bluuebunny/crossref_metadata_2025 huggingface dataset:
Nocardia infections in solid organ transplantation: Guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation
Authors: Restrepo Alejandro , Clark Nina M. ,   on behalf of the Infectious Diseases Community of Practice of the American Society of Transplantation
Published: February 2019

These updated guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation review the diagnosis, prevention, and management of Nocardia infections after solid organ transplantation (SOT). Nocardia infections have increased in the last two decades, likely due to improved detection and identification methods and an expanding immunocompromised population. The risk of developing nocardiosis after transplantation varies with the type of organ transplanted and the immunosuppression regimen used. Nocardia infection most commonly involves the lung. Disseminated infection can occur, with spread to the bloodstream, skin, or central nervous system. Early recognition of the infection and initial appropriate treatment is important to achieve good outcomes. Species identification and antimicrobial susceptibility testing are strongly recommended, as inter‐ and intraspecies susceptibility patterns can vary. Sulfonamide is the first‐line treatment of Nocardia infections, and combination therapy with at least two antimicrobial agents should be used initially for disseminated or severe nocardiosis. Trimethoprim‐sulfamethoxazole (TMP‐SMX) prophylaxis may be helpful in preventing Nocardia infection after SOT.
Viral hepatitis: Guidelines by the American Society of Transplantation Infectious Disease Community of Practice
Authors: Te Helen , Doucette Karen
Published: February 2019

These updated guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation review the diagnosis, prevention, and management of viral hepatitis in the pre‐ and post‐transplant period. The current guidelines reflect the declining need for hepatitis B immunoglobulin following liver transplant, now replaced with nucleos(t)ide analogues that effectively suppress viral replication for the long term with minimal risk for drug resistance. It describes the limitations of pegylated interferon alpha in the treatment for chronic hepatitis D. The guidelines feature the paradigm shift in the treatment arena of chronic hepatitis C, now consisting of highly effective direct‐acting antiviral (DAA) medications that effect a cure almost universally. Its safety profile and easy tolerance have permitted its use in patients with decompensated cirrhosis and/or end‐stage renal disease. The high potency of the DAA's has fueled the rapidly expanding utilization of hepatitis C‐exposed grafts in non‐hepatitis C‐infected liver, heart, or kidney recipients within structured protocols, followed by viral eradication with DAA therapy in the peri‐ or post‐transplant period. Chronic hepatitis E has become more recognized in the solid‐organ transplant recipients, and the therapeutic approach has been streamlined to start with reduction of immunosuppression, and if indicated afterward, ribavirin monotherapy.
Effect of carbamazepine on spontaneous recurrent seizures recorded from the dentate gyrus in rats with kainate‐induced epilepsy
Authors: Grabenstatter Heidi L. , Dudek F. Edward
Published: February 2019

Objective

Animal models of chronic epilepsy with spontaneous recurrent seizures (SRSs) may be useful in the discovery and mechanistic analyses of antiseizure drugs (ASDs). Carbamazepine (CBZ), a widely used ASD with a well‐defined mechanism, was analyzed in this proof‐of‐principle study to determine how a traditional ASD affects the properties of SRSs.

Methods

The effects of CBZ on electrographic SRSs recorded from the dentate gyrus were studied in freely behaving rats using a repeated, low‐dose kainate model of acquired epilepsy with a repeated‐measures, crossover protocol.

Results

Almost all seizure durations were >20 seconds. Both seizure likelihood and duration appeared to be similar between 1 and 8 hours after individual CBZ injections. CBZ‐induced decreases in seizure frequency were not significant at 10 mg/kg; however, at 30 mg/kg, seizure frequency was significantly reduced for convulsive but not nonconvulsive seizures. At 100 mg/kg, CBZ strongly suppressed both convulsive and nonconvulsive seizures. Although CBZ had a dose‐dependent effect on seizure frequency, CBZ did not affect seizure duration at any dose. The preceding interictal interval did not affect seizure duration; however, at 30 mg/kg CBZ, nearly all seizures were nonconvulsive when the interictal interval was <30 minutes (ie, during clusters).

Significance

Increased doses of CBZ (10‐100 mg/kg) suppressed the frequency but not the duration of convulsive and nonconvulsive seizures in the repeated, low‐dose kainate model. The repeated‐measures, crossover protocol, which requires relatively few animals and compensates for progressive increases in seizure frequency during epileptogenesis after status epilepticus, allowed quantitative analyses of clinically relevant and translatable properties of SRSs.
Sapwood biomass carbon in northern boreal and temperate forests
Authors: Thurner Martin , Beer Christian , Crowther Thomas , Falster Daniel , Manzoni Stefano , Prokushkin Anatoly , Schulze Ernst‐Detlef
Published: February 2019

Aim

Information on the amount of carbon stored in the living tissue of tree stems (sapwood) is crucial for carbon and water cycle applications. Here, we aim to investigate sapwood‐to‐stem proportions and differences therein between tree genera and derive a sapwood biomass map.

Location

Northern Hemisphere boreal and temperate forests.

Time period

2010.

Major taxa studied

Twenty‐five common tree genera.

Methods

First, we develop a theoretical framework to estimate sapwood biomass for a given stem biomass by applying relationships between sapwood cross‐sectional area (CSA) and stem CSA and between stem CSA and stem biomass. These measurements are extracted from a biomass and allometry database (BAAD), an extensive literature review and our own studies. The established allometric relationships are applied to a remote sensing‐based stem biomass product in order to derive a spatially continuous sapwood biomass map. The application of new products on the distribution of stand density and tree genera facilitates the synergy of satellite and forest inventory data.

Results

Sapwood‐to‐stem CSA relationships can be modelled with moderate to very high modelling efficiency for different genera. The total estimated sapwood biomass equals 12.87 ± 6.56 petagrams of carbon (PgC) in boreal (mean carbon density: 1.13 ± 0.58 kgC m−2) and 15.80 ± 9.10 PgC in temperate (2.03 ± 1.17 kgC m−2) forests. Spatial patterns of sapwood‐to‐stem biomass proportions are crucially driven by the distribution of genera (spanning from 20–30% in Larix to > 70% in Pinus and Betula forests).

Main conclusions

The presented sapwood biomass map will be the basis for large‐scale estimates of plant respiration and transpiration. The enormous spatial differences in sapwood biomass proportions reveal the need to consider the functionally more important sapwood instead of the entire stem biomass in global carbon and water cycle studies. Alterations in tree species distribution, induced by forest management or climate change, can strongly affect the available sapwood biomass even if stem biomass remains unchanged.
Outcomes indicators and processes in transitional care in adolescents with haemophilia: A Delphi survey of Canadian haemophilia care providers
Authors: Sun Haowei (Linda) , Breakey Vicky R. , Straatman Lynn , Wu John K. , Jackson Shannon
Published: February 2019

Introduction

It is unclear which outcome indicators should be used to measure the success of haemophilia transition programs, and what are key elements of a haemophilia transition program to ensure success.

Aim

To establish by expert consensus a list of important and feasible outcome indicators of successful haemophilia transition, and a list of key elements of transition planning.

Methods

A modified two‐stage Delphi survey was developed and disseminated among a panel of Canadian interdisciplinary haemophilia care providers. Participants were asked to rate the importance and feasibility of outcome indicators of effective haemophilia transition and elements of haemophilia transition program. In the second round, participants were asked to choose the top five outcomes suitable for inclusion in a core outcome set of transition effectiveness, and the top five elements that are important and feasible for implementation within the next 5 years.

Results

In total, 34/73 (47%) of participants completed the first round and 33 completed the second round, representing a variety of disciplines. Top outcome indicators recommended for a core outcome set include measurement of adherence, change in bleeding rate, self‐efficacy skills, haemophilia knowledge, patient and caregiver satisfaction, time gap between last paediatric and first adult clinic, and number of emergency room or hospital admissions. Fourteen elements of transition achieved consensus in importance ratings, while eight were felt to be feasible for implementation within next 5 years.

Conclusions

Results will contribute towards the development of a haemophilia transition outcome instrument and provide guidance for future studies of the effectiveness of transition programs.
Once‐weekly prophylaxis with glycoPEGylated recombinant factor VIII (N8‐GP) in severe haemophilia A: Safety and efficacy results from pathfinder 2 (randomized phase III trial)
Authors: Curry Nicola , Albayrak Canan , Escobar Miguel , Andre Holme Pål , Kearney Susan , Klamroth Robert , Misgav Mudi , Négrier Claude , Wheeler Allison , Santagostino Elena , Shima Midori , Landorph Andrea , Tønder Sidsel Marie , Lentz Steven R.
Published: February 2019

Introduction

Turoctocog alfa pegol (N8‐GP) is a site‐specific, 40 kDa glycoPEGylated recombinant factor VIII (FVIII) product with an extended half‐life. The comprehensive main phase of the pivotal pathfinder 2 trial showed N8‐GP dosed every 4 days (Q4D) provided favourable safety and efficacy for preventing bleeds in 175 patients with haemophilia A.

Aim and methods

We investigated the safety and efficacy of N8‐GP prophylaxis when administered weekly (Q7D) for 24 weeks to patients with low bleeding rates in the pathfinder 2 extension trial. Patients (≥12 years) with ≤2 bleeds during the preceding 6 months of the pathfinder 2 main phase were eligible for randomization to receive N8‐GP 50 IU/kg Q4D or 75 IU/kg Q7D. Safety and efficacy endpoints were incidence of FVIII inhibitors and annualized bleeding rate (ABR), respectively.

Results

Fifty‐five of 143 (38.5%) patients on prophylaxis who continued into the extension phase were randomized to receive 50 IU/kg Q4D (n = 17) or 75 IU/kg Q7D (n = 38). Nine patients in the Q7D cohort reverted to 50 IU/kg Q4D. No inhibitors were detected. In both cohorts, >50% of patients experienced no bleeds. Median ABR for overall, joint, spontaneous, traumatic and muscle was 0.00 for both cohorts. Overall estimated success rate for treating bleeding episodes was 87.5%; 94.7% of bleeds were controlled with ≤2 injections.

Conclusions

Weekly N8‐GP was well tolerated and efficacious and may benefit selected “low bleeder” patients with haemophilia A.
Genetic variants of VWF gene in type 2 von Willebrand disease
Authors: Freitas Samuel da Silva , Rezende Suely Meireles , de Oliveira Luciana Correa , Prezotti Alessandra Nunes Loureiro , Renni Marília Sande , Corsini Camila Amormino , Amorim Marcos Vinícius de Almeida , Matosinho Carolina Guimarães Ramos , Carvalho Maria Raquel Santos , Chaves Daniel Gonçalves
Published: February 2019

Introduction

von Willebrand disease (VWD) is the most common inherited bleeding disorder. Few studies have explored the molecular basis of type 2 VWD.

Aim

This study aimed to identify variants associated with type 2 VWD.

Methods

We collected clinical and laboratory data, as well as response to desmopressin and bleeding assessment tool (BAT) score in patients diagnosed with type 2 VWD. We sequenced exons 17, 18, 20 and 28 of the VWF gene.

Results

We identified 19 different variants in 40 unrelated patients (47.5%). Most of the variants (84.2%) were found in exon 28. A total of 10/19 variants (52.6%) were identified as “likely causative” in 17/40 patients (42.5%), according to the ISTH‐SSC and EAHAD VWF gene mutations databases. Nine variants were initially identified as potentially benign. However, through analyses in silico, four of these variants were reclassified as “likely pathogenic” (Ile1380Val, Asn1435Ser, Ser1486Leu and Tyr1584Cys). Response to desmopressin was associated with three variants: Met740Ile, Arg1597Gln and Tyr1584Cys. Major bleeding was associated with variants related to VWD subtypes 2B and 2M.

Conclusion

In conclusion, we identified 19 variants, of which 14 are “likely pathogenic” and therefore associated with VWD. We suggest a possible association of pathogenic variants with major bleeding, response to desmopressin and BAT score ≥10, although this requires further confirmation.
Microwave ablation vs. parathyroidectomy for secondary hyperparathyroidism in maintenance hemodialysis patients
Authors: Jiang Binghu , Wang Xiaoyun , Yao Zhiyong , Wu Hongfei , Xiao Leijuan , Gong Hai , Gao Zhanhui
Published: February 2019

Introduction: Secondary hyperparathyroidism (SHPT) is a serious and common problem in patients undergoing maintenance hemodialysis. Minimally invasive microwave ablation (MWA) has been used to treat SHPT and shows some advantages. However, its efficacy is still undefined. The primary purpose of this study was to determine the efficacy and safety of MWA compared to total parathyroidectomy plus forearm autotransplantation.

Methods: The SHPT patients who were undergoing maintenance hemodialysis (follow‐up for 6 to 24 months after treatments) were divided into a MWA group (n = 33) and a parathyroidectomy group (n = 48). The efficacy (serum intact parathyroid hormone [iPTH], calcium, and phosphorus levels) and safety (hoarseness, hypocalcaemia, and persistently low iPTH) were compared between the two groups. Additionally, the study explored potential predictors of response to MWA by a logistic regression analysis.

Findings: There were no significant differences in baseline characteristics between the two groups. The rates of achieving the recommended goal for iPTH were significantly higher in the MWA group than that in the parathyroidectomy group at all follow‐up times: 57.58% vs. 12.50% at one‐day (P < 0.001), 45.45% vs. 16.67% at 1‐week (P = 0.005), 57.58% vs. 16.67% at 2‐week (P < 0.001), 57.58% vs. 22.92% at 1‐month (P = 0.002), and 69.70% vs. 35.42% at 3‐month (P = 0.002), 76.47% vs. 28.57% at 6‐month (P = 0.005), 87.50% vs. 47.37% at 12‐month (P = 0.008), and 81.82% vs. 52.63% at 24‐month (P = 0.015), respectively. However, there were no significant differences for phosphorus or calcium at any of the follow‐up times (P > 0.05). The persistently low iPTH was more in the parathyroidectomy group (64.6%) than that in the MWA group (0%) (P < 0.001), but there was no significant difference in hoarseness or hypocalcaemia (P > 0.05). Baseline levels of iPTH (P = 0.021) and patient age (P = 0.011) were determined as predictors by univariate logistic regression analysis.

Conclusion: The MWA could be an alternative to parathyroidectomy for SHPT but its eventual superiority has to be demonstrated by a proper study.
Effect of ZrC amount and distribution on the thermomechanical properties of Cf/SiC‐ZrC composites
Authors: Zhou Haijun , Yang Jinshan , Le Gao , Ni Dewei , Wang Hongda , Dong Shaoming
Published: February 2019

Cf/SiC‐ZrC composites with different amounts and distributions of ZrC were fabricated by polymer impregnation and pyrolysis. The effects of the ZrC amount and distribution on the microstructural, mechanical, and ablation properties of Cf/SiC‐ZrC composites were investigated. Cf/SiC‐ZrC composites obtained by the alternating infiltration of ZrC organic precursors and polycarbosilane groups exhibit good tensile strength (240 ± 17.7 MPa) because the ZrC and SiC matrix can mix evenly. However, Cf/SiC‐ZrC composites using only ZrC organic precursor infiltration show a low tensile strength (191 ± 16.6 MPa) because more defects can be introduced into the composites. Ablation characterization by a 30 kW plasma wind tunnel for 60 seconds showed that the Cf/SiC‐ZrC composites with the highest amount of ZrC matrix (67.8 wt.%) possessed the lowest linear erosion rate of 4 μm/s because liquid SiO2 could fill the porous ZrO2 to form a homogenous protective layer. Nevertheless, the Cf/SiC‐ZrC composites with a relatively high ZrC amount (55.3 wt.%) exhibited a poorer ablation performance compared to that of Cf/SiC‐ZrC composites with a low ZrC amount (38.7 wt.%).
Effect of Eggplant Flour (Solanum melongenaL.) associated with hypoenergetic diet on antioxidant status in overweight women ‐ a randomised clinical trial
Authors: Scorsatto Mauara , Rosa Glorimar , Raggio Luiz Ronir , da Rocha Pinheiro Mulder Alessandra , Junger Teodoro Anderson , Moraes de Oliveira Gláucia M.
Published: February 2019

The objectives of this study were to assess the effect of hypoenergetic diet associated with eggplant (SolanummelongenaL.) flour (EF) consumption on the antioxidant status in overweight women and compare the effect among metabolically healthy obese (MHO) and metabolically unhealthy obese (MUO) women. This is a 4‐month double‐blind, randomised and placebo‐controlled clinical trial. The volunteers were divided into two groups: (a) balanced and individualised hypoenergetic diet + 13 g ofEF(Eggplant Flour Group [EFG]); and (b) balanced and individualised hypoenergetic diet + 13 g of placebo (Placebo Group [PG]). One hundred and eighty‐six women completed the study. TheEFGexhibited significant increase in antioxidant capacity after the intervention (P = 0.044).MHOexhibited statistically significant increased antioxidant capacity (P = 0.028). Body fat had significant reduction in theEFG(P = 0.010). Waist circumference was reduced in the two groups. The hypoenergetic diet associated withEFimproved the antioxidant status in comparison to thePGand inMUOwomen the eggplant flour reduced fat mass.
Under‐detection of acute kidney injury in hospitalised patients: a retrospective, multi‐site, longitudinal study
Authors: Campbell Craig A. , Li Ling , Kotwal Sradha , Georgiou Andrew , Horvath Andrea R. , Westbrook Johanna , Endre Zoltan
Published: February 2019

Background

Acute kidney injury (AKI) is a rapid deterioration of renal function, often caused by a variety of co‐existing morbidities complicating its recognition and treatment, leading to short‐ and long‐term adverse clinical outcomes. There are limited data on the incidence of AKI in Australia using the Kidney Disease Improving Global Outcomes creatinine‐based consensus definition.

Aim

To determine the incidence and estimate the extent of under‐reporting of AKI in four hospitals in the South‐Eastern Sydney/Illawarra regions of New South Wales, Australia.

Method

A laboratory algorithm based on the Kidney Disease Improving Global Outcomes creatinine‐based definition for AKI was applied retrospectively to laboratory data for adult patients admitted to the study hospitals between 2009 and 2013 to identify those with AKI. The results were compared with the incidence of AKI based on diagnostic codes for AKI reported for the same period.

Results

AKI was detected in 12.4% of all hospitalisations (46 101/370 969) and 16.4% of patients (31 448/192 133) across the 5‐year study period using the laboratory algorithm. Of these, 72.1% were AKI Stage 1 (33 246/46101). AKI was coded in only 15.9% of hospitalisations with AKI Stage 1 (5294/33 246), 38.5% of hospitalisations with Stage 2 (2381/6185), and 46.8% with Stage 3 (3120/6670). Yearly incidence of laboratory‐identified AKI trended downward between 2009 and 2013, while annual incidence determined by coding trended upward.

Conclusion

Although coding trends suggested a continuous increase in clinician awareness of AKI across the study period, AKI in hospitalised patients remained significantly under‐reported.
Evaluating a risk assessment tool to improve triaging of patients to colonoscopies
Authors: Elliott Thomas M. , Lord Anton , Simms Lisa A. , Radford‐Smith Graham , Valery Patricia C. , Gordon Louisa G.
Published: February 2019

Background

Colonoscopy is the gold standard in the diagnosis of significant bowel disease (SBD), including colorectal cancer, high‐risk adenoma and inflammatory bowel disease. As the demand for colonoscopy services is placing significant pressure on hospital resources, new solutions are needed to manage patients more efficiently and effectively.

Aim

We investigated the impact of using a risk assessment tool (RAT) to improve selection of patients for colonoscopy procedures to detect SBD.

Methods

A hybrid simulation model was constructed to replicate the current patient triage bookings and waiting times in a large metropolitan hospital. The model used data on 327 patients who were retrospectively assessed for risk of SBD. Risk assessment incorporated blood and faecal immunochemical test results, gender and age in addition to patient symptoms. The model was calibrated over 12 months to current outcomes and was compared with the RAT and a third scenario where low‐risk patients did not proceed to a colonoscopy. One‐way sensitivity analyses were undertaken.

Results

Using the RAT was expected to shorten waiting times by 153 days for moderately‐urgent patients and 138 days for non‐urgent patients. If low‐risk patients did not proceed to colonoscopy, waiting times were expected to reduce for patients with SBD by 17 days producing cost‐savings of AU$373 824 through avoided colonoscopies.

Conclusions

A hybrid model that combines patient‐level characteristics with hospital‐level resource constraints can demonstrate improved efficiency in a hospital clinic. Further research on risk assessment is required to improve quality patient care and reduce low‐value service delivery.
Front‐line management of indolent non‐Hodgkin lymphoma in Australia. Part 2: mantle cell lymphoma and marginal zone lymphoma
Authors: Cheah Chan Y. , Opat Stephen , Trotman Judith , Marlton Paula
Published: February 2019

Mantle cell lymphoma (MCL) and the marginal zone lymphoma (MZL) subtypes (nodal MZL, extra‐nodal MZL of mucosa‐associated lymphoid tissue (MALT lymphoma) and splenic MZL) are uncommon lymphoma subtypes, accounting for less than 5–10% of all non‐Hodgkin lymphoma. The evidence base for therapy is therefore limited and enrolment into clinical trials is preferred. Outcomes for patients with MCL have been steadily improving mainly due to the adoption of more intense strategies in younger patients, the use of rituximab maintenance and the recent introduction of bendamustine in older patients. MZL is a more heterogeneous group of cancer with both nodal, extra‐nodal and splenic subtypes. Extranodal MZL may be associated with autoimmune or infectious aetiologies, and can respond to eradication of the causative pathogen. Proton pump inhibitor plus dual antibiotics in Helicobacter pylori positive gastric MALT lymphoma is curative in many patients. Watchful waiting is appropriate in most patients with asymptomatic advanced stage disease, which tends to behave in a particularly indolent manner. Other options for symptomatic disease include splenectomy, chemoimmunotherapy with rituximab and, more recently, targeted therapies.
Constipation, antiepileptic drugs, and gingivitis in children and adolescents with cerebral palsy
Authors: Ferreira Ana Cristina Fernandes Maria , Mayer Marcia Pinto Alves , Kawamoto Dione , Santos Maria Teresa Botti Rodrigues
Published: February 2019

Background

Cerebral palsy (CP) individuals present with epilepsy, which requires the use of antiepileptic drug (AED).

Hypothesis

Since an inflammatory response may contribute to epileptogenesis, the hypothesis tested was that constipation would be associated with gingivitis and the use of AED in children and adolescents (CA) with CP.

Design

A comparative study was conducted with 101 CA aged 5‐17 years (10.8 ± 4.9), classified as constipated (G1; n = 57) or not constipated (G2; n = 44). Clinical patterns, AED used, body mass index (BMI), fluid intake, toilet transfer, and gingival condition were evaluated. Student's t test, chi‐squared test, and logistic regression analysis were performed (α = 0.05).

Results

There were no differences between groups regarding gender (P = 0.531), age (P = 0.227), BMI (P = 0.437), and fluid intake (P = 0.346). G1, however, presented a higher percentage of quadriplegic individuals (P < 0.001), dependency for toilet transfer (P < 0.001), the presence of gingivitis (P = 0.020), and the use of AED polytherapy (P < 0.001) compared to G2. Constipation was associated with quadriplegic CA, using GABA as AED (P = 0.002).

Conclusions

Mucosal inflammation evidenced by constipation and gingivitis is associated with the most neurologically compromised CAs under the use of GABA AED.
Quantum chemical calculations of the thermochemistry of tantalum oxyhydroxide species
Authors: Bauschlicher Charles W. , Jacobson Nathan S. , Myers Dwight L.
Published: February 2019

Tantalum pentoxide and water vapor are predicted to react at elevated temperatures to form TaO(OH)3(g), TaO2(OH)(g), and Ta(OH)5(g). The thermochemistry of these species is calculated with quantum chemistry methods. Geometries and vibrational frequencies are determined from B3LYP DFT methods. Energetics are calculated from high levels of theory—CCSD(T) and larger basis sets for Ta, O, and H. We report the enthalpies of formation at 0 K and 298.15 K, entropy at 298.15 K, and heat capacity. These quantities are used to calculate vapor pressures at 1400‐1800 K and 50% water vapor. TaO(OH)3(g) is found to be the dominant species. The calculated vapor pressure of TaO(OH)3(g) is converted to a vapor flux and compared to previous experimental flux measurements from a flat plate in a slowly flowing H2O/Ar gas and also vapor flux from a steam jet experiment. These “open system” experiments result in lower fluxes that are within 1.12‐17X of the calculated equilibrium fluxes. This suggests that the experimental measurements are near equilibrium or have a small kinetic barrier.
Nursing students' perceptions of peer learning through cross‐cultural student‐led webinars: A qualitative study
Authors: Carlson Elisabeth , Stenberg Marie , Lai Timothy , Reisenhofer Sonia , Chan Bessie , Cruz Eric , Leung Doris , Wong Arkers , Chan Engle Angela
Published: February 2019

Aims

To explore nursing students’ perception of peer learning during cross‐cultural learning activities through student‐led webinars.

Design

An exploratory qualitative study.

Methods

Thematic analysis of data collected from reflective journals and focus‐group interviews of participating nursing students across three international universities in Australia, Hong Kong, and Sweden during autumn 2017.

Results

Three themes were identified: peer learning as creation of friendship; peer learning from interactions that went beyond what was originally intended; and peer learning as empowered learning.

Conclusion

Combining peer learning as an educational approach with cross‐cultural and student‐led webinars provided new perspectives. On‐line learning across global boundaries, based on a sound educational model, creates new opportunities for internationalization without straining individual and institutional financial resources.
Do safety briefings improve patient safety in the acute hospital setting? A systematic review
Authors: Ryan Sharon , Ward Marie , Vaughan David , Murray Bridget , Zena Moore , O'Connor Tom , Nugent Linda , Patton Declan
Published: February 2019

Aims

To synthesize current knowledge about the impact of safety briefings as an intervention to improve patient safety.

Background

Improving safety in health care remains an ongoing challenge. There is a lack of evidence underpinning safety enhancing interventions.

Design

Mixed method multi‐level synthesis.

Data Sources

Four health literature databases were searched (Cinahl, Medline, Scopus and Health Business Elite) from January 2002 – March 2017.

Review Methods

Thomas and Harden approach to mixed method synthesis.

Results

Following quality appraisal, 12 studies were included. There was significant heterogeneity in study aims, measures, and outcomes. Findings showed that safety briefings achieved beneficial outcomes and can improve safety culture. Outcomes included improved risk identification, reduced falls, enhanced relationships, increased incident reporting, ability to voice concerns, and reduced length of stay.

Conclusion

Healthcare leaders should embrace the potential of safety briefings by promoting their effective use whilst allowing for local adaptation.
Health consequences of bullying in the healthcare workplace: A systematic review
Authors: Lever Isabel , Dyball Daniel , Greenberg Neil , Stevelink Sharon A. M.
Published: February 2019

Aims

To review both mental and physical health consequences of bullying for healthcare employees.

Design

Systematic literature review.

Data sources

EMBASE,MEDLINE, PsycINFO,PUBMEDand Web of Science Core Collection were searched for articles published between 2005 ‐ January 2017.

Review methods

This review was conducted using the framework described by Khan and reported using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses. Two independent reviewers performed systematic data extraction and appraised the methodological quality of included articles. A pooled mean prevalence of bullying was estimated.

Results

Forty‐five papers met inclusion criteria. Bullying prevalence ranged from 3.9% to 86.5%, with a pooled mean estimate of 26.3%. Perceived bullying was associated with mental health problems including psychological distress, depression and burnout, and physical health problems including insomnia and headache. Bullied staff took more sick leave.

Conclusion

Bullying occurs frequently amongst healthcare staff and is deleterious to health and occupational functionality.
The SUMAMOS EXCELENCIA Project
Authors: Escobar‐Aguilar Gema , Moreno‐Casbas María‐Teresa , González‐María Esther , Martínez‐Gimeno María‐Lara , Sánchez‐Pablo Clara , Orts‐Cortés Isabel
Published: February 2019

Aim

The gap between research and clinical practice leads to inconsistent decision‐making and clinical audits are an effective way of improving the implementation of best practice. Our aim is to assess the effectiveness of a model that implements evidence‐based recommendations for patient outcomes and healthcare quality.

Design

National quasi‐experimental, multicentre, before and after study.

Methods

This study focuses on patients attending primary care and hospital care units and associated socio‐healthcare services. It uses the Joanna Brigg's Institute Getting Research into Practice model, which improves processes by referring to prior baseline clinical audits. The variables are process and outcome criteria for pain, urinary incontinence, and fall prevention, with data collection at baseline and key points over 12 months drawn from clinical histories and records. Project funding was received from the Spanish Strategic Health Action in November 2014.

Discussion

The project results will provide knowledge on the effectiveness of the Getting Research into Practice model, to apply evidence‐based recommendations for the detection and management of pain, urinary incontinence, and fall prevention. It will also establish whether using research results, based on clinical audits and situation analysis, is effective for implementing evidence‐based recommendations and improving patients’ health.

Impact

This nationwide Spanish project aims to detect and prevent high‐prevalence healthcare problems, namely pain in patients at any age and falls and urinary incontinence in people aged 65 and over. Tailoring clinical practice to evidence‐based recommendations will reduce unjustified clinical variations in providing healthcare services.

Clinical Trial ID: NCT03725774.
Female resistance to sexual coercion can evolve to preserve the indirect benefits of mate choice
Authors: Snow Samuel S. , Alonzo Suzanne H. , Servedio Maria R. , Prum Richard O.
Published: February 2019

Sexual conflict over the indirect benefits of mate choice may arise when traits in one sex limit the ability of the other sex to freely choose mates but when these coercive traits are not necessarily directly harmful (i.e. forced fertilization per se). Although we might hypothesize that females can evolve resistance in order to retain the indirect, genetic benefits (reflected in offspring attractiveness) of mating with attractive males, up to now it has been difficult to evaluate potential underlying mechanisms. Traditional theoretical approaches do not usually conceptually distinguish between female preference for male mating display and female resistance to forced fertilization, yet sexual conflict over indirect benefits implies the simultaneous action of all of these traits. Here, we present an integrative theoretical framework that draws together concepts from both sexual selection and sexual conflict traditions, allowing for the simultaneous coevolution of displays and preferences, and of coercion and resistance. We demonstrate that it is possible for resistance to coercion to evolve in the absence of direct costs of mating to preserve the indirect benefits of mate choice. We find that resistance traits that improve the efficacy of female mating preference can evolve as long as females are able to attain some indirect benefits of mating with attractive males, even when both attractive and unattractive males can coerce. These results reveal new evolutionary outcomes that were not predicted by prior theories of indirect benefits or sexual conflict.
The clinicopathological differences of sporadic non‐ampullary duodenal epithelial neoplasm depending on tumor location
Authors: Matsueda Katsunori , Kanzaki Hiromitsu , Matsueda Kazuhiro , Nasu Junichiro , Yoshioka Masao , Nakagawa Masahiro , Inoue Masafumi , Inaba Tomoki , Imagawa Atsushi , Takatani Masahiro , Takenaka Ryuta , Suzuki Seiyu , Tomoda Jun , Yagi Takahito , Fujiwara Toshiyoshi , Tanaka Takehiro , Okada Hiroyuki
Published: February 2019

Background and Aim

Although sporadic non‐ampullary duodenal adenoma is speculated to be precancerous lesion, the relationship between adenoma and carcinoma remains unclear due to their rarity. Previous studies on sporadic non‐ampullary duodenal epithelial neoplasm (SNADEN) have mainly targeted superficial tumors, like adenoma and early carcinoma. The clinicopathological features, including those of advanced carcinoma, remain poorly investigated. We assessed the clinicopathological features of SNADEN, including advanced carcinoma, focusing on tumor location.

Methods

We retrospectively collected the data of 410 patients who had been clinically and pathologically diagnosed with SNADEN at 11 institutions in Japan between June 2002 and March 2014.

Results

The SNADEN was mucosal neoplasia and invasive carcinoma in 321 (78.3%) and 89 (21.7%) patients, respectively. The proportion of invasive carcinomas in SNADEN was significantly higher on the oral side of the papilla of Vater (oral‐Vater) than on the anal side (anal‐Vater) (27.9% vs 14.4%, P < 0.001). Undifferentiated‐type carcinoma was significantly more frequent with oral‐Vater than anal‐Vater (38.7% vs 14.8%, P = 0.026). The recurrence rate of surgically R0 resected locally advanced carcinomas was significantly higher with oral‐Vater than anal‐Vater (46.4% vs 8.3%, P = 0.021). Furthermore, the relapse‐free survival with oral‐Vater was significantly shorter than with anal‐Vater (hazard ratio: 2.35; 95% confidence interval: 1.09–5.50; P = 0.028).

Conclusions

The clinicopathological features of SNADEN on oral‐Vater were different from those on anal‐Vater. SNADEN on oral‐Vater was more likely to be invasive carcinomas and might behave more aggressively due to biologically higher malignancy than that on anal‐Vater.
The association of genetic polymorphisms in serotonin transporter and catechol‐O‐methyltransferase on temporomandibular disorders and anxiety in adolescents
Authors: Brancher João Armando , Spada Paula Porto , Meger Michelle Nascimento , Fatturri Aluhe Lopes , Dalledone Mariana , de Paiva Bertoli Fernanda Mara , Deeley Kathleen , Scariot Rafaela , Vieira Alexandre Rezende , Küchler Erika Calvano , de Souza Juliana Feltrin
Published: February 2019

Background

Temporomandibular disorder (TMD) is a multifactorial condition involving environmental, psychological and genetic factors.

Objective

The aim of this case‐control study was to evaluate the influence of genetic polymorphisms in 5HTT and COMT on TMD and anxiety in adolescents.

Methods

TMD was diagnosed and classified according to the RDC/TMD criteria. For case group, the following TMD categories were used: myofascial pain, disc displacement, arthralgia and painful TMD (myofascial and arthralgia). Anxiety levels were assessed according to the State‐Trait Anxiety Inventory. Genomic DNA was extracted, and genetic polymorphisms were genotyped by TaqMan chemistry and endpoint analysis. Logistic multivariate regression was used to analyse the associations between TMD types and genotypes, anxiety level and genotypes, using an adjusted odds ratio (ORa; CI 95%) that considered the gender.

Results

In 5HTT, the rs1042173 was associated with painful TMD (arthralgia and myofascial pain) (ORc = 1.97; CI 95%: 1.02‐3.77; P = 0.04). Polymorphisms in COMT rs4818 were significantly associated with myofascial pain (ORc = 2.15; CI 95%: 1.08‐4.29; P = 0.02) and were borderline for painful TMD (ORc = 1.85; CI 95%: 0.97‐3.51; P = 0.06) and disc displacement (ORc = 2.42; CI 95%: 1.00‐5.87; P = 0.05). The rs6269 was borderline for myofascial pain (ORc = 1.82; CI 95%: 0.92‐3.59; P = 0.08) and disc displacement (ORc = 2.38; CI 95% 0.95‐5.97; P = 0.06) and also was associated with anxiety (ORa = 2.34; CI 95% 1.04‐5.25; P = 0.03).

Conclusion

Polymorphisms in 5HTT and COMT are associated with TMD in adolescents. Moreover, polymorphism in COMT is associated with anxiety in adolescents.
Leucine alone or in combination with glutamic acid, but not with arginine, increases biceps femoris muscle and alters muscle AA transport and concentrations in fattening pigs
Authors: Hu Chengjun , Li Fengna , Duan Yehui , Kong Xiangfeng , Yan Yingli , Deng Jinping , Tan Chengquan , Wu Guoyao , Yin Yulong
Published: February 2019

Forty‐eight Duroc × Large White × Landrace pigs with an average initial body weight of 77.09 ± 1.37 kg were used to investigate the effects of combination of leucine (Leu) with arginine (Arg) or glutamic acid (Glu) on muscle growth, free amino acid profiles, expression levels of amino acid transporters and growth‐related genes in skeletal muscle. The animals were randomly assigned to one of the four treatment groups (12 pigs/group, castrated male:female = 1:1). The pigs in the control group were fed a basal diet (13% Crude Protein), and those in the experimental groups were fed the basal diet supplemented with 1.00% Leu (L group), 1.00% Leu + 1.00% Arg (LA group) or 1.00% Leu + 1.00% Glu (LG group). The experiment lasted for 60 days. Results showed an increase (p < 0.05) in biceps femoris (BF) muscle weight in the L group and LG group relative to the basal diet group. In longissimus dorsi (LD) muscle, Lys, taurine and total essential amino acid concentration increased in the LG group relative to the basal diet group (p < 0.05). In LG group, Glu and carnosine concentrations increased (p < 0.05) in the BF muscle, when compared to the basal diet group. The Leu and Lys concentrations of BF muscle were lower in the LA group than that in the L group (p < 0.05). A positive association was found between BF muscle weight and Leu concentration (p < 0.05). The LG group presented higher (p < 0.05) mRNA levels of ASCT2, LAT1, PAT2, SANT2 and TAT1 in LD muscle than those in the basal diet group. The mRNA levels of PAT2 and MyoD in BF muscle were upregulated (p < 0.05) in the LG group, compared with those in the basal diet group. In conclusion, Leu alone or in combination with Glu is benefit for biceps femoris muscle growth in fattening pig.
Interactive effects of family and stocking density on survival and growth of the sea urchin Strongylocentrotus intermedius
Authors: Zhang Weijie , Chen Xiaohui , Jiang Huijie , Wang Zhong , Wang Baofeng , Zhan Yaoyao , Qi Shoubing , Chang Yaqing
Published: February 2019

To investigate the effects of family, stocking density, and their interaction on mortality, growth rate, and size dispersal in the sea urchin Strongylocentrotus intermedius, 1,440 juveniles from six full‐sib families were exposed to three stocking densities, that is, low stocking density (LD), middle stocking density (MD), and high stocking density (HD), and reared for 10 months in sea‐based suspended cages. The results demonstrated significant family effects on cumulative mortality rate (CMR); specific growth rate for test diameter (SGR for TD); specific growth rate for body weight (SGR for BW); coefficient of variation for body weight at the 10th month (CV for BW10); and significant stocking density effects on SGR for TD, SGR for BW, and CV for BW10. Statistically significant family by stocking density interaction was only found in SGR for TD. A certain degree of family‐ranking inversions occurred in SGR for TD. The present study provides evidence for the existence of family by stocking density interaction on the growth rate of test diameter in the family selection for S. intermedius. More attention should be paid to this interaction effect to select correct parents in S. intermedius.
Gut‐focused hypnotherapy for Functional Gastrointestinal Disorders: Evidence‐base, practical aspects, and the Manchester Protocol
Authors: Vasant Dipesh H. , Whorwell Peter J.
Published: February 2019

Background

Despite their high prevalence and advances in the field of neurogastroenterology, there remain few effective treatment options for functional gastrointestinal disorders (FGIDs). It is recognized that approximately 25% of sufferers will have symptoms refractory to existing therapies, causing significant adverse effects on quality of life and increased healthcare utilization and morbidity. Gut‐focused hypnotherapy, when delivered by trained therapists, has been shown to be highly effective in severe refractory FGIDs. However, hypnotherapy continues to be surrounded by much misunderstanding and skepticism.

Purpose

The purpose of this review is to provide a contemporary overview of the principles of gut‐focused hypnotherapy, its effects on gut‐brain interactions, and the evidence‐base for its efficacy in severe FGIDs. As supplementary material, we have included a hypnotherapy protocol, providing the reader with an insight into the practical aspects of delivery, and as a guide, an example of a script of a gut‐focused hypnotherapy session.
Bone fill following secondary alveolar bone grafting for children with cleft of the alveolus in New Zealand
Authors: Fowler Peter V. , Al‐Ani Azza H. , Thompson John M. D.
Published: February 2019

Structured Abstract

Objective

To investigate the amount of bone fill post‐secondary alveolar bone grafting for children with cleft in New Zealand.

Settings and Sample Population

Retrospective analysis of post‐operative intra‐oral periapical and upper anterior occlusal radiographs of 45 grafted sites where all grafting was undertaken within the New Zealand public hospital service.

Materials and Methods

A modified Kindelan Index and a 100 mm visual analogue scale (VAS) were used to assess the amount of bone fill using intra‐oral radiographs by 4 orthodontists experienced in cleft care and who were blind to the patient's identity. Fourteen duplicated radiographs were randomly selected and added to the sample for reliability assessment.

Results

The Kindelan Index rated 37.8% Grade 1 (Good), 31.1% rated Grade 2 (Satisfactory), 22.2% rated Grade 3 (Unsatisfactory) and 8.9% Grade 4 (Failure), a combined unsatisfactory/failure rate of 31.1%. The average VAS score was 50 mm ± 24 mm, and there was a strong relationship between Kindelan and VAS assessments.

Those patients aged 10‐11 years had significantly better outcomes using both assessments compared to those aged <10 and >11. The VAS assessment found that higher caseload surgeons had better outcomes, although the difference was of borderline statistical significance (mean VAS 56 mm vs 44 mm P = 0.07).

Conclusions

Contemporary secondary alveolar bone grafting bone fill outcomes in New Zealand are poor when compared to contemporary international studies. These findings indicate a review of secondary bone grafting is required to improve outcomes for New Zealand children with cleft.
Effects of multiple timescales of resource supply on the maintenance of species and functional diversity
Authors: Smith Alaina N. , Edwards Kyle F.
Published: February 2019

It is well known that variable resource supply can allow competitors to coexist on a single limiting resource, and this is one mechanism that may explain the maintenance of diversity in paradoxically speciose communities. Ecosystems experience fluctuations in resource supply on a range of timescales, but we have a poor understanding of how multiple frequencies of resource supply affect the maintenance of diversity and community structure. Here we explore this question using a model of phytoplankton competition for a limiting nutrient, parameterized using empirical tradeoffs between rapid growth, nutrient storage capacity and nutrient uptake affinity. Compared to a single frequency of nutrient supply, we find that multiple frequencies of nutrient supply increase functional diversity, by permitting the coexistence of strategies adapted to different frequencies of supply. Species richness is also promoted by multiple modes of nutrient supply, but not as consistently as functional diversity. Although this model is parameterized for phytoplankton, the fundamental dynamics and tradeoffs likely occur in a variety of ecosystems. Our results suggest that the spectrum of temporal variation driving communities should be further investigated in the context of the maintenance of diversity and the functional composition of communities under different environmental regimes.
Social evolution and the two elements of causation
Authors: Pernu Tuomas K. , Helanterä Heikki
Published: February 2019

The kin selection theory has recently been criticised on the basis of claiming that genetic relatedness does not play a causal role in the social evolution among individuals of insect societies. We outline here a line of criticism of this view by demonstrating two things. First, there are strong conceptual, theoretical and empirical reasons to think that close genetic relatedness has been necessary for the rise of the helper castes of social insects. And second, once we understand how causal explanation itself results from an interplay of two logically distinct elements, necessity and sufficiency, we can also understand the scenarios in which relatedness does not seem to play a causal role for evolution of helper castes. The result of this analysis is that we should be more careful about the way we frame the empirical data on the evolution of social behaviour.