bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment outcomes after the introduction of a new seizure management protocol
Authors: Gillinder Lisa , Lehn Alexander , Brown Helen , Dionisio Sasha
Published: February 2018

Background/Aim

The present study aims to determine qualitative outcomes of presentations with acute recurrent seizures or status epilepticus to the emergency department of our institution after the introduction of a new seizure management protocol.

Methods

We performed a retrospective analysis on two cohorts of patients for all presentations to the emergency department of our institution. Presentations were reviewed from January to July pre‐protocol introduction and the same period post‐protocol. Patients were included if they were treated for acute recurrent seizures or status epilepticus. The protocol applied a strict treatment regimen and used levetiracetam, valproate and phenobarbitone in place of phenytoin.

Results

A total of 77 patients was included from the pre‐protocol cohort and 72 from the post‐protocol group. There was a significant reduction in intensive care unit (ICU) admission (seven patients in cohort 1 and 0 patients in cohort 2) and adverse drug reactions (18 patients in cohort 1 and four patients in cohort 2). There was a trend towards fewer deaths.

Conclusion

The introduction of the new seizure management protocol assessed in this study has resulted in fewer ICU admissions, adverse drug reactions and most importantly fewer patient deaths. This is likely attributable to a combination of improved efficacy of the newer antiepileptic agents and a clearly defined protocol directed therapy.
The relationship between haemoglobin level and type 1 diabetic nephropathy in Han patients in Anhui, China
Authors: Jiang Jun , Lan Lei , Zhou Xiaowan , Peng Li , Ren Wei
Published: February 2018

Background/Aim

Recent studies have shown that low haemoglobin (Hb) levels promote the progression of chronic kidney disease. This study assessed the relationship between Hb level and type 1 diabetic nephropathy (DN) in Han patients in Anhui, China.

Methods

There was a total of 236 patients diagnosed with type 1 diabetes mellitus (T1DM) seen between January 2014 and December 2016 in our centre. Haemoglobin levels in patients with DN were compared with those without DN. The relationship between Hb level and the urinary albumin–creatinine ratio (ACR) was examined by Spearman's correlational analysis and multiple stepwise regression analysis. The binary logistic multivariate regression analysis was performed to analyse the correlated factors for type 1 DN, calculate the odds ratio (OR) and 95% confidence interval (CI). The predicting value of Hb level for DN was evaluated by area under receiver operation characteristic curve (AUROC) for discrimination and Hosmer–Lemeshow goodness‐of‐fit test for calibration.

Results

The average Hb levels in the DN group (116.1 ± 20.8 g/L) were significantly lower than the non‐DN group (131.9 ± 14.4 g/L), P < 0.001. Hb levels were independently correlated with the urinary ACR in multiple stepwise regression analysis. The logistic multivariate regression analysis showed that the Hb level (OR: 0.936, 95% CI: 0.910–0.963, P < 0.001) was inversely correlated with DN in patients with T1DM. In sub‐analysis, low Hb level (Hb < 120 g/L in female, Hb < 130 g/L in male) was still negatively associated with DN in patients with T1DM. The AUROC was 0.721 (95% CI: 0.655–0.787) in assessing the discrimination of the Hb level for DN. The value of P was 0.593 in Hosmer‐Lemeshow goodness‐of‐fit test.

Conclusions

In patients with T1DM, the Hb level is inversely correlated with urinary ACR and DN.
Identifying and prioritizing topics for evidence‐based geriatric nursing practice guidelines in Korea
Authors: Kim S. , Kim K. , Kim S. J.
Published: February 2018

Background

Despite the increasing population of elderly individuals in Korea, there are no evidence‐based geriatric nursing practice guidelines.

Aim

This study aimed to identify and prioritize topics related to the development of evidence‐based geriatric nursing practice guidelines in long‐term care facilities in Korea.

Methods

To identify potential topics, 89 nurses responded to a questionnaire on activities that require further evidence and/or standardization in the long‐term care facility setting. To prioritize these topics, 14 geriatric nursing experts completed surveys to prioritize five categories.

Results

The collected data included 240 clinical topics, which were classified into 41 subcategories and 18 main categories. According to topic prioritization by the geriatric nursing experts, the following were the most heavily weighted categories: fall prevention, position change and prevention of pressure ulcers.

Conclusions

The development of standardized guidelines based on these results may help improve the quality of geriatric care and quality of life of older individuals. The small number of respondents may be a limitation of this study, and further study is needed to expand the population.

Implications for nursing and health policy

The development of evidence‐based nursing guidelines based on the present findings will help improve the quality of nursing in long‐term care facilities. Additionally, health policies and systems, such as introduction of a fee for nursing services for older individuals based on the evidence, are worth considering.
Temporal enactment of resettled refugees' ICT‐mediated information practices
Authors: Díaz Andrade Antonio , Doolin Bill
Published: February 2018

“In this paper, we explain how resettled refugees use information and communication technology (ICT) to respond to their changed circumstances and, in doing so, enhance their well‐being and effective participation in a new society. Focusing on three modes of ICT‐mediated information practices (ie, orienting, instrumental, and expressive), we identify eight patterns of ICT use: learning about a new environment, keeping informed, transacting online, communicating with others, managing everyday life, sustaining support networks, maintaining transnational ties, and expressing cultural identity. Further, we draw on a temporal theory of human agency to explain how current dilemmas and contingencies, cultural identities and connections to the past, and future expectations and aspirations shape resettled refugees' enactment of these patterns of ICT‐mediated information practices. We show that, as resettled refugees move between multiple and overlapping temporal‐relational contexts, ICT use makes a difference to managing their bifurcated lives.”
Ion irradiation effect on spark plasma sintered silicon carbide ceramics with nanostructured ferritic alloy aid
Authors: Ning Kaijie , Lu Kathy
Published: February 2018

Silicon carbide (SiC) is a promising material with excellent chemical and physical performance under irradiation for advanced nuclear applications. The addition of nanostructured ferritic alloy (NFA) has been proven beneficial for the densification of SiC ceramics based on our previous work. To understand their microstructural evolution and irradiation resistance, spark plasma sintered (SPSed) SiC ceramics with and without NFA aid (0 vol% NFA‐100 vol% SiC, 2.5 vol% NFA‐97.5 vol% SiC, and 5 vol% NFA‐95 vol% SiC) were exposed to 5 MeV Si++ irradiation. The ion irradiation strongly modifies the surface morphology with isolated sand dune shaped structures, which can be explained by the Bradley‐Harper (B‐H) theory. SRIM simulation for both the pure SiC and NFA‐SiC predicts similar surface damage of ~45 dpa and peak damage of ~790 dpa at ~2.0 μm depth. For the actual samples, the SiC matrix is completely amorphous up to ~2.2 μm thickness (from the surface dune valley to the amorphous layer boundary), which is consistent with the SRIM predicted depth of ~2.3 μm. Reaction product (Fe,Cr)3Si in the NFA‐SiC samples maintains a crystalline structure with dislocation loops. A defect rate model is applied to understand the fundamental difference in ion irradiation resistance between SiC and (Fe,Cr)3Si.
Divergent rectrix moult: the implications and conditions of moult sequence
Authors: Kiat Yosef
Published: February 2018

Wing and tail morphology strongly affect flight performance which may consequently decline during feather moult due to the creation of feather gaps in the flight‐surface. Hence, the size and shape of moult‐related gaps may directly affect flight capacity. Here, I examined the divergent rectrix moult sequence compared to the more common distal moult sequence. In the divergent moult, the focus of rectrix moult is shifted from the tail centre (R1; rectrices numbered distally from mid‐tail outward) to another rectrix (R2 or R3), and then rectrices are moulted bidirectionally, towards the tail centre and outwards. The result of this moult sequence is the splitting of the tail gap into multiple smaller gaps. Using a large moult database including 5669 individuals of 47 Western Palaearctic passerine species, I found evidence of divergent moult sequence for only seven species. Using comparative and experimental approaches, I found that the divergent rectrix sequence is correlated with higher moult speed and lower aerodynamic cost. Furthermore, the divergent rectrix sequence is more common among adults than juveniles. This work focused on the feather moult sequence – a seldom studied aspect of the avian life‐history. I propose that moult‐related aerodynamic costs may be an important evolutionary factor not only in moult speed, but also in moult sequence.
Propofol exposure during early gestation impairs learning and memory in rat offspring by inhibiting the acetylation of histone
Authors: Lin Jiamei , Wang Shengqiang , Feng Yunlin , Zhao Weihong , Zhao Weilu , Luo Foquan , Feng Namin
Published: February 2018

Propofol is widely used in clinical practice, including non‐obstetric surgery in pregnant women. Previously, we found that propofol anaesthesia in maternal rats during the third trimester (E18) caused learning and memory impairment to the offspring rats, but how about the exposure during early pregnancy and the underlying mechanisms? Histone acetylation plays an important role in synaptic plasticity. In this study, propofol was administered to the pregnant rats in the early pregnancy (E7). The learning and memory function of the offspring were tested by Morris water maze (MWM) test on post‐natal day 30. Two hours before each MWM trial, histone deacetylase 2 (HDAC2) inhibitor, suberoylanilide hydroxamic acid (SAHA), Senegenin (SEN, traditional Chinese medicine), hippyragranin (HGN) antisense oligonucleotide (HGNA) or vehicle were given to the offspring. The protein levels of HDAC2, acetylated histone 3 (H3) and 4 (H4), cyclic adenosine monophosphate (cAMP) response element‐binding protein (CREB), N‐methyl‐D‐aspartate receptor (NMDAR) 2 subunit B (NR2B), HGN and synaptophysin in offspring's hippocampus were determined by Western blot or immunofluorescence test. It was discovered that infusion with propofol in maternal rats on E7 leads to impairment of learning and memory in offspring, increased the protein levels of HDAC2 and HGN, decreased the levels of acetylated H3 and H4 and phosphorylated CREB, NR2B and synaptophysin. HDAC2 inhibitor SAHA, Senegenin or HGN antisense oligonucleotide reversed all the changes. Thus, present results indicate exposure to propofol during the early gestation impairs offspring's learning and memory via inhibiting histone acetylation. SAHA, Senegenin and HGN antisense oligonucleotide might have therapeutic value for the adverse effect of propofol.
Quality assessment of clinical practice guidelines for infectious diseases in China
Authors: Wu Dongbo , Jiang Wei , Yu Le , Wang Yonghong , Tao Yachao , Tang Hong , Chen Enqiang
Published: February 2018

Aim

We aimed to appraise the quality of Chinese Society of Infectious Diseases of China Medical Association clinical practice guidelines (CPGs) for infectious diseases in China.

Methods

We performed the electronic search and hand search on the above‐mentioned CPGs for infectious diseases published from January 1997 to October 2017. Each publication was evaluated using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument.

Results

Thirteen guidelines were identified and enrolled for the further evaluation. The median scores of the AGREE II domains across all 13 guidelines were as follows: scope and purpose 73.61% (36.11% to 84.72%), stakeholder involvement 12.50% (8.33% to 20.83%), rigor of development 19.27% (12.50% to 26.04%), clarity of presentation 86.11% (23.61% to 94.44%), applicability 33.33% (26.04% to 50.00%), and editorial independence 8.33% (4.17% to 16.67%). The clarity of presentation domain got the highest score among the six domains. Moreover, when compared the CPGs by the year of publication (2002 to 2006 vs. 2007 to 2017), the quality scores were higher in the CPGs published in the last 10 years than those published before, but with no significant difference.

Conclusions

The quality score of CPGs for infectious diseases in China from January 1997 to October 2017 was moderate, but had significant shortcomings, especially in the stakeholder involvement and editorial independence domains. However, the AGREE II instrument is useful and feasible for appraising the CPGs and should be applied to develop, implement, and promote the CPGs in China.
Assessment of quality performance measures in patients with acute coronary syndromes: Data from the Portuguese Registry of Acute Coronary Syndromes (ProACS), a nationwide registry
Authors: Timóteo Ana Teresa , Mimoso Jorge ,   on behalf of the ProACS Investigators
Published: February 2018

Rational, aims, and objectives

Registries are a powerful tool to assess specific performance measurements and quality of care in acute coronary syndromes (ACSs). In Portugal, ProACS is a nationwide registry of ACS that has been active for the past 15 years, and our objective was to assess specific quality indicators for the treatment of ACS.

Methods

Descriptive analysis of data from ProACS registry in specific quality indicators previously defined by international scientific societies.

Results

A total of 45,141 patients were included since 2002, 43.5% with ST‐segment elevation myocardial infarction. In ST‐segment elevation myocardial infarction, reperfusion rates, particularly by primary angioplasty, have increased dramatically with 85% being submitted to any form of reperfusion presently. In‐hospital time delays are, however, suboptimal, particularly in patients admitted first to hospitals without catheterization facilities. For non‐ST elevation ACS, invasive strategy also showed important improvements, with more than 80% of patients being submitted to catheterization. Although there was also improvement in the use of guideline recommended medication, particularly statins, it is also suboptimal, requiring additional specific interventions.

Conclusion

The quality of care of ACS improved dramatically in the last 15 years in Portugal, with major improvements in hospital mortality. It is, however, suboptimal in specific points that have been identified and that require additional measures.
The influence of the linear growth velocity on the properties of sucrose crystals produced from mixed syrups
Authors: Schlumbach K. , Schwenkler M. , Flöter E.
Published: February 2018

The systematic study presented addresses the need to understand the co‐crystallization of beet and cane material better. This is important because of the sugar market liberalization in 2017. Here the effect of crystal growth velocity on final sugar quality is investigated. Comparing three different thermal setups, studying different cane and beet mixtures color inclusion into sucrose crystals was analyzed. Within one thermal setup supersaturation was practically constant. Almost exclusively the time necessary to complete the crystallization at 50% solids level changed. Particle size and distribution remained unchanged. Hence, only the growth velocity varied. Growth rate appears to influence color inclusion less than mixing of beet and cane syrups. In cane syrups the relative color inclusion is the highest and most sensitive to growth velocities. Admixing only 33% of beet syrup, already changes this pattern dramatically and the color transfer factor is more than halved. This effect of beet material is most prominent for the mechanism liquid inclusion but also significant for co‐crystallization of colorants. This observation is possibly due to the different nature of the colorants originating from beet and cane. The findings provide a framework to optimize the space‐time yield under consideration of highest sugar quality to manufacturers.

Practical applications

Co‐production of beet and cane is a promising opportunity to increase competitiveness by increasing utilization of equipment in the seasonal sugar industry. To do so reliably, quality parameters have to be met. The main problem to be solved is the control of white sugar color. Since cane and sugar beet deliver different coloring minor components, their interaction and respective inclusion mechanisms need to be understood. The work presented is part of a comprehensive study to elucidate this area of sugar processing that has not been studied yet. Next to the findings on inclusion characteristic and relative contribution of different mechanisms, the conclusions can directly be transferred into practice. The data gathered give a clear guidance to producers that higher inclusion levels of “colored” material, than current conservative practice dictates, can be tolerated due to the mutual suppression mechanism found.
Safety assessment, biological effects, and mechanisms of Myrica rubra fruit extract for anti‐melanogenesis, anti‐oxidation, and free radical scavenging abilities on melanoma cells
Authors: Juang Lih‐Jeng , Gao Xiang‐Yu , Mai Shou‐Ting , Lee Cheng‐Hung , Lee Ming‐Chung , Yao Chao‐Ling
Published: February 2018

Objective

Currently, the cosmetic and medical industries are paying considerable attention to solve or prevent skin damage or diseases, such as hyperpigmentation and oxidation and free radical damage. In this study, the effective compounds in Myrica rubra fruit were extracted and studied the biological effects of these M. rubra fruit extracts.

Methods

In this study, we extracted M. rubra fruit using solutions with various ratios of water to ethanol (100:0, 50:50, 5:95) and studied the anti‐melanogenesis, anti‐oxidation and radical scavenging effects of these M. rubra fruit extracts on two melanoma cell lines: mouse melanoma (B16‐F0) and human melanoma (A2058). The cytotoxicity, melanin synthesis, mushroom and cellular tyrosinase activities, enzyme kinetics, melanogenesis‐related gene expression, melanogenesis‐related protein secretion, radical DPPH scavenging activity and ROS inhibition after treatment with M. rubra fruit extracts were determined.

Results

The results showed that the water extract of M. rubra fruit was less cytotoxic to the melanoma cell lines, effectively inhibited melanin synthesis and tyrosinase activity and down‐regulated the gene expression and protein secretion of MITF and TRP‐1. In addition, the M. rubra fruit extracts also showed the abilities to scavenge DPPH free radicals and suppress ROS production. Finally, the effective compounds in the water extract were Myricetin‐O‐deoxyhexoside, Quercetin‐O‐deoxyhexoside, and Kaempferol‐O‐hexoside determined by LC/MS/MS assay.

Conclusion

Overall, the water extract of M. rubra fruit is a safe and effective melanin inhibitor and anti‐oxidant and can be applied widely in the fields of cosmetics and medicine.
Histopathological and immunophenotypic features of ipilimumab‐associated colitis compared to ulcerative colitis
Authors: Adler B. L. , Pezhouh M. K. , Kim A. , Luan L. , Zhu Q. , Gani F. , Yarchoan M. , Chen J. , Voltaggio L. , Parian A. , Lazarev M. , Lauwers G. Y. , Pawlik T. M. , Montgomery E. A. , Jaffee E. , Le D. T. , Taube J. M. , Anders R. A.
Published: February 2018

Background

Use of the immune checkpoint inhibitor ipilimumab is sometimes complicated by ipilimumab‐associated colitis (Ipi‐AC), an immune‐mediated colitis that mimics inflammatory bowel disease.

Objective

We sought to characterize the histopathologic and immunophenotypic features of Ipi‐AC and to directly compare these features to ulcerative colitis (UC).

Methods

This is a retrospective cohort study of 22 patients with Ipi‐AC, 12 patients with treatment‐naïve UC and five controls with diarrhoea but normal endoscopic findings. Immunohistopathologic features were described, and quantitative immunohistochemistry (IHC) was performed for CD4, CD8, CD20, CD138 and FOXP3.

Results

Endoscopic findings in both the Ipi‐AC and UC groups included ulcerated, oedematous and erythematous mucosa. Involvement of the GI tract was more diffuse in Ipi‐AC. As compared to UC, a smaller proportion of Ipi‐AC biopsies had basal plasmacytosis (14% for Ipi‐AC vs. 92% for UC, P < 0.0001) and crypt distortion (23% for Ipi‐AC vs. 75% for UC, P = 0.003), whereas Ipi‐AC biopsies had more apoptotic bodies in the left colon (17.6 ± 15.3 for Ipi‐AC vs. 8.2 ± 4.2 for UC, P = 0.011). Cryptitis, ulcerations and crypt abscesses were common in both groups. Biopsy specimens from Ipi‐AC had a lower density of CD20‐positive lymphocytes than UC (275.8 ± 253.3 cells mm−2 for Ipi‐AC vs. 1173.3 ± 1158.2 cells mm−2 for UC, P = 0.022) but had a similar density of CD4, CD8, CD138 and FOXP3‐positive cells.

Conclusions

Ipi‐AC is a distinct pathologic entity with notable clinical and histopathological differences compared to UC. These findings provide insights into the pathophysiology of immune‐related adverse events (iAEs) from ipilimumab therapy.
Physiological response of 10 phytoplankton species exposed to macondo oil and the dispersant, Corexit
Authors: Bretherton Laura , Williams Alicia , Genzer Jennifer , Hillhouse Jessica , Kamalanathan Manoj , Finkel Zoe V. , Quigg Antonietta
Published: February 2018

Culture experiments were conducted on ten phytoplankton species to examine their biological and physiological responses during exposure to oil and a combination of oil and dispersant. The species tested included a range of taxa typically found in the Gulf of Mexico such as cyanobacteria, chlorophytes, and diatoms. Cultures were exposed to Macondo surrogate oil using the water accommodated fraction (WAF), and dispersed oil using a chemically enhanced WAF (CEWAF) and diluted CEWAF, to replicate conditions following the Deepwater Horizon spill in the Gulf of Mexico. A range of responses were observed, that could broadly class the algae as either “robust” or “sensitive” to oil and/or dispersant exposure. Robust algae were identified as Synechococcus elongatus, Dunaliella tertiolecta, two pennate diatoms Phaeodactylum tricornutum and Navicula sp., and Skeletonema grethae CCMP775, and were largely unaffected by any of the treatments (no changes to growth rate or time spent in lag phase relative to controls). The rest of the phytoplankton, all centric diatoms, exhibited at least some combination of reduced growth rates or increased lag time in response to oil and/or dispersant exposure. Photophysiology did not have a strong treatment effect, with significant inhibition of photosynthetic efficiency (Fv/Fm) only observed in the CEWAF, if at all. We found that the effects of oil and dispersants on phytoplankton physiology were species‐dependent, and not always detrimental. This has significant implications on how oil spills might impact phytoplankton community structure and bloom dynamics in the Gulf of Mexico, which in turn impacts higher trophic levels.
Exercise‐induced pulmonary hemorrhage in barrel racing horses in the Pacific Northwest region of the United States
Authors: Gold Jenifer R. , Knowles Donald P. , Coffey Todd , Bayly Warwick M.
Published: February 2018

Background

Exercise‐induced pulmonary hemorrhage (EIPH) refers to bleeding from the lungs in association with strenuous exercise. It has been documented in race horses but little information exists on EIPH in barrel racing horses.

Hypothesis/Objectives

Our goals were to evaluate the presence of EIPH in barrel racing horses and estimate its prevalence in the Pacific Northwest.

Animals

149 barrel racing horses enrolled at events in WA (11), ID (3), and MT (33).

Methods

Observational cross‐sectional study. Data collected included signalment, history of illness, respiratory disease, race division, and pre‐race medications. Endoscopy was performed and tracheobronchoscopic (TBE) EIPH score was assigned based on quantity of blood in the trachea (0 = no blood to 4 = abundance of blood within the trachea). After TBE, bronchoalveolar lavage (BAL) was performed. Erythrocyte (red blood cell, RBC) counts were obtained from bronchoalveolar lavage fluid (BALF). Statistical analysis included linear and logistic regression, Fisher's exactttest, and calculation of correlation coefficient. Significance was set atP < .05.

Results

The prevalence of EIPH based on TBE EIPH score was 54%. When based on BALF RBC count >1,000 cells, EIPH prevalence was 66%. Race time did not significantly affect the presence of EIPH. A significant (P < .0001) positive linear relationship between the TBE and BAL erythrocyte count was identified, but its strength was poor (r2 = .15).

Conclusions and Clinical Importance

EIPH occurs in over 50% of barrel racing horses in the Pacific Northwest. Precise determination of the impact of EIPH on health of barrel racers requires further study.
Fecal microbiota transplantation in puppies with canine parvovirus infection
Authors: Pereira Giorgio Q. , Gomes Lucas A. , Santos Iago S. , Alfieri Alice F. , Weese J. S. , Costa Marcio C.
Published: February 2018

Background

Diarrhea associated with parvovirus infection is common in dogs. Supportive care is the mainstay of treatment, but recovery may be prolonged and mortality rate can be high. Modification of the intestinal bacterial microbiota has been promising in human and veterinary medicine as an adjunctive treatment of various enteric diseases.

Objectives

To investigate the safety and efficacy of fecal microbiota transplantation (FMT) on the clinical recovery of puppies with acute hemorrhagic diarrhea syndrome.

Animals

Sixty‐six puppies with parvovirus infection were evaluated at 2 veterinary hospitals.

Methods

Randomized clinical trial. Puppies were randomly distributed into 2 groups: standard treatment (STD) and standard treatment + FMT (STD + FMT). The STD puppies (n = 33) received only treatment with IV fluids and antimicrobials and the STD + FMT puppies (n = 33) received FMT in addition to standard treatment. For FMT, 10 g of feces from a healthy dog diluted in 10 mL of saline were administered rectally 6‐12 hours post‐admission.

Results

Among survivors, treatment with FMT was associated with faster resolution of diarrhea (P < .001) and shorter hospitalization time (P = .001; median, 3 days in STD + FMT; median, 6 days in STD) compared to standard treatment. Mortality in STD was 36.4% (12/33) as compared to 21.2% (7/33) in puppies treated with FMT, but there was no statistical difference between groups (P = .174). Polymerase chain reaction indicated that all animals carried canine parvovirus, strain CPV‐2b.

Conclusions

Fecal microbiota transplantation in parvovirus‐infected puppies was associated with faster resolution of diarrhea.
Effect of sucralfate on gastric permeability in an ex vivo model of stress‐related mucosal disease in dogs
Authors: Hill Tracy L. , Lascelles B. Duncan X. , Blikslager Anthony T.
Published: February 2018

Background

Sucralfate is a gastroprotectant with no known systemic effects. The efficacy of sucralfate for prevention and treatment of stress‐related mucosal diseases (SRMD) in dogs is unknown.

Hypothesis/Objectives

To develop a canine ex vivo model of SRMD and to determine the effect of sucralfate on mucosal barrier function in this model.

Animals

Gastric antral mucosa was collected immediately postmortem from 29 random‐source apparently healthy dogs euthanized at a local animal control facility.

Methods

Randomized experimental trial. Sucralfate (100 mg/mL) was applied to ex vivo canine gastric mucosa concurrent with and after acid injury. Barrier function was assessed by measurement of transepithelial electrical resistance (TER) and radiolabeled mannitol flux.

Results

Application of acidified Ringers solution to the mucosal side of gastric antrum caused a reduction in gastric barrier function, and washout of acidified Ringers solution allowed recovery of barrier function (TER: 34.0 ± 2.8% of control at maximum injury, 71.3 ± 5.5% at recovery, P < .001). Sucralfate application at the time of injury or after injury significantly hastened recovery of barrier function (TER: 118.0 ± 15.2% of control at maximum injury, P < .001 and 111.0 ± 15.5% at recovery, P = .35).

Conclusions and Clinical Importance

Sucralfate appeared effective at restoring defects in gastric barrier function induced by acid and accelerating repair of tissues subjected to acid in this model, suggesting that sucralfate could have utility for the treatment and prevention of SRMD in dogs.
Functional characterization of the citrus canker susceptibility gene CsLOB1
Authors: Duan Shuo , Jia Hongge , Pang Zhiqian , Teper Doron , White Frank , Jones Jeffrey , Zhou Changyong , Wang Nian
Published: February 2018

Xanthomonas citri ssp. citri (Xcc) is an important plant‐pathogenic bacterium that causes citrus canker disease worldwide. PthA, a transcriptional activator‐like (TAL) effector, directs the expression of the canker susceptibility gene CsLOB1. Here, we report our recent progress in the functional characterization of CsLOB1. Subcellular localization analysis of CsLOB1 protein in citrus protoplast revealed that CsLOB1 is primarily localized in the nucleus. We showed that CsLOB1 expression driven by dexamethasone (DEX) in CsLOB1‐GR transgenic plants is associated with pustule formation following treatment with DEX. Pustule formation was not observed in DEX‐treated wild‐type plants and in non‐treated CsLOB1‐GR transgenic plants. Water soaking is typically associated with symptoms of citrus canker. Weaker water soaking was observed with pustule formation in CsLOB1‐GR transgenic plants following DEX treatment. When CsLOB1‐GR‐transgenic Duncan grapefruit leaves were inoculated with Xcc306ΔpthA4 and treated with DEX, typical canker symptoms, including hypertrophy, hyperplasia and water soaking symptoms, were observed on DEX‐treated transgenic plant leaves, but not on mock‐treated plants. Twelve citrus genes that are induced by PthA4 are also stimulated by the DEX‐induced expression of CsLOB1. As CsLOB1 acts as a transcriptional factor, we identified putative targets of CsLOB1 via bioinformatic and electrophoretic mobility shift assays. Cs2g20600, which encodes a zinc finger C3HC4‐type RING finger protein, has been identified to be a direct target of CsLOB1. This study advances our understanding of the function of CsLOB1 and the molecular mechanism of how Xcc causes canker symptoms via CsLOB1.
Experimental study on TGF‐β1‐mediated CD147 expression in oral submucous fibrosis
Authors: Wang W , Xiong H , Hu Z , Zhao R , Hu Y , Chen W , Han Y , Yang L , Hu X , Wang C , Mao T , Xia K , Su T
Published: February 2018

Objective

Although previous evidence indicates that CD147 is closely involved in the progression of organ fibrosis and various signaling pathways have been proven to regulate its expression, the role of CD147 in oral submucous fibrosis (OSF) remains largely unknown.

Methods

In this study, we investigated the expression of CD147 and transforming growth factor β1 (TGF‐β1) in human samples of an OSF tissue array by immunohistopathology. Pearson's correlation analysis was conducted to explore the correlation between CD147 and TGF‐β1. Immunofluorescence and Western blotting were used to investigate to levels of CD147 in Human Oral Keratinocytes (HOKs) followed by TGF‐β1 or LY2157299, an inhibitor of TGF‐β1 receptor and arecoline stimulation.

Results

We found that CD147 was highly expressed in both HOKs and the fibrotic oral mucosa and that this expression was correlated with TGF‐β1 expression. Additionally, CD147 levels were significantly associated with the fibrosis stage. The TGF‐β1 signaling pathway was found to be mainly responsible for CD147 up‐regulation after arecoline treatment whereas inhibition of TGF‐β1 down‐regulated CD147 expression.

Conclusion

Our findings suggest arecoline promotes CD147 expression via the TGF‐β1 signaling pathway in HOKs, whereas overexpression of CD147 may promote OSF progression.
Urinary liver‐type fatty acid‐binding protein in pediatric nephrotic syndrome and tubular dysfunction
Authors: Nishida Masashi , Kawakatsu Hidekazu , Hamaoka Kenji
Published: February 2018

Background

Urinary liver‐type fatty acid‐binding protein (uL‐FABP) has recently been identified as a biomarker for kidney injury. uL‐FABP excretion in pediatric relapsing nephrotic syndrome and tubular dysfunction, however, has not been reported previously.

Methods

We measured uL‐FABP level in children with steroid‐sensitive nephrotic syndrome (SSNS), in those with tubular dysfunction, and in control subjects.

Results

uL‐FABP was markedly increased in relapsing SSNS (median, 30.3 μg/gCr; range, 12.6–171.0 μg/gCr; n = 13), and also in the tubular dysfunction group (median, 164.8 μg/gCr; range, 41.6–834.5 μg/gCr; n = 7), compared with the control subjects (median, 3.0 μg/gCr; range, 1.1–13.9 μg/gCr; n = 21). uL‐FABP level was significantly correlated with urinary protein excretion in the SSNS group, and in the total group. Additionally, in the SSNS group, elevated uL‐FABP in the relapsing stage returned to a level similar to that in the control group on remission of NS. In the tubular dysfunction group, uL‐FABP was significantly correlated with urinary β2‐microglobulin.

Conclusion

Urinary protein amount, and the ability of the proximal tubules to reabsorb low‐molecular‐weight proteins, should also be considered when evaluating the clinical significance of uL‐FABP as a biomarker for kidney injury in children.
Thyroid function in asphyxiated newborns who received hypothermia therapy
Authors: Kobayashi Akira , Usuda Touhei , Wada Masaki , Kaneko Takayuki , Kojima Kinuko , Saitoh Akihiko
Published: February 2018

Background

Thyroid function in asphyxiated newborns who received hypothermia therapy and its relation to neurological outcome are not well described.

Methods

We performed a prospective study to measure thyroid function in 12 asphyxiated newborns who received hypothermia therapy. We measured serum thyroid‐stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) on admission, at 24, 72, and 96 h after birth, and at discharge (range, 17–54 days). The 12 newborns were divided into two groups based on the presence of brain injury on head magnetic resonance imaging (six in the abnormal imaging group and six in the normal imaging group), and thyroid function was compared between the two groups.

Results

Serum TSH was within the normal range in the 12 newborns. Serum FT3 and FT4 remained low at 24, 72, and 96 h after birth, and returned to normal range at discharge in the 12 newborns. There was no significant difference in serum TSH between the two groups, but serum FT3 at 96 h after birth, and serum FT4 at 72 and 96 h after birth, were significantly lower in the abnormal imaging group than in the normal imaging group (P = 0.02; P = 0.03; and P = 0.01, respectively).

Conclusions

Asphyxiated newborns have transient low thyroid hormone levels at 24–96 h after birth. Serum FT3 and FT4 between 72 and 96 h after birth may predict brain injury in asphyxiated newborns.
Development of a method to preliminarily embed tissue samples using low melting temperature fish gelatin before sectioning: A technical note
Authors: Ushida Kaori , Asai Naoya , Uchiyama Kozo , Enomoto Atsushi , Takahashi Masahide
Published: February 2018

Embedding of tissue samples that maintains a desired orientation is critical for preparing sections suitable for diagnosis and study objectives. Methods to prepare tissue sections include: (i) paraffin embedding or snap‐freezing followed by microtome or cryostat sectioning; and (ii) agarose embedding followed by cutting on a vibrating microslicer. Although these methods are useful for routine laboratory work, preparation of small and fragile tissues such as mouse organs, small human biopsy samples, and cultured floating spheres is difficult and requires special skills. In particular, tissue specimen orientation can be lost during embedding in molds and subsequent sectioning. Here, we developed a method using low melting temperature (LM) gelatin either alone or mixed with agarose to preliminarily embed collected tissues that are either prefixed or unfixed, followed by conventional fixation, paraffin embedding, freezing, and sectioning. The advantage of the method is that the LM gelatin and its mixture with agarose can be handled at room temperature but quickly hardens at 4°C, which allows embedding, trimming, and arranging of small and fragile tissues in a desired orientation and are compatible with traditional stainings. Thus, this method can have various laboratory applications and can be modified according to the needs of each laboratory.
Communicating the Vision: How Face‐to‐Face Dialogue Facilitates Transformational Leadership
Authors: Jensen Ulrich Thy , Moynihan Donald P. , Salomonsen Heidi Houlberg
Published: February 2018

For public managers facing political and structural constraints, transformational leadership promises to meaningfully improve outcomes by communicating an inspiring vision of the organization. But this promise rests to a great degree on the communication skills and behaviors of the leader. A better understanding of how transformational leadership functions in organizations therefore requires a deeper application of theory from the field of communications. This article explores the question of what communication behaviors facilitate transformational leadership. A media richness framework is applied to propose that transformational leaders will be most effective when employing a face‐to‐face dialogue approach to communication. Using a multisource longitudinal research design, the authors find support for this proposition in an empirical test of 256 Danish tax units, lower and upper secondary schools, child care centers, and bank branches. The findings also show that size matters, with diminishing effectiveness of face‐to‐face dialogue in larger organizations.
Exploring complaints by female and male patients at Swedish hospitals using a probabilistic graphical model
Authors: Eriksson Erik Masao , Raharjo Hendry , Gustavsson Susanne
Published: February 2018

Background

Patients’ complaints have been highlighted as important for constructively improving healthcare services. In so doing, it may be important to identify disparities in experiences based on patients’ demographics, such as sex.

Aim

To explore hospital recorded complaints addressing potential sex differences and whether complaints were reported by the patient or a relative.

Methods

Quantitative study of all 835 closed patient complaints during 2013 at three mid‐sized hospitals in Sweden. The complaints were categorisation based on perceived quality theory and analysed using a probabilistic graphical model. The findings were validated through qualitative interviews.

Findings

Female patients were more likely than male patients to report dissatisfaction with interpersonal issues, whereas male patients were more likely to report dissatisfaction with administration. If a complaint from a male patient had been reported by a relative, the matter was more likely to be interpersonal. Improvement suggestions were predominantly reported by staff. However, patients and relatives proved more likely than staff to report improvement suggestions when dissatisfied with interpersonal matters.

Conclusion

Using a Bayesian network, this article suggests that complaints in health care should be more holistically understood and the factors should be viewed as interconnected. This article addresses complaints as an important source of identifying not only perceived healthcare deficiencies and sex disparities, but also improvement suggestions.
Scalable Bayes under Informative Sampling
Authors: Savitsky Terrance D. , Srivastava Sanvesh
Published: February 2018

Bayesian hierarchical formulations are utilized by the U.S. Bureau of Labor Statistics (BLS) with respondent‐level data for missing item imputation because these formulations are readily parameterized to capture correlation structures. BLS collects survey data under informative sampling designs that assign probabilities of inclusion to be correlated with the response on which sampling‐weighted pseudo posterior distributions are estimated for asymptotically unbiased inference about population model parameters. Computation is expensive and does not support BLS production schedules. We propose a new method to scale the computation that divides the data into smaller subsets, estimates a sampling‐weighted pseudo posterior distribution, in parallel, for every subset and combines the pseudo posterior parameter samples from all the subsets through their mean in the Wasserstein space of order 2. We construct conditions on a class of sampling designs where posterior consistency of the proposed method is achieved. We demonstrate on both synthetic data and in application to the Current Employment Statistics survey that our method produces results of similar accuracy as the usual approach while offering substantially faster computation.
Race/Ethnic Differences in Nonresident Fathers’ Involvement After a Nonmarital Birth*
Authors: Ellerbe Calvina Z. , Jones Jerrett B. , Carlson Marcia J.
Published: February 2018

Objectives

This article examines how the levels of nonresidential fathers' involvement (over child ages 1–9) differ by race/ethnicity (comparing white, black, and Hispanic fathers), and then considers how individual and couple characteristics may “account for” any observed differences.

Method

Data from the Fragile Families and Child Wellbeing Study (N = 2,447) and random effects models were used to examine how nonresidential fathers' involvement (with respect to time, engagement, shared responsibility, and co‐parenting with mothers) is differentiated by race and ethnicity.

Results

Overall, black nonresident fathers were significantly more likely to spend time and engage in activities with their children as compared to Hispanic fathers—but not white fathers. Black fathers also shared responsibilities more frequently and displayed more effective co‐parenting than Hispanic and white fathers.

Conclusion

Fathers’ involvement with children is shown to differ across major race/ethnic groups, with implications for children as well as for future research and public policy.
Equity dimensions of the availability and quality of reproductive, maternal and neonatal health services in Zambia
Authors: Yan Lily D. , Mwale Jonas , Straitz Samantha , Biemba Godfrey , Bhutta Zulfiqar , Ross Julia F. , Mwananyanda Lawrence , Nambao Mary , Ngwakum Paul , Genovese Eleonora , Banda Bowen , Akseer Nadia , Yeboah‐Antwi Kojo , Rockers Peter C. , Hamer Davidson H.
Published: February 2018

Objective

To assess how quality and availability of reproductive, maternal, neonatal (RMNH) services vary by district wealth and urban/rural status in Zambia.

Methods

We conducted a retrospective analysis of data from the Millennium Development Goal Acceleration Initiative baseline assessment of 117 health facilities in 9 districts. Quality was assessed through a composite score of 23 individual RMNH indicators, ranging from 0 to 1. Availability was evaluated by density of providers and facilities. Districts were divided into wealth groups based on the multidimensional poverty index (MPI). Relative inequity was calculated using the concentration index for quality indicators (positive favours rich, negative favours poor). Multivariable linear regression was performed for the dependent variable composite quality indicator using MPI, urban/rural, and facility level of care as independent variables.

Results

13 hospitals, 85 health centres and 19 health posts were included. The RMNH composite quality indicator was 0.64. Availability of facilities and providers was universally low. The concentration index for the composite quality indicator was −0.015 [−0.043, 0.013], suggesting no clustering to favour either rich or poor districts. Rich districts had the highest absolute numbers of health facilities and providers, but lowest numbers per facility per 1 000 000 population. Urban districts had slightly better service quality, but not availability. Using regression analysis, only facility level of care was significantly associated with quality outcome.

Conclusions

Composite quality of RMNH services did not vary by district wealth, but was slightly higher in urban districts. The availability data suggest that the higher population in richer districts outpaces health infrastructure
Multinational activity of European firms and heterogeneity
Authors: Fariñas José C. , Martín‐Marcos Ana , Velázquez Francisco J.
Published: February 2018

This paper offers an empirical assessment of the multinational activity of European firms. It takes the predictions of models of firm heterogeneity and FDI activity as a reference to explore the characteristics of multinational firms from 30 European countries. We use a data set, based on ORBIS, which links information of parent–affiliate pairs of firms. Our results show that more productive firms have greater multinational activity in terms of both scope, the number of foreign markets where they invest, and scale, the volume of local sales by subsidiaries active in foreign markets. The estimation of gravity equations shows that country characteristics that encourage multinational activity successively induce the entry of less productive parent firms. We confirm this asymmetry for the GDPs of the home and host countries, distance, contiguity and other standard gravity equation variables.
Changes in D‐dimer concentration after soft tissue and orthopedic surgery in dogs
Authors: Shipov Anna , Milgram Josh , Shalev Nitzan , Aroch Itamar , Segev Gilad
Published: February 2018

Objective

D‐dimer is a specific marker of active coagulation and fibrinolysis. The objective of this study is to determine the influence of surgery on D‐dimer concentration as well as to examine the relation between the magnitude of change and invasiveness of the surgical procedures.

Study design

Prospective clinical study.

Animals

Forty‐five client‐owned dogs undergoing elective neutering (n = 15), elective orthopedic (n = 15), or posttraumatic orthopedic (n = 15) surgical procedures.

Methods

Dogs undergoing elective neutering, elective orthopedic, and posttraumatic orthopedic surgical procedures were enrolled. D‐dimer concentration, measured immediately prior to, immediately after, and 24 hours after surgery (T0, T1, and T24, respectively), was compared within and among study groups.

Results

D‐dimer concentration was >250 ng/mL in 8 (18%) dogs at T0, in 9 (20%) at T1, and in 5 (11%) at T24. At T1 and T24, only 2 dogs had a D‐dimer concentration >500 ng/mL, and it was <750 ng/mL in all dogs. There was no difference in the proportion of increased D‐dimer concentration (>250 ng/mL) among the time points (P = 0.29). Median D‐dimer concentration did not vary between time points within the groups, except in the neutering group (P = 0.029), in which T1 concentration tended to increase compared with T0 values (161 ng/dL, range 71‐727 vs 122 ng/mL, range, 43‐353, respectively;P = .065).

Conclusion

The surgical procedures tested in this study are unlikely to cause a direct increase in D‐dimer concentration.

Clinical significance

Any increase in D‐dimer concentration after elective neutering, elective orthopedic, and posttraumatic orthopedic surgical procedures should be regarded as clinically important and trigger investigations to detect a hemostatic derangement.