bluuebunny/crossref_metadata_2025 huggingface dataset:
Salaires et mobilité de l'emploi des professionnels de santé dans les milieux urbains du Cameroun
Authors: Nkoumou Ngoa Gaston Brice
Published: April 2019

The objective of this study was to analyse the influence of wages on health professionals' job mobility. Based on health professionals data collected in urban areas of Cameroon, a binomial logit model was estimated. Our results show that wages are negatively correlated with the likelihood of health professionals to consider an imminent departure from the current health facility for another job in or outside the health sector. The increase of one unit of the residual potential wage gain decreases the probability to consider a voluntary departure from the current job of 4 per cent to 8 per cent for another job in the health sector or outside. Wage improvement can then be considered as a retention policy of health professionals in their current health facility. This strategy can be used to curb the migration problems of health professionals and strengthen a health system which is already suffering the pangs of the human resource crisis for health. However, this wage improvement strategy expresses the complexity of retention policies for health professionals based on wages in the public sector, as it can induce adverse effects linked to the loss of human resources.
Review article: A primer for clinical researchers in the emergency department: Part IX. How to conduct a systematic review in the field of emergency medicine
Authors: Long Elliot , Craig Simon , Babl Franz E , Tavender Emma , Lunny Carole
Published: April 2019

In this series we address important topics for emergency clinicians who either participate in research as part of their work, or use the knowledge generated by research studies. Emergency clinicians are routinely in the position of applying new evidence in clinical practice. With an ever‐increasing volume of evidence generated, this can be problematic when studies are conducted in different settings, and include different patient groups, different interventions and different outcomes. This is made even more difficult when the results of primary research studies do not agree. Systematic reviews are becoming increasingly valuable as they appraise and synthesise research findings using a clear methodology, and summarise the results of primary studies. As such, systematic reviews help translate research findings into clinical practice. This paper provides a practical starting point for understanding the steps involved in conducting a systematic review in emergency medicine and will help readers appraise the findings of systematic reviews.
Effect of forest fire prevention treatments on bacterial communities associated with productive Boletus edulis sites
Authors: Mediavilla Olaya , Geml József , Olaizola Jaime , Oria‐de‐Rueda Juan Andrés , Baldrian Petr , Martín‐Pinto Pablo
Published: April 2019

Cistus ladanifer scrublands, traditionally considered as unproductive, have nonetheless been observed to produce large quantities of king bolete (Boletus edulis) fruitbodies. These pyrophytic scrublands are prone to wildfires, which severely affect fungi, hence the need for fire prevention in producing C. ladanifer scrublands. In addition, B. edulis productions have severely decreased in the last years. A deeper understanding of the B. edulis life cycle and of biotic and abiotic factors influencing sporocarp formation is needed to implement management practices that facilitate B. edulis production. For example, some bacteria likely are involved in sporocarp production, representing a key part in the triple symbiosis (plant–fungus–bacteria). In this study, we used soil DNA metabarcoding in C. ladanifer scrublands to (i) assess the effect of site history and fire prevention treatment on bacterial richness and community composition; (ii) test if there was any correlation between various taxonomic groups of bacteria and mycelial biomass and sporocarp production of B. edulis; and to (iii) identify indicator bacteria associated with the most productive B. edulis sites. Our results show that site history drives bacterial richness and community composition, while fire prevention treatments have a weaker, but still detectable effect, particularly in the senescent plots. Sporocarp production correlated positively with genera in Verrucomicrobia. Several genera, e.g. Azospirillum and Gemmatimonas, were identified as indicators of the most productive sites, suggesting a potential biological role in B. edulis fructification. This study provides a better understanding of the triple symbiosis (plant–fungus–bacteria) involved in C. ladanifer–B. edulis systems.
Cryptic diversity and ranavirus infection of a critically endangered Neotropical frog before and after population collapse
Authors: Puschendorf R. , Wallace M. , Chavarría M. M. , Crawford A. J. , Wynne F. , Knight M. , Janzen D. H. , Hallwachs W. , Palmer C.V. , Price S. J.
Published: April 2019

Mesoamerican amphibian declines in apparently pristine and protected habitats have been severe, especially at elevations above 500 m sea level and have been linked to emerging diseases and a changing climate. The Craugastor punctariolus species series of direct developing frogs is endemic to the region and used to be comprised of 33 species, seven of which have known populations at present. One of these, C. ranoides, endemic to southern Nicaragua and Costa Rica, was historically found in cloud forest sites of Área de Conservación Guanacaste (ACG) in north‐west Costa Rica and extended into dry forest sites 20 km distant. Here, C. ranoides declined and disappeared from high elevation sites between the mid‐1980s and early 1990s, but populations persisted in the lowland dry forest. We compared the genetic richness and ranavirus infection status of C. ranoides from extant dry forest populations to historic museum specimens of now extinct ACG cloud forest populations using DNA sequence diversity at two mitochondrial loci and molecular screening for ranavirus. Extant dry forest populations of C. ranoides formed a monophyletic group which included historic specimens sampled at cloud forest sites. However, the extirpated ACG cloud forest population contained additional diversity: samples formed a divergent clade with unknown spatial distribution. Ranavirus was detected in both current and museum samples of C. ranoides and sequences from a 267‐nucleotide region of the major capsid protein gene shared 100% sequence identity with one another and with Frog virus 3. Our findings document cryptic diversity within an endangered species that has demonstrated no recovery in cloud forests and raises questions about Ranavirus and its potential link to the amphibian declines in this system. The presence of the same C. ranoides clade within present day and historical samples suggests a potential for effective translocation and repopulation of extirpated cloud forest populations.
Life history of peracarid species in South‐western Atlantic: Comparison of population traits between native and exotic species
Authors: Rumbold Carlos E.
Published: April 2019

Life‐history traits of exotic species are important to understand the process involved in their settlement and their potential impact on native biodiversity. In this context, the seasonal density, the population structure and the reproductive patterns of exotic and native peracarid species of two natural marine environments of Southwestern Atlantic were studied in order to determine the traits that favour the invasion success of exotic species. Five samples, consisted of algal patches (0.20 × 0.20 m quadrants), were collected seasonally from 2016 to 2017 in two intertidal environments (La Estafeta and Cerro Avanzado). Both environments presented high richness of cryptogenic and exotic species (Tanais dulongii, Monocorophium insidiosum, Ampithoe valida, Melita palmata and Jassa marmorata), and only two native species were recorded (Apohyale grandicornis and Exosphaeroma lanceolatum). The comparison of life‐history traits suggested that the distribution, dominance and the highest densities of some exotic species are closely related to their continuous reproductive and recruitment periods, their capability to adapt their life‐history strategies to different environmental conditions and to a more efficient distribution of resources during reproduction; however, in native species, only A. grandicornis registered similar life‐history traits than exotic populations, suggesting that their distribution could be limited by a latitudinal gradient. We expect that these results provide essential information to understand the invasion pattern of exotic species and their potential impact on native biodiversity in Southwestern Atlantic.
Positivity is an up‐to‐date predictor of well‐functioning instead of a eudaemon
Authors: Oláh Attila
Published: April 2019

Summing up the process of conceptualization of positive orientation theory (POT), the results of empirical studies which confirmed its validity, the operationalization of the positive orientation as a personality disposition in the Positivity Scale (PS), and the verification of the scale responsibility and empirical validity, it can be established that POT is a very promising, empirically validated theory. The dissemination of the POT and the PS in high‐impact scientific journals is an important contribution to the research on well‐being and in the domains of health psychology and positive psychology as well.
Acute surgical unit improves outcomes in appendicectomy
Authors: Kinnear Ned , Bramwell Eliza , Frazzetto Alannah , Noll Amy , Patel Prajay , Hennessey Derek , Otto Greg , Dobbins Christopher , Sammour Tarik , Moore James
Published: April 2019

Background

Few large Australian studies have explored the impact of acute surgical unit (ASU) model in appendicitis.

Methods

An ASU model commenced practice at our institution on 1 August 2012. In this retrospective cohort study, patients undergoing appendicectomy 2.5 years before (Traditional group) or after (ASU group) this date were compared. Primary outcomes were median length of stay, median time from emergency department referral to theatre start and proportion of cases performed in‐hours. Secondary outcomes were rates of complications, open appendicectomy, consultant scrubbed for procedure, intensive care unit admission and re‐presentation to emergency department within 30 days.

Results

After removing those with incomplete data, 1214 patients were enrolled; 465 in the Traditional group and 749 in the ASU group. There were no significant baseline differences between groups. Compared with the Traditional group, ASU patients had similar length of stay (1.81 versus 1.81 days; P = 0.54) and time to theatre (0.59 versus 0.56 days; P = 0.14), but a greater proportion of in‐hours operation (72% versus 79%; P = 0.014). The ASU group also experienced fewer complications (9% versus 6%; P = 0.031), fewer primary open (4% versus 1%; P < 0.0001) or conversion‐to‐open appendicectomies (6% versus 2%; P < 0.0005) and had superior rates of consultant scrubbed in theatre (21% versus 56%; P < 0.00001). Rates of intensive care unit admission (1% versus 1%; P = 0.72) and re‐presentation were unchanged (5% versus 5%; P = 0.46).

Conclusion

In our institution, the introduction of an ASU model was associated with more in‐hours operations and safer care for patients undergoing appendicectomy.
“Just keep pushing”: Parents' experiences of accessing child and adolescent mental health services for child anxiety problems
Authors: Crouch Lauren , Reardon Tessa , Farrington Alice , Glover Frankie , Creswell Cathy
Published: April 2019

Background

Anxiety disorders are among the most common psychopathologies in childhood; however, a high proportion of children with anxiety disorders do not access effective treatments. The aim of the present qualitative study was to understand families' experiences of seeking help and accessing specialist treatment for difficulties with childhood anxiety.

Methods

Parents of 16 children (aged 7–12 years) referred to a child mental health service for difficulties with anxiety were interviewed about their experiences of seeking and accessing treatment within Child and Adolescent Mental Health Service (CAMHS). All interviews were transcribed verbatim and thematically analysed for similarities and differences in families' experiences.

Results

Factors that helped and/or hindered families accessing treatment related to (a) parental recognition, (b) contact with professionals, (c) reaching CAMHS, (d) parental effort, and (e) parental knowledge and concerns. High demands on services and parents' uncertainty surrounding the help‐seeking process presented key hurdles for families. The critical role of parental persistence and support from general practitioners and school staff was evident across interviews.

Conclusions

Findings highlighted the need for information and guidance on identifying child anxiety difficulties and professional, peer, and self‐help support, and ensuring sufficient provision is available to allow families prompt access to support.
Quantitative Systems Pharmacology Model of Chimeric Antigen Receptor T‐Cell Therapy
Authors: Hardiansyah Deni , Ng Chee Meng
Published: April 2019

Chimeric antigen receptor T‐cell (CART) therapy is a new and promising cancer therapy. However, severe toxicity due to cytokine release syndrome (CRS) in CART‐treated patients highlighted the possible danger of this new therapy. Disease burden and CART doses are the potential factors associated with CRS but the detail relationships between these factors and the severity of the CRS remain largely unknown. In this study, the quantitative systems pharmacology (QSP) approach is used to quantify the complex relationships among CART doses, disease burden, and pro inflammatory cytokines in human subjects and to gain relevant insights into the determinant of clinical toxicity/efficacy in development of CART therapy. The expansion of CART and elimination of B cells are more highly correlated with disease burden than the administered CART doses. To our best knowledge, this is the first QSP model that can describe the observed clinical data from CART‐treated patients with cancer. This QSP model is a valuable tool for deepening our understanding of how the mechanism of action connects to the clinical outcomes and, therefore, may serve as an important model‐based platform to guide the development and personalized dosing of the CART therapy.
Posttranslational modifications of titin from cardiac muscle: how, where, and what for?
Authors: Koser Franziska , Loescher Christine , Linke Wolfgang A.
Published: April 2019

Titin is a giant elastic protein expressed in the contractile units of striated muscle cells, including the sarcomeres of cardiomyocytes. The last decade has seen enormous progress in our understanding of how titin molecular elasticity is modulated in a dynamic manner to help cardiac sarcomeres adjust to the varying hemodynamic demands on the heart. Crucial events mediating the rapid modulation of cardiac titin stiffness are post‐translational modifications (PTMs) of titin. In this review, we first recollect what is known from earlier and recent work on the molecular mechanisms of titin extensibility and force generation. The main goal then is to provide a comprehensive overview of current insight into the relationship between titin PTMs and cardiomyocyte stiffness, notably the effect of oxidation and phosphorylation of titin spring segments on titin stiffness. A synopsis is given of which type of oxidative titin modification can cause which effect on titin stiffness. A large part of the review then covers the mechanically relevant phosphorylation sites in titin, their location along the elastic segment, and the protein kinases and phosphatases known to target these sites. We also include a detailed coverage of the complex changes in phosphorylation at specific titin residues, which have been reported in both animal models of heart disease and in human heart failure, and their correlation with titin‐based stiffness alterations. Knowledge of the relationship between titin PTMs and titin elasticity can be exploited in the search for therapeutic approaches aimed at softening the pathologically stiffened myocardium in heart failure patients.
Ethnographic Reviews
Authors: deRoche Constance
Published: April 2019

Books reviewed in this issue.

The Poisonwood Bible: a novel. Barbara Kingsolver.
Consensus statements on vaccination in patients with haemophilia—Results from the Italian haemophilia and vaccinations (HEVA) project
Authors: Santagostino Elena , Riva Agostino , Cesaro Simone , Esposito Susanna , Matino Davide , Mazzucchelli Renata Ilde , Molinari Angelo Claudio , Mura Rosamaria , Notarangelo Lucia Dora , Tagliaferri Annarita , Di Minno Giovanni , Clerici Mario ,   the HEVA Study Group
Published: April 2019

Vaccination against communicable diseases is crucial for disease prevention, but this practice poses challenges to healthcare professionals in patients with haemophilia. Poor knowledge of the vaccination requirements for these patients and safety concerns often result in vaccination delay or avoidance. In order to address this issue, a panel of 11 Italian haemophilia and immunization experts conducted a Delphi consensus process to identify the main concerns regarding the safe use of vaccines in patients with haemophilia. The consensus was based on a literature search of the available evidence, which was used by the experts to design 27 consensus statements. A group of clinicians then rated these statements using the 5‐point Likert‐type scale (1 = strongly disagree; 5 = strongly agree). The main issues identified by the expert panel included vaccination schedule for haemophilic patients; protocol and optimal route of vaccine administration; vaccination of haemophilic patients with antibodies inhibiting coagulation factor VIII (inhibitors); and vaccination and risk of inhibitor development. This manuscript discusses these controversial areas in detail supported by the available literature evidence and provides evidence‐ and consensus‐based recommendations. Overall, participants agreed on most statements, except those addressing the potential role of vaccination in inhibitor formation. Participants agreed that patients with haemophilia should receive vaccinations according to the institutional schedule for individuals without bleeding disorders; however, vaccination of patients with haemophilia requires comprehensive planning, taking into account disease severity, type and route of vaccination, and bleeding risk. Data also suggest vaccination timing does not need to take into consideration when the patient received factor VIII replacement.
INTIMIDATION: LINKING NEGOTIATION AND CONFLICT
Authors: Ghosh Sambuddha , Gratton Gabriele , Shen Caixia
Published: April 2019

A challenger wants a resource initially held by a defender, who can negotiate a settlement by offering to share the resource. If Challenger rejects, conflict ensues. During conflict, each player could be a tough type for whom fighting is costless. Therefore, nonconcession intimidates the opponent into conceding. Unlike in models where negotiations happen in the shadow of exogenously specified conflicts, offers made during negotiations determine how conflict unfolds if negotiations fail. In turn, how conflict is expected to unfold determines the players' negotiating positions. In equilibrium, negotiations always fail with positive probability, even if players face a high cost of conflict. Allowing multiple offers leads to brinkmanship—the only acceptable offer is the one made when conflict is imminent. If negotiations fail, conflict is prolonged and not duration dependent.
Short‐term and long‐term positive outcomes of the multidisciplinary care implemented by the French health networks for the prevention and care of paediatric overweight and obesity
Authors: Carriere Caroline , Thibault Hélène , Barat Pascal , Guemazi‐Kheffi Fatiha , Mellouet‐Fort Blandine , Ancillon Laurent , Bertrand Anne‐Marie , Quinart Sylvain , Guilmin‐Crépon Sophie , Arsan Armine , Lestournelle Anne , Brument Régine , Saison‐Canaple Camille , Renel Lise , Daussac Adeline , Jouret Béatrice , Negre Véronique , Tauber Maïthé
Published: April 2019

Background

The nine French regional health networks for the prevention and care of paediatric obesity offer a 2‐year program of multidisciplinary primary care (medical, dietetical, psychological, adapted physical activity) based on multicomponent lifestyle interventions.

Objectives

To assess the short‐term and long‐term impact of care management.

Methods

The impact of the multidisciplinary care was assessed by changes in the body mass index (BMI) Z score during the period of the care, and at least 2 years after the end. Anthropometric data were collected at baseline and at the end of the care either through a digital medical file or through direct phone contacts with the referring. Long‐term outcomes were assessed through studies relative to post follow‐up evaluation.

Results

At the end of the period of the care in a network, 72.9% of 6947 children had decreased their BMI Z score from 3.6 ± 1.0 DS at baseline to 3.3 ± 1.1 DS at the end. The four studies relative to long‐term evaluation showed a pursuit of the decrease of BMI Z score during the 5.1 years after the beginning of the care.

Conclusions

The care provided by regional French networks for prevention and care of paediatric obesity induce a reduction of BMI that continues afterwards.
Neoadjuvant chemotherapy in non‐metastatic breast cancer: a study on practice trends in a regional cancer treatment service
Authors: Ang Edmond , Wewala Navin , Carroll Rebecca , Forgeson Garry , Anderson Malcolm , Fernando Jennifer , Jordan Jody , Isaacs Richard
Published: April 2019

Background

Neoadjuvant chemotherapy (NACT) is increasingly used for managing locally advanced and high risk non‐metastatic breast cancer.

Aims

To describe trends in NACT use, assess compliance to best practice recommendations and determine treatment response rates in a regional cancer treatment service.

Methods

In this retrospective cross‐ sectional study, electronic records of patients who underwent NACT in centres covered by the MidCentral Regional Cancer Treatment Service in 2013 and 2017 were reviewed. Data pertaining to patient demographics, disease status, compliance to best practice recommendations and treatment outcomes were extracted and analysed.

Results

Of a total of 502 referrals for non‐metastatic breast cancer, 34 underwent NACT with the estimated NACT rate rising from 3.85% (2013) to 9.92% (2017). Compliance to practice recommendations improved in all domains (pre‐treatment tumour and axillary evaluation, marker placement, multidisciplinary discussion). Overall, NACT was well tolerated with only three patients experiencing treatment limiting toxicity. Response rates mirror published data (complete response: 29.4%, partial: 61.8%) with higher responses registered in HER2 positive and triple negative subtypes. Discordance between radiological and pathological response was 28%, with imaging overestimating response in five out of seven cases. Of the 11 (32%) patients who initially underwent breast conserving surgery, six required a second surgery.

Conclusion

NACT is increasingly used in the Regional Cancer Treatment Service, with improving compliance to practice recommendations. These results are reassuring and can be used to help patients develop a realistic expectation towards NACT.
Relaxed Credit Standards in the U.S. Housing Boom: Changes in Risk Characteristics of Mortgage Recipients*
Authors: Durguner Seda
Published: April 2019

This paper examines components of credit risk and how their ability to predict the interface between households and mortgage market changed under the relaxed lending standards prevailing during the U.S. housing boom of the 2000s. Using data from the Federal Reserve Board's 1998 and 2007 Survey of Consumer Finances, the paper evaluates changes between 1998 and 2007 in the significance of credit risk characteristics in explaining three variables regarding the purchase of a primary residence by households in low‐, moderate‐, and high‐income groups: the loan‐to‐value ratio of the purchase mortgage, the likelihood of purchase, and the price paid. The study also analyzes the extent to which the period saw increases in the values of those three variables. The findings strongly suggest a decline in the ability of credit risk characteristics in predicting the interface between households and mortgage market over the period.
Carbothermal conversion of self‐supporting organic/inorganic interpenetrating networks to porous metal boride monoliths
Authors: Li Fei , Liu Ji‐Xuan , Huang Xiao , Bao Weichao , Zhang Guo‐Jun , Wang Hongzhi
Published: April 2019

In this work, we present a general sol‐gel protocol for the synthesis of highly porous monolithic transition metal borides via carbothermal conversion of the organic/inorganic interpenetrating networks (IPNs). The formation of organic/inorganic IPNs is clearly demonstrated by simple oxidation and boiling water treatment. A series of transition metal boride porous monoliths, including CrB2, ZrB2, TiB2, Cr3C2/CrB, and ZrB2/ZrC with porosities ranging from 70% to 85% and pore sizes ranging from 0.5 to 35 μm, have been prepared. In each case, a porous hybrid monolith is obtained by drying the wet gel under ambient pressure. It is believed that the formation of organic/inorganic IPNs strengthens the gel network, so that it can withstand the severe changes during desiccation to give out a monolithic xerogel. Samples are characterized by TG‐DSC, XRD, SEM, EDS, TEM, BET, and MIP, and the ceramic monoliths are shown to be well defined and rather homogeneous.
Siblings of adults with intellectual and developmental disabilities: Their knowledge and perspectives on guardianship and its alternatives
Authors: Brady Anna M. , Burke Meghan M. , Landon Trenton , Oertle Kathleen
Published: April 2019

Background

Siblings of adults with intellectual and developmental disabilities (IDD) often support their brothers and sisters through caregiving and guardianship.

Methods

In this qualitative study, the knowledge and views of 10 adult siblings were explored.

Results & Conclusions

The tripartite impact of limited knowledge of guardianship and alternatives, the viewpoint of full guardianship as necessary and the desired/anticipated roles of siblings combined to create the Sibling Reciprocal Effect (SRE). The present authors define SRE as the phenomenon of siblings to recognize the applicability of complementary forms of guardianship for other adults with IDD, but fail to see the advantage of available decision‐making alternatives with their own brothers/sisters. Instead, siblings defer to full guardianship as the preferred mechanism for decision making. Implications for practitioners include informing families of the full range of options for supporting persons with IDD in decision making. Future research suggestions include examining the elements of the SRE and siblings’ knowledge regarding guardianship and the alternatives.
Crime and victimization among people with intellectual disability with and without comorbid mental illness
Authors: Thomas Stuart D. M. , Nixon Margaret , Ogloff James R. P. , Daffern Michael
Published: April 2019

Background

Accumulating evidence internationally points to an increased risk of crime perpetration and victimization among people with an intellectual disability (ID). This study aimed to examine the impact that comorbid mental illness had on the association between intellectual disability, crime perpetration and criminal victimization.

Method

A case linkage methodology involving 2,220 individuals with an intellectual disability from an Australian State.

Results

One in four (27%) had contacts with public mental health services; 8.2% had a comorbid mental illness. This “dual disability” group was between 2.97 and 3.22 times more likely than those with intellectual disability alone to have a history of criminal charges, and between 2.76 and 2.97 times more likely to have been a victim of crime.

Conclusions

The extent of criminality and victimization found among people with dual disability indicates a potentially multiply stigmatized group for whom the need for a coordinated cross‐agency service response remains paramount.
Egg investment in response to helper presence in cooperatively breeding Tibetan ground tits
Authors: Zhao Qingtian , Hammers Martijn , Li Chen , Zeng Xixia , Hao Chenxi , Lu Xin , Komdeur Jan
Published: April 2019

Life‐history theory predicts a trade‐off between current and future reproduction to maximize lifetime fitness. In cooperatively breeding species, where offspring care is shared between breeders and helpers, helper presence may influence the female breeders’ egg investment, and consequently, survival and future reproductive success. For example, female breeders may reduce egg investment in response to helper presence if this reduction is compensated by helpers during provisioning. Alternatively, female breeders may increase egg investment in response to helper presence if helpers allow the breeders to raise more or higher quality offspring successfully. In the facultatively cooperative‐breeding Tibetan ground titPseudopodoces humilis, previous studies found that helpers improve total nestling provisioning rates and fledgling recruitment, but have no apparent effects on the number and body mass of fledglings produced, while breeders with helpers show reduced provisioning rates and higher survival. Here, we investigated whether some of these effects may be explained by female breeders reducing their investment in eggs in response to helper presence. In addition, we investigated whether egg investment is associated with the female breeder's future fitness. Our results showed that helper presence had no effect on the female breeders’ egg investment, and that egg investment was not associated with breeder survival and reproductive success. Our findings suggest that the responses of breeders to helping should be investigated throughout the breeding cycle, because the conclusions regarding the breeders’ adjustment of reproductive investment in response to being helped may depend on which stage of the breeding cycle is considered.
Exploring Disparities in Influenza Immunization for Older Women
Authors: MacCarthy Sarah , Burkhart Q , Haviland Amelia M. , Dembosky Jacob W. , Wilson‐Frederick Shondelle , Saliba Debra , Gaillot Sarah , Elliott Marc N.
Published: April 2019

OBJECTIVES

While women obtain most recommended preventive health interventions more often than men, evidence is mixed regarding influenza vaccination for older adults. Therefore, we evaluated sex differences in influenza vaccination among older adults.

DESIGN

Nationally representative cross‐sectional survey.

SETTING

United States.

PARTICIPANTS

A total of 1 252 705 adults, aged 65 years and older, responding to 2013 to 2017 Medicare Consumer Assessment of Healthcare Providers and Systems surveys.

MEASUREMENTS

The dependent variable was Healthcare Effectiveness Data and Information Set self‐reported influenza immunization. The primary predictor was sex. Covariates included general health status, education, race/ethnicity, and Medicare Advantage (MA; managed care) vs Fee‐for‐Service (FFS) coverage.

RESULTS

After adjusting for health status and other sociodemographic factors, women's immunization was 2% lower than men's immunization in MA, with no significant overall sex difference in FFS. Women were immunized less often than men in 95% of MA health plans, with the largest gaps in low‐immunizing plans. Further analyses revealed variation in sex differences by health status, education, and race/ethnicity in both MA and FFS. Notably in MA, women in poor health were immunized less often than men in similar health (−4%; P < .001). Black women were immunized much less often than black men in both MA and FFS (−5%; P < .001 for each). Hispanic women were immunized less often than Hispanic men in MA (−4%; P < .001) but not within FFS.

CONCLUSION

Women in MA experience small disparities overall in influenza immunization, with larger disparities for black and Hispanic women. Providers and MA plans should increase efforts to recommend and monitor immunization for older women, especially black and Hispanic women and those in poor health. Given the potential to reduce morbidity and mortality, equitable access to a critical preventive health service, such as influenza immunization, is crucial for all older adults.
Flexible assertive community treatment for individuals with a mild intellectual disability or borderline intellectual functioning: results of a longitudinal study in the Netherlands
Authors: Neijmeijer L. J. , Korzilius H. P. L. M. , Kroon H. , Nijman H. L. I. , Didden R.
Published: April 2019

Background

Assertive community treatment (ACT) and Flexible assertive community treatment (FACT) are organisation models for intensive assertive outreach that were originally developed for individuals with severe mental illness. The models are increasingly applied to people with mild intellectual disability (MID) or borderline intellectual functioning (BIF) and challenging behaviour or mental illness. Research on these types of care for this population is limited. To gain experience in FACT MID/BIF in the Netherlands and to obtain insight in its outcomes, four organisations specialised in the treatment of individuals with MID/BIF and challenging behaviour participated in a 6‐year implementation and research project.

Methods

A longitudinal study was set up to investigate outcomes over time. Outcome measures concerned admissions to (mental) health care, social and psychological functioning, (risk of) challenging and criminal behaviour, social participation and client satisfaction. Data were analysed using descriptive statistics and linear mixed models.

Results

Over time, clients showed improvement in their social and psychiatric functioning and living circumstances. The number of admissions to (mental) health care diminished as well as the number of contacts with police and justice, the level of social disturbance and the risk factors for challenging and criminal behaviour. Problems related to finances, work and substance abuse remained unchanged.

Conclusions

The results are encouraging and give rise to continued development of and broader research on FACT MID/BIF.
Innate immunity – a clinical perspective
Authors: Egesten A. , Gordon S. , Herwald H.
Published: April 2019

Content List ‐ 15th Key symposium ‐ “Innate immunity”.
Broken smiles: The impact of untreated dental caries and missing anterior teeth on employment
Authors: Halasa‐Rappel Yara A. , Tschampl Cynthia A. , Foley Mary , Dellapenna Martha , Shepard Donald S.
Published: April 2019

Objectives

We aimed to quantify the impact of dental caries and missing anterior teeth on employment, estimate the impact of a routine dental visit on the health of anterior teeth, and the benefits of expanding dental coverage for nonelderly adults.

Methods

We used the 2013–2014 Continuous National Health and Nutritional Examination Survey to develop a dental problem index (DPI) using tooth counts and tooth surface conditions. We estimated the impact of DPI on employment with logistic regression, controlling for seven demographic and socioeconomic covariates. We used a routine dental visit within 6 months as a proxy for access to dental services, and a linear regression to predict the DPI score for an average individual with and without a recent routine dental visit. We then computed the incremental probability of employment associated with a recent routine dental visit. Finally, we estimated the additional number of working age adults who might become employed due to improved access to dental services.

Results

The probability of being employed was negatively associated with poor oral health: a one‐point increase in DPI decreased the odds of being employed by 7.70 percent (CI: 5.15–10.19%). Having a routine dental visit had a negative and statistically significant impact on DPI [−0.41 (CI: −0.68 to −0.14)]. The incremental probability of employment associated with a routine dental visit was 0.62 percent (CI: 0.21–1.03%).

Conclusions

Oral health in the United States is worse among minorities and poor than among other residents. The benefits associated with access to dental care should justify expanding dental services.
Differential feeding by common heterotrophic protists on four Scrippsiella species of similar size
Authors: Kim So Jin , Jeong Hae Jin , Kang Hee Chang , You Ji Hyun , Ok Jin Hee
Published: April 2019

The dinoflagellate genus Scrippsiella is known to cause red tides. Mortality due to predation should be assessed in order to understand the population dynamics of Scrippsiella species. However, predation has been explored only in a few species. In this study, we examined feeding by common heterotrophic dinoflagellates Oxyrrhis marina, Gyrodinium dominans, Polykrikos kofoidii, Oblea rotunda, and Pfiesteria piscicida, and a ciliate Strombidinopsis sp., on four Scrippsiella species, of similar size, namely Scrippsiella acuminata, Scrippsiella donghaiensis, Scrippsiella lachrymosa, and Scrippsiella masanensis. All the heterotrophic protists tested could feed on all the four Scrippsiella species. However, the numerical and functional responses of P. kofoidii to the mean prey concentration were apparently different between the Scrippsiella species. With increasing prey concentration, the growth and ingestion rates of P. kofoidii on S. lachrymosa increased rapidly, and then saturated similar to those on S. acuminata, as previously reported, but those on S. donghaiensis continuously decreased. The cells of S. donghaiensis lysed P. kofoidii cells. In contrast, the growth and ingestion rates of P. kofoidii on S. masanensis were not significantly related to the prey concentration. At similarly high mean prey concentration, the growth and ingestion rates of G. dominans were significantly different between the four Scrippsiella species Therefore, differences in the growth and/or ingestion rates of G. dominans and P. kofoidii on the four Scrippsiella species might result in different ecological niches of both the predator and prey species.
RNAi of the sesquiterpene cyclase gene for phytoalexin production impairs pre‐ and post‐invasive resistance to potato blight pathogens
Authors: Yoshioka Miki , Adachi Ayako , Sato Yutaka , Doke Noriyuki , Kondo Tatsuhiko , Yoshioka Hirofumi
Published: April 2019

Potato antimicrobial sesquiterpenoid phytoalexins lubimin and rishitin have been implicated in resistance to the late blight pathogen, Phytophthora infestans and early blight pathogen, Alternaria solani. We generated transgenic potato plants in which sesquiterpene cyclase, a key enzyme for production of lubimin and rishitin, is compromised by RNAi to investigate the role of phytoalexins in potato defence. The transgenic tubers were deficient in phytoalexins and exhibited reduced post‐invasive resistance to an avirulent isolate of P. infestans, resulting in successful infection of the first attacked cells without induction of cell death. However, cell death was observed in the subsequently penetrated cells. Although we failed to detect phytoalexins and antifungal activity in the extract from wild‐type leaves, post‐invasive resistance to avirulent P. infestans was reduced in transgenic leaves. On the other hand, A. solani frequently penetrated epidermal cells of transgenic leaves and caused severe disease symptoms presumably from a deficiency in unidentified antifungal compounds. The contribution of antimicrobial components to resistance to penetration and later colonization may vary depending on the pathogen species, suggesting that sesquiterpene cyclase‐mediated compounds participate in pre‐invasive resistance to necrotrophic pathogen A. solani and post‐invasive resistance to hemibiotrophic pathogen P. infestans.
Morphological Measurement of Supracondylar Femur Based on Digital Technology in Chinese Han Population
Authors: Wang Lei , Tian Dong‐mu , Liu Xin , Zhang Jian‐feng , Zhao Li‐ming , He Xin , Hu Yong‐cheng
Published: April 2019

Objective

Relatively few studies have reported on the morphology of the supracondylar femur, which is a fundamental factor affecting prosthetic reconstruction. The objectives of the present study were to measure the morphological parameters of the supracondylar femur, to classify the supracondylar femur, and to provide theoretical guidance for the development of distal femoral prostheses.

Methods

The study consisted of 82 patients of Han Chinese nationality in North China. There were 57 men and 25 women included in the study, with an average age of 50.9 years (range, 18–87 years). Effective CT data should include a range of more than 10 cm for the distal femur. CT data for the right distal supracondylar femurs was obtained from DICOM files. Results for the cancellous bone and marrow cavity were retained, and information for the cortical bone was erased to obtain information of the lumen. Measurements of the intracortical cavity have not been reported previously. Lumen models were reconstructed with Mimics 17.0 software. The surfaces of the lumen models were smoothed with Geomagic studio 12.0 software. Using the Solidworks 2014 software, we established a 3‐D coordinate system, where variables of the lumen were examined. Correlations between the various measurements were calculated.

Results

The supracondylar region of the femur was divided into five levels, and the length, breadth, height, and angle values were measured at each level. There were strong correlations between the length indexes (transverse diameter [EF], medial anteroposterior diameter [AC], middle anteroposterior diameter [GH], and lateral anteroposterior diameter [BD]) and the volume index (V). There were also strong correlations among the length indicators (EF, AC, GH, and BD) in each layer. Angle γ was correlated with the lateral anteroposterior diameter (BD) at L2–L6 layers (r = −0.383, −0.385, −0.296, −0.258, −0.24; all P < 0.05) and with the height index (h) at L4–L6 layers (r = −0.244, −0.385, −0.506; all P < 0.05). The most representative parameters were the medial anteroposterior diameter (AC2R2 = 0.865; AC6R2 = 0.932), the coronal width ratio, and the sagittal width ratio with volume. The analysis found that the lumen shape of flower–top hat accounted for 81% at most.

Conclusions

The supracondylar femur has an asymmetrical structural area. The coronal plane is dominated by a flowerpot‐like morphology, and the sagittal plane is narrowest in the lateral 1/3 and resembles a top‐hat‐like morphology. Our results provide theoretical guidance for developing distal femoral prostheses and for their clinical application.
Comparison of Less Invasive Stabilization System Plate and Retrograde Intramedullary Nail in the Fixation of Femoral Supracondylar Fractures in the Elderly: A Biomechanical Study
Authors: Du Yu‐ren , Ma Jian‐xiong , Wang Shuo , Sun Lei , Wang Ying , Lu Bin , Bai Hao‐hao , Hu Yong‐cheng , Ma Xin‐long
Published: April 2019

Objective

To compare the biomechanical stabilities of less invasive stabilization system (LISS) plate and retrograde intramedullary nail (IMN) for the comminuted femoral supracondylar fracture fractures in the elderly.

Methods

Sixteen pairs of embalmed cadaver femurs were obtained to simulate a comminuted supracondylar femur fracture (AO/OTA33‐A3) gap model. All left‐side specimens were fixed with LISS plate, and retrograde IMN were applied to the right‐side specimens. All specimens were tested in torsional, axial and cyclic load mode on an Instron testing machine.

Results

The mean torsional stiffness for LISS plate group was 34.1% greater than retrograde IMN group (2.90 vs. 1.91 Nm/degree, P = 0.002), but the mean axial stiffness was greater for the retrograde IMN (199.16 vs. 303.93 N/mm, P < 0.001). The total deformation of LISS plate caused by cyclic axial loading was greater than retrograde IMN (4.17 vs. 3.57 mm, P = 0.014). Significantly less mean irreversible deformation was detected in LISS plate than in retrograde IMN (1.64 vs. 1.69 mm, P = 0.699). Failure loads of the constructs were significantly different between the two groups (LISS plate: 2941±128 N; retrograde IMN: 4022±176 N, P < 0.001).

Conclusion

For comminuted femoral supracondylar fractures in the elderly, the tested instruments can both maintain sufficient biomechanical stabilities, but retrograde IMN is superior to LISS plate in deformation of fracture site.
A biosafety algorithm for the protection of pathology staff during intraoperative examinations of pulmonary lesions
Authors: Sugiyama Tomoko , Tajiri Takuma , Fujita Hirotaka , Hiraiwa Shinichiro , Toguchi Suguru , Nomura Nozomi , Machida Tomohisa , Suga Atsushi , Nakamura Yusuke , Nakagawa Tomoki , Yamada Shyunsuke , Iwazaki Masayuki , Nakamura Naoya
Published: April 2019

We aimed to propose a biosafety algorithm for the protection of pathology staff during intraoperative examinations of pulmonary lesions when working with cytological imprints and/or frozen sections for the intraoperative diagnosis of pulmonary lesions. We examined 148 pulmonary surgical tissues obtained intraoperatively for imprint cytology (IC) and for frozen sectioning and compared the diagnoses against the final pathological diagnoses. We analyzed concordance and non‐concordance rates and then used the data to produce a biosafety algorithm. The diagnostic sensitivity, specificity, positive predictive value, negative predictive value and accuracy of scratch‐IC were 91%, 100%, 100%, 50% and 92%, respectively, and those of frozen sectioning were 99%, 100%, 100%, 96% and 99%, respectively. Our data indicate that frozen sectioning is unnecessary if scratch‐IC yields a ‘malignant’ diagnosis but recommended with a ‘benign’ diagnosis. When a scratch‐IC preparation deemed inadequate for a diagnosis or an abscess, the pathologist must consult the surgeon concerning the possibility of granuloma with caseous necrosis and should ask the surgeon to be prepared for a frozen section. If granuloma with caseous necrosis is found in the frozen section, the pathologist must immediately communicate the information to entire staff and perform a PCR test before making a permanent section.
Addressing viral and bacterial threats to salmon farming in Chile: historical contexts and perspectives for management and control
Authors: Figueroa Jaime , Cárcamo Juan , Yañez Alejandro , Olavarria Victor , Ruiz Pamela , Manríquez René , Muñoz Claudio , Romero Alex , Avendaño‐Herrera Ruben
Published: April 2019

The rapid growth of the salmon farming industry in Chile has led to the appearance of various viral, bacterial, parasitic, and fungal pathogens affecting farmed fish. The Chilean salmon industry has suffered several health crises associated with high fish mortalities, such as caused by the infectious salmon anaemia virus (2007) and harmful algal blooms (2016). In addition to these events, marine farms are continuously affected by outbreaks of harmful pathogens, including the bacteria Piscirickettsia salmonis and, most recently, a reappearance of Renibacterium salmoninarum, and the infectious pancreatic necrosis virus. These outbreaks have led to stricter regulations, but the salmon farming industry continues to struggle despite reforms. In addition to the aforementioned pathogens, which are a continuous threat, other apparently under control pathogens have also reappeared in recent years. In this review, we analyse the current state of knowledge on four of the main pathogens affecting salmon farming in Chile. The infectious pancreatic necrosis virus is relevant as it affects freshwater‐stage fish, with survivors then acting as carriers. The infectious salmon anaemia virus currently appears to be under control; however, P. salmonis and R. salmoninarum continue to be the cause for high mortalities in the Chilean aquaculture industry.
Knowing, Remembering, and Relating to Others Online: A Commentary
Authors: Baker Michael J. , Détienne Françoise
Published: April 2019

Baker and Detiénne argue that the results reported in Stone and Wang and Alea et al. should be contextualized within a broader historical and societal perspective that takes into account the co‐evolution of social interaction practices and technology‐mediated collaborative activities.