rotation Task, and Benton Visual Retention Test. To exclude general diffuse intellectual dysfunction, the WISC‐R Verbal Intelligence IQ, Performance IQ, and Full‐Scale IQ scores were analysed. Post‐surgical medical consequences were measured with the International Cooperative Ataxia Rating Scale. Compared to controls, the cerebellar group manifested problems with mental rotation of objects, visuospatial organization, planning, and spatial construction processes which could not be explained by medical complications or general intellectual retardation. The intensity of visuospatial syndrome highly depends on cerebellar lesion side. Patients with left‐sided cerebellar lesions display more severe spatial problems than those with right‐sided cerebellar lesions. In conclusion, focal cerebellar lesions in children affect their visuospatial ability. The impairments profile is characterized by deficits in complex spatial processes such as visuospatial organization and mental rotation, requiring reconstruction of visual stimuli using the imagination, while elementary sensory analysis and perception as well as spatial processes requiring direct manipulation of objects are relatively better preserved. This pattern is analogous to the one previously observed in adult population and appears to be typical for cerebellar pathology in general, regardless of age.
Correlates of Physical Activity Among Middle‐Aged and Older Korean Americans at Risk for Diabetes
Authors: Han Benjamin H. , Sadarangani Tina , Wyatt Laura C. , Zanowiak Jennifer M. , Kwon Simona C. , Trinh‐Shevrin Chau , Lee Linda , Islam Nadia S.
Published: December 2015

Purpose

To explore correlates of meeting recommended physical activity (PA) goals among middle‐aged and older Korean Americans at risk for diabetes mellitus (DM).

Design and Methods

PA patterns and their correlates were assessed among 292 middle‐aged and older Korean Americans at risk for DM living in New York City using cross‐sectional design of baseline information from a diabetes prevention intervention. PA was assessed by self‐report of moderate and vigorous activity, results were stratified by age group (45–64 and 65–75 years), and bivariate analyses compared individuals performing less than sufficient PA and individuals performing sufficient PA. Logistic regression was used to calculate adjusted odds ratios predicting sufficient PA.

Findings

After adjusting for sex, age group, years lived in the United States, marital status, health insurance, and body mass index (BMI), sufficient PA was associated with male sex, older age, lower BMI, eating vegetables daily, and many PA‐specific questions (lack of barriers, confidence, and engagement). When stratified by age group, male sex and eating vegetables daily was no longer significant among Koreans 65 to 75 years of age, and BMI was not significant for either age group.

Conclusions

PA interventions targeting this population may be beneficial and should consider the roles of sex, age, physical and social environment, motivation, and self‐efficacy.

Clinical Relevance

Clinical providers should understand the unique motivations for PA among Korean Americans and recognize the importance of culturally driven strategies to enable lifestyle changes and support successful aging for diverse populations.
The Influence of Work‐Related Fatigue, Work Conditions, and Personal Characteristics on Intent to Leave Among New Nurses
Authors: Liu Yi , Wu Li‐Min , Chou Pi‐Ling , Chen Mei‐Hsin , Yang Li‐Chien , Hsu Hsin‐Tien
Published: December 2015

Purpose

This study aimed to (a) test the fit of the hypothesized model for new nurses’ intent to leave and (b) determine the extent to which personal characteristics, work conditions, and work‐related fatigue predict intent to leave among new nurses.

Design and Methods

This study was a cross‐sectional survey study. A total of 162 new nurses were recruited. A hypothesized model was proposed for model testing. Structural equation modelling was used for data analysis.

Findings

Work conditions only had an effect through work‐related fatigue on new nurses’ intent to leave. Personal characteristics did not have a significant effect on new nurses’ intent to leave. The final model showed a good fit. Work‐related fatigue, work conditions, and health explained 65% of the variance in new nurses’ intent to leave.

Conclusions

Work‐related fatigue was a major determinant of new nurses’ intent to leave. More attention should be paid to fatigue reduction strategies among new nurses.

Clinical Relevance

Work‐related fatigue should be monitored, particularly for new nurses who work more than 10 hr per day and who have greater workloads.
The Relationships of Nurse Staffing Level and Work Environment With Patient Adverse Events
Authors: Cho Eunhee , Chin Dal Lae , Kim Sinhye , Hong OiSaeng
Published: December 2015

Purpose

The purpose of this study was to examine the relationships of nurse staffing level and work environment with patient adverse events.

Design

This cross‐sectional study used a combination of nurse survey data (N = 4,864 nurses), facility data (N = 58 hospitals), and patient hospital discharge data (N = 113,426 patients) in South Korea.

Methods

The three most commonly nurse‐reported adverse events included administration of the wrong medication or dose to a patient, pressure ulcers, and injury from a fall after admission. Multilevel ordinal logistic regression was employed to explore the relationships of nurse staffing level (number of patients assigned to a nurse) and work environment (Practice Environment Scale of the Nursing Work Index) with patient adverse events after controlling for nurse, hospital, and patient characteristics.

Findings

A larger number of patients per nurse was significantly associated with a greater incidence of administration of the wrong medication or dose (odds ratio [OR] = 1.01, 95% confidence interval [CI] = 1.007–1.016), pressure ulcer (OR = 1.01, 95% CI = 1.007–1.016), and patient falls with injury (OR = 1.02, 95% CI = 1.013–1.022). A better work environment had a significant inverse relationship with adverse events; the odds of reporting a higher incidence of adverse events were 45% lower for administration of the wrong medication or dose (OR = 0.55, 95% CI = 0.400–0.758), followed by 39% lower for pressure ulcer (OR = 0.61, 95% CI = 0.449–0.834) and 32% lower for falls with injury after admission (OR = 0.68, 95% CI = 0.490–0.939).

Conclusions

This study found that a larger number of patients per nurse and poor work environment increase the incidence of patient adverse events, such as administration of the wrong medication or dose to a patient, pressure ulcers, and injury from falling after admission. The findings suggest that South Korean hospitals could prevent patient adverse events by improving nurse staffing and work environment.

Clinical Relevance

Healthcare strategies and efforts to modify adequate nurse staffing levels and better work environments for nurses are needed to improve patient outcomes.
Melatonin attenuated early brain injury induced by subarachnoid hemorrhage via regulating NLRP3 inflammasome and apoptosis signaling
Authors: Dong Yushu , Fan Chongxi , Hu Wei , Jiang Shuai , Ma Zhiqiang , Yan Xiaolong , Deng Chao , Di Shouyin , Xin Zhenlong , Wu Guiling , Yang Yang , Reiter Russel J. , Liang Guobiao
Published: December 2015

Subarachnoid hemorrhage (SAH) is a devastating condition with high morbidity and mortality rates due to the lack of effective therapy. Nucleotide‐binding oligomerization domain‐like receptor family pyrin domain‐containing 3 (NLRP3) inflammasome activation associated with the upregulation of apoptotic signaling pathway has been implicated in various inflammatory diseases including hemorrhagic insults. Melatonin is reported to possess substantial anti‐inflammatory properties, which is beneficial for early brain injury (EBI) after SAH. However, the molecular mechanisms have not been clearly identified. This study was designed to investigate the protective effects of melatonin against EBI induced by SAH and to elucidate the potential mechanisms. The adult mice were subjected to SAH. Melatonin or vehicle was injected intraperitoneally 2 hr after SAH. Melatonin was neuroprotective, as shown by increased survival rate, as well as elevated neurological score, greater survival of neurons, preserved brain glutathione levels, and reduced brain edema, malondialdehyde concentrations, apoptotic ratio, and blood–brain barrier (BBB) disruption. Melatonin also attenuated the expressions of NLRP3, apoptosis‐associated speck‐like protein containing a caspase recruitment domain (ASC), cleaved caspase‐1, interleukin‐1β (IL‐1β), and interleukin‐6 (IL‐6); these changes were also associated with an increase in the anti‐apoptotic factor (Bcl2) and reduction in the pro‐apoptotic factor (Bim). In summary, our results demonstrate that melatonin treatment attenuates the EBI following SAH by inhibiting NLRP3 inflammasome‐associated apoptosis.
An occurrence of tuite, γ‐Ca3(PO4)2, partly transformed from Ca‐phosphates in the Suizhou meteorite
Authors: Xie Xiande , Gu Xiangping , Chen Ming
Published: December 2015

Tuite is a high‐pressure γ‐form of Ca3(PO4)2. An occurrence of tuite partly transformed from merrillite and chlorapatite was observed in the chondritic area adjacent to the shock veins in the Suizhou meteorite. Tuite grains are found in contact with both merrillite and chlorapatite, indicating two different transformation pathways. Tuite isochemically transformed from merrillite contains much higher contents of Na2O and MgO than those transformed from chlorapatite. Tuite transformed from merrillite does not contain Cl, but tuite transformed from chlorapatite contains 1.90–3.91 wt% of Cl, hence indicating an incomplete phase transformation from chlorapatite to tuite. P‐T conditions of above 12 GPa and 1100 °C are probably required for the transformation from merrillite and chlorapatite to tuite. A temperature gradient from the hot vein at 2000 °C to the surrounding chondritic area at 1000 °C corresponds to the partial phase transitions in the Suizhou phosphates. Fast cooling of the thin shock veins plays a key role in the preservation of phosphates that suffered partial high‐pressure phase transformation.
Microvascular Plasticity: Angiogenesis in Health and Disease – Preface
Authors: Secomb Timothy W. , Pries Axel R.
Published: December 2015

This Special Topic Issue is concerned with the mechanisms that determine the structure of microvascular networks. The vast number of vessels and the highly plastic character of the microcirculation give evidence that microvascular network structures emerge as a result of responses of individual vessels and cells to the local stimuli that they experience, through a combination of angiogenesis, remodeling and pruning. The articles in this issue of Microcirculation address a range of cellular and molecular mechanisms involved in these processes.
Autocorrelated environmental variation and the establishment of invasive species
Authors: Cuddington Kim , Hastings Alan
Published: December 2015

Environmental parameters such as temperature and rainfall have a positively autocorrelated variance structure which makes it likely that runs of good or bad conditions will occur. It has previously been demonstrated that such autocorrelated environmental variance can increase the probability of extinction in small populations, in much the same way that increased variance without autocorrelation can increase extinction risk. As a result, it has also been suggested that positive autocorrelation will decrease the probability that a species will establish in a novel location. We suggest that describing the probability of invasion success as the probability of indefinite persistence may be an inappropriate definition of risk. Economic or ecological damage may be associated with a population that initially reaches high densities before going extinct in the new location. In addition, such populations may spread to new locations before extirpation. We use a modeling approach to examine the effect of positively autocorrelated conditions on the probability that small populations will reach large size before extinction. We find that where variance is high and the geometric mean of the population growth rate is low, autocorrelation increases the risk that a population will pass a an upper threshold density, even when extinction probability is unaffected. Therefore species classified as having low probability of invasion risk on the basis of population growth rates measured in low variance environments may actually have quite a substantial probability of establishing a large population for a period of time. The mechanism behind the effect is the disproportionate influence of short runs of good conditions initially following introduction.
American Indian Poverty in the Contemporary United States
Authors: Davis James J. , Roscigno Vincent J. , Wilson George
Published: December 2015

Little sociological attention over the last two decades has focused on the deprivation experienced by indigenous people. Fusing insights from American Indian history and the race and labor market inequality literatures, we address this gap in this article through a historically informed labor market analysis of poverty—an analysis that considers the pervasiveness of contemporary Native poverty, its potential basis in labor market opportunities, and the extent to which it has been patterned by two major demographic and economic shifts: (1) the rapid urbanization of the American Indian population and (2) the proliferation of tribally owned casinos. Findings reveal, most notably, the incredibly rigid and durable character of poverty for this population, historically and currently and across geographic space, and with little overall impact of local labor market opportunity. The presence of tribal casinos reduces such poverty, but only to a small degree and not nearly enough to compensate for sizable American Indian and white poverty differentials. Group history is key, we conclude, to shaping how space, labor markets, and economic development reduce or buttress relations of inequality.
Paragenesis of magma chamber internal wall discovered in Oman ophiolite gabbros
Authors: Nicolas Adolphe , Boudier Françoise , Mainprice David
Published: December 2015

A detailed study in Wadi Farah reveals a singular point in Jebel Dihm (southern Oman ophiolite). Here, we investigated some primitive features of accretion at a fast‐spreading ridge that has exceptionally been exempt from hydrous alteration while crossing the TBL (thermal boundary layer). The conjunction of two factors has made this possible in the Farah area: its location at the point of sharp foliation rotation from the upper to the transitional gabbros and a locally twisted TBL. These factors may have favoured the intrusion within the TBL of hydrous wedges transverse to the ridge. Deeper into the TBL, near the active ridge, the wedges merge and are covered by veneers of totally fresh gabbros bearing glittering acicular clinopyroxene. These gabbros are interpreted as relics of the crystallizing internal wall of the magma chamber that have interacted with hydrous fluids. This internal TBL has anisotropic thermal properties and acts as a thermal blanket, maintaining high magma‐chamber temperatures.
Conductive cooling of spherical bodies with emphasis on the Earth
Authors: Criss Robert E. , Hofmeister Anne M.
Published: December 2015

To explore planetary evolution, we provide conductive cooling profiles that account for planet size, phonon diffusivity and various internal heating scenarios. Our new analytical solution for simple cooling of spheres reveals that heat is removed from only Earth's outermost ~1000 km over geological time. Numerical models with decaying heat production show that any upward concentration of radionuclides causes high temperatures at shallow depths, forcing interior temperatures to increase with time while producing a thermal gradient that forbids lower mantle convection. Hence, differentiation drives upper mantle magmatism and tectonics, leaving a quiescent but hot deep interior, while slowly melting the core.