bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of the body image of patients with facial palsy before and after the application of botulinum toxin
Authors: de Carvalho Viviane F. , Vieira Ana Paula S. , Paggiaro Andre O. , Salles Alessandra G. , Gemperli Rolf
Published: March 2019

Background

The face is responsible for nonverbal communication. Facial nerve paralysis, which is the weakness or paralysis of the nerve responsible for the innervation of the muscles that perform these movements, is a condition that can raise serious physical, psychological, social, professional, aesthetic, and functional disorders. The physical aspect has a disastrous effect on the patient's self‐image and emotional state. This study aimed to evaluate the self‐image of patients with facial paralysis through the Body Image Quality Life Index (BIQLI), pre‐ and postclinical treatment with botulinum toxin.

Method

A prospective, exploratory, comparative cohort was carried out, with quantitative analysis of the variables with 40 patients with facial paralysis treated by the Ambulatory of Plastic Surgery of Hospital das Clínicas, Faculty of Medicine, University of São Paulo. The Sociodemographic and clinical instrument and the BIQLI were applied. Descriptive statistics and statistical inference were used to perform the analyses.

Results

It was found that the majority of the paralysis occurred in female individuals (55%), with an average age of 47,875 (DP), single and married (38.88%), and with secondary education completed (16.66%).

Conclusion

The body image evaluation of patients with facial paralysis submitted to the botulinum toxin treatment showed an ability to identify the positive impact of therapy in the period between 15 and 180 days by theBIQLI.
End‐of‐life care in an Australian acute hospital: a retrospective observational study
Authors: Maubach Ninya , Batten Monique , Jones Scott , Chen Judy , Scholz Brett , Davis Alison , Bromley Jonathan , Burke Brandon , Tan Ren , Hurwitz Mark , Rodgers Helen , Mitchell Imogen
Published: March 2019

Background

There is a gap in knowledge about the kind and quality of care experienced by hospital patients at the end of their lives.

Aims

To document and compare the patterns in end‐of‐life care for patients dying across a range of different medical units in an acute care hospital.

Methods

A retrospective observational study of consecutive adult inpatient deaths between 1 July 2010 and 30 June 2014 in four different medical units of an Australian tertiary referral hospital was performed. Units were selected on the basis of highest inpatient death rates and included medical oncology, respiratory medicine, cardiology and gastroenterology/hepatology.

Results

Overall, 41% of patients died with active medical treatment plans, but significantly more respiratory and cardiology patients died with ongoing treatment (46 and 75% respectively) than medical oncology and gastroenterology patients (each 27%, P < 0.05). More medical oncology and gastroenterology patients were recognised as dying (92 and 88%) compared with 72% of respiratory and only 38% of cardiology patients (P < 0.001). Significantly, more medical oncology patients were referred to palliative care and received comfort care plans than all other patient groups. However, the rate of non‐palliative interventions given in the final 48 h was not significantly different between all four groups.

Conclusions

There were differences in managing the dying process between all disciplines. A possible solution to these discrepancies would be to create an integrated palliative care approach across the hospital. Improving and reducing interdisciplinary practice variations will allow more patients to have a high‐quality and safe death in acute hospitals.
The effect of collegial solidarity among nurses on the organizational climate
Authors: Kılıç E. , Altuntaş S.
Published: March 2019

Aim

This research was carried out in a descriptive and relationship‐seeking design to examine the effect on the organizational climate of collegial solidarity among the nurses.

Background

It is important that nurses work in an organizational climate where they can be in solidarity with their colleagues to offer quality service and to deal with all the problems they face. However, the impact of collegial solidarity on the organizational climate is not yet clear enough.

Methods

This study was performed with a cohort of 333 nurses working in a university hospital in Turkey. Data were collected using the personal information form, the Colleague Solidarity of Nurses’ Scale and the Organizational Climate Scale. The data were evaluated using Cronbach's α coefficient, frequency and percentage distribution, the Pearson product‐moment correlation coefficient and a simple linear regression analysis.

Results

A relationship was identified between the collegial solidarity among nurses and the organizational climate. We have determined that collegial solidarity effects organizational commitment, teamwork, supportive climate, stress, negative interaction, human relations, job satisfaction, hierarchy, and the communication and innovative climate.

Conclusion

Collegial solidarity among nurses has effects on the organizational climate.

Implication for nursing policy and health policy

It is recommended that executive nurses support the colleague solidarity between nurses in healthcare settings, in particular by reducing stress in nurses, strengthening teamwork and communication and, thus, making the organizational climate more positive.
The efficiency of private and public schools in urban and rural areas: moving beyond the development goals
Authors: Johnes Geraint , Virmani Swati
Published: March 2019

Data from the Young Lives study are used to evaluate the efficiency of education systems in four low and middle income countries: Ethiopia, India, Peru and Vietnam. A meta‐frontier variant of data envelopment analysis is used to assess the relative performance of each country's system, and, within each country, to evaluate the impact of public and private schooling, and of urban and rural location. Comparisons are drawn between the four countries; the results indicate that in no country does the educational system perform uniformly badly or well. Conditioning on the inputs available, rural areas are often indicative of higher levels of efficiency, thus suggesting a number of implications for policy.
A first screening of chytrid fungus Batrachochytrium in amphibians in French zoos
Authors: Marquis O. , Miaud C. , Gibault C. , Chai N.
Published: March 2019

Batrachochytrium dendrobatidis (Bd) and Batrachochytrium salamandrivorans (Bsal) screening was carried out in captive amphibians in order to establish the presence of these fungal pathogens in French zoos. Over a period of 3 years, 437 skin swabs were collected at eight French zoos and one private breeding centre [38 species of Anura, 7 species and 2 subspecies of Urodela (salamanders and newts), and 1 caecilian species] and these were analysed using qPCR. None of the samples revealed the presence of Bsal. Bd was detected four times on three species – American bullfrog Lithobates catesbeianus, Common midwife toad Alytes obstetricans and Yellow‐bellied toad Bombina variegata – all of which originated from or were in contact with the natural environment.
Effect of acupuncture at Neiguan point combined with amiodarone therapy on early recurrence after pulmonary vein electrical isolation in patients with persistent atrial fibrillation
Authors: Yin Junkui , Yang Mei , Yu Shengbo , Fu Haixia , Huang He , Yang Bo , Liu Yu , He Bo , Bao Mingwei , Wu Gang , Lu Zhibing , Liu Huangfen , Liu Xiujuan , Dong Libin , Huang Congxin , Zhao Qingyan
Published: March 2019

Objective

Early atrial fibrillation (AF) recurrences are common and have been shown to predict AF recurrences late after AF ablation during follow‐up. Neiguan point acupuncture has been recognized to be therapeutic in treating AF in clinical practice.

Methods and results

Eighty‐five patients were enrolled in succession due to persistent AF. All patients were randomized divided into control group and acupuncture group. In the control group (n = 45), amiodarone was orally taken from the first day after pulmonary vein isolation (PVI). In the acupuncture group (n = 40), patients were treated with Neiguan point acupuncture for 7 days and amiodarone was prescribed as same as the control group after PVI. The levels of inflammatory factors were analyzed before operation, 1 week after the operation and 3 months later. After 3 months, the acupuncture group had a lower rate of early recurrences than the control group (5/40 [12.5%] vs 15/45 [33.3%], P = 0.039). The inflammatory factors level in the two groups were significantly increased after ablation. However, compared with the control group, the levels of TNF‐α, IL‐6, CRP, TGF‐β1, MMP2 in the acupuncture group significantly lower (P < 0.05). In a multivariate analysis, acupuncture was an independent factor associated with a lower rate of early recurrences during the blanking period (odds ratio, 0.17; 95% confidence interval, 0.05‐0.63; P = 0.008).

Conclusion

Neiguan point acupuncture combined with amiodarone is superior to amiodarone alone in reducing early recurrences of patients with persistent AF after PVI. The efficacy of Neiguan acupuncture therapy on the early recurrence is associated with the decreased inflammation factors.
Pathophysiology and treatment of obesity‐related hypertension
Authors: Chrysant Steven G.
Published: March 2019

The prevalence of overweight and obesity has increased significantly in the United States and worldwide. Among the many complications of obesity, hypertension is the most common and major one accounting for about 70% in the obese subjects. However, the pathophysiologic factors of obesity‐related hypertension and its therapeutic options are not well understood at present. To better understand the pathophysiology of obesity‐related hypertension and its treatment options, a Medline search of the English language literature was contacted between 2010 and 2018 and 22 pertinent papers were selected. The information from these papers together with collateral literature will be discussed in this review.
Laminin promotes differentiation of rat embryonic stem cells into cardiomyocytes by activating the integrin/FAK/PI3K p85 pathway
Authors: Wang Duo , Wang Yumei , Liu Huan , Tong Chang , Ying Qilong , Sachinidis Agapios , Li Li , Peng Luying
Published: March 2019

The generation of germline competent rat embryonic stem cells (rESCs) allows the study of their lineage commitment. Here, we developed a highly efficient system for rESC‐derived cardiomyocytes, and even the formation of three‐dimensional (3D)‐like cell clusters with cTNT and α‐Actinin. We have validated that laminin can interact with membrane integrin to promote the phosphorylation of both phosphatidylinositol 3‐kinase (PI3K) p85 and the focal adhesion kinase (FAK). In parallel, GATA4 was up‐regulated. Upon inhibiting the integrin, laminin loses the effect on cardiomyocyte differentiation, accompanied with a down‐regulation of phosphorylation level of PI3K p85 and FAK. Meanwhile, the expression of Gata4 was inhibited as well. Taken together, laminin is a crucial component in the differentiation of rESCs into cardiomyocytes through increasing their proliferation via interacting with integrin pathway. These results provide new insights into the pathways mediated by extracellular laminin involved in the fate of rESC‐derived cardiomyocytes.
Sal B targets TAZ to facilitate osteogenesis and reduce adipogenesis through MEK‐ERK pathway
Authors: Wang Na , Li Yukun , Li Ziyi , Liu Chang , Xue Peng
Published: March 2019

Salvianolic acid B (Sal B), a major bioactive component of Chinese herb, was identified as a mediator for bone metabolism recently. The aim of this study is to investigate the underlying mechanisms by which Sal B regulates osteogenesis and adipogenesis. We used MC3T3‐E1 and 3T3‐L1 as the study model to explore the changes of cell differentiation induced by Sal B. The results indicated that Sal B at different concentrations had no obvious toxicity effects on cell proliferation during differentiation. Furthermore, Sal B facilitated osteogenesis but inhibited adipogenesis by increasing the expression of transcriptional co‐activator with PDZ‐binding motif (TAZ). Accordingly, TAZ knock‐down offset the effects of Sal B on cell differentiation into osteoblasts or adipocytes. Notably, the Sal B induced up‐expression of TAZ was blocked by U0126 (the MEK‐ERK inhibitor), rather than LY294002 (the PI3K‐Akt inhibitor). Moreover, Sal B increased the p‐ERK/ERK ratio to regulate the TAZ expression as well as the cell differentiation. In summary, this study suggests for the first time that Sal B targets TAZ to facilitate osteogenesis and reduce adipogenesis by activating MEK‐ERK signalling pathway, which provides evidence for Sal B to be used as a potential therapeutic agent for the management of bone diseases.
Gut microbial dysbiosis is associated with development and progression of radiation enteritis during pelvic radiotherapy
Authors: Wang Zhongqiu , Wang Qingxin , Wang Xia , Zhu Li , Chen Jie , Zhang Bailin , Chen Ye , Yuan Zhiyong
Published: March 2019

Radiation enteritis (RE) is the most common complication of radiotherapy for pelvic irradiation receivers. Herein we investigated the alterations in gut microbial profiles and their association with enteritis in patients undergoing pelvic radiotherapy. Faecal samples were collected from 18 cervical cancer patients during radiotherapy. Microbiota profiles were characterized based on 16S rRNA sequencing using the Illumina HiSeq platform. Epithelial inflammatory response was evaluated using bacterial‐epithelial co‐cultures. Dysbiosis was observed among patients with RE, which was characterized by significantly reduced α‐diversity but increased β‐diversity, relative higher abundance of Proteobacteria and Gammaproteobacteria and lower abundance of Bacteroides. Coprococcus was clearly enriched prior to radiotherapy in patients who later developed RE. Metastat analysis further revealed unique grade‐related microbial features, such as more abundant Virgibacillus and Alcanivorax in patients with mild enteritis. Additionally, using bacterial‐epithelial co‐cultures, RE patient‐derived microbiota induced epithelial inflammation and barrier dysfunction, enhanced TNF‐α and IL‐1β expression compared with control microbiota. Taken together, we define the overall picture of gut microbiota in patients with RE. Our results suggest that dysbiosis of gut microbiota may contribute to development and progression of RE. Gut microbiota can offer a set of biomarkers for prediction, disease activity evaluation and treatment selection in RE.
Parenting, deviant peer affiliation, and externalizing behavior during adolescence: processes conditional on sympathetic nervous system reactivity
Authors: Hinnant J. Benjamin , Erath Stephen A. , Shimizu Mina , El‐Sheikh Mona
Published: March 2019

Background

This study examined associations between permissive parenting, deviant peer affiliations, and externalizing behavior across mid to late adolescence in a plausible indirect effects model of change over time with deviant peer affiliation serving as the mediator. We also evaluated potential conditional indirect effects wherein these relationships may be moderated by sex and sympathetic nervous system (SNS) activity, indexed by skin conductance level (SCL) reactivity.

Method

Participants included 242 community‐sampled adolescents (M = 15.79 years; 48% boys; 66% European American, 34% African American) with two additional longitudinal assessments lagged by 1 year. Permissive parenting, SCL reactivity, and sex were considered as time invariant predictors of repeated measures of deviant peer affiliation and externalizing behavior in latent growth models that tested whether any of the direct or indirect associations were conditional on sex or SCL reactivity.

Results

Evidence was found for indirect effects of permissive parenting on externalizing behavior via deviant peer affiliation, but only for males with lower SCL reactivity to stress. Additionally, these effects were found on latent intercepts, but not slopes indexing change over time, perhaps reflecting established individual differences in relationships among these variables.

Conclusions

Findings are discussed in the context of biosocial models of adolescent development and risk factors that may inform interventions for vulnerable youth.
Investigation of a developmental pathway from infant anger reactivity to childhood inhibitory control and ADHD symptoms: interactive effects of early maternal caregiving
Authors: Miller Natalie V. , Hane Amie A. , Degnan Kathryn A. , Fox Nathan A. , Chronis‐Tuscano Andrea
Published: March 2019

Background

ADHD is a neurodevelopmental disorder with a complex pathogenesis. Individual differences in temperamental reactivity – in particular, anger reactivity – are predictive of ADHD. The goal of this study was to examine the moderating (maternal caregiving behaviors; MCB) and mediating (inhibitory control) variables of reactivity using a 9‐year multimethod prospective longitudinal design.

Methods

Participants included 291 children (135 male; 156 female) who participated in a larger study of temperament and social‐emotional development. Anger reactivity was assessed by observation of facial anger during an arm restraint task, and MCB were observed during a series of semi‐structured mother–infant tasks, both at 9 months of age. Inhibitory control was assessed by performance on a go/no‐go task at 5 years of age. ADHD symptoms were assessed by parent and teacher report questionnaires at 7 and 9 years, respectively.

Results

Anger reactivity and poor inhibitory control were predictive of later ADHD symptoms. Results supported a moderated mediation model, in which the indirect effects of anger reactivity on ADHD symptoms through inhibitory control were conditional on quality of early MCB. Inhibitory control mediated the effect of anger reactivity on ADHD symptoms, but only among children exposed to lower‐quality MCB.

Conclusions

Infant anger reactivity exerts a direct effect on later ADHD from infancy, suggesting anger reactivity as a very early indicator of ADHD risk. Higher‐quality caregiving did not buffer against the direct risk of anger reactivity on ADHD but did buffer against the indirect risk by reducing the negative effect of anger reactivity on inhibitory control. Thus, in the developmental pathway from anger reactivity to ADHD, more sensitive, less intrusive parenting supports the development of protective mechanisms (i.e. inhibitory control) to remediate ADHD risk.
Automated discrimination of deveined shrimps based on grayscale image parameters
Authors: Thanasarn Nawaporn , Chaiprapat Supapan , Waiyakan Kriangkrai , Thongkaew Kunlapat
Published: March 2019

The “Vein” in a shrimp is its digestive tract filled with grit, sand, and sediments stretching along the back of the abdomen. In most shrimp market forms, presence of vein is highly restricted and limited according to the U.S. standard for imports. This research aims to develop an image‐based approach for detection of improperly deveined shrimps. Two hundred shrimp images were subjected to a sequence of image processing techniques before extracting significant parameters from grayscale images. These parameters include shape measurements and pixel value measurements drawn from an image histogram. In this research, disqualified shrimps were identified by two classification techniques: linear discriminant analysis and support vector machine (SVM). Better than 98% classification accuracy was obtained with the SVM using a polynomial kernel function. The success of this research has filled a void left by past studies to facilitate fully automated shrimp quality inspection.

Practical applications

Rising wages and labor scarcity are among critical problems to seafood industries, along with low productivity due to ergonomics limitations. Such problems will be even worse in the near future and automated machines are becoming a popular alternative to tackle them. These machines must be driven by an intelligent processing unit capable of handling unavoidable variability naturally found in agricultural products. In most shrimp market forms, presence of veins is highly restricted and limited by the U.S. standards for imports. Deveining always leaves remnants of uncertain length. Employing statistical learning techniques, the approach developed in this study can accurately and automatically discriminate shrimps by acceptability based on the vein. Findings of this research contribute to the development of a fully automated shrimp processing machine, supporting sustainability of the industry by reducing reliance on labor policies and workforce availability.
Fluorescence emission difference microscopy by superoscillation excitation
Authors: LIU YONG , WANG XIAONA , LIU SHAOCONG , KUANG CUIFANG
Published: March 2019

A superresolution fluorescence emission difference (FED) microscopy based on superoscillation excitation is investigated. The solid superoscillation excitation spot is produced by the radially polarised Laguerre–Gaussian beam (LG), and the donut superoscillation excitation spot is produced by the same LG beam with spiral phase modulation. We show that the superoscillation excitation can enhance the spatial resolution of FED microscopy. When the ratio of the pupil radius and the second moment radius of the LG3,1 beam is 0.85 and the subtractive factor is 0.3, the resolution can be enhanced about 2 times than the general confocal microscopy. Compared with the general FED microscopy, the resolution can be enhanced about 1.1 times. Our simulations also demonstrate that two‐view Richardson–Lucy (RL) deconvolution method can reduce the effect of side lobes, which is related to subtractive factor and pinhole.

Lay Description

The fluorescence emission difference (FED) microscopy is a high‐resolution light microscopy, which is based on the subtraction of images produced by two different confocal imaging modes. Here, the solid excitation spot is used in one imaging mode, and the donut excitation spot is in another imaging mode. There are various ways that the solid and donut excitation spots can be structured, but superoscillation excitation spots are still not used in the FED microscopy. Considering that the main lobe of superoscillation can be arbitrarily small in principle, we exploit the radially polarised Laguerre–Gaussian beam (LG) and spiral phase plate to produce superoscillation solid and donut spots. We present a detailed analysis about the performance of FED microscopy via superoscillation excitation. Our analysis is based on vector diffraction theory and supported by simulations of imaging. We find the proposed FED microscopy has better resolution than the confocal microscopy or the general FED microscopy excited by Gaussian beam. Especially, two‐view Richardson–Lucy (RL) deconvolution method can reduce the negative impact of strong side lobes, which is related to the subtractive factor and the size of pinhole located at the detector.
Inference for asymmetric exponentially weighted moving average models
Authors: Li Dong , Zhu Ke
Published: March 2019

The exponentially weighted moving average (EWMA) model in ‘Risk‐Metrics’ has been a benchmark for controlling and forecasting risks in financial operations. However, it is incapable of capturing the asymmetric volatility effect and the heavy‐tailed innovation, which are two important stylized features of financial returns. We propose a new asymmetric EWMA model driven by the Student's t‐distributed innovations to take these two stylized features into account and study its maximum likelihood estimation and model diagnostic checking. The finite‐sample performance of the estimation and diagnostic test statistic is examined by the simulated data.
The financialization of the non‐financial corporation. A critique to the financial turn of accumulation hypothesis
Authors: Rabinovich Joel
Published: March 2019

One aspect in which non‐financial corporations (NFCs) are said to be financialized is that they have been increasingly engaged in financial accumulation from which they derive a growing proportion of financial income. This is what we call the financial turn of accumulation hypothesis. In this article, we show that the evidence used to sustain it, in the U.S. setting, has to be reconsidered. Our findings show that, contrary to the financial turn of accumulation hypothesis, financial income averages 2.5% of NFCs’ total income since the 1980s, oscillating since the beginnings of the 1990s until 2005 and then declining. In terms of assets, some of the alleged financial assets might actually reflect other activities in which NFCs have been increasingly engaged, such as tax avoidance, internationalization of production, activities refocusing and M&As.
Lane width‐based cellular automata model for mixed bicycle traffic flow
Authors: Jin Sheng , Xu Liang , Xu Cheng , Ma Dongfang
Published: March 2019

In this paper, an improved extended Burgers cellular automata (EBCA) model for heterogeneous bicycle traffic flow is proposed. The compressibility of bicycle traffic flow is considered as a probability, which is related to the bicycle path width. The proposed improved EBCA model is calibrated and validated using the field data collected from three sites in Hangzhou, China. The proposed model is compared with the original EBCA model that does not consider compressibility. The comparison results show that our improved model can simulate heterogeneous bicycle traffic flow better. Moreover, the proposed model overcomes the shortcoming of the other BCA models that only specific path widths can be simulated directly when lane width is determined. Lastly, the EBCA model performance in the congested regions is improved significantly.
Contribution of Malassezia spp. to the development of atopic dermatitis
Authors: Nowicka Danuta , Nawrot Urszula
Published: March 2019

The prevalence of atopic dermatitis (AD) has been increasing. Whereas AD symptoms are obvious and easy to recognise, the etiopathogenesis remains not fully elucidated. Recently, the role of microorganisms and their impact on the immunology of AD have been discussed. In this review, we summarise a possible role of Malassezia in the development and persistence of eczema in patients with atopic eczema/dermatitis syndrome. A high proportion of AD patients present with a positive reaction to Malassezia allergens. Several possible pathogenic mechanisms enable Malassezia to trigger the development of AD. Malassezia spp. may release more allergens in a less acidic (pH <6), typical for AD, environment. The similarity between fungal thioredoxin and human proteins causes T‐cell cross‐reactivity. TLR‐mediated mechanisms are involved in host response against Malassezia spp. An interaction between Malassezia spp. and keratinocytes alters the profile of cytokine release, and what is more, yeast cells can survive when absorbed by keratinocytes. Dendritic cells of AD patients induced by Malassezia are less susceptible to lysis mediated by NK cells which exerts a pro‐inflammatory effect. Despite the evidence that Malassezia spp. contribute to the development of AD, the pathogenetic mechanisms and relationship between Malassezia and immune defense remain partly unexplained and require further research.
Primary intracranial malignant ectomesenchymoma in an adult: Report of a rare case and review of the literature
Authors: Mahajan Swati , Suri Vaishali , Sharma Mehar C. , Kedia Shweta , Sardana Hardik , Nakra Tripti
Published: March 2019

Malignant ectomesenchymoma (MEM) is an exceedingly rare rapidly progressing tumor of soft tissues of the central nervous system, believed to be derived from neural crest cells. The majority of cases have been observed in young children or adolescents. So far only 11 patients with intracranial manifestations (with confirmed clinicopathological data) have been documented. We report the first case of adult intracranial MEM in a 54‐year‐old man who presented with a 4 months history of headache and weakness of right side of the body. Magnetic resonance imaging showed a homogenously enhanced dural‐based lesion in the left fronto‐temporo‐parietal lobe with significant perilesional edema and mass effect. No metastatic disease was identified and the lesion was grossly resected. Histopathological and immunohistochemical examination revealed mature and immature neurons and bizarre astrocytes admixed with a mesenchymal spindle cell (rhabdomyoblastic) component. Specific risk factors that contribute toward the development of MEM are unknown. Due to the scarcity of reported cases the role of adjuvant therapy is unclear.
Property Tax Exemptions for Nonprofit Hospitals: What Are They Worth? Do They Earn Them? Evidence From New York City
Authors: Propheter Geoffrey
Published: March 2019

This study estimates the property tax expenditure for nonprofit hospitals (NPHs) in New York City using Medicare and IRS data from 2011 through 2013. After comparing the estimates to various definitions of community benefits, it is concluded that NPHs generally earn their property tax break. Evidence is also presented that using book values is a reasonably accurate method for estimating the property tax expenditure nationwide. Finally, econometric analyses reveals that net income is negatively associated with community benefits, suggesting justification for taxing higher net income hospitals and reallocating the funds to similarly sized but lower net income hospitals.
Cefmetazole for extended‐spectrum β‐lactamase‐producing Enterobacteriaceae in pediatric pyelonephritis
Authors: Araki Kotaro , Fukuoka Kahoru , Higuchi Hiroshi , Aizawa Yuta , Horikoshi Yuho
Published: March 2019

Background

Pyelonephritis caused by extended‐spectrum β‐lactamase (ESBL)‐producing Enterobacteriaceae is an urgent problem in pediatrics. Although carbapenem is the standard therapy for infections caused by ESBL‐producing Enterobacteriaceae, some cephamycins, including cefmetazole, are stable against hydrolysis by ESBL. There are few reports, however, on the use of cefmetazole in children. The aim of this study was to evaluate the therapeutic effect of cefmetazole in pediatric pyelonephritis caused by ESBL‐producing Enterobacteriaceae.

Methods

Children with pyelonephritis caused by ESBL‐producing Enterobacteriaceae were enrolled between April 2010 and November 2016 at Tokyo Metropolitan Children's Medical Center. Presence of ESBL was tested for using the disk diffusion method. Medical records were reviewed for a past history of bacterial infection. The outcomes were clinical cure rate at 4 weeks and the duration of therapy in the cefmetazole and non‐cefmetazole groups.

Results

Fifty‐five patients met the criteria for pyelonephritis caused by ESBL‐producing Enterobacteriaceae. The most common causative organisms were Escherichia coli (n = 51; 92.7%), Klebsiella pneumoniae (n = 3; 5.5%), and K. oxytoca (n = 1; 1.8%). Thirty‐six and 19 patients were treated with cefmetazole and with other antibiotics as definitive therapy, respectively. There was no difference in the clinical cure rate (86.1% vs 89.5%; P = 0.72) or duration of therapy (median, 7.0 vs 7.0 days; P = 0.73) between the cefmetazole and non‐cefmetazole groups.

Conclusions

Cefmetazole was not inferior to the other antibiotics in the treatment of pyelonephritis caused by ESBL‐producing Enterobacteriaceae in children. Cefmetazole is a valuable therapeutic alternative to carbapenems for treating pyelonephritis caused by ESBL‐producing Enterobacteriaceae.
High sensitivity and reproducibility of in‐house ELISAs using different genotypes of Trypanosoma cruzi
Authors: Caballero E. Zuleima , Correa Ricardo , Nascimento Marilda S. , Villarreal Alcibiades , Llanes Alejandro , Kesper, JR. Norival
Published: March 2019

The adequate choice of Trypanosoma cruzi strains as antigen source for the diagnosis of Chagas disease is still controversial due to differences in terms of accuracy reported between different diagnostic tests. In this study was determined if the genetic variability between different genotypes of T. cruzi (TcI, TcII and TcIV) affect the final diagnosis of Chagas disease. The sensitivity and specificity index of in‐house ELISA tests prepared with different T. cruzi strains were evaluated with chagasic and non‐chagasic control sera and using the TESA‐blot as a reference test. The results of this study revealed that the sensitivity index did not vary, with percentages of 100% for all strains in both tests. However, the specificity index for ELISA tests showed differences between 92% and 98%, but were reduced to 78%‐89% when Leishmania‐positive sera were included. All ELISAs and TESA‐blot prepared with different antigens and the recombinant Wiener test were challenged in an endemic community for Chagas disease in Panama. Both ELISAs and TESA‐blot recognized the same positive sera, corroborating the sensitivity indexes (100%) found with the control sera. The TESA‐blot maintained the specificity index of 100% and did not display false positives. However, the recombinant Wiener test decreased its sensitivity to 81.25%.
Invasion windows for a global legume invader are revealed after joint examination of abiotic and biotic filters
Authors: Vetter V. M. S. , Walter J. , Wilfahrt P. A. , Buhk C. , Braun M. , Clemens S. , Dinkel E. , Dubbert M. , Schramm A. , Wegener F. , Werner C. , Jentsch A.
Published: March 2019

Successful alien plant invasion is influenced by both climate change and plant–plant interactions. We estimate the single and interactive effects of competition and extreme weather events on the performance of the global legume invader Lupinus polyphyllus (Lindl.).

In three experimental studies we assessed (i) the stress tolerance of seedling and adult L. polyphyllus plants against extreme weather events (drought, fluctuating precipitation, late frost), (ii) the competitive effects of L. polyphyllus on native grassland species and vice versa, and (iii) the interactive effects of extreme weather events and competition on the performance of L. polyphyllus.

Drought reduced growth and led to early senescence of L. polyphyllus but did not reduce adult survival. Fluctuating precipitation events and late frost reduced the length of inflorescences. Under control conditions, interspecific competition reduced photosynthetic activity and growth of L. polyphyllus. When subjected to competition during drought, L. polyphyllus conserved water while simultaneously maintaining high assimilation rates, demonstrating increased water use efficiency. Meanwhile, native species had reduced performance under drought.

In summary, the invader gained an advantage under drought conditions through a smaller reduction in performance relative to its native competitors but was competitively inferior under control conditions. This provides evidence for a possible invasion window for this species. While regions of high elevation or latitude with regular severe late frost events might remain inaccessible for L. polyphyllus, further spread across Europe seems probable as the predicted increase in drought events may favour this non‐native legume over native species.
Plasticity of endometrial epithelial and stromal cells—A new approach towards the pathogenesis of equine endometrosis
Authors: Minkwitz Claudia , Schoon Heinz‐Adolf , Zhang Qian , Schöniger Sandra
Published: March 2019

Contents

Equine endometrosis, a frequent cause of subfertility, is characterized by periglandular fibrosis, and no treatment exists. Endometrial biopsies not only contain diseased glands, but also contain healthy glands and stroma. Myoepithelial (ME) and myofibroblastic (MF) markers are calponin, smooth muscle actin (SMA), desmin and glial fibrillary acidic protein (GFAP). Epithelial vimentin expression indicates epithelial to mesenchymal transition (EMT). The aim of this immunohistochemical study was to investigate whether biopsies with endometrosis express MF and ME markers and vimentin. Compared to healthy areas, significantly higher percentages of endometrotic glands were lined by calponin‐ and vimentin‐positive epithelial cells, whereas periglandular fibrosis contained significantly higher percentages of stromal cells positive for vimentin, desmin and SMA and significantly less calponin‐positive stromal cells. The rare GFAP expression was restricted to endometrotic glands. Of these, the most frequent features of endometrotic glands were higher percentages of SMA‐ and vimentin‐positive stromal cells and the prominent epithelial calponin staining that occurred in 100%, 93% and 95% of examined biopsies. Results indicate plasticity of equine endometrial epithelial and stromal cells. Particularly, endometrotic glands show evidence for ME differentiation and EMT. The different expression of MF markers between stromal cells from healthy and endometrotic areas suggests functional differences. The characteristic changes in the expression of SMA, vimentin and calponin between endometrotic glands and healthy areas can be helpful to confirm early stages of endometrosis. The characterization of cellular differentiation may help to decipher the pathogenesis of endometrosis and could lead to therapeutic strategies.
When public principals give up control over private agents: The new independence of ICANN in internet governance
Authors: Becker Manuel
Published: March 2019

In 2016, the United States (US) government relinquished its long‐standing delegation contract with the Internet Corporation for Assignment of Names and Numbers (ICANN), a private organization that governs the technical infrastructure of the internet. This presents a puzzle as the US not only gave up a power resource, but also relinquished the possibility, as a public principal, to hold the private agent ICANN accountable. I argue that public principals have incentives to leave control in the hands of private stakeholders when a delegation contract is exposed to external pressure by powerful outside states and the probability of extensive policy changes by the privatized agent is limited. The analysis shows that the unilateral US control over ICANN was strongly challenged by other states and private actors. Instead of granting a greater role to rising powers in internet governance, the US gave up its unilateral influence after internal reforms limited the risk that an independent ICANN could deviate too far from former policies.
Data Integrative Bayesian Inference for Mixtures of Regression Models
Authors: Aflakparast Mehran , Gunst Mathisca
Published: March 2019

Modern data collection techniques, which often produce different types of relevant information, call for new statistical learning methods that are adapted to cope with data integration. In the paper Bayesian inference is considered for mixtures of regression models with an unknown number of components, that facilitates data integration and variable selection for high dimensional data. In the approach presented, named data integrative mixture of regressions, data integration is accomplished by introducing a new data allocation scheme that summarizes additional data in the form of an informative prior on latent variables. To cope with high dimensionality, a shrinkage-type prior is assumed on the regression parameters, and a posteriori variable selection is conducted based on Bayesian credible intervals. Posterior estimation is achieved via a Markov chain Monte Carlo algorithm. The method is validated through simulation studies and illustrated by its performance on real data.
Regulation of p38MAPK‐mediated dendritic cell functions by the deubiquitylase otubain 1
Authors: Xuan Nguyen Thi , Trung Do Minh , Minh Nghiem Ngoc , Nghia Vu Xuan , Giang Nguyen Van , Canh Nguyen Xuan , Toan Nguyen Linh , Cam Truong Dinh , Nga Nguyen Thanh , Tien Tran Viet , Hoang Nguyen Huy
Published: March 2019

Dendritic cells (DCs) are professional antigen presenting cells (APCs) that represent the essential link between innate and acquired immunity. Otubain (OTUB) 1 is shown to deubiquitinate TRAFs to suppress virus‐induced inflammatory response. MAPK, a downstream molecule of TRAFs, is involved in regulating LPS‐induced immune reactions and its activation is sensitive to the presence of OTUB1. Little is known about contributions of OTUB1 to changes in biological properties of DCs. The present study, therefore, explored whether DC functions are influenced by OTUB1. To this end, DCs were isolated and cultured with GM‐CSF to attain bone marrow‐derived DCs (BMDCs) and followed by treatment with lipopolysaccharide (LPS) in the presence or absence of OTUB1 siRNA. Expression of markers of cellular maturation and proliferation were analyzed by flow cytometry, and secretion of inflammatory cytokines and ability to stimulate CD4+ T‐cells in allogenic mixed leukocyte reaction (allo‐MLR) by ELISA, cell migration by a transwell migration assay and phagocytic capacity by FITC‐dextran uptake measurement. As a result, treatment of the cells with OTUB1 siRNA prolonged activation of p38MAPK, increased CD54 expression and IL‐6 release and reduced FITC‐dextran uptake. Moreover, cytokine release produced from CD4+ T‐cells in allo‐MLR was different. The enhanced level of IFN‐γ, but not other cytokine production was observed in the presence of siRNA OTUB1. All the effects were completely abolished when the cells were exposed with p38MAPK inhibitor SB203580. In conclusion, OTUB1 prevents the prolonged activation of p38MAPK, which in turn compromises DC functions.
Patient, family and nurse experiences with patient presence during handovers in acute care hospital settings: a systematic review of qualitative evidence
Authors: McCloskey Rose M. , Furlong Karen E. , Hansen Linda
Published: March 2019

Objective:

The objective of this systematic review was to synthesize the best available evidence on patients’, family members’ and nurses’ experiences with bedside handovers in acute care settings.

Introduction:

The transfer of patient information between nurses represents a critical component of safety within health care. Conducting handover at the bedside allows patients and families to participate in information exchanges. Studies that address bedside handover highlight benefits and concerns with their implementation. Insight into patients’, families’ and nurses’ experiences with bedside handovers can help to identify the most appropriate and safest approach to handovers.

Inclusion criteria:

The current review considered patients, family members and nurses in the acute care hospital setting. Nurses included licensed nurses, registered nurses, practical nurses, nursing assistants, nurse researchers, and advanced practice nurses.

Methods:

A three-step search strategy was used to identify English language qualitative primary research studies. Two reviewers independently appraised the included studies using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research. Qualitative studies that considered attitudes, beliefs and experiences of patients, families and nurses on patient presence during bedside handover were considered for this review. Papers included in the review were from 1998 to 2017.

Results:

The review included 12 qualitative publications. Key findings were extracted and classified as unequivocal (U) or credible (C). A total of 96 findings were extracted and aggregated into 14 categories. From the 14 categories, five synthesized findings were developed: i) becoming more informed; ii) upholding confidentiality and privacy; iii) varying desire and ability to participate; iv) individualizing patient care; and v) challenges in conducting bedside handovers can be overcome with adaptive practices.

Conclusions:

This review captured the experiences of patients, families and nurses with patient presence during bedside handovers in a hospital setting. For the most part, patients and families describe bedside handover positively, reporting feeling more informed and engaged in care. This review highlights areas where patients’ and nurses’ views on bedside reporting may differ, particularly in the areas of desire to participate and the need for confidentiality. Although hospital environments can create challenges in sharing personal patient information at the bedside, these may be overcome through education and by the adoption of a flexible and individualized approach.
Safe injection practices among anesthesia providers: a scoping review protocol
Authors: Adams Julie Lynn , Rust Daniel Bryan , Anderson Lori Rae , McShane Franklin John
Published: March 2019

Objective:

The objective of this review is to identify and map literature related to safe injection practices among anesthesia providers in developed nations. The mapped literature will be used to determine if there is sufficient literature available to pose specific questions that can be valuably addressed, through a future systematic review, to reduce the prevalence of unsafe injections.

Introduction:

A safe injection is one that does not harm the recipient, does not expose the healthcare worker to avoidable risk, and does not result in waste that is a danger to the community. The literature is replete with examples of disease outbreaks connected to unsafe injections via the misuse of syringes, needles and medications. Many such outbreaks involve unsafe injections by anesthesia providers.

Inclusion criteria:

This scoping review will consider any research article or policy document, including unpublished reports, that provides information related to safe injection practices by anesthesia providers in developed nations.

Methods:

For studies published in English from 2000, the databases to be searched include Ovid MEDLINE, CINAHL and Google Scholar. The search for unpublished literature will include the websites of anesthesia organizations, the Centers for Disease Control and Prevention, and the National Institutes of Health. Results will be screened by two independent reviewers who will use a standardized tool to independently extract data from each included source. The results of the review will be presented as a map of the data extracted in a tabular form and in a narrative descriptive summary.
Outcome measurement and reporting in childhood epilepsy treated with ketogenic diet therapy: a scoping review protocol
Authors: Carroll Jennifer , Martin-McGill Kirsty , Cross Helen , Hickson Mary , Collinson Avril
Published: March 2019

Review objective/question:

The objective of this scoping review is to investigate the outcomes measured and reported in trials of children with refractory epilepsy treated with ketogenic diet therapy. The scoping review will aim to list the outcomes and map the associated components including intervention (type of ketogenic diet therapy), definition (if used) of the outcome, the tool or indicators used to measure the outcome, validity of tool used, the time from intervention commencement to measurement of the outcome and the reporting of the outcome.

Specifically, the review question is: What outcomes are measured and reported in studies of childhood epilepsy treated with ketogenic diet therapy?