bluuebunny/crossref_metadata_2025 huggingface dataset:
Triptans for Acute Migraine: Drug Class Review to Help Inform Policy Decisions
Authors: Knowles Sandra , Oh Paul , Gomes Tara ,   Ontario Drug Policy Research Network
Published: July 2015

Background/Objective

In Ontario, triptans are publicly funded through the Ontario Drug Benefit's Exceptional Access Program, a prior authorization program. However, it was unclear whether this listing aligned with current evidence of safety and effectiveness for triptans in migraine. Using a comprehensive and novel drug class review framework, we describe our review of triptans for the management of acute migraine to evaluate the appropriateness of triptan listing on the public drug formulary in Ontario.

Methods

This supplement in Headache highlights four key components of the triptan drug class review, including findings from a qualitative analysis of patient and clinician perspectives, a systematic review and network meta‐analysis of clinical trial evidence, a pharmacoepidemiologic analysis comparing utilization trends across Canada, and a reimbursement‐based economic analysis.

Results

We found that triptans were efficacious and safe for the treatment of acute migraine. However, Ontario has among the lowest rates of publically funded triptan use in Canada, which may be due to the highly restrictive nature of access to triptans in Ontario. Expanding access to triptans via a less restrictive listing (eg, Limited Use) would potentially increase use by 20‐fold, with increase in costs of approximately 220%.

Conclusion

Based on findings from our multi‐faceted review and after stakeholder review and input from the Citizens' Panel, two policy options for triptans were recommended for Ontario's publically funded drug program: Limited Use access or coverage via the Exceptional Access Program, both options including quantity limits of 12 units per month.
Triptans in the Acute Treatment of Migraine: A Systematic Review and Network Meta‐Analysis
Authors: Cameron Chris , Kelly Shannon , Hsieh Shu‐Ching , Murphy Meghan , Chen Li , Kotb Ahmed , Peterson Joan , Coyle Doug , Skidmore Becky , Gomes Tara , Clifford Tammy , Wells George
Published: July 2015

Background

Although triptans are widely used in the acute management of migraine, there is uncertainty around the comparative efficacy of triptans among each other and vs non‐triptan migraine treatments. We conducted systematic reviews and network meta‐analyses to compare the relative efficacy of triptans (alone or in combination with other drugs) for acute treatment of migraines compared with other triptan agents, non‐steroidal anti‐inflammatory drugs (NSAIDs), acetylsalicylic acid (ASA), acetaminophen, ergots, opioids, or anti‐emetics.

Methods

The Cochrane Library, MEDLINE, and EMBASE were searched for randomized controlled trials that compared triptans (alone or in combination with other drugs) with placebo‐controlled or active migraine treatments. Study selection, data extraction, and quality assessment were completed independently by multiple reviewers. Outcome data were combined and analyzed using a Bayesian network meta‐analysis. For each outcome, odds ratios, relative risks, and absolute probability of response were calculated.

Results

A total of 133 randomized controlled trials met the inclusion criteria. Standard dose triptans relieved headaches within 2 hours in 42 to 76% of patients, and 2‐hour sustained freedom from pain was achieved for 18 to 50% of patients. Standard dose triptans provided sustained headache relief at 24 hours in 29 to 50% of patients, and sustained freedom from pain in 18 to 33% of patients. Use of rescue medications ranged from 20 to 34%. For 2‐hour headache relief, standard dose triptan achieved better outcomes (42 to 76% response) than ergots (38%); equal or better outcomes than NSAIDs, ASA, and acetaminophen (46 to 52%); and equal or slightly worse outcomes than combination therapy (62 to 80%). Among individual triptans, sumatriptan subcutaneous injection, rizatriptan ODT, zolmitriptan ODT, and eletriptan tablets were associated with the most favorable outcomes.

Interpretation/Conclusions

Triptans are effective for migraine relief. Standard dose triptans are associated with better outcomes than ergots, and most triptans are associated with equal or better outcomes compared with NSAIDs, ASA, and acetaminophen. Use of triptans in combination with ASA or acetaminophen, or using alternative modes of administration such as injectables, may be associated with slightly better outcomes than standard dose triptan tablets.
Water and energy fluxes during summer in an arid‐zone passerine bird
Authors: Smit Ben , McKechnie Andrew E.
Published: July 2015

Endothermic animals resident in hot, arid terrestrial environments are likely to face a trade‐off between their ability to obtain water and elevated thermoregulatory water requirements. We assessed whether daily water flux (DWF) is higher on hot days, reflecting increases in evaporative cooling demands, in an arid‐zone bird that obtains its water through food intake. We obtained measurements of DWF (partitioned into water influx and efflux rates) in 71 White‐browed Sparrow‐Weavers Plocepasser mahali at a desert site and a semi‐desert site, during summer in the Kalahari Desert of southern Africa. We found no evidence that DWF varied with maximum daily air temperature (Tair, range = 27.6–39.2 °C). Instead, DWF was lower during dry periods than in the wet season at the semi‐desert site. Furthermore, birds showed deficits in water balance (water influx/water efflux) during the dry periods at both sites. Our data show that DWF is low in a non‐drinking bird that obtains its water through food, and that demands for evaporative water loss on very hot days (maximum Tair of 40–44 °C) may exceed water intake rates during hot and dry periods. Species that do not have opportunities to drink will experience strong trade‐offs between thermoregulation, hydration state and activity levels as temperatures increase.
Floater interference reflects territory quality in the Spanish Imperial Eagle Aquila adalberti: a test of a density‐dependent mechanism
Authors: Ferrer Miguel , Morandini Virginia , Newton Ian
Published: July 2015

We report on an 11‐year study of floater interference in a population of Spanish Imperial Eagles Aquila adalberti. We analysed changes over the years in the productivity of 15 territories to test predictions of two hypotheses of density‐dependent productivity in relation to the presence of floaters (birds without territories). According to the ‘interference' hypothesis, the frequency of intrusion by floaters increases with density, resulting in a decrease in productivity. Thus, in a high‐density population a negative relationship between floater intrusions and productivity of the territory is expected. In contrast, under the ‘habitat heterogeneity' hypothesis, as density increases a higher proportion of individuals is forced to occupy lower quality habitats. Support of this hypothesis requires that floaters detect differences in quality among territories and preferentially visit the better quality territories. Consequently, a positive relationship between floater intrusions and productivity is expected. Results showed that floaters tended to visit their natal area at the beginning of the breeding season. Among floater Eagles, males made significantly more intrusions per day than did females, but females stayed in the natal population for longer each year than males. Floater intrusions and productivity were highly positively correlated, supporting the ‘habitat heterogeneity' hypothesis; individuals were apparently able to assess the quality of a territory and, at the frequencies observed, their interference with the breeding pair had no obvious negative effect on productivity.
The structure and robustness of nocturnal Lepidopteran pollen‐transfer networks in a Biodiversity Hotspot
Authors: Banza Paula , Belo Anabela D. F. , Evans Darren M.
Published: July 2015

The role of nocturnal moths within plant‐pollinator networks is poorly understood but could be important in the context of declining biodiversity and the ecosystem services they provide.

For the first time, this study examined the role of moths as pollen vectors in the Mediterranean Biodiversity Hotspot. Light traps were used to sample moths in SW Portugal in 2010. The pollen on moth head parts was collected, identified, and counted to construct a nocturnal pollen‐transfer and flower‐visitor network.

A total of 257 moths belonging to 95 species were captured in 11 trapping sessions in 2010; 196 moths (76%) carried pollen and the total number of pollen grains counted and identified was 9064.

The pollen‐transfer network exhibited a high degree of selectivity (H2′) but low robustness when the most‐to‐least connected plants were made extinct in the network. The flower‐visitor network (based on the incidences of interactions by individual moths), however, exhibited high linkage density and was generally more robust to simulated plant or moth extinction.

Including nocturnal moths in plant–pollinator networks will provide a better understanding of their robustness to species extinctions due to environmental change as well as the impacts on ecosystem structure and functioning. Nocturnal pollen–transfer networks could be developed for identifying key species for targeted conservation.
Nanoemulsion: process selection and application in cosmetics – a review
Authors: Yukuyama M. N. , Ghisleni D. D. M. , Pinto T. J. A. , Bou‐Chacra N. A.
Published: July 2015

Synopsis

In recent decades, considerable and continuous growth in consumer demand in the cosmetics field has spurred the development of sophisticated formulations, aiming at high performance, attractive appearance, sensorial benefit and safety. Yet despite increasing demand from consumers, the formulator faces certain restrictions regarding the optimum equilibrium between the active compound concentration and the formulation base taking into account the nature of the skin structure, mainly concerning to the ideal penetration of the active compound, due to the natural skin barrier. Emulsion is a mixture of two immiscible phases, and the interest in nanoscale emulsion has been growing considerably in recent decades due to its specific attributes such as high stability, attractive appearance and drug delivery properties; therefore, performance is expected to improve using a lipid‐based nanocarrier. Nanoemulsions are generated by different approaches: the so‐called high‐energy and low‐energy methods. The global overview of these mechanisms and different alternatives for each method are presented in this paper, along with their benefits and drawbacks. As a cosmetics formulation is reflected in product delivery to consumers, nanoemulsion development with prospects for large‐scale production is one of the key attributes in the method selection process. Thus, the aim of this review was to highlight the main high‐ and low‐energy methods applicable in cosmetics and dermatological product development, their specificities, recent research on these methods in the cosmetics and consideration for the process selection optimization. The specific process with regard to inorganic nanoparticles, polymer nanoparticles and nanocapsule formulation is not considered in this paper.
Comparison of ProTaper, RaCe and Safesider instruments in the induction of dentinal microcracks: a micro‐CT study
Authors: Ceyhanli K. T. , Erdilek N. , Tatar İ. , Celik D.
Published: July 2015

Aim

To evaluate ex vivo the incidence of microcracks in root dentine after canal preparation with ProTaper Universal (PTU), RaCe or Safesider instrumentation systems using microcomputed tomography (micro‐CT).

Methodology

Thirty freshly extracted mandibular molars with two separate mesial canals and foramina were used. The roots were allocated into three similar groups according to curvature angles and radii of the canals and lengths of the roots. Distal roots were removed and mesial roots were embedded in acrylic resin and instrumented with the PTU, RaCe or Safesider systems up to size 30 (F3 for PTU, size 30, 0.04 taper for RaCe and Safesider) for all instrumentation groups. Dentinal microcracks were evaluated on micro‐CT images of the apical 10 mm of the roots with 1‐mm intervals. Two experienced observers evaluated the images twice in a blinded fashion. The presence of dentinal microcracks (complete/incomplete cracks and craze lines) was noted and analysed statistically using McNemar and chi‐square tests (P = 0.05).

Results

There were microcracks on uninstrumented root sections. All instrumentation systems significantly increased the number of dentinal microcracks when compared to preoperative specimens (P < 0.05). There were new microcracks on the postoperative samples. The PTU system (42%) led to greater number of post‐instrumentation microcracks than Safesider (35%) and RaCe (25%) systems, respectively. The difference between PTU and RaCe system was significant (P < 0.05).

Conclusions

All instrumentation systems significantly increased the number of microcracks compared with preoperative specimens. The PTU system generated more post‐instrumentation dentinal microcracks than the RaCe system.
Factorial analysis of variables influencing mechanical characteristics of a post used to restore a root filled premolar using the finite element stress analysis combined with the Taguchi method
Authors: Wang C. H. , Du J. K. , Li H. Y. , Chang H. C. , Chen K. K.
Published: July 2015

Aims

To identify the contributions of various mechanical factors related to cast posts in a root filled tooth by integration of finite element analysis and the Taguchi method. The investigated factors included post‐length (Post‐L), post‐diameter (Post‐D), ferrule height (Ferrule‐H) and periodontal bone loss (Bone‐H).

Methodology

Three‐dimensional finite element models of a mandibular premolar were developed to simulate a root filled tooth. For each investigated factor, three levels and values were selected, and based on a Taguchi orthogonal array, nine models were established. An inclination load of 100 N was applied on the buccal cusp tip, and the dentine peak von Mises stress was used as the evaluation index.

Results

Among the four investigated factors, Bone‐H was the predominant mechanical factor, with a contribution of more than 97%. Among the other three controllable factors of post‐design, Post‐D was the primary contributing factor and was almost five times more substantial than the least contributing factor, Ferrule‐H.

Conclusion

Bone‐H was the predominant factor influencing the stress of the dentine on a post‐restored root filled tooth, followed by the Post‐D, Post‐L and Ferrule‐H. For patients with severe periodontal bone loss, a large post‐diameter is essential for endodontic post‐restoration treatment.
Accessory roots and root canals in human anterior teeth: a review and clinical considerations
Authors: Ahmed H. M. A. , Hashem A. A.
Published: July 2015

Anterior teeth may have aberrant anatomical variations in the number of roots and root canals. A review of the literature was conducted using appropriate key words in major endodontic journals to identify the available reported cases as well as experimental and clinical investigations on accessory roots and root canals in anterior teeth. After retrieving the full text of related articles, cross‐citations were identified, and the pooled data were then discussed. Results revealed a higher prevalence in accessory root/root canal variations in mandibular anterior teeth than in maxillary counterparts. However, maxillary incisor teeth revealed the highest tendency for accessory root/root canal aberrations caused by anomalies such as dens invaginatus and palato‐gingival groove. Primary anterior teeth may also exhibit external and internal anatomical variations in the root, especially maxillary canines. Therefore, dental practitioners should thoroughly assess all teeth scheduled for root canal treatment to prevent the undesirable consequences caused by inadequate debridement of accessory configurations of the root canal system.
In vitro Cytotoxicity, Apoptotic and Hemolysis Assay of Kalsilite‐Based Glass Ceramics for Dental Veneering Application
Authors: Kumar Pattem , Singh Vinay , Hira Sumit , Manna Partha , Kumar Pradeep
Published: July 2015

Nanocrystalline kalsilite material was synthesized via a gel‐trapped coprecipitation for dental veneering applications. The prepared kalsilite powder was further mixed with a separately processed low temperature frit (LTF), in different weight ratio to optimize its coefficient of thermal expansion (CTE). These mixes were analyzed for their flexural strength and surface morphology. The cytocompatibility of mixes was investigated with reference to their effect on human buccal epithelial cells (SCC‐25). The flexural strength and CTE values of prepared kalsilite have been found to be comparable to the values obtained for a commercial opaque VMK 95 1M2 (product no. B333250; VITA Zahnfabrik H. Rauter GmbH KG Postfach 1338 D‐79704 Bad Sackingen, Germany). This confirmed the feasibility of prepared kalsilite material for dental veneering application. Kalsilite glass‐ceramic materials caused moderate levels of apoptosis in SCC‐25 cells at higher concentrations and were also tolerable by human RBC as evaluated from hemolytic assay. Human buccal epithelial cells were tolerant to kalsilite glass‐ceramic materials at lower concentrations although higher concentration (500 μg/mL) caused moderate damages in proliferative capacity of SCC‐25. The improved mechanical and biological properties of the prepared kalsilite confirmed its potential use in dental veneering.
Improvement in sprouted wheat flour functionality: effect of time, temperature and elicitation
Authors: Świeca Michał , Dziki Dariusz
Published: July 2015

This study was aimed at optimising conditions of wheat germination (temperature, time of sprouting and elicitation) to improve its phenolics content, antioxidative capacity and nutritional quality. Total phenolics and antioxidant potential were improved most effectively after 4 days of sprouting at 20 °C. The highest reducing ability and the ability to quench free radicals (1.24 mg Trolox equivalent (TE) g−1 d.m. and 0.38 mg TE g −1 d.m., respectively) were determined for 4‐day‐old control and willow + yeast elicited sprouts germinated at 20 °C. The kinetics of starch and protein mobilisation were affected by sprouting conditions. The highest protein digestibility was found for 2‐day‐old sprouts germinated at 20 °C, whereas the lowest for 4‐day‐old sprouts germinated at 25 °C. Starch was more effectively mobilised during germination at 25 °C. Sprouting conditions were found to effectively modify the quality of sprouts. A key role was ascribed to time and temperature of sprouting, whereas the effect of elicitation was marginal.
Influence of roasting pretreatment on high‐oleic rapeseed oil quality evaluated by analytical and sensory approaches
Authors: Rękas Agnieszka , Wroniak Małgorzata , Rusinek Robert
Published: July 2015

Qualitative and quantitative effects on the contents of minor components of cold‐pressed high‐oleic rapeseed oil (HORO) were evaluated in a function of different roasting temperatures (80, 100, 120 and 140 °C). Along with roasting temperature elevation, a significant increase in the content of total tocopherols up to 32% (mainly γ‐T homologue) and a slight increase of total sterols concentration (up to 5%) were observed, whereas no significant changes in the fatty acid composition occurred during seeds thermal pretreatment. Additionally, an increased degree of hydrolysis and lipid oxidation was reported; however, obtained results were within codex limits. The peroxide value of the oil ranged from 1.30 to 2.34 mEq O2 kg−1, while the acid value did not exceed 0.46 mg/KOH g. Principal component analysis was capable of differentiating between rapeseed oils acquired from seeds pretreated with different roasting temperatures.
Soy sauce odour induces and enhances saltiness perception
Authors: Chokumnoyporn Napapan , Sriwattana Sujinda , Phimolsiripol Yuthana , Torrico Damir Dennis , Prinyawiwatkul Witoon
Published: July 2015

Developing products with reduced sodium content is one alternative for consumers interested in reducing their daily sodium intake. In this research, we determined whether soy sauce odour could induce and enhance salty taste perception in salt solution models. The sensory threshold technique (ASTM E679‐04, the ascending forced choice method of limits) was used to determine thresholds at 25 °C. Group best estimate threshold geometric means of soy sauce odour were expressed as parts‐per‐billion (ppb, v/v). At 28.45 ppb (recognition threshold), soy sauce odour could induce salty taste in 0.03 mm NaCl solution (in which salty taste was undetectable without soy sauce odour) and at 122.71 ppb (difference threshold), it enhanced salty taste (i.e. saltier) perception in 20 mm NaCl solution. Through the odour–taste interaction concept, this study demonstrated that the soy sauce odour could induce and enhance salty taste perception, which could be applied in the development of reduced‐sodium foods.
Antioxidant, enzyme inhibitory and antiproliferative activity of polyphenolic‐rich fraction of commercial dry ginger powder
Authors: Sakulnarmrat Karunrat , Srzednicki George , Konczak Izabela
Published: July 2015

Polyphenolic‐rich fraction obtained from locally produced dry ginger powder in Brahmaputra valley, India, and commercially available dry ginger (Zingiber officinale) rhizome powder consisted of [6]‐gingerol (41.9%), [6]‐shogaol (24.3%), 1‐dehydro‐6‐gingerdione (8.6%), [8]‐gingerol (7.2%), [10]‐gingerol (5.1%), [6]‐paradol (5.9%) and [4]‐gingerol (3.6%). Traces of methyl‐[6]‐gingerol and methyl‐[8]‐gingerol (both at 1.8%) were also detected. The fraction exhibited high antioxidant capacity [total phenolics (TP), ferric reducing antioxidant power (FRAP), oxygen radical absorbance capacity (ORAC) and cellular antioxidant activity (CAA assay)], effectively inhibited isolated digestive enzymes (α‐glucosidase, pancreatic lipase and angiotensin converting enzyme) and inhibited the proliferation of colon (HT29; IC50 of 1.06 ± 0.02 mg mL−1) and gastric (AGS IC50 of 1.29 ± 0.03 mg mL−1) adenocarcinoma cells, without affecting the proliferation of their nontransformed counterparts (IC50 > 2.0 mg mL−1). This case study demonstrates that locally produced and commercially available dry ginger powder from Brahmaputra valley, India, retains numerous food components that may enhance human health.
Maternal smoking in pregnancy association with childhood adiposity and blood pressure
Authors: Li L. , Peters H. , Gama A. , Carvalhal M. I. M. , Nogueira H. G. M. , Rosado‐Marques V. , Padez C.
Published: July 2015

Background

Maternal smoking during pregnancy has been associated with increased risk of childhood overweight/obesity defined by body mass index (BMI). We examined its association with a range of adiposity measures and cardiovascular indicators in children aged 3–10 years.

Methods

We used data from a cross‐sectional study of schoolchildren across mainland Portuguese districts (2009–2010). We applied quantile regressions to examine maternal smoking associations with adiposity (n = 17 286), blood pressure (BP) and resting pulse rate (RPR) (n ≈ 2500) measures across the age range, adjusting for prenatal and early life factors.

Results

Maternal smoking during pregnancy was associated with increases in offspring adiposity levels. The difference in median BMI between children of smokers and non‐smokers was 0.39 kg m−2 (95% confidence interval: 0.25, 0.53) in boys and 0.46 kg m−2 (0.31, 0.62) in girls; 0.55 cm (0.24, 0.87) and 0.82 cm (0.45, 1.19), respectively, in median waist circumference; and 0.94 mm (0.49, 1.40) and 1.47 mm (0.87, 2.07) in median sum of (triceps, subscapular, suprailiac) skin‐folds. The associations appeared to be stronger with increasing age. The differences in the 90th centile tended to be greater than those in median. There was no consistent association of maternal smoking with BP and RPR.

Conclusions

Children whose mother smoked during pregnancy had higher adiposity levels than children of non‐smokers, across several measures, particularly among older children. Although there was no consistent association with cardiovascular indicators, maternal smoking association with childhood obesity may have implications for cardiovascular risk factors over the life course.
Heavy Ethanol Consumption Aggravates the Ischemic Cerebral Injury by Inhibiting ALDH2
Authors: Wang Wei , Lin Li-Li , Guo Jin-Min , Cheng Yan-Qiong , Qian Jiao , Mehta Jawahar L. , Su Ding-Feng , Luan Ping , Liu Ai-Jun
Published: July 2015

Background

Heavy ethanol consumption is widely accepted as a risk for ischemic stroke. The molecular mechanisms of ethanol-induced brain injury have not been fully understood.

Aim

This study aims to find out the mechanism of the ischemic cerebral injury.

Methods

We used Sprague-Dawley rats with transient middle cerebral artery occlusion for acute experiment and stroke-prone spontaneously hypertensive rats for long-term experiment in vivo, and oxygen-glucose deprivation model in vitro to define a detrimental effect of different doses of ethanol on ischemic stroke injury. We also used mitochondrial aldehyde dehydrogenase 2 knockdown/overexpression or inhibitor/activator to investigate mechanism of the adverse effects of ethanol.

Results

High-dose ethanol (36% of calorie derived from ethanol) significantly increased the infarct size in rats ( P < 0·01) and decreased the survival time of stroke-prone spontaneously hypertensive rats by about 20%. Six-week treatment with high-dose ethanol changed a distribution of isoelectric point of aldehyde dehydrogenase 2 and inhibited aldehyde dehydrogenase 2 activity in brain. High dose of ethanol increased the cerebral acetaldehyde level, and increased 4-hydroxy-2-nonenal and malondialdehyde in serum of rats with middle cerebral artery occlusion. The activator of aldehyde dehydrogenase 2, Alda-1 abolished neuronal cells death and ischemic injury induced by ethanol and the inhibitor reversed the injurious effects. An overexpression of aldehyde dehydrogenase 2 completely abolished the increased infarct size and neurological deficit score by ethanol. Conversely, knockdown of aldehyde dehydrogenase 2 increased the infarct size and exaggerated the cerebral injury induced by ethanol.

Conclusions

High concentrations of ethanol aggravate cerebral injury by inhibiting of aldehyde dehydrogenase 2 and inducing excess accumulation of aldehydes.
Prevalence of stroke symptoms among stroke-free residents: first national data from Lebanon
Authors: Farah Rita , Zeidan Rouba Karen , Chahine Mirna N. , Asmar Roland , Chahine Ramez , Salameh Pascale , Hosseini Hassan
Published: July 2015

Background

Stroke symptoms are common among people without a history of stroke or transient ischemic attack. Reported stroke symptoms may represent stroke episodes that failed to reach the threshold for clinical diagnosis.

Aims

This study aimed to assess in the Lebanese population the prevalence of self-reported stroke symptoms in a stroke-and transient ischemic attack-free population, and the association of these symptoms with major risk factors for stroke.

Methods

We carried out a cross-sectional study using a multistage cluster sample across Lebanon. We interviewed residents aged 40 years and more. Stroke symptoms were assessed using the Questionnaire for Verifying Stroke-Free Status.

Results

We included 1515 individuals (mean age was 57.2 ± 12.4 years, 783 women, 51.7%). Among 1460 participants stroke- and transient ischemic attack-free, 175 had experienced at least one stroke symptom (12.1%, 95% CI 9.9%-14.3%). Arterial hypertension (adjOR 4.37, 95% CI 2.68-7.12), history of heart disease (adjOR 3.34, 95% CI 2.00-5.56), current waterpipe smoking (adjOR 3.88, 95% CI 2.33-6.48), current and former cigarette smoking (adjOR 1.84, 95% CI 1.18-2.87 and adjOR 2.01, 95% CI 1.13-3.5, respectively), psychological distress (adjOR 1.04, 95% CI 1.02-1.05), the Mediterranean diet score (adjOR 0.87, 95% CI 0.76-0.99), and regular physical activity (adjOR 0.45, 95% CI 0.26-0.77) were independently associated with stroke symptoms.

Conclusions

This is the first study conducted in the Middle East, assessing self-reported stroke symptoms among stroke-free residents. Our study showed that almost one in eight residents without a history of stroke or transient ischemic attack has had stroke symptoms. Major vascular risk factors are associated with these symptoms, thus allowing for prevention strategies.
Hyponatremia predicts mortality after stroke
Authors: Soiza Roy L. , Cumming Kirsten , Clark Allan B. , Bettencourt-Silva Joao H. , Metcalf Anthony K. , Bowles Kristian M. , Potter John F. , Myint Phyo K.
Published: July 2015

Background

Hyponatremia, the commonest electrolyte imbalance encountered in clinical practice, is associated with adverse outcomes. Despite this, understanding of the association between hyponatremia and stroke mortality outcome is limited.

Aims

To investigate the association between admission serum sodium and mortality at various time-points after stroke.

Methods

Cases of acute stroke admitted to Norfolk and Norwich University Hospital consecutively from January 2003 until June 2013 were included, with mortality outcomes ascertained until the end of December 2013. Odds ratios or hazards ratios for death were constructed for various time-points (within seven-days, 8-30 days, within one-year, and over full follow-up).

Results

There were 8540 participants included (47.4% male, mean age 77.3 (±12.0) years). Point prevalence of hypernatremia and hyponatremia were 3.3% and 13.8%, respectively. In fully adjusted models controlling for age, gender, prestroke modified Rankin score, stroke type, Oxford community stroke project class, and laboratory biochemical and hematological results, the odds ratio (up to one-year)/hazards ratio (for full follow-up) for the above time-points were 1.00, 1.11, 1.03, 1.05 for mild hyponatremia; 1.97, 0.78, 1.11, 1.2 for moderate hyponatremia; 3.31, 1.57, 2.45, 1.67 for severe hyponatremia; and 0.47, 1.23, 1.30, 1.10 for hypernatremia. When stratified by age groups, outcomes were poorer in younger hyponatremic patients (aged <75 years).

Conclusion

Hyponatremia is prevalent in acute stroke admissions and is independently associated with higher mortality in patients <75 years).
Direct medical cost of stroke in Singapore
Authors: Ng Charmaine Shuyu , Toh Matthias Paul Han Sim , Ng Jiaying , Ko Yu
Published: July 2015

Background

Globally, stroke is recognized as one of the main causes of long-term disability, accounting for approximately 5.7 million deaths each year. It is a debilitating and costly chronic condition that consumes about 2-4% of total healthcare expenditure.

Aims

To estimate the direct medical cost associated with stroke in Singapore in 2012 and to determine associated predictors.

Methods

The National Healthcare Group Chronic Disease Management System database was used to identify patients with stroke between the years 2006 and 2012. Estimated stroke-related costs included hospitalizations, accident and emergency room visits, outpatient physician visits, laboratory tests, and medications.

Results

A total of 700 patients were randomly selected for the analyses. The mean annual direct medical cost was found to be S$12 473.7, of which 93.6% were accounted for by inpatient services, 4.9% by outpatient services, and 1.5% by A&E services. Independent determinants of greater total costs were stroke types, such as ischemic stroke ( P = 0.005), subarachnoid hemorrhage ( P < 0.001) and intracerebral haemorrhage ( P < 0.001), shorter poststroke period, more than one complications ( P = 0.045), and a greater number of comorbidities ( P = 0.001).

Conclusion

There is a considerable economic burden associated with stroke in Singapore. The type of stroke, length of poststroke period, and stroke complications and comorbidities are found to be associated with the total costs. Efforts to reduce inpatient costs and to allocate health resources to focus on the primary prevention of stroke should become a priority.
Migrant Domestic Workers in Asia: Transnational Variations and Policy Concerns
Authors: Islam M. Rezaul , Cojocaru Stefan
Published: July 2015

The labour force of the migrant domestic workers (MDWs) has become one of the significant policy concerns in Asia. Most of the Asian countries are not following (or not to an equal extent) the Domestic Workers Convention 2011 (No. 189) which has been adopted by the International Labour Organization (ILO). The objective of this article is to show the transnational variations and policy concerns of the MDWs in Asia. Based on content analysis, the authors found that there are considerable transnational variations of the MDWs in terms of their age and nature of work, legal identity, working hours, and remuneration across Asian countries. These variations have serious policy concerns in a number of areas such as lack of available data of the MDWs, working conditions, exploitations, and gender issues. The findings of the article would be an important guideline for adopting new legislation and labour policy for the MDWs in Asia.
Contribution of dendritic cells to the autoimmune pathology of systemic lupus erythematosus
Authors: Mackern‐Oberti Juan P. , Llanos Carolina , Riedel Claudia A. , Bueno Susan M. , Kalergis Alexis M.
Published: July 2015

Systemic lupus erythematosus (SLE) is a heterogeneous disease in which excessive inflammation, autoantibodies and complement activation lead to multisystem tissue damage. The contribution of the individual genetic composition has been extensively studied, and several susceptibility genes related to immune pathways that participate in SLE pathogenesis have been identified. It has been proposed that SLE takes place when susceptibility factors interact with environmental stimuli leading to a deregulated immune response. Experimental evidence suggests that such events are related to the failure of T‐cell and B‐cell suppression mediated by defects in cell signalling, immune tolerance and apoptotic mechanism promoting autoimmunity. In addition, it has been reported that dendritic cells (DCs) from SLE patients, which are crucial in the modulation of peripheral tolerance to self‐antigens, show an increased ratio of activating/inhibitory receptors on their surfaces. This phenotype and an augmented expression of co‐stimulatory molecules is thought to be critical for disease pathogenesis. Accordingly, tolerogenic DCs can be a potential strategy for developing antigen‐specific therapies to reduce detrimental inflammation without causing systemic immunosuppression. In this review article we discuss the most relevant data relative to the contribution of DCs to the triggering of SLE.
CD8 T‐cell priming upon mRNA vaccination is restricted to bone‐marrow‐derived antigen‐presenting cells and may involve antigen transfer from myocytes
Authors: Lazzaro Sandra , Giovani Cinzia , Mangiavacchi Simona , Magini Diletta , Maione Domenico , Baudner Barbara , Geall Andrew J. , De Gregorio Ennio , D'Oro Ugo , Buonsanti Cecilia
Published: July 2015

Self‐amplifying mRNAs (SAM®) are a novel class of nucleic acid vaccines, delivered by a non‐viral delivery system. They are effective at eliciting potent and protective immune responses and are being developed as a platform technology with potential to be used for a broad range of targets. However, their mechanism of action has not been fully elucidated. To date, no evidence of in vivo transduction of professional antigen‐presenting cells (APCs) by SAM vector has been reported, while the antigen expression has been shown to occur mostly in the muscle fibres. Here we show that bone‐marrow‐derived APCs rather than muscle cells are responsible for induction of MHC class‐I restricted CD8 T cells in vivo, but direct transfection of APCs by SAM vectors is not required. Based on all our in vivo and in vitro data we propose that upon SAM vaccination the antigen is expressed within muscle cells and then transferred to APCs, suggesting cross‐priming as the prevalent mechanism for priming the CD8 T‐cell response by SAM vaccines.
Opting in to Opt out? Emigration and Group Participation in Albania
Authors: Cattaneo Cristina
Published: July 2015

The objective of this paper is to determine whether the participation in social organizations represents a complement or a substitute with respect to international emigration. To address this research question, an instrumental variable approach is used, as group participation and international migration are potentially jointly determined. This is the case if the family considers emigration and group participation as alternative strategies to cope with uncertainty or a liquidity need, or alternatively when the family decides to invest in group participation in order to gain information helpful to emigrate. The results of the empirical estimation reveal that families participating in social organizations are more likely to migrate internationally and therefore social networks act as a complement for emigration. This may indicate that families recourse to social networks in order to collect important information that facilitates international migration.
The Effect of Residential Concentration on Voter Turnout among Ethnic Minorities
Authors: Bhatti Yosef , Hansen Kasper M.
Published: July 2015

Utilizing a large and unique dataset composed of government records, we study the widely contested effect of co-ethnic residential concentrations on voter turnout. Non-Western immigrants are moderately affected by the concentration of co-ethnic voters in their neighborhoods. As the local concentration of same-ethnicity voters increases, so does the individual's propensity to turn out for the election. In general, the concentration of non-Western immigrants in the neighborhood has only a very limited impact on an immigrant's propensity to vote. Finally, we investigate the possible mobilizing effect of local candidates and, in particular, local co-ethnic candidates on voter turnout. We find that the presence of candidates in general and co-ethnic candidates running for office in a neighborhood has a moderate positive mobilization effect. However, taking this factor into account, the effect of residential concentrations was not eliminated.
Drugs Around the Corner: Domestic Drug Markets and Violence in Colombia and Mexico
Authors: Durán-Martínez Angélica
Published: July 2015

Over the past decade, drug consumption has increased in Colombia and Mexico, countries traditionally concerned with drug production and trafficking. Governments and observers have associated this growth with spikes in violence. Drawing on drug consumption surveys and fieldwork in four cities, this study argues that contrary to this perception, there is no automatic connection between domestic drug markets and violence. Violence depends on whether large drug-trafficking organizations (DTOs) control low-level street dealers and on whether those DTOs have a market monopoly at the local level. When dealers are independent, violence might be sporadic, but when DTOs control dealers, violence can explode (given competition between DTOs) or implode (if one organization holds a monopoly). Control over dealers provides DTOs not only income but also informants and armed muscle. This article also shows that domestic drug markets are not new, and have grown incrementally in the past two decades.
The Politics of Building Municipal Institutional Effectiveness in Chile
Authors: Pribble Jennifer
Published: July 2015

Institutional effectiveness varies widely across Chile's 346 municipalities. Whereas some local governments seem to work with impeccable precision, others struggle to deliver basic services and welfare benefits to the population. This article seeks to explain why such variation exists; it combines quantitative and qualitative evidence to show how mayors can play a crucial role in building institutional effectiveness. The study focuses on the administration of Chile's municipal job placement offices. It finds that municipalities where mayors have held office for three or more consecutive terms exhibit stronger institutional capacity than those localities where electoral turnover is the norm. The analysis, therefore, underscores an interesting finding: electoral competition has the potential both to improve and to undermine administrative capacity.
Additive Manufacturing of Ceramics: Issues, Potentialities, and Opportunities
Authors: Zocca Andrea , Colombo Paolo , Gomes Cynthia M. , Günster Jens
Published: July 2015

Additive manufacturing (AM) is a technology which has the potential not only to change the way of conventional industrial manufacturing processes, adding material instead of subtracting, but also to create entirely new production and business strategies. Since about three decades, AM technologies have been used to fabricate prototypes or models mostly from polymeric or metallic materials. Recently, products have been introduced into the market that cannot be produced in another way than additively. Ceramic materials are, however, not easy to process by AM technologies, as their processing requirements (in terms of feedstock and/or sintering) are very challenging. On the other hand, it can be expected that AM technologies, once successful, will have an extraordinary impact on the industrial production of ceramic components and, moreover, will open for ceramics new uses and new markets.
On the Rapid Synthesis of the Ternary Mo2GaC
Authors: Hu Chunfeng , Li Chao , Halim Joseph , Kota Sankalp , Tallman Darin J. , Barsoum Michel W.
Published: July 2015

The reaction path to form the Mo2GaC MAX phase starting with Mo, Ga, and C (molar ratio, 2:1.2:1) powders was investigated in the 850°C and 1000°C temperature range. It was found that Mo2GaC could be synthesized from reactions between Mo3Ga and C or Mo2C and Ga. Powders that contained >90 wt% Mo2GaC were successfully fabricated by heating a 1:1.4 molar ratio of Mo2C:Ga to 900°C for 24 h under flowing argon, followed by the dissolution of excess Ga by HCl. The a‐ and c‐lattice parameters were measured to be 3.022(1) and 13.179(5) Å.
Nurse′s A‐Phase: Synthesis and Characterization in the Binary System Ca2SiO4–Ca3(PO4)2
Authors: Lugo Gerardo J. , Mazón Patricia , Baudin Carmen , De Aza Piedad N.
Published: July 2015

In the present study, a new single phase Si–Ca–P‐based ceramic was obtained by conventional sintering of compacted mixtures of calcium hydrogen phosphate anhydrous, calcium carbonate, and silicon oxide. The synthesis conditions were the followings: heated up to 1550°C for a total period of time of 72 h (3 d), with quenching in liquid nitrogen, milling, pressing, and reheating every 24 h. Second, heating at 1300°C/3 h and subsequent annealed at 1200°C/24 h. Mineralogical and microstructural characterization of the obtained Si–Ca–P‐based material was determined by Differential Thermal Analysis, X‐ray diffraction, Scanning Electron Microscopy with attached wavelength dispersive spectroscopy, Micro‐Raman and Fourier Transform Infrared Spectrometer. The results showed a single Si–Ca–P phase material with a Ca2SiO4/Ca3(PO4)2 molar ratio equal to 2:1. The parameters of the Weibull distribution of strength, determined by diametrical compression of disks, were: modulus, m = 13, and characteristic strength σ0 = 0.60 MPa.
Direct Crystallization of Sulfate‐Type Layered Hydroxide, Derivation of (Gd,Tb)2O3 Green Phosphor, and Photoluminescence
Authors: Wang Xuejiao , Li Ji‐Guang , Zhu Qi , Sun Xudong
Published: July 2015

The sulfate‐type layered hydroxides of (Gd1−xTbx)2(OH)5(SO4)0.5·nH2O (x = 0.06–0.10) have been directly crystallized via hydrothermal reaction at 120°C and pH ~10.0, without the need of conventional anion exchange. The primary crystallites were found to be thin platelets having lateral sizes of ~450–1000 nm and thicknesses of ~65–85 nm. Combined analysis by DTA/TG, FTIR, and XRD revealed that the layered compounds convert into cubic (Gd1−xTbx)2O3 solid‐solutions through dehydration, dehydroxylation, and desulfuration up to ~1200°C and via a (Gd1−xTbx)2O2.5(SO4)0.5 intermediate phase. Optical spectroscopies found that the layered compounds and the derived oxides have their strongest 4f8→4f75d1 transition excitations at ~248 and 305 nm and optimal Tb3+ contents of 9 at.% (x = 0.09) and 8 at.%, respectively. Both the types of materials exhibit the strongest emission at ~544 nm (the 5D4→7F5 transition of Tb3+), but the oxide has an emission intensity ~3 times that of the hydroxide. Fluorescence lifetime of the 544 nm green emission was found to decrease from 2.45 to 2.15 ms along with increasing Tb3+ content for the oxide, and smaller values of ~1.55 ms were derived for the layered hydroxides.
Evaluation of conceptual frameworks applicable to the study of isolation precautions effectiveness
Authors: Cohen Catherine Crawford , Shang Jingjing
Published: July 2015

Aims

A discussion of conceptual frameworks applicable to the study of isolation precautions effectiveness according to Fawcett and DeSanto‐Madeya's (2013) evaluation technique and their relative merits and drawbacks for this purpose.

Background

Isolation precautions are recommended to control infectious diseases with high morbidity and mortality, but effectiveness is not established due to numerous methodological challenges. These challenges, such as identifying empirical indicators and refining operational definitions, could be alleviated though use of an appropriate conceptual framework.

Design

Discussion paper.

Data sources

In mid‐April 2014, the primary author searched five electronic, scientific literature databases for conceptual frameworks applicable to study isolation precautions, without limiting searches by publication date.

Implications for nursing

By reviewing promising conceptual frameworks to support isolation precautions effectiveness research, this article exemplifies the process to choose an appropriate conceptual framework for empirical research. Hence, researchers may build on these analyses to improve study design of empirical research in multiple disciplines, which may lead to improved research and practice.

Conclusion

Three frameworks were reviewed: the epidemiologic triad of disease, Donabedian's healthcare quality framework and the Quality Health Outcomes model. Each has been used in nursing research to evaluate health outcomes and contains concepts relevant to nursing domains. Which framework can be most useful probably depends on whether the study question necessitates testing multiple interventions, concerns pathogen‐specific characteristics and yields cross‐sectional or longitudinal data. The Quality Health Outcomes model may be slightly preferred as it assumes reciprocal relationships, multi‐level analysis and is sensitive to cultural inputs.