bluuebunny/crossref_metadata_2025 huggingface dataset:
SLE myopathy: a clinicopathological study
Authors: Jakati Saumya , Rajasekhar Liza , Uppin Megha , Challa Sundaram
Published: May 2015

Aim

To study the histological changes in muscle biopsy in patients diagnosed with systemic lupus erythematosus (SLE) and presenting with muscle symptoms.

Materials and Methods

Patients with SLE presenting with muscle symptoms at presentation or during follow‐up and treatment between January 2010 and May 2014 and who underwent muscle biopsy were included in the study. Demographic, clinical features, serological markers, and Electromyoneurography findings were collected. Muscle biopsies were evaluated for inflammation, fiber type abnormalities, vasculitis and interstitial changes according to 2004 European Neuromuscular Centre criteria.

Results

Fifteen patients underwent muscle biopsy in the study period. Clinical presentations included mucocutaneous (9), musculoskeletal (14), hematological (3), renal (8), hepatic (1) and central nervous system (CNS) (4) manifestations, and neuropathy (4), serositis (2), Raynaud's phenomenon (1) and infectious complications (8). Histological findings were perivascular/perimysial inflammation (7/15), type 1 predominance (7/15) and type 2 atrophy (13/15). Clinical evidence of myositis was seen in 8.8% of patients in the SLE registry, whereas histological evidence of myositis was seen in 46.66% of biopsied patients with muscle symptoms. There was no significant difference in clinical, serological, laboratory and muscle histology features between groups of patients with or without myositis. Type 2 atrophy was the predominant finding in SLE patients irrespective of time of muscle biopsy, treatment received and presence or absence of myositis.

Conclusions

Histological evidence of myositis was found in 46.66% of SLE patients and there were no significant differences in clinical/laboratory features in patients with or without myositis. Type 2 atrophy was seen in patients irrespective of time of the biopsy, treatment received and presence or absence of myositis. Type 2 atrophy was considered the major cause for muscle symptoms.
Global statistics on addictive behaviours: 2014 status report
Authors: Gowing Linda R. , Ali Robert L. , Allsop Steve , Marsden John , Turf Elizabeth E. , West Robert , Witton John
Published: May 2015

Background and aims

Addictive behaviours are among the greatest scourges on humankind. It is important to estimate the extent of the problem globally and in different geographical regions. Such estimates are available, but there is a need to collate and evaluate these to arrive at the best available synthetic figures. Addiction has commissioned this paper as the first of a series attempting to do this.

Methods

Online sources of global, regional and national information on prevalence and major harms relating to alcohol use, tobacco use, unsanctioned psychoactive drug use and gambling were identified through expert review and assessed. The primary data sources located were the websites of the World Health Organization (WHO), the United Nations Office on Drugs and Crime (UNODC) and the Alberta Gambling Research Institute. Summary statistics were compared with recent publications on the global epidemiology of addictive behaviours.

Results

An estimated 4.9% of the world's adult population (240 million people) suffer from alcohol use disorder (7.8% of men and 1.5% of women), with alcohol causing an estimated 257 disability‐adjusted life years lost per 100 000 population. An estimated 22.5% of adults in the world (1 billion people) smoke tobacco products (32.0% of men and 7.0% of women). It is estimated that 11% of deaths in males and 6% of deaths in females each year are due to tobacco. Of ‘unsanctioned psychoactive drugs’, cannabis is the most prevalent at 3.5% globally, with each of the others at < 1%; 0.3% of the world's adult population (15 million people) inject drugs. Use of unsanctioned psychoactive drugs accounts for an estimated 83 disability‐adjusted life years lost per 100 000 population. Global estimates of problem gambling are not possible, but in countries where it has been assessed the prevalence is estimated at 1.5%.

Conclusions

Tobacco and alcohol use are by far the most prevalent addictive behaviours and cause the large majority of the harm. However, the quality of data on prevalence and addiction‐related harms is mostly low, and comparisons between countries and regions must be viewed with caution. There is an urgent need to review the quality of data on which global estimates are made and coordinate efforts to arrive at a more consistent approach.
SVSI: Fast and Powerful Set‐Valued System Identification Approach to Identifying Rare Variants in Sequencing Studies for Ordered Categorical Traits
Authors: Bi Wenjian , Kang Guolian , Zhao Yanlong , Cui Yuehua , Yan Song , Li Yun , Cheng Cheng , Pounds Stanley B. , Borowitz Michael J. , Relling Mary V. , Yang Jun J. , Liu Zhifa , Pui Ching‐Hon , Hunger Stephen P. , Hartford Christine M. , Leung Wing , Zhang Ji‐Feng
Published: May 2015

In genetic association studies of an ordered categorical phenotype, it is usual to either regroup multiple categories of the phenotype into two categories and then apply the logistic regression(LG), or apply ordered logistic(oLG), or ordered probit(oPRB)regression, which accounts for the ordinal nature of the phenotype. However, they may lose statistical power or may not control type I error due to their model assumption and/or instable parameter estimation algorithm when the genetic variant is rare or sample size is limited. To solve this problem, we propose a set‐valued(SV)system model to identify genetic variants associated with an ordinal categorical phenotype. We couple this model with a SV system identification algorithm to identify all the key system parameters. Simulations and two real data analyses show thatSVandLGaccurately controlled the Type I error rate even at a significance level of 10−6but notoLGandoPRBin some cases.LGhad significantly less power than the other three methods due to disregarding of the ordinal nature of the phenotype, andSVhad similar or greater power thanoLGandoPRB. We argue thatSVshould be employed in genetic association studies for ordered categorical phenotype.
Influence of less than full‐time or full‐time on totality of training and subsequent consultant appointment in anaesthesia
Authors: Randive S. , Johnston C. L. , Fowler A. M. , Evans C. S.
Published: May 2015

Changes in medical training have increased the popularity of less than full‐time training. However, there are no data on the impact on training time or consultant workforce. We reviewed a three‐year cohort of trainees via the Royal College of Anaesthetist's training and recruitment databases. Eighty‐eight (96%) less than full‐time trainees and 677 (95%) full‐time trainees were appointed to a substantive consultant post (p = 0.82). Three (3%) less than full‐time trainees and 12 (2%) full‐time trainees gained part‐time consultant posts (p < 0.001). Average length of training (years, months, days) was 8 y, 5 m, 6 d (median (IQR [range]) 5 y, 0 m, 14 d (4 y, 11 m, 29 d – 9 y, 8 m, 3 d [4 y, 2 m, 18 d – 12 y, 0 m, 0 d]) for full‐time and 10 y, 8 m, 23 d (median (IQR [range]) 7 y, 3 m, 28 d (6 y, 7 m, 24 d – 11 y, 1 m, 23 d [4 y, 11 m, 29 d – 11 y, 9 m, 10 d]) for less than full‐time trainees. The average length of training for both groups is significantly longer than the seven years used in workforce planning.
Concrete connections? Articulation, homology and the political geography of boundary walls
Authors: Alan Boyce Geoffrey , Marshall David J , Wilson Jeffrey
Published: May 2015

Scholarly and activist discourses alike have invoked a homology between walling practices along the US/Mexico border and in occupied Palestine. Such discourses often rely on visual/rhetorical manoeuvres to assert equivalence between distinct sites, technologies and practices. Often, this equivalence then enables the collapsing of difference into what we describe as the ‘global security’ paradigm, one that represents a multiplicity of governmental practices, logics and outcomes as manifestations of a singular ‘global’ phenomenon. Although we celebrate the impulse to articulate common struggles against violence or dispossession, we question whether the assertion of singularity or equivalence between sites obscures important differences that might more productively inform a politics of solidarity. We furthermore ask whether viewing ‘securitisation’ as a ubiquitous global phenomenon risks reiterating the very logic by which states rhetorically justify their walling practices. In this paper we explore these issues, and identify a need for further work that takes seriously the heterogeneity of walling projects while examining the translocal practices and articulations that inform their proliferation and construction.
In patients with myelodysplastic syndromes with del(5q), factors other than age and sex contribute to the prognostic advantage, which diminishes over time
Authors: Lauseker Michael , Schemenau Jennifer , Strupp Corinna , Kündgen Andrea , Gattermann Norbert , Hasford Joerg , Germing Ulrich
Published: May 2015

This study aimed to determine the extent to which the prognostic advantage of myelodysplastic syndromes (MDS) with del(5q) is due to the more favourable age and sex distribution of patients in that group when compared to other MDS subtypes. A total of 1912 MDS patients from the Duesseldorf registry with less than 5% blasts in the bone marrow were evaluable and had complete covariates. As endpoints, overall survival and progression to acute myeloid leukaemia (AML) were considered. Cox models were computed for both outcomes. A multivariate Cox model for survival confirmed higher age and male sex as risk factors. In addition, we found a survival advantage of 9·1 years for MDS del(5q) patients compared to refractory cytopenia with unilineage dysplasia, while the survival advantage of MDS del(5q) over refractory cytopenia with multilineage dysplasia was 18·6 years. Considering progression to AML, we did not find any significant differences between the World Health Organization classification subtypes. Our analyses show that the higher survival probabilities of MDS del(5q) patients are not only due to age and sex, although higher age and male sex were also important risk factors. Interestingly, it seems that the survival advantage of MDS del(5q) decreases over time.
A meta‐analysis of mammographic screening with and without clinical breast examination
Authors: Hamashima Chisato , Ohta Koji , Kasahara Yoshio , Katayama Takafumi , Nakayama Tomio , Honjo Satoshi , Ohnuki Koji
Published: May 2015

Mammographic screening with clinical breast examination has been recommended in Japan since 2000. Although mammographic screening without clinical breast examination has not been recommended, its introduction is anticipated. The efficacies of mammographic screening with and without clinical breast examination were evaluated based on the results of randomized controlled trials. PubMed and other databases for studies published between 1985 and 2014 were searched. The study design was limited to randomized controlled trials to evaluate mortality reduction from breast cancer. Five studies were eligible for meta‐analysis of mammographic screening without clinical breast examination. The relative risk for women aged 40–74 years was 0.75 (95% confidence interval, 0.67–0.83). Three studies evaluated the efficacy of mammographic screening with clinical breast examination. The relative risk for women aged 40–64 years was 0.87 (95% confidence interval, 0.77–0.98). The number needed to invite was always lower in mammographic screening without clinical breast examination than in mammographic screening with clinical breast examination. In both screening methods, the number needed to invite was higher in women aged 40–49 years than in women aged 50–70 years. These results suggest that mammographic screening without clinical breast examination can afford higher benefits to women aged 50 years and over. Although evidence of the efficacy of mammographic screening without clinical breast examination was confirmed based on the results of the randomized controlled trials, a Japanese study is needed to resolve local problems.
Real-time quantitative reverse transcription–polymerase chain reaction to detect propionibacterial ribosomal RNA in the lymph nodes of Chinese patients with sarcoidosis
Authors: Zhou Y , Wei Y-R , Zhang Y , Du S-S , Baughman R P , Li H-P
Published: May 2015

The aim of this study was to investigate the diagnostic value of using the copy number of propionibacterial rRNA as a biomarker for sarcoidosis. Ribosomal RNA of Propionibacterium acnes and P. granulosum was measured by real-time quantitative reverse transcription–polymerase chain reaction (RT–PCR) using formalin-fixed and paraffin-embedded tissue of lymph node biopsy from 65 Chinese patients with sarcoidosis, 45 with tuberculosis and 50 controls with other diseases (23 with non-specific lymphadenitis and 27 with mediastinal lymph node metastasis from lung cancer). The receiver operating characteristic (ROC) curve was analysed to determine an optimal cut-off value for diagnosis, and the diagnostic accuracy of the cut-off value was evaluated in additional tissue samples [24 patients with sarcoidosis and 22 with tuberculosis (TB)]. P. acnes or P. granulosum rRNA was detected in 48 of the 65 sarcoidosis samples but only in four of the 45 TB samples and three of the 50 control samples. Analysis of the ROC curve revealed that an optimal cut-off value of the copy number of propionibacterial rRNA for diagnosis of sarcoidosis was 50·5 copies/ml with a sensitivity and specificity of 73·8 and 92·6%, respectively. Based on the cut-off value, 19 of the 24 additional sarcoidosis samples exhibited positive P. acnes or P. granulosum, whereas only one of the 22 additional TB samples was positive, resulting in a sensitivity and specificity of 79·2 and 95·5%, respectively. These findings suggest that propionibacteria might be associated with sarcoidosis granulomatous inflammation. Detection of propionibacterial rRNA by RT–PCR might possibly distinguish sarcoidosis from TB.
Refugees in the Arab Middle East: Academic and Policy Perspectives
Authors: Fábos Anita
Published: May 2015

The field of Refugee Studies is relatively unfamiliar to Middle East area specialists despite the significance of refugees in the region. The strong policy orientation of much of the work in the field has often shaped the way refugee issues are framed by scholars as well as practitioners. Concerns and discourses about refugee‐producing regions in general, and the Arab Middle East in particular, have tended to reflect Western notions of belonging, citizenship, and the state; and in recent years, have been seen through a lens of securitization in the region. This article addresses the development of the field, the subject of displacement and dispossession in the Arab Middle East from a Western perspective, the significant role that Arab cities play as sites for hosting refugees, and the challenges presented by the continued existence of Palestinian refugees.
Fulbright's Middle East: A Senator's Influence on American Foreign Policy
Authors: Stocker James R.
Published: May 2015

This article examines Sen. J. William Fulbright's views of and impact on U.S. policy toward the Middle East, particularly the Arab‐Israeli conflict. It contributes to the literature on the history of U.S.‐Middle East relations and the role of Congress in foreign policy. While Fulbright was not always (or even most of the time) successful in shaping debate and policy along the lines that he advocated, at several crucial junctures, he did have an important influence on U.S. policy toward the region.
Direct negative density‐dependence in a pond‐breeding frog population
Authors: Băncilă Raluca I. , Ozgul Arpat , Hartel Tibor , Sos Tibor , Schmidt Benedikt R.
Published: May 2015

Understanding population dynamics is critical for the management of animal populations. Comparatively little is known about the relative importance of endogenous (i.e. density‐dependent) and exogenous (i.e. density‐independent) factors on the population dynamics of amphibians with complex life cycles. We examined the potential effects of density‐dependent and ‐independent (i.e. climatic) factors on population dynamics by analyzing a 15‐yr time series data of the agile frogRana dalmatinapopulation from Târnava Mare Valley, Romania. We used two statistical models: 1) the partial rate correlation function to identify the feedback structure and the potential time lags in the time series data and 2) a Gompertz state‐space model to simultaneously investigate direct and delayed density dependence as well as climatic effects on population growth rate. We found evidence for direct negative density dependence, whereas delayed density dependence and climate did not show a strong influence on population growth rate. Here we demonstrated that direct density dependence rather than delayed density dependence or climate determined the dynamics of our study population. Our results confirm the findings of many experimental studies and suggest that density dependence may buffer amphibian populations against environmental stress. Consequently, it may not be easy to scale up from individual‐level effects to population‐level effects.
Brain size affects female but not male survival under predation threat
Authors: Kotrschal Alexander , Buechel Séverine D. , Zala Sarah M. , Corral‐Lopez Alberto , Penn Dustin J. , Kolm Niclas
Published: May 2015

There is remarkable diversity in brain size among vertebrates, but surprisingly little is known about how ecological species interactions impact the evolution of brain size. Using guppies, artificially selected for large and small brains, we determined how brain size affects survival under predation threat in a naturalistic environment. We cohoused mixed groups of small‐ and large‐brained individuals in six semi‐natural streams with their natural predator, the pike cichlid, and monitored survival in weekly censuses over 5 months. We found that large‐brained females had 13.5% higher survival compared to small‐brained females, whereas the brain size had no discernible effect on male survival. We suggest that large‐brained females have a cognitive advantage that allows them to better evade predation, whereas large‐brained males are more colourful, which may counteract any potential benefits of brain size. Our study provides the first experimental evidence that trophic interactions can affect the evolution of brain size.
Prospective assessment of autism traits in children exposed to antiepileptic drugs during pregnancy
Authors: Wood Amanda G. , Nadebaum Caroline , Anderson Vicki , Reutens David , Barton Sarah , O'Brien Terence J. , Vajda Frank
Published: May 2015

Purpose

The association between autism spectrum disorders (ASDs) and prenatal anticonvulsant exposure is increasingly investigated, but comprehensive, blinded assessment using a validated instrument for autism within a well‐characterized prospective cohort has not been conducted. Thus, existing studies may represent an underestimate of the true risk. Herein we present a prospective cohort study in children exposed to anticonvulsants during pregnancy, with all assessments conducted by examiners who were blinded to drug‐exposure status.

Methods

Participants were 105 Australian children aged 6–8 years who were recruited via the Australian Pregnancy Register for Women on Antiepileptic Medication. Maternal epilepsy, pregnancy, and medical history data were obtained prospectively. Autism traits were assessed using the Childhood Autism Rating Scale (CARS).

Results

Eleven children (10.5%) had elevated CARS scores. Two were exposed to valproate monotherapy (2/26; 7.7%), two to carbamazepine monotherapy (2/34; 5.9%), and seven to valproate in polytherapy (7/15; 46.7%). Linear regression analysis showed that the mean valproate dose during pregnancy was a significant predictor of CARS scores after controlling for polytherapy, mean carbamazepine dose, folic acid use, seizures during pregnancy, tobacco and marijuana use, maternal intelligence quotient (IQ), and socioeconomic status. First trimester folic acid supplementation and marijuana use were also significant predictors of CARS scores.

Significance

Using direct assessment of children in our prospective study, we found an elevated rate of autism traits across the sample. The most important determinant of association with autistic traits was higher doses of sodium valproate exposure. The use of valproate in women who may become pregnant is now generally avoided; however, there are insufficient data regarding the risk of ASD with low‐dose valproate. If this risk is no greater than with other antiepileptic drugs (AED)s, it may enable women with genetic generalized epilepsy to retain optimal seizure control as well as minimize harm to their unborn child.
Understanding Federal Student Loan Repayment
Authors: Johnson Carrie
Published: May 2015

The purpose of this study was to explain the federal student loan repayment process. Individuals with a college degree earn more over their lifetime than those without a college degree. However, the price of a college education has increased substantially and 69% of college graduates in 2012 had student loans to repay. There are eight federal repayment plans that may lead to confusion for borrowers. Education is needed to assist borrowers in making informed repayment decisions. Educators at postsecondary institutions have an opportunity to provide education to students.
The Financial Wellness Industry and a Crowded Legal‐Employment Market: Market Failure Summons Synergy
Authors: Steven Swan George
Published: May 2015

A mismatch between meager job openings for attorneys and a years‐long eruption of law school graduates is a concern. By contrast, in 2014, the personal financial planning occupation appeared among the more rapidly growing fields for the timeframe ending in 2020. The law degree marks an asset within the financial planning industry. Personal financial planning overlaps with law in estate planning and income taxation. The purpose of this paper is to suggest for underemployed Juris Doctors that (1) the financial wellness industry possibly affords an opening into the broader arena of financial services; and that (2) the Certified Personal and Family Finance Educator credential awarded by the American Association of Family and Consumer Sciences provides a potential bridge from the law school campus into the financial wellness industry. Research into the feasibility of this pair of propositions is suggested, while potential sources of relevant information are identified.
Land‐use legacy and the differential response of stream macroinvertebrates to multiple stressors studied usingin situexperimental mesocosms
Authors: Baumgartner Simone D. , Robinson Christopher T.
Published: May 2015

The historical reduction in habitat heterogeneity and water quality of running waters is an ongoing challenge being addressed by resource managers worldwide. The persistent legacy of past land use, reflected in part by depauperate macroinvertebrate assemblages, is likely to affect the responses of macroinvertebrate assemblages to novel anthropogenic stressors and amendments (e.g. river restoration).

The response of macroinvertebrate assemblages differing in the abundance of sensitive taxa to stressors was investigated using a mesocosm experiment conducted at five sites within two sub‐basins that differed in historic land‐use impacts. The sub‐basins were similar in morphology and water quality, but a higher dissolved organic carbon (DOC) level in the sub‐basin with a less sensitive assemblage reflected a greater agricultural influence.

Macroinvertebrate assemblages were assessed monthly over an annual cycle in replicatedin situmesocosms manipulated with respect to substratum heterogeneity (fine, coarse) and water quality (nutrient amendments) following a full‐factorial design. Due to relatively high background nutrient levels, there was no effect of nutrient amendment on macroinvertebrate colonisation of mesocosms.

In the sub‐basin harbouring a more sensitive macroinvertebrate assemblage, higher total andEPTtaxa richness was found in coarse (heterogeneous) substratum than that in fine (homogeneous) substratum mesocosms, whereas this response was not observed in the sub‐basin with a less sensitive assemblage. In the former sub‐basin, coarse substratum mesocosms were more favourable for sensitive taxa, as they had more diverse flow patterns, less clogging of interstitial spaces and more benthic organic matter than fine substratum mesocosms.

These results suggest that past land‐use legacies influencing current macroinvertebrate assemblages can underlie differential response patterns of macroinvertebrates to habitat mitigation measures in human‐dominated catchments.
The Great Recession and the Migration Redistribution of Blacks and Whites in the U.S. South
Authors: Rivers Natasha , Wright Richard , Ellis Mark
Published: May 2015

Abtract

For much of the last century, the South was a net loser of blacks and whites to other regions. The end of this “Great Migration” occurred around 1970. Since then, the South is the only U.S. region to gain both blacks and whites through migration in every decade. As recessions often perturb migration systems by restraining rates of movement and altering patterns, this paper explores how the Great Recession of 2007–2009 and its aftermath affected the established migration gains of native‐born blacks and whites within the South. We use data from the 1990 and 2000 censuses and pooled data from American Community Survey to evaluate these changes. While the South continued to add both blacks and whites from migration during the recessionary years, key states bucked this trend. Georgia, for example, experienced a net migration gain of blacks but a net loss of whites. Florida added population in all time periods studied but lost large numbers of educated blacks and whites between 2008–2010. Texas, in contrast, added both blacks and whites from migration no matter their age or education throughout the recent recession. This economic downturn, then, has disturbed long‐term migration patterns in the South. A more nuanced set of interstate movements has emerged, differentiated by age and education within race groups, which we suspect will last for some time.
Dynamics of the Russia–China Forest Products Trade
Authors: Narins Thomas P.
Published: May 2015

Relying primarily on English language scholarship, this paper seeks to highlight the dynamics ofChina's economic integration beyond its borders as Chinese economic actors extend their search for commodities—in this case into theRussianFederation for timber products. The paper considers the shifts in the political economy ofRussian forestry exports from a predominantly domestic andJapan‐focused trade during the 1947–1991ColdWar era to a north–south trajectory increasingly emphasizing trade withChina from 1993 to 2010. Chinese andRussian bilateral trade data, acting as a barometer of national forestry‐related policies, highlight the economic convergence and benefits brought to both theRussian andChinese timber sectors over the past two decades. Far from being an environmentally deterministic process—one based on the physical geographic characteristics on the ground in both of these states—this binational commodity trade shows that the geography of theRussia–China forest product trade is highly dynamic, temporally variable, and intimately intertwined with national political and economic considerations.
Body mass index and early CD4 T‐cell recovery among adults initiating antiretroviral therapy in North America, 1998–2010
Authors: Koethe JR , Jenkins CA , Lau B , Shepherd BE , Silverberg MJ , Brown TT , Blashill AJ , Anema A , Willig A , Stinnette S , Napravnik S , Gill J , Crane HM , Sterling TR ,   North American AIDS Cohort Collaboration on Research and Design (NA‐ACCORD)
Published: May 2015

Objectives

Adipose tissue affects several aspects of the cellular immune system, but prior epidemiological studies have differed on whether a higher body mass index (BMI) promotes CD4 T‐cell recovery on antiretroviral therapy (ART). The objective of this analysis was to assess the relationship between BMI at ART initiation and early changes in CD4 T‐cell count.

Methods

We used the North American AIDS Cohort Collaboration on Research and Design (NA‐ACCORD) data set to analyse the relationship between pre‐treatment BMI and 12‐month CD4 T‐cell recovery among adults who started ART between 1998 and 2010 and maintained HIV‐1 RNA levels < 400 copies/mL for at least 6 months. Multivariable regression models were adjusted for age, race, sex, baseline CD4 count and HIV RNA level, year of ART initiation, ART regimen and clinical site.

Results

A total of 8381 participants from 13 cohorts contributed data; 85% were male, 52% were nonwhite, 32% were overweight (BMI 25–29.9 kg/m2) and 15% were obese (BMI > 30 kg/m2). Pretreatment BMI was associated with 12‐month CD4 T‐cell change (P < 0.001), but the relationship was nonlinear (P < 0.001). Compared with a reference of 22 kg/m2, a BMI of 30 kg/m2 was associated with a 36 cells/μL [95% confidence interval (CI) 14, 59 cells/μL] greater CD4 T‐cell count recovery among women and a 19 cells/μL (95% CI 9, 30 cells/μL) greater recovery among men at 12 months. At a BMI > 30 kg/m2, the observed benefit was attenuated among men to a greater degree than among women, although this difference was not statistically significant.

Conclusions

A BMI of approximately 30 kg/m2 at ART initiation was associated with greater CD4 T‐cell recovery at 12 months compared with higher or lower BMI values, suggesting that body composition may affect peripheral CD4 T‐cell recovery.
Prevalence of cryptococcal antigenuria at initial HIV diagnosis in KwaZulu‐Natal
Authors: Drain PK , Kleene JM , Coleman SM , Losina E , Katz JN , Giddy J , Ross D , Freedberg KA , Bassett IV
Published: May 2015

Objectives

The World Health Organization (WHO) recommends screening HIV‐infected people for cryptococcal antigens to identify cryptococcosis, a major cause of AIDS‐related deaths. As the burden of cryptococcosis is unknown in South Africa's KwaZulu‐Natal province, we assessed the cryptococcal antigenuria prevalence among newly diagnosed HIV‐infected adults there.

Methods

We conducted a cross‐sectional study of newly diagnosed HIV‐infected adults who received voluntary HIV testing in an out‐patient clinic. Participants provided a urine specimen in a sterile container, and we performed testing with a WHO‐endorsed rapid cryptococcal antigen lateral flow assay (Immy Inc., Norman, OK, USA) per the manufacturer's specifications. We assessed cryptococcal antigenuria prevalence among participants with CD4 counts < 200 cells/μL, and stratified results by CD4 count categories.

Results

Among 432 participants, the mean (± standard deviation) age was 36.1 ± 9.9 years and 172 (40%) were female. The overall estimated prevalence of cryptococcal antigenuria was 9.0% [95% confidence interval (CI) 6.5–12.1%]. CD4 counts were available for 319 participants (74%); the median CD4 count was 75 cells/μL [interquartile range (IQR) 34–129 cells/μL]. Participants with a negative cryptococcal antigenuria screening test had a median CD4 count of 79 cells/μL (IQR 36–129 cells/μL), while participants with a positive cryptococcal test had a median CD4 count of 41 cells/μL (IQR 10–112 cells/μL). The estimated prevalence of cryptococcal antigenuria among participants with CD4 counts < 50 cells/μL was 12.5% (95% CI 7.0–20.1%), which was significantly higher than that among participants with CD4 counts of 50–200 cells/μL (4.8%; 95% CI 2.3–8.7%).

Conclusions

Nearly 1 in 10 newly diagnosed HIV‐infected adults with CD4 counts < 200 cells/μL in KwaZulu‐Natal had evidence of cryptococcal antigenuria. Point‐of‐care CD4 count testing and cryptococcal antigen screening may rapidly identify cryptococcosis at the time of HIV diagnosis.
Uniqueness, stability, and local comparative statics for competitive equilibrium
Authors: Keenan Donald C. , Kim Taewon
Published: May 2015

The aggregate law of demand for an exchange economy can be weakened while still obtaining uniqueness, global stability, and good local comparative static properties for equilibrium. Classically, this is done by assuming that the Jacobian of excess demand is negative definite in the dimensions of compensated price changes, this being the weak axiom for aggregate demand. Similarly, though, one obtains the very same properties of equilibrium by only assuming that this Jacobian acts negatively in the one remaining complementary dimension. We refer to this dimension as the direction of the income effect, in analogy to a representative consumer. It is further argued that stability under this complementary condition is less sensitive than is the weak axiom to breakdowns in the condition far from the region under consideration.
Optimal intermediated investment in a liquidity‐driven cycle
Authors: Li Jenny X. , Pan Jia
Published: May 2015

A general equilibrium model of a financial intermediary extends the one first introduced by Diamond and Dybvig to an infinite‐horizon environment. As in the Diamond–Dybvig model, the bank is considered as an optimal financial intermediary coalition in the present work. With the enriched framework, we study how the bank adjusts its asset portfolio in response to a shock that affects the size of its liability. Analysis shows that the bank adjusts not only the supply of credit but also its liquidity composition. The results are qualitatively consistent with what we observe from the banking industry in the United States.
Sexual size dimorphism in anadromous brown trout Salmo trutta
Authors: Jonsson B. , Jonsson N.
Published: May 2015

Anadromous trout Salmo trutta exhibits sexual size dimorphism (SSD); females were larger than males in populations where male mean total length (LT) at maturity was below 49 cm and females were smaller than males when mean male LT was above 49 cm, the slope of the regression of female on male LT was 0·59. In streams with mean annual discharge below 41 m3 s−1, flow added significantly to a model with SSD as the dependent variable and male mean LT at maturity as the first predictor variable. There was a slight increase in SSD with increasing latitude, which may result from an increase in male size with increasing latitude.
The effect of working time on the displacement of Biodentine™ beneath prefabricated stainless steel crown: a laboratory study
Authors: Dawood Alaa E. , Manton David J. , Parashos Peter , Wong Rebecca H. K.
Published: May 2015

Objective

To investigate the displacement of Biodentine™ following cementation of stainless steel crowns (SSC) with glass‐ionomer cement (GIC) on plastic deciduous teeth prepared for pulpotomy.

Methods

Twenty plastic teeth with prepared occlusal cavities were divided into four groups and had Biodentine™ placed as a mock pulpotomy agent. The pulp chamber was filled with freshly mixed Biodentine™ then a GIC‐loaded SSC was seated on the tooth using a standardized seating force for periods of: 1 min (Group 1); 2 min (Group 2), 3 min (Group 3) and 6 min (Group 4) after mixing. After 24 h at 37°C and 90% humidity, the crowns were sectioned mesio‐distally and standardized digital photographs taken. Image analysis software was used to determine the ratio of the surface area of displaced Biodentine™ relative to the surface area of the pulp chamber. The thinnest section of the remaining Biodentine™ was measured.

Results

The lowest values of Biodentine™ displacement and the highest values of remaining Biodentine™ thickness were associated with Group 4. There were no significant differences between the results in Group 3 and Group 4.

Conclusion

Within the limitations of this in vitro study, a GIC‐loaded SSC can be seated on Biodentine™ placed into a pulp chamber 3 min after mixing.
Boundaries for the Retail Geographical Market and Factors Influencing Shoppers' Mobility
Authors: Anić Ivan‐Damir , Radas Sonja
Published: May 2015

A growing number of mergers and their potentially negative impacts on consumer welfare in the retailing sector have prompted discussion on how to define the boundaries of the relevant market. This article explores the boundaries of the geographic market of daily consumer goods through an examination of factors that influence shoppers' mobility in Croatia. The study takes into consideration the purpose of the trip and differentiates between major and fill‐in shopping trips, and demonstrates that different factors impact the shopper mobility for each of the two shopping trips. It provides support for the practice of defining market boundaries empirically on the basis of region and store format specificities, taking into account prevalent shopping occasion, economic situation of the residents, size of the residential area, and geographical placement of the stores among other things. The study shows that the boundaries of the retail market may be more narrow than expected.
A prospective, comparative survey to investigate practitioners’ satisfaction with a cohesive, polydensified‐matrix®, hyaluronic acid‐based filler gel with and without lidocaine for the treatment of facial wrinkles
Authors: Prager Welf , Micheels Patrick
Published: May 2015

Background

Lidocaine‐containing dermal fillers may reduce procedural pain compared with lidocaine‐free counterparts.

Objectives

To assess practitioners’ administration experience with, and the efficacy and safety of, a cohesive, polydensified‐matrix®, hyaluronic acid‐based filler containing lidocaine vs. its lidocaine‐free counterpart.

Methods

The lidocaine‐containing formulation was injected to one side of the face and the lidocaine‐free to the other in 29 females (30–85 years). Administered dose was appropriate to the treatment zone and technique varied according to zone and practitioner preference. Questionnaires assessed practitioners’ administration experience, their perception of results, subject satisfaction, and product safety.

Results

Practitioners considered the formulations to be similar in terms of ejection force, texture, and placement. The blanching technique was used for 72% of subjects, and its ease was rated as “identical” for both products in 81% of applications and “easier” for the lidocaine‐containing product in 6.9% of applications. Results with both formulations were “identical” for 86% of applications and “similar” for the remainder. In 86% of cases, practitioners would “certainly” consider continuing treatment with the lidocaine‐containing formulation. All subjects were “satisfied” with treatment. Practitioners reported that, compared with the lidocaine‐free product, subject‐assessed pain with the lidocaine‐containing product was “less prominent” for 86% and 79% of participants during and following treatment, respectively. Similarly, mean pain intensity was significantly lower for the lidocaine‐containing preparation (P = 0.0001). Adverse events were similar for both treatments.

Conclusions

The lidocaine‐containing dermal filler significantly reduced pain during and following treatment compared with the same preparation without lidocaine, without impact on administration, aesthetic outcome, or safety.
Psychometric performance of the English language six‐item Caring Behaviours Inventory in an acute care context
Authors: Edvardsson David , Mahoney Anne‐Marie , Hardy Juanita , McGillion Tony , McLean Anne , Pearce Frances , Salamone Kathryn , Watt Elizabeth
Published: May 2015

Aims and objectives

This study aimed to evaluate the psychometric performance of the six‐item Caring Behaviours Inventory in a sample of Australian acute hospital inpatients.

Background

Caring is significant for nursing, and exploring the prevalence of staff‐caring behaviours is imperative for high‐quality acute care. There is a need for psychometrically sound scales that measures caring in acute care, without imposing extensive respondent burden.

Design

A cross‐sectional survey design was used to distribute the six‐item Caring Behaviours Inventory to an Australian sample of hospital inpatients (n = 210) in December 2012.

Method

Psychometric evaluation included item performance, construct validity and internal consistency reliability.

Results

The six‐item Caring Behaviours Inventory had satisfactory psychometric performance as evidenced by normally distributed scores, a uni‐dimensional structure explaining 65% of variance in data, a total Cronbach's α of 0·89 and corrected item‐total correlations between 0·51–0·82.

Conclusion

The six‐item Caring Behaviours Inventory had satisfactory estimates of validity and reliability when tested in an Australian sample of acute hospital inpatients. The tool contributes to the literature by being a brief and nonburdensome alternative with seemingly strong psychometric properties to be used in future measures of caring in nursing.

Relevance to clinical practice

The six‐item Caring Behaviours Inventory provides a psychometrically tested fundament for reflective clinical discussions on how nurse behaviours facilitate or impede patient experiences of caring. This can benefit quality development in clinical practice as being in tune with patient experiences and expectations is fundamental to high quality services and patient satisfaction.
Experience of living with an enterocutaneous fistula
Authors: Härle Karolina , Lindgren Margareta , Hallböök Olof
Published: May 2015

Aims and objectives

The purpose of this study was to describe patients’ experiences of living with an enterocutaneous fistula.

Background

An enterocutaneous fistula is a complex and serious illness that usually occurs as a complication from surgery or spontaneously as a result of an underlying disease. The illness is demanding both physically and mentally and causes substantial medical and nursing problems for the afflicted individual.

Design

A descriptive design with a qualitative approach.

Methods

In‐depth interviews were performed with nine participants who had experiences of living with an enterocutaneous fistula. The analysis was conducted using descriptive phenomenology according to Giorgi.

Results

The essence of this study was that living with an enterocutaneous fistula is about handling an illness that causes several limitations in daily life and the following five themes emerged from the data: restrictions in daily life, approaches to illness, emotions, dependence and need of support. A constant fear of leakage from the fistula appliance, being dependent on intravenous fluids and being dependent on health care professionals caused isolation and social restriction.

Conclusions

The participants had many strategies for handling their illness. By being well trained, engaged and having a positive and understanding approach, health care professionals can encourage hope, motivation and self‐care. This can lead to decreased dependence and help the patient to better handle their illness.

Relevance to clinical practice

The competence of health care professionals is essential in the care of patients with an enterocutaneous fistula.
Why close relatives make bad neighbours: phylogenetic conservatism in niche preferences and dispersal disproves Darwin's naturalization hypothesis in the thistle tribe
Authors: Park Daniel S. , Potter Daniel
Published: May 2015

The number of exotic plant species that have been introduced into the United States far exceeds that of other groups of organisms, and many of these have become invasive. As in many regions of the globe, invasive members of the thistle tribe, Cardueae, are highly problematic in the California Floristic Province, an established biodiversity hotspot. While Darwin's naturalization hypothesis posits that plant invaders closely related to native species would be at a disadvantage, evidence has been found that introduced thistles more closely related to native species are more likely to become invasive. To elucidate the mechanisms behind this pattern, we modelled the ecological niches of thistle species present in the province and compared niche similarity between taxa and their evolutionary relatedness, using fossil‐calibrated molecular phylogenies of the tribe. The predicted niches of invasive species were found to have higher degrees of overlap with native species than noninvasive introduced species do, and pairwise niche distance was significantly correlated with phylogenetic distance, suggesting phylogenetic niche conservatism. Invasive thistles also displayed superior dispersal capabilities compared to noninvasive introduced species, and these capabilities exhibited a phylogenetic signal. By analysing the modelled ecological niches and dispersal capabilities of over a hundred thistle species, we demonstrate that exapted preferences to the invaded environment may explain why close exotic relatives may make bad neighbours in the thistle tribe.
Dietary mobile apps and their effect on nutritional indicators in chronic renal disease: A systematic review
Authors: Campbell Janice , Porter Judi
Published: May 2015

Dietary apps for mobile technology are becoming increasingly available and can assist in recording food and fluid intake for nutrition assessment or monitoring. Patients with chronic renal disease, particularly those on dialysis, are required to make significant dietary changes. This study systematically reviews the current literature to assess whether dietary mobile apps improve dietary intake and clinical outcomes in the renal population, specifically those with chronic kidney disease levels 3–5, including dialysis. A systematic search ofMedlineComplete,CINAHL,Embase,PsycINFOand theCochraneLibrary was performed and supplemented by manual searches of citation and reference lists. Of the 712 studies considered, five were eligible for inclusion in this review. The quality of each included study was assessed using aQualityCriteriaChecklist forPrimaryResearch. Among five studies (two randomised controlled trials (RCTs) and three case studies/reports), none found significant changes in nutrient intake, biochemical markers or intradialytic weight gain, through the use of dietary mobile apps. The included studies show potential for clinical benefits of mobile app interventions in a renal population. However, there is a need for additional rigorous trials to demonstrate if there is a clinical benefit of mobile app interventions in this population.
Agitation in dementia and the role of spatial and sensory interventions: experiences of professional and family caregivers
Authors: Van Vracem Marieke , Spruytte Nele , Declercq Anja , Van Audenhove Chantal
Published: May 2015

Aim

There is a growing interest in environmental interventions to complement the psychosocial approaches to cope with agitation in dementia. The aim of this study was to present this evidence from literature and research to care practitioners and family carers in order to gather their reflections. In this way, we can identify experienced gaps in care practice and define needs for further research.

Method

A framework with seven types of environmental interventions for agitation in dementia was developed through literature review, referring to the impact of light, smell, noise, temperature, nature, colour and spatial configuration. This framework guided three expert panels, respectively, with family caregivers of persons with dementia (N = 5), professional home care workers (N = 12) and professional caregivers working in nursing homes (N = 10).

Results

All caregivers stressed the impact of agitation on their quality of life and on the quality of life of the person with dementia. Most caregivers were familiar with the impact of daylight, natural elements and domestic smells. Caregivers were unfamiliar with the specific effects of bright light therapy and were interested in more research on the effectiveness of light, temperature and spatial configuration. They stressed the individuality of agitation in dementia.

Conclusion

Caregivers already use sensory and spatial interventions to manage agitation, and they are interested in knowing more about feasible effective interventions. Caregivers need to be informed on the possible benefits of sensory environmental factors on coping with agitation. To this end, it is very useful to take the experiences of caregivers into account.