bluuebunny/crossref_metadata_2025 huggingface dataset:
A high-throughput whole cell screen to identify inhibitors of Mycobacterium tuberculosis
Authors: Ollinger Juliane , Kumar Anuradha , Roberts David M. , Bailey Mai A. , Casey Allen , Parish Tanya
Published: September 2018

Tuberculosis is a disease of global importance for which novel drugs are urgently required. We developed a whole-cell phenotypic screen which can be used to identify inhibitors of Mycobacterium tuberculosis growth. We used recombinant strains of virulent M. tuberculosis which express far-red fluorescent reporters and used fluorescence to monitor growth in vitro. We optimized our high throughput assays using both 96-well and 384-well plates; both formats gave assays which met stringent reproducibility and robustness tests. We screened a compound set of 1105 chemically diverse compounds previously shown to be active against M. tuberculosis and identified primary hits which showed ≥ 90% growth inhibition. We ranked hits and identified three chemical classes of interest – the phenoxyalkylbenzamidazoles, the benzothiophene 1–1 dioxides, and the piperidinamines. These new compound classes may serve as starting points for the development of new series of inhibitors that prevent the growth of M. tuberculosis. This assay can be used for further screening, or could easily be adapted to other strains of M. tuberculosis.
Bet-hedging strategies in expanding populations
Authors: Paula Villa Martín , Muñoz Miguel A. , Pigolotti Simone
Published: September 2018

In ecology, species can mitigate their extinction risks in uncertain environments by diversifying individual phenotypes. This observation is quantified by the theory of bet-hedging, which provides a reason for the degree of phenotypic diversity observed even in clonal populations. The theory of bet-hedging in well-mixed populations is rather well developed. However, many species underwent range expansions during their evolutionary history, and the importance of phenotypic diversity in such scenarios still needs to be understood. In this paper, we develop a theory of bet-hedging for populations colonizing new, unknown environments that fluctuate either in space or time. In this case, we find that bet-hedging is a more favorable strategy than in well-mixed populations. For slow rates of variation, temporal and spatial fluctuations lead to different outcomes. In spatially fluctuating environments, bet-hedging is favored compared to temporally fluctuating environments. In the limit of frequent environmental variation, no opportunity for bet-hedging exists, regardless of the nature of the environmental fluctuations. For the same model, bet-hedging is never an advantageous strategy in the well-mixed case, supporting the view that range expansions strongly promote diversification. These conclusions are robust against stochasticity induced by finite population sizes. Our findings shed light on the importance of phenotypic heterogeneity in range expansions, paving the way to novel approaches to understand how biodiversity emerges and is maintained.

Author summary

Ecological populations are often exposed to unpredictable and variable environmental conditions. A number of strategies have evolved to cope with such uncertainty. One of them is stochastic phenotypic switching, by which some individuals in the community are enabled to tackle adverse conditions, even at the price of reducing overall growth in the short term. In this paper, we study the effectiveness of these “bet-hedging” strategies for a population in the process of colonizing new territory. We show that bet-hedging is more advantageous when the environment varies spatially rather than temporally, and infrequently rather than frequently.
Unmanned aircraft automatic flight control algorithm in loop manoeuvre
Authors: Rogalski Tomasz
Published: September 2018

Purpose

This paper aims to present the idea of an automatic control system dedicated to small manned and unmanned aircraft performing manoeuvres other than those necessary to perform a so-called standard flight. The character of these manoeuvres and the range of aircraft flight parameter changes restrict application of standard control algorithms. In many cases, they also limit the possibility to acquire complete information about aircraft flight parameters. This paper analyses an alternative solution that can be applied in such cases. The loop manoeuvre, an element of aerobatic flight, was selected as a working example.

Design/methodology/approach

This paper used theoretical discussion and breakdowns to create basics for designing structures of control algorithms. A simplified analytical approach was then applied to tune regulators. Research results were verified in a series of computer-based software-in-the-loop rig test computer simulations.

Findings

The structure of the control system enabling aerobatic flight was found and the method for tuning regulators was also created.

Practical implications

The findings could be a foundation for autopilots working in non-conventional flight scenarios and automatic aircraft recovery systems.

Originality/value

This paper presents the author’s original approach to aircraft automated control where high precision control is not the priority and flight parameters cannot be precisely measured or determined.
Design optimization of helicopter rotor using kriging
Authors: Kizhakke Kodakkattu Saijal , Nair Prabhakaran , M.L. Joy
Published: September 2018

Purpose

The purpose of this study is to obtain optimum locations, peak deflection and chord of the twin trailing-edge flaps and optimum torsional stiffness of the helicopter rotor blade to minimize the vibration in the rotor hub with minimum requirement of flap control power.

Design/methodology/approach

Kriging metamodel with three-level five variable orthogonal array-based data points is used to decouple the optimization problem and actual aeroelastic analysis.

Findings

Some very good design solutions are obtained using this model. The best design point in minimizing vibration gives about 81 per cent reduction in the hub vibration with a penalization of increased flap power requirement, at normal cruise speed of rotor-craft flight.

Practical implications

One of the major challenges in the helicopters is the high vibration level in comparison with fixed wing aircraft. The reduction in vibration level in the helicopter improves passenger and crew comfort and reduces maintenance cost.

Originality/value

This paper presents design optimization of the helicopter rotor blade combining five design variables, such as the locations of twin trailing-edge flaps, peak deflection and flap chord and torsional stiffness of the rotor. Also, this study uses kriging metamodel to decouple the complex aeroelastic analysis and optimization problem.
Awareness and accessibility of the Dutch mental health care system for people with borderline intellectual functioning or mild intellectual disabilities
Authors: Wieland Jannelien , ten Doesschate Mascha
Published: September 2018

Purpose

In The Netherlands, curative mental health care and supportive care for people with an intellectual disability (ID) are organised in separate domains. Prevalence of mental health problems is known to be high among people with borderline intellectual functioning (BIF) or mild intellectual disabilities (MID). By contrast, according to recent findings, prevalence of BIF and MID is high among patients in mental health care (17.5–58 per cent). In The Netherlands, a new quality standard of care (QSOC) on mental health care for people with BIF or MID is developed. It is designed to supplement existing guidelines on mental health care so that they can be used appropriately in people with BIF or MID and meant for use in both mental health care organisations (MHCO) as in organisations for ID care. To a large extent, the QSOC should describe the existing practice. This paper aims to discuss these issues.

Design/methodology/approach

To assess the existing practice in current mental health care for people with BIF or MID in The Netherlands, the authors examined the views and accessibility of MHCO on the mental health care for patients with and IQ<85. In addition, the authors reviewed published criteria for in- and exclusion of all 39 top clinical mental health care departments for criteria on BIF or (mild) ID.

Findings

The authors found there is a clear awareness of the high prevalence of BIF and MID among large Dutch MHCO. Dutch MHCO estimate the prevalence of BIF and MID among their patients to be around 30 per cent. Nonetheless, most MCHO surveyed (76 per cent) indicated they do not routinely estimate or measure IQ among their patients and 53 per cent of MHCO indicated not having knowledge and expertise on the dual diagnoses of mental health problems and BIF or MID. Fitting in with the new QSOC most of the MHCO (59 per cent) agreed on the statement in the survey that professionals should be able to treat patients with BIF or ID and all but one of the MHCO stated to have some form of collaboration with an institute for ID care.

Originality/value

The authors concluded there is a clear awareness of the high prevalence of BIF and MID among large Dutch MHCO. The new QSOC on mental health care for people with BIF or MID can help improve accessibility and quality of mental health care for these patients.
A service-oriented context-awareness reasoning framework and its implementation
Authors: Cheng Xiufeng , Yang Jinqing , Xia Lixin
Published: September 2018

Purpose

This paper aims to propose an extensible, service-oriented framework for context-aware data acquisition, description, interpretation and reasoning, which facilitates the development of mobile applications that provide a context-awareness service.

Design/methodology/approach

First, the authors propose the context data reasoning framework (CDRFM) for generating service-oriented contextual information. Then they used this framework to composite mobile sensor data into low-level contextual information. Finally, the authors exploited some high-level contextual information that can be inferred from the formatted low-level contextual information using particular inference rules.

Findings

The authors take “user behavior patterns” as an exemplary context information generation schema in their experimental study. The results reveal that the optimization of service can be guided by the implicit, high-level context information inside user behavior logs. They also prove the validity of the authors’ framework.

Research limitations/implications

Further research will add more variety of sensor data. Furthermore, to validate the effectiveness of our framework, more reasoning rules need to be performed. Therefore, the authors may implement more algorithms in the framework to acquire more comprehensive context information.

Practical implications

CDRFM expands the context-awareness framework of previous research and unifies the procedures of acquiring, describing, modeling, reasoning and discovering implicit context information for mobile service providers.

Social implications

Support the service-oriented context-awareness function in application design and related development in commercial mobile software industry.

Originality/value

Extant researches on context awareness rarely considered the generation contextual information for service providers. The CDRFM can be used to generate valuable contextual information by implementing more reasoning rules.
Semantic Web and ontology-based applications for digital libraries
Authors: Khan Shakeel Ahmad , Bhatti Rubina
Published: September 2018

Purpose

The purpose of this paper is to explore useful Semantic Web technologies and ontology-based applications for digital libraries. It also investigates the perceptions of university librarians and academicians in Pakistan about Semantic Web technologies and their use in digital libraries.

Design/methodology/approach

An exploratory research design based on Delphi research strategy was conducted to answer the research questions. Interviews were conducted with a purposive sample of 50 key informants including university librarians and academicians to explore their perceptions about Semantic Web technologies and their use in digital libraries. Thematic analysis of interview data was conducted to obtain results.

Findings

The results of this paper showed that DuraCloud, Semantic information mashup, OntoEdit and resource description framework (RDF) are the various Semantic Web applications which are useful for digital libraries to develop semantic relationships among digital contents and increase their accessibility in the web environment. Findings revealed that Semantic Web provides precise results and meets user information needs in an effective way. Results also showed that next-generation digital libraries use context-awareness technology, intelligent agent software and detecting sensors to analyze user information needs and provide dynamic information services. This paper recommended that librarians should embrace the use of emerging web technologies in libraries and offer library services through the medium of the web.

Practical implications

This paper envisaged the future of digital library services and Semantic Web applications that can be used to re-structure metadata of digital library. This paper has practical implications for librarians to consider the useful applications of Semantic Web for digital library and enhance the interoperability of metadata among heterogeneous information systems. Practically, results obtained from this paper are highly useful for library schools and LIS teachers to up-date their curriculum by incorporating new contents related to web languages and Semantic Web applications for digital libraries.

Originality/value

This paper identifies various Semantic Web applications which are useful for developing Semantic Digital Libraries.
Endogenous cases and the evolution of the common law
Authors: Parameswaran Giri
Published: September 2018

I develop a dynamic model of judge‐made law in which the ideal legal rule is unknown but can be learned. In contrast to existing articles, the flow of cases heard by the court is affected by the court's prior decisions. The model highlights the significance of this feedback in explaining when and why the court will write broader or narrower opinions, and the long‐run properties of common law. In equilibrium, the law settles endogenously, because the incentives to make legally controversial choices disappear as the law evolves. Settled law exhibits residual uncertainty and ambiguity, and potentially implements inefficient outcomes.
Comparing auction designs where suppliers have uncertain costs and uncertain pivotal status
Authors: Holmberg Pär , Wolak Frank A.
Published: September 2018

We analyze how market design influences bidding in multiunit procurement auctions where suppliers have asymmetric information about production costs. Our analysis is particularly relevant to wholesale electricity markets, because it accounts for the risk that a supplier is pivotal; market demand is larger than the total production capacity of its competitors. With constant marginal costs, expected welfare improves if the auctioneer restricts offers to be flat. We identify circumstances where the competitiveness of market outcomes improves with increased market transparency. We also find that, for buyers, uniform pricing is preferable to discriminatory pricing when producers' private signals are affiliated.
Vascular plant species richness and bioindication predict multi‐taxon species richness
Authors: Brunbjerg Ane Kirstine , Bruun Hans Henrik , Dalby Lars , Fløjgaard Camilla , Frøslev Tobias G. , Høye Toke T. , Goldberg Irina , Læssøe Thomas , Hansen Morten D. D. , Brøndum Lars , Skipper Lars , Fog Kåre , Ejrnæs Rasmus
Published: September 2018

Plants regulate soils and microclimate, provide substrate for heterotrophic taxa, are easy to observe and identify and have a stable taxonomy, which strongly justifies their use as indicators in monitoring and conservation. However, there is no consensus as to whether plants are strong predictors of total multi‐taxon species richness. In this study, we investigate if general terrestrial species richness can be predicted by vascular plant richness and bioindication.

To answer this question, we collected an extensive dataset on species richness of vascular plants, bryophytes, macrofungi, lichens, plant‐galling arthropods, gastropods, spiders, carabid beetles, hoverflies, and genetic richness (operational taxonomic units = OTUs) from environmental DNA metabarcoding. We also constructed a Conservation Index based on threatened red list species. Besides using richness of vascular plants for prediction of other taxonomic groups, we also used plant‐derived calibration of the abiotic environment (moisture, soil fertility and light conditions) as well as the degree of anthropogenic impact.

Bivariate relationships between plant species richness and other species groups showed no consistent pattern. After taking environmental calibration by bioindication into account, we found a consistent, and for most groups significant, positive effect of plant richness. Plant species richness was also important for richness of fungal OTUs, Malaise OTUs and for the Conservation Index. Our multiple regression analyses revealed (a) a consistently positive effect of plant richness on other taxa, (b) prediction of 12%–55% of variation in other taxa and 48% of variation in the total species richness when bioindication and plant richness were used as predictors.

Our results justify that vascular plants are strong indicators of total biodiversity across environmental gradients and broad taxonomic realms and therefore a natural first choice for biodiversity monitoring and conservation planning.
Correlation between port‐to‐target distance and procedural difficulty in single‐incision laparoscopic cholecystectomy: An observational study
Authors: Ohira Masafumi , Shibuya Kazuaki , Uemura Kazuhito , Takahashi Hiroaki , Ito Yoshio
Published: September 2018

Introduction

Single‐incision laparoscopic cholecystectomy (SILC) is more challenging than conventional (multiport) laparoscopic cholecystectomy (CLC) because of the increased likelihood of instrument collision and the limited surgical workspace. In SILC, procedural difficulties may increase when the port‐to‐target distance is long. We aimed to assess the correlation between port‐to‐target distance and procedural difficulty.

Methods

Thirty‐six consecutive patients who underwent SILC at our hospital were included in this study. The umbilicus‐to‐Calot's triangle distance (UCD) was measured intraoperatively. The correlations between the UCD and operative time were analyzed, and for comparison, CLC cases during the same period (n = 28) were similarly analyzed. Moreover, UCD was estimated from preoperative CT (UCD‐CT), and the usefulness of UCD‐CT was assessed during SILC and CLC.

Results

Thirty‐four patients successfully underwent SILC. There were positive correlations between the UCD and pneumoperitoneum time. Multivariate linear regression analysis, including BMI and height, which were previously reported to have a correlation with longer operative time in SILC, showed that UCD is an independent predictive factor for prolonged operative duration. However, BMI and height were not independent predictive factors. UCD and UCD‐CT had a very strong positive correlation; therefore, UCD was estimated from CT. UCD‐CT had a strong positive correlation with operative time in SILC, but not in CLC.

Conclusions

A longer UCD is an important predictive factor for difficult cases of SILC, but this finding is not applicable in CLC. The usefulness of UCD is specific to SILC.
White Integration or Segregation? The Racial and Ethnic Transformation of Rural and Small Town America
Authors: Lichter Daniel T. , Parisi Domenico , Taquino Michael C.
Published: September 2018

Rural America has seemingly been “left behind” in an era of massive immigration and growing diversity. The arrival of new immigrants has exposed many rural whites, perhaps for the first time, to racial and ethnic minority populations. Do rural whites increasingly live in racially diverse nonmetropolitan places? Or is white exposure to racially diverse populations expressed in uneven patterns of residential integration from place to place? We link microdata from the Panel Survey of Income Dynamics (1989–to–2009 waves) to place data identified in the 1990–2010 decennial censuses. We estimate multilevel, fixed–effects models of rural white exposure to minority populations that involve linking individual predictors to changing demographic and economic local environments. Using entropy scores, our analyses highlight the extraordinary rise since 1990 in exposure of all rural populations, including whites, to racially diverse communities. Variation in white exposure to rural minorities is driven primarily by changing local demographic and economic conditions. Net of individual background characteristics, whites are significantly less likely to live in racially diverse places than other ethnoracial groups. White population growth is occurring disproportionately in the least racially diverse rural communities. For blacks and other minorities, growth is taking place disproportionately in the most racially diverse places.
Opportunity for Whom? The Diverse Definitions of Neighborhood Opportunity in Baltimore
Authors: Lung–Amam Willow S. , Knaap Elijah , Dawkins Casey , Knaap Gerrit–Jan
Published: September 2018

Across the United States, communities are increasingly interested in the spatial structure of opportunity. Recently, several federal programs have promulgated opportunity mapping as a tool to help increase disadvantaged communities’ access to neighborhood opportunity. The increasing institutionalization of opportunity mapping raises questions about how opportunity is defined and by whom. This paper analyzes data from community engagement events held for a regional planning process throughout the Baltimore metropolitan area. During these events, over 100 residents were asked what it means to live in neighborhoods that provide opportunity. The results showed similarities as well as remarkable differences in residents’ definitions of opportunity across race, income, and geography. Racial and ethnic minorities, low–income groups, and those living in distressed neighborhoods were more likely to identify job accessibility, employment, and job training as key components of and pathways to opportunity, whereas White, higher income groups, and wealthier neighborhoods placed a stronger emphasis on a sense of community, freedom of choice, education, and retirement savings. These differences challenge urban policymakers and planners to consider how greater flexibility in mapping tools, qualitative data, and community–engaged processes might better reflect the diversity in the ways that residents view and experience opportunity in their everyday lives.
Mobile but Stuck: Multigenerational Neighborhood Decline and Housing Search Strategies for African Americans
Authors: Taplin–Kaguru Nora E.
Published: September 2018

While many scholars have demonstrated that entrenched racial residential segregation perpetuates racial inequality, the causes of persistent racial segregation continue to be debated. This paper investigates how geographically and socioeconomically mobile African Americans approach the home–buying process in the context of a segregated metropolitan region, by using qualitative interviews with working–class to middle–income African American aspiring homebuyers. Homebuyers use three principal search strategies to determine suitable neighborhoods: avoiding decline, searching for improvement, and searching for stability. The findings suggest that despite these strategies African American homebuyers end up in areas that may not retain characteristics they desire in terms of racial demographics and amenities, in large part because such neighborhoods remain rare.
Problems, Puzzles, and the Production of Knowledge: Harnessing Census Data in the Age of Trump
Authors: Lacy Karyn
Published: September 2018

We tend to think of the Census Bureau as merely a bean counter, but the institution performs another, less apparent, role: signaling which demographic shifts carry the most weight in society. Trump's insistence that the Census Bureau include a controversial citizenship question on the 2020 census would mark a decisive shift in the Bureau's ability to count unauthorized immigrants accurately and in the distribution of federal resources to communities where immigrants settle in large numbers. This essay considers what these consequences, should Trump prevail, would mean for social scientists who study immigration. This distressing prospect presents an opportunity for demographers to consider how the work of ethnographers could be utilized to circumvent the data limitations a citizenship question would likely impose.
Clinical outcomes and inflammatory response to single‐incision laparoscopic (SIL) colorectal surgery: a single‐blinded randomized controlled pilot study
Authors: Borowski D. W. , Baker E. A. , Wilson D. , Garg D. K. , Gill T. S.
Published: September 2018

Aim

Single‐incision laparoscopic (SIL) surgery is expanding, but its benefits, efficacy and safety compared with conventional laparoscopic (CL) surgery remain unclear. This pilot study examined clinical outcomes and biochemical markers of inflammation for colorectal resections by SIL and CL in a randomized controlled pilot trial.

Method

Fifty patients undergoing elective colorectal resection were randomized to either SIL or CL. Primary outcomes were operating time and length of stay (LoS); secondary outcomes included combined length of scars, pain scores, complications, Quality of Life EQ5D‐VAS and the inflammatory markers interleukin‐6 (IL‐6), IL‐8 and C‐reactive protein (CRP) at baseline, 2, 6, 24 and 72 h.

Results

There was no difference in age, gender, body mass index, indications and site of surgery, American Society of Anesthesiologists grade or incidence of previous surgery between the groups. Except for one conversion from SIL to open surgery, surgery was completed as intended. No difference between SIL and CL was found for operating time [median 130 (72–220) vs 130 (90–317) min, respectively, P = 0.528], LoS [median 4 (3–8) vs 4 (2–19)days, P = 0.888] and time to first flatus [2 (1–4) vs 2 (1–5) days, P = 0.374]. The combined length of scars was significantly shorter for SIL [4 (2–18) vs 7 (5–8) cm, P < 0.001]; in each group, four postoperative complications occurred (16%). Postoperative pain scores were similar [mean 7.67 (interquartile range 4) vs 7.25 (interquartile range 3.75), P = 0.835] to day 3. EQ5D‐VAS was no different for both groups at discharge [72.5 (40–90) vs 70 (30–100), P = 0.673] but slightly higher for CL at 3 months [79 (45–100) vs 90 (50–100), P = 0.033].The IL‐6, IL‐8 and CRP levels between both groups showed similar peaks and no significant differences.

Conclusion

SIL colorectal surgery by experienced laparoscopic surgeons appears to be safe and equivalent to CL, with no discernible difference in its effect on the physiological response to surgical trauma.
Labour after Land Reform: The Precarious Livelihoods of Former Farmworkers in Zimbabwe
Authors: Scoones Ian , Mavedzenge Blasio , Murimbarimba Felix , Sukume Chrispen
Published: September 2018

What happens to labour when major redistributive land reform restructures a system of settler colonial agriculture? This article examines the livelihoods of former farmworkers on large‐scale commercial farms who still live in farm compounds after Zimbabwe's land reform. Through a mix of surveys and in‐depth biographical interviews, four different types of livelihood are identified, centred on differences in land access. These show how diverse, but often precarious, livelihoods are being carved out, representing the ‘fragmented classes of labour’ in a restructured agrarian economy. The analysis highlights the tensions between gaining new freedoms, notably through access to land, and being subject to new livelihood vulnerabilities. The findings are discussed in relation to wider questions about the informalization of the economy and the role of labour and employment in a post‐settler agrarian economy, where the old ‘farmworker’ label no longer applies.
Exenatide corrects postprandial hyperglycaemia in young people with cystic fibrosis and impaired glucose tolerance: A randomized crossover trial
Authors: Geyer Myfanwy C. , Sullivan Thomas , Tai Andrew , Morton Judith M. , Edwards Suzanne , Martin A. James , Perano Shiree J. , Gagliardi Lucia , Rayner Christopher K. , Horowitz Michael , Couper Jennifer J.
Published: September 2018

Impaired glucose tolerance (IGT) in cystic fibrosis (CF) manifests as postprandial hyperglycaemia. Pancreatic enzyme supplementation reduces the latter; restoring incretin secretion and slowing gastric emptying. We aimed to determine the acute effect of exenatide on postprandial glycaemia in young people with CF and IGT. Six participants with CF and IGT were studied on 2 days, in a double‐blind randomized crossover trial. After overnight fasting, they received exenatide 2.5 mcg or placebo (0.9% saline) subcutaneously 15 minutes before a pancake meal labelled with 13C octanoate and pancreatic enzyme replacement. The primary outcomes, area under the curve over 240 minutes (AUC 240) for blood glucose (P < 0.0001) and peak blood glucose (7.65 mM ± 0.34 [mean ± SE] vs 9.53 mM ± 0.63, P < 0.0001), were markedly lower after exenatide than placebo. AUC240 for insulin, C‐peptide, glucagon‐like peptide‐1 (GLP‐1) and glucose‐dependent insulinotropic polypeptide (GIP) was also lower after exenatide. Gastric emptying was markedly slower after exenatide, as assessed by time for 10% gastric emptying and peak 13CO2 excretion. We report for the first time that exenatide corrects postprandial hyperglycaemia in young people with CF and IGT. GLP‐1 agonists are a candidate treatment in CF‐related diabetes.
Pioglitazone prevents the increase in plasma ketone concentration associated with dapagliflozin in insulin‐treated T2DM patients: Results from the Qatar Study
Authors: Abdul‐Ghani Muhammad , Migahid Osama , Megahed Ayman , Singh Rajvir , Fawaz Mohammad , DeFronzo Ralph A. , Jayyousi Amin
Published: September 2018

Because of the unique mechanism of action of sodium‐glucose co‐transport inhibitors (SGLT2i), which is independent of insulin secretion and insulin action, members of this class of drugs effectively lower plasma glucose concentration when used in combination with all other antidiabetic agents, including insulin. Increased plasma ketone concentration has been reported in association with SGLT2i initiation, which, under certain clinical conditions, has developed into diabetic ketoacidosis. The daily insulin dose often is reduced at the time of initiating SGLT2i therapy in insulin‐treated patients to avoid hypoglycaemia. However, reduction of insulin dose can increase the risk of ketoacidosis. In the present study, we examined the effect of the addition of dapagliflozin plus pioglitazone on plasma ketone concentration in insulin‐treated T2DM patients and compared the results to the effect of dapagliflozin alone. A total of 18 poorly controlled, insulin‐treated T2DM participants in the Qatar Study received dapagliflozin (10 mg) plus pioglitazone (30 mg), and 10 poorly controlled non‐insulin‐treated T2DM patients received dapagliflozin (10 mg) alone for 4 months. Dapagliflozin plus pioglitazone produced a robust decrease in HbA1c (−1.4%) and resulted in a 50% reduction in daily insulin dose, from 133 to 66 units, while dapagliflozin alone caused a 0.8% reduction in HbA1c. Dapagliflozin caused a four‐fold increase in fasting plasma ketone concentration, while the combination of pioglitazone plus dapagliflozin was not associated with a significant increase (0.13 vs 0.15 mM) in plasma ketone concentration or in risk of hypoglycaemia. These results demonstrate that the addition of pioglitazone to dapagliflozin prevents the increase in plasma ketone concentration associated with SGLT2i therapy.
Developing a Voluntary Sector Model for Engaging Offenders
Authors: WONG KEVIN , KINSELLA RACHEL , MEADOWS LINDA
Published: September 2018

This article proposes the development of a distinct offender engagement model for voluntary and community sector agencies, recognising the contribution of: reciprocity, reliability, consistency, and emotional pleasure, to effective offender engagement. Drawing on empirical data from users of a voluntary sector programme in England for young adults, this article makes an original contribution to the evidence base by: identifying the key elements (within the programme) of effective engagement with offenders; seeing how this relates to the National Offender Management Service (NOMS) engaging practitioner model and companion literature review and considers the implications for voluntary sector criminal justice policy and practice.
Robotics in Nursing: A Scoping Review
Authors: Maalouf Noel , Sidaoui Abbas , Elhajj Imad H. , Asmar Daniel
Published: September 2018

Purpose

Driven by the shortage in qualified nurses and the high percentage of aging populations, the past decade has witnessed a significant growth in the use of robots in nursing, especially in countries like Japan. This article is a scoping review of the different tracks in which robots are used in nursing. Whereas assistive robots are used for physical care, including service and monitoring tasks, social assistive robots focus on the cognitive and emotional well‐being of patients in need of companionship.

Methods

A total of six electronic databases were used in the search for journal papers and conference proceedings. The key words used in searching the databases were nursing OR nurses, AND robots OR robotics. Topics covering surgical robotics, nursing education robotics, and clinical procedures were excluded.

Findings

A total of 1,758 articles were retrieved, from which 69 articles were included in the final review. The analysis of the chosen papers led to the categorization of robots into two main categories: assistive robots and social assistive robots.

Conclusions

After a detailed review of the state of the art in assistive robots and social assistive robots, an insight into the future of robotics in this field is provided. The recommendations include the need to intensify research on human robot interaction, greater focus on monitoring robots, and analysis of the psychological barriers that need to be surmounted to achieve more tolerance and higher acceptance of robots.

Clinical Relevance

For researchers and developers to provide suitable technological solutions, a full understanding of robotics in nursing is needed. An overview of the most recent applications and their proper categorization is key to finding areas for contribution.
The Woodhull Study Revisited: Nurses’ Representation in Health News Media 20 Years Later
Authors: Mason Diana J. , Nixon Laura , Glickstein Barbara , Han Sarah , Westphaln Kristi , Carter Laura
Published: September 2018

Purpose

To determine if nurses are represented in health news stories more frequently today than 20 years ago when Sigma Theta Tau International Nursing Honorary Society published The Woodhull Study on Nursing and the Media, which found that nurses were cited as sources in only 4% of the stories.

Design

Content analysis of health news stories for the month of September 2017 in the same publications used in the original Woodhull study.

Methods

Searches with Nexis and Webhose identified 2,243 articles related to health care published by the news outlets in September 2017. A random sample of 537 of these articles was obtained: 258 from seven newspapers, 127 from three weekly newsmagazines, and 152 from three health industry publications. After removing irrelevant articles or those with only passing references to health, 365 articles were reviewed and coded, using the original study's coding schema.

Findings

Nurses were identified as the source of only 2% of quotes in the articles and were never sourced in stories on health policy. When quoted, nurses mainly commented on the profession itself. Nurses or the nursing profession were mentioned in 13% of the articles. Nurses were identified in 4% of photographs or other images that accompanied the articles.

Conclusions

Nurses remain invisible in health news media, despite their increasing levels of education, unique roles, and expertise.

Clinical Relevance

Nurses’ clinical expertise is accompanied by unique perspectives on health, illness, and health care; but the public is not benefiting from the wisdom and insight that nurses can provide in health news stories.
Human beta‐defensin‐1 is a highly predictive marker of mortality in patients with acute‐on‐chronic liver failure
Authors: Mani Iliana , Alexopoulou Alexandra , Vasilieva Larisa , Hadziyannis Emilia , Agiasotelli Danai , Bei Myrianthi , Alexopoulos Theodoros , Dourakis Spyros P.
Published: September 2018

Background & Aim

Human beta‐defensin‐1 (hBD‐1) is a natural antimicrobial peptide expressed in the epithelia of multiple tissues including the digestive tract. In the current study, hBD‐1 levels were determined in different subsets of patients with decompensated cirrhosis including acute‐on‐chronic liver failure (ACLF). In addition, the association with mortality of hBD‐1, C‐reactive protein (CRP) and procalcitonin (PCT) was assessed.

Methods

A total of 125 patients were divided into three groups: 39 with ACLF (derivation cohort), 46 with acute decompensation without ACLF (AD) and 40 with decompensated cirrhosis without an acute event (DC). The data from 24 different ACLF patients were used for validation and 15 healthy individuals as control group.

Results

Serum hBD‐1, CRP and PCT levels were higher in ACLF compared to both AD and DC groups (P < 0.001). Healthy controls demonstrated similar hBD‐1 and PCT values compared to DC group. In ROC curve, the performance of hBD‐1 to predict 60‐day mortality in ACLF group was similar in derivation and validation cohorts (c‐statistic 0.834 and 0.879, respectively). CRP was a poor predictor of mortality. In ACLF group, patients with high hBD‐1 (>36.625 ng/mL) had a poor prognosis at 60 days compared to those with lower values (log‐rank P = 0.001). In Cox multivariate regression analysis, only hBD‐1 (HR 1.020, 95%CI 1.006‐1.035, P = 0.006) emerged as an independent predictor of death in ACLF group. In AD group, neither hBD‐1 nor PCT or CRP variables were associated with mortality.

Conclusions

High hBD‐1 was detected at presentation in patients with ACLF who died during follow‐up period. hBD‐1 is an accurate predictor of short‐term mortality in patients with ACLF.
Altruistic behaviour, but not volunteering, has been associated with cognitive performance in community‐dwelling older persons
Authors: Corrêa Jimilly C. , Ávila Maria P.W. , Lucchetti Alessandra L.G. , Lucchetti Giancarlo
Published: September 2018

Aim

Studies have indicated that altruistic behaviour may be associated with better health. Nevertheless, it has not been determined if volunteering acts as a protective factor against cognitive decline or if a person's altruistic character does so. This study aims to evaluate whether altruistic behaviour and volunteering are associated with better cognitive function in active community‐dwelling older persons.

Methods

This was a cross‐sectional study in healthy older persons. Sociodemographics, altruistic behaviour (self‐report altruism scale), volunteering (days volunteered), cognitive state (cognitive assessment battery), and factors associated with cognition (e.g. depression, social support, functional status, and religiosity) were evaluated. Adjusted and non‐adjusted models were created in order to understand the relationship of altruistic behaviour and volunteering with cognitive performance.

Results

A total of 312 older adults were evaluated; 89.4% were women, and the mean age was 69.6 years. In the linear regression models, greater altruistic behaviour was associated with higher scores on the Mini‐Mental State Examination (β = 0.148, P < 0.05) and the verbal fluency test (β = 0.219, P < 0.001), even after adjustments. In contrast, volunteering was not associated with any of the cognitive tests used.

Conclusion

Altruistic behaviour seems to have a role in older persons’ cognition, with more altruistic people tending to have greater cognitive performance. These findings can assist in developing mechanisms that can help keep older people more cognitively active and serve as the foundation for future interventions and studies in this area.
Leaf litter stoichiometry affects decomposition rates and nutrient dynamics in tropical forests under restoration in Costa Rica
Authors: Lanuza Oscar , Casanoves Fernando , Delgado Diego , Van den Meersche Karel
Published: September 2018

Active restoration strategies increase the production of leaf litter in tropical forests, but little is known about their effect on litter decomposition and subsequent nutrient release. We quantified changes in leaf litter stoichiometry during decomposition in former pasture sites under contrasting restoration strategies (natural regeneration, applied nucleation/islands tree planting and plantation), as well as in nearby primary forest. Litterbags were employed to evaluate decomposition. We used a leaf mixture of either the four planted tree species in the plantation and island treatments or the nearby primary forest and compared them under a factorial design. Decomposition rates were similar between restoration treatments (p > 0.5), but leaves decomposed faster in the forest mixture than in the plantation mixture (p < 0.01). The content of Ca, Mg, K, P, and the C:N ratio were higher in the forest mixture at the beginning and during decomposition (p < 0.05); the N content in the plantation mixture was higher at the beginning but lower during decomposition (p < 0.05), which meant greater mobilization of nitrogen per unit of carbon lost. K and P had a strong initial release, while Mg was released more gradually. N and Ca had an irregular pattern of initial fast release, immobilization, and re‐release in the later stages. We conclude that the differences in rates of decomposition and nutrient release in these systems under restoration were at least partly determined by the floristic heterogeneity and chemical quality of the leaf litter that reaches the soil.
Access to social services as a rite of integration: Power, rights, and identity
Authors: Fargion Silvia , Nagy Andrea , Berger Elisabeth
Published: September 2018

Access to social services is a multifaceted and multifactorial process, involving social policy lines, services organization, and professional front line practices. It appears to have a crucial role in how personal social services work: depending on the way the process is handled, access to social services could provide a bridge to an inclusive and solidarizing community or worsen discrimination and marginalization. Many underline how studying the actual encounters between citizens and practitioners can provide a privileged site to highlight the interconnections between the abovementioned factors. This is the focus of our research that explored access in a specific Italian region using a case study strategy. After a pilot study, the main points of access to social services were identified, and three units were selected as best examples of different approaches. The three units were explored using mainly qualitative methods inspired by ethnography. We were able to gain in depth understanding of three cultural approaches to access, defined as the “ethical duty,” the “good organization,” and the “professional approach” and reach an in‐depth understanding of their impact on access. There is a vast literature on the power of street‐level bureaucrats, seen as similar to gatekeepers. However, our research suggests that specific organizational cultures also play an important part: different organizational cultures may impact the implementation of local social policy, the organizational procedures, and social workers' practices.
Minimum Income and Flat Tax Revisited: A Combined CGE‐Microsimulation Analysis for Germany*
Authors: Schubert Stefanie
Published: September 2018

Objective

This article quantifies the economic effects of a fundamental reform proposal for Germany's social security system that integrates most parts of the prevailing social security insurances into the general tax‐transfer system.

Methods

Drawing on individual household data, we use a combined approach that employs both computable general equilibrium modeling and microsimulations.

Results

By discussing two revenue‐neutral reform scenarios that both encompass a negative income tax for low incomes and a flat tax rate otherwise, but differ in the effective marginal tax rates and tax allowances, we find a negligible or even negative impact on employment and GDP.

Conclusion

Our results cast doubt on whether such a fundamental reform would have positive welfare effects.
Refractoriness to red blood cell transfusion therapy due to hypersplenism
Authors: Sahin Ilyas , Reagan John L. , Niroula Rabin , Sweeney Joseph D.
Published: September 2018

BACKGROUND

A 55‐year‐old male presented with myelodysplastic/myeloproliferative neoplasm and severe splenomegaly. The patient is blood group O, D+ with a negative indirect antiglobulin test. Transfusion of 5 units of red blood cells (RBCs) increased the hemoglobin (Hb) level from 6.7 to 7.2 g/dL. No active bleeding or hemolysis was evident. The patient was readmitted 1 week later with a Hb level of 3.3 g/dL. An additional 6 units of RBCs showed only an increase from 3.3 to 3.5 g/dL. Partial splenic embolization was performed, which resulted in a stabilization of the Hb level at approximately 7 g/dL. Because of this, total splenectomy was performed, which resulted in a gradual increase in Hb level to approximately 13 g/dL. The patient remains transfusion independent 160 days postsplenectomy.

RESULTS

RBC transfusion increases Hb concentration by 1 g/dL per unit in a typical adult. This increase is attenuated in the presence of ongoing hemolysis or active blood loss. Occasionally, a low‐RBC‐volume unit transfused to a recipient with a large intravascular blood volume may show an unexpectedly small increase. In rare situations, however, the etiology of a greatly attenuated response is more perplexing. The pattern of Hb concentration posttransfusion was suggestive of splenic sequestration in our patient.

CONCLUSION

Severe refractoriness to RBC transfusion attributable to severe hypersplenism is a rare event. Our case suggests that splenic artery embolization may be a useful initial approach in individual cases and a potential predictor of the utility of a subsequent surgical splenectomy.