bluuebunny/crossref_metadata_2025 huggingface dataset:
Pleural dye marking of lung nodules by electromagnetic navigation bronchoscopy
Authors: Bowling Mark R. , Folch Erik E. , Khandhar Sandeep J. , Arenberg Douglas A. , Awais Omar , Minnich Douglas J. , Pritchett Michael A. , Rickman Otis B. , Sztejman Eric , Anciano Carlos J.
Published: August 2019

Introduction

Electromagnetic navigation bronchoscopy (ENB)‐guided pleural dye marking is useful to localize small peripheral pulmonary nodules for sublobar resection.

Objective

To report findings on the use of ENB‐guided dye marking among participants in the NAVIGATE study.

Methods

NAVIGATE is a prospective, multicentre, global and observational cohort study of ENB use in patients with lung lesions. The current subgroup report is a prespecified 1‐month interim analysis of ENB‐guided pleural dye marking in the NAVIGATE United States cohort.

Results

The full United States cohort includes 1215 subjects from 29 sites (April 2015 to August 2016). Among those, 23 subjects (24 lesions) from seven sites underwent dye marking in preparation for surgical resection. ENB was conducted for dye marking alone in nine subjects while 14 underwent dye marking concurrent with lung lesion biopsy, lymph node biopsy and/or fiducial marker placement. The median nodule size was 10 mm (range 4‐22) and 83.3% were <20 mm in diameter. Most lesions (95.5%) were located in the peripheral third of the lung, at a median of 3.0 mm from the pleura. The median ENB‐specific procedure time was 11.5 minutes (range 4‐38). The median time from dye marking to resection was 0.5 hours (range 0.3‐24). Dye marking was adequate for surgical resection in 91.3%. Surgical biopsies were malignant in 75% (18/24).

Conclusion

In this study, ENB‐guided dye marking to localize lung lesions for surgery was safe, accurate and versatile. More information is needed about surgical practice patterns and the utility of localization procedures.
Achievement of glycaemic control is associated with improvements in lipid profile with iGlarLixi versus iGlar: A post hoc analysis of the LixiLan‐L trial
Authors: Giorgino Francesco , Shaunik Alka , Liu Minzhi , Saremi Aramesh
Published: August 2019

Diabetic dyslipidaemia is a major risk factor for accelerated atherosclerosis. Glycaemic treatments that improve dyslipidaemia may help reduce the burden of atherosclerosis. This analysis investigated the effect of iGlarLixi [insulin glargine U100 (iGlar) and lixisenatide] versus iGlar on lipid profiles in patients with type 2 diabetes uncontrolled on basal insulin. Data from LixiLan‐L were used to estimate changes in fasting lipid levels from baseline to week 30, overall and in patients stratified by achievement of glycaemic targets {2‐hour postprandial glucose [≤10, >10 mmoL/L], fasting plasma glucose [≤6.1, >6.1 mmoL/L], HbA1c [≤7, >7% (≤53, >53 mmol/mol)]}. At week 30, median percentage change in triglycerides remained nearly unchanged (0.3% increase) with iGlarLixi versus a 6.5% increase with iGlar (P = 0.035; overall); similarly, trends towards better total and LDL cholesterol levels were observed with iGlarLixi versus iGlar. In patient subgroups achieving glycaemic targets, all lipid variables except for HDL cholesterol improved with iGlarLixi but not with iGlar. In summary, patients with type 2 diabetes uncontrolled on basal insulin showed improved fasting lipid profiles with iGlarLixi compared with iGlar, particularly when achieving glycaemic targets.
Comparison of the urinary glucose excretion contributions of SGLT2 and SGLT1: A quantitative systems pharmacology analysis in healthy individuals and patients with type 2 diabetes treated with SGLT2 inhibitors
Authors: Yakovleva Tatiana , Sokolov Victor , Chu Lulu , Tang Weifeng , Greasley Peter J. , Peilot Sjögren Helena , Johansson Susanne , Peskov Kirill , Helmlinger Gabriel , Boulton David W. , Penland Robert C.
Published: August 2019

Aim

To develop a quantitative drug‐disease systems model to investigate the paradox that sodium‐glucose co‐transporter (SGLT)2 is responsible for >80% of proximal tubule glucose reabsorption, yet SGLT2 inhibitor treatment results in only 30% to 50% less reabsorption in patients with type 2 diabetes mellitus (T2DM).

Materials and methods

A physiologically based four‐compartment model of renal glucose filtration, reabsorption and excretion via SGLT1 and SGLT2 was developed as a system of ordinary differential equations using R/IQRtools. SGLT2 inhibitor pharmacokinetics and pharmacodynamics were estimated from published concentration‐time profiles in plasma and urine and from urinary glucose excretion (UGE) in healthy people and people with T2DM.

Results

The final model showed that higher renal glucose reabsorption in people with T2DM versus healthy people was associated with 54% and 28% greater transporter capacity for SGLT1 and SGLT2, respectively. Additionally, the analysis showed that UGE is highly dependent on mean plasma glucose and estimated glomerular filtration rate (eGFR) and that their consideration is critical for interpreting clinical UGE findings.

Conclusions

Quantitative drug‐disease system modelling revealed mechanistic differences in renal glucose reabsorption and UGE between healthy people and those with T2DM, and clearly showed that SGLT2 inhibition significantly increased glucose available to SGLT1 downstream in the tubule. Importantly, we found that the findings of lower than expected UGE with SGLT2 inhibition are explained by the shift to SGLT1, which recovered additional glucose (~30% of total).
Superior HbA1c control with the fixed‐ratio combination of insulin degludec and liraglutide (IDegLira) compared with a maximum dose of 50 units of insulin degludec in Japanese individuals with type 2 diabetes in a phase 3, double‐blind, randomized trial
Authors: Watada Hirotaka , Kaneko Shizuka , Komatsu Mitsuhisa , Agner Bue Ross , Nishida Tomoyuki , Ranthe Mattis , Nakamura Jiro
Published: August 2019

Aims

To investigate the efficacy and safety of insulin degludec/liraglutide (IDegLira) compared with 50 U insulin degludec (degludec) or less in Japanese individuals with type 2 diabetes (T2D).

Materials and methods

In this 26‐week, double‐blind, multicentre, treat‐to‐target trial, Japanese individuals with T2D that was uncontrolled with basal or pre‐mix insulin (20–50 units) were randomized (1:1) to receive IDegLira or degludec, both with metformin. The maximum dose was 50 dose steps (IDegLira) or 50 units (degludec). The primary endpoint was change from baseline in HbA1c with IDegLira vs degludec after 26 weeks of treatment.

Results

In total, 210 Japanese individuals were randomized to IDegLira or degludec and completion rates were 100% and 93%, respectively. IDegLira was superior to degludec with respect to change from baseline in HbA1c: estimated treatment difference (ETD) (95% confidence interval), −13.98 mmol/Mol (−16.41; −11.55); P < 0.0001. The change in mean HbA1c was from 70.6 by −21.3 mmol/Mol with IDegLira and from 70.1 by −7.1 mmol/Mol with degludec. Mean change in body weight was −0.7 kg with IDegLira and 0.7 kg with degludec: ETD (95% CI) −1.41 kg (−2.26; −0.56); P = 0.0012. Mean daily total insulin dose was significantly lower with IDegLira (37.6 U) as compared to that with degludec (41.2 U) at Week 26. Overall rates of severe or blood glucose‐confirmed hypoglycaemia and adverse events were comparable between treatment groups.

Conclusions

IDegLira provided superior reductions in HbA1c compared with ≤50 U degludec, with weight loss and similar hypoglycaemia rates and no unexpected safety or tolerability issues. These results suggest that this treatment could be an attractive intensification option for Japanese subjects with T2D that was uncontrolled with basal or pre‐mixed insulin.
The effects of cardiac resynchronization therapy on left ventricular and mitral valve geometry and secondary mitral regurgitation in patients with left bundle branch block
Authors: Mihos Christos G. , Santana Orlando , Yucel Evin , Capoulade Romain , Upadhyay Gaurav A. , Orencole Mary P. , Singh Jagmeet P. , Picard Michael H.
Published: August 2019

Background

Secondary mitral regurgitation (MR) is common in patients with left bundle branch block (LBBB) undergoing cardiac resynchronization therapy (CRT). We aimed to define CRT effects on left ventricular (LV) and mitral valve (MV) geometry, and their correlation with MR severity.

Methods

Forty‐one patients with LBBB and ≥mild secondary MR underwent CRT between 2009 and 2012, and had baseline and follow‐up echocardiograms available. Repeated measure and linear regression analyses were performed to assess for changes in MV and LV geometry and MR severity, and associations with follow‐up MR grade.

Results

The mean age and baseline QRS duration were 65.5 ± 14.9 years and 160 ± 24 ms. At a mean follow‐up of 2.6 ± 1.8 years, there was an increase in LV ejection fraction and reductions in LV end‐systolic volume index, MR grade, and end‐systolic interpapillary muscle distance (P < .05 for all). Linear correlations were observed between follow‐up MR grade and baseline MV tenting height (r = .44), left atrial volume index (r = .41), LV end‐systolic volume index (r = .4), MV tenting area (r = .38), LV ejection fraction (r = −.34), and end‐systolic interpapillary muscle distance (r = .34) (P < .05 for all). Multiple regression analysis revealed associations between follow‐up MR grade and baseline MV tenting height (β/mm = 0.42, P = .006) and left atrial volume index (β/mL/m2 = 0.4, P = .008), independent of QRS duration (β/ms=−0.07; P = 0.6) and nonischemic cardiomyopathy (β = −0.34, P = .02).

Conclusions

Cardiac resynchronization therapy in patients with LBBB and secondary MR results in LV and MV geometric reverse remodeling and decreases MR severity. Extent of baseline MV tethering is independently associated with persistent MR at follow‐up.
The ventromedial hypothalamic circuitry and male alloparental behaviour in a socially monogamous rodent species
Authors: Liu Yan , Donovan Meghan , Jia Xixi , Wang Zuoxin
Published: August 2019

As prairie voles (Microtus ochrogaster) display spontaneous biparental care, and the ventromedial hypothalamus (VMH) has been implicated in reproductive behaviour, we conducted experiments to test the hypothesis that the VMH neurochemical circuitry is involved in alloparental behaviours in male prairie voles. We compared alloparental behaviours of adult, sexually naïve male and female voles—both displayed licking/grooming, huddling and retrieving behaviours towards conspecific pups. We also stained for the immediate‐early gene encoded early growth protein Egr‐1 in the vole brain. The pup‐exposed animals showed levels of Egr‐1 staining that was higher in the VMH but lower in the amygdala compared to animals exposed to a pup‐sized piece of plastic (control). A retrograde tracer, Fluoro‐Gold (FG), was injected into the VMH of male voles that were subsequently tested in the pup exposure or control condition. More FG/Egr‐1 cells were detected for glutamatergic (GLU) staining in the ventral bed nucleus of the stria terminalis (BNSTv) and medial amygdala (MeA), whereas less FG/Egr‐1 cells were stained for gamma‐aminobutyric acid (GABA) in the MeA of the pup‐exposed group compared to the control group. Further, the ratio of GLU:GABA expression in FG/Egr‐1 projection neurons from both the BNSTv and MeA to the VMH was increased following pup exposure. Finally, pharmacological blockade of either dopamine D1 receptor or oxytocin receptor in the VMH impaired the onset of male alloparental behaviour. Together, these data suggest that the VMH may be involved in the onset of alloparental care and play a role in regulating social approach in male prairie voles.
A method to assess the impact of soil available water capacity uncertainty on crop models with a tipping‐bucket approach
Authors: Constantin Julie , Picheny Victor , Nassar Lina H. , Bergez Jacques‐Eric
Published: August 2019

Most agronomic crop models use a reservoir tipping‐bucket approach to model the water budget in the soil. Soil available water capacity (AWC) is the main soil property considered in this approach. Because AWC is difficult to measure, uncertainty in AWC may be high. We developed a method using a specific kriging technique to determine the effects of uncertainty in AWC on crop model predictions. The AqYield crop model was used as an example to assess the effects of uncertainty in AWC on two agronomic output variables (grain yield and drainage). The factors considered were the climatic region, crop type and soil depth. We assessed the results using the coefficient of variation (CV) and sets of critical values for which CV exceeded 5, 10 and 15%. The experiment provided insight into the criticality of AWC uncertainty over a wide range of agropedoclimatic situations according to crop, model and output of interest. The method revealed the greater effect of AWC uncertainty on both outputs for the spring crop than for the winter crop and identified cases where AWC uncertainty was critical. There was a stronger effect of AWC uncertainty on yield for shallow soil and climatic water deficit conditions. For each situation, the AWC uncertainty levels were determined above or below which the impact becomes significant on a given output because the sensitivity was very dependent on climate–crop–soil combinations. It was also observed that uncertainty in AWC had little effect in AqYield for a wide range of situations. The method developed uses a small number of model simulations to produce accurate results to better understand the impact of this major soil input data according to the target model and specific objectives. It could help to determine the level of accuracy needed in AWC measurement, depending on the objectives.

Highlights

The method quantifies the effects of AWC uncertainty on crop models with a tipping‐bucket approach.

This method can assess the impact of uncertainty with only a few runs using a kriging approach.

The method identifies critical situations for a wide range of agropedoclimatic conditions.

Critical region graphs give critical thresholds for accuracy needed in AWC.
Soil aggregates impact nitrifying microorganisms in a vertisol under diverse fertilization regimes
Authors: Han Shun , Luo Xuesong , Tan Shuang , Wang Jianfei , Chen Wenli , Huang Qiaoyun
Published: August 2019

Ammonia oxidizers (ammonia‐oxidizing archaea (AOA) and bacteria (AOB)), nitrite oxidizers (e.g., Nitrobacter and Nitrospira) and comammox Nitrospira play important roles in the nitrogen cycle in agroecosystems, yet their activities and abundance in soil microhabitats under environmental disturbances remain unclear. In this study, we collected samples from treatment plots in a field experiment established in 2010 in a lime concretion black soil in central China to investigate the effects of varying inorganic and organic fertilizer managements in a wheat–maize crop rotation, in order to investigate the impacts on the abundance and activities of ammonia and nitrite oxidizers inhabiting different microenvironments in soil, represented by three soil aggregate size fractions. The treatments were: control without fertilizer (CK), chemical fertilization (NPK), NPK and straw (NPKS), NPKS and pig manure (NPKSP) or cow manure (NPKSC). The potential nitrite oxidation activity (PNO) and soil nutrients (soil carbon, nitrogen and phosphorus content) were the highest in the microaggregates, followed by those in the macroaggregates and silt+clay fractions in all the plots. Both the ammonia and nitrite oxidizers were more abundant in the macroaggregates and microaggregates than in the silt+clay fractions. A two‐way analysis of variance (ANOVA) indicated that the soil aggregate size had a significant influence on the abundance of ammonia and nitrite oxidizers and the soil nutrients. We also found a significant positive correlation between PNO and the nitrite oxidizer and AOA abundance. In addition, the abundances of the ammonia oxidizers (AOA and AOB) and nitrite oxidizers (Nitrobacter and Nitrospira) were positively correlated with each other. Overall, the soil aggregates with a higher inorganic nutrient and organic carbon content may provide a better protective microenvironment to guard against environmental disturbances and facilitate the inhabitation of ammonia and nitrite oxidizers, which cooperate in the nitrogen cycling process.

Highlights

Nitrifying guilds and their activities were investigated under soil aggregates in a Vertisol.

Soil aggregates of different sizes provide spatially heterogeneous habitats for nitrifying guilds.

Ammonia‐ and nitrite‐oxidizer abundances and their activities are controlled by soil aggregate size.

Soil aggregates with higher nutrients may provide a better protective habitat for nitrifying guilds.
Method of invasive monitoring in epilepsy surgery and seizure freedom and morbidity: A systematic review
Authors: Yan Han , Katz Joel S. , Anderson Melanie , Mansouri Alireza , Remick Madison , Ibrahim George M. , Abel Taylor J.
Published: August 2019

Objective

Invasive monitoring is sometimes necessary to guide resective surgery in epilepsy patients, but the ideal method is unknown. In this systematic review, we assess the association of postresection seizure freedom and adverse events in stereoelectroencephalography (SEEG) and subdural electrodes (SDE).

Methods

We searched three electronic databases (MEDLINE, Embase, and CENTRAL [Cochrane Central Register of Controlled Trials]) from their inception to January 2018 with the keywords “electroencephalography,” “intracranial grid,” and “epilepsy.” Studies that presented primary quantitative patient data for postresection seizure freedom with at least 1 year of follow‐up or complication rates of SEEG‐ or SDE‐monitored patients were included. Two trained investigators independently collected data from eligible studies. Weighted mean differences (WMDs) with 95% confidence interval (CIs) were used as a measure of the association of SEEG or SDE with seizure freedom and with adverse event outcomes.

Results

Of 11 462 screened records, 48 studies met inclusion criteria. These studies reported on 1973 SEEG patients and 2036 SDE patients. Our systematic review revealed SEEG was associated with 61.0% and SDE was associated with 56.4% seizure freedom after resection (WMD = +5.8%, 95% CI = 4.7‐6.9%, P = .001). Furthermore, SEEG was associated with 4.8% and SDE was associated with 15.5% morbidity (WMD = −10.6%, 95% CI = −11.6 to −9.6%, P = .001). SEEG was associated with 0.2% mortality and SDE was associated with 0.4% mortality (WMD = −0.2%, 95% CI = −0.3 to −0.1%, P = .001).

Significance

In this systematic review of SEEG and SDE invasive monitoring techniques, SEEG was associated with fewer surgical resections yet better seizure freedom outcomes in those undergoing resections. SEEG was also associated with lower mortality and morbidity than SDE. Clinical studies directly comparing these modalities are necessary to understand the relative rates of seizure freedom, morbidity, and mortality associated with these techniques.
Bargains in the diamond market? How to take advantage from online information
Authors: Arcos‐Vargas Angel , Núñez Fernando , Tallón‐Ballesteros Antonio J.
Published: August 2019

This paper empirically analyses the price of diamonds from different perspectives. The sample data contains detailed information on more than 165,000 diamonds certified by Gemological Institute of America, which can be purchased since July 2016 from a large online diamond supplier. Our empirical analysis allows to extend the classic 4Cs model in several directions as follows: (a) the classical 4Cs model is insufficient in order to explain the price, so that other attributes, such as polishing, symmetry, and fluorescence, must be incorporated to accurately estimate the price of a particular piece; (b) the large sample size allows us to analyse specific price ranges characterized by high market activity; (3) a very detailed analysis has been conducted for round diamonds, incorporating interactions between attributes within the regression model and studying the marginal rates of substitution between diamond weight and alternative characteristics given a certain price. Our model is able to detect diamonds that could constitute a clear market opportunity for buyers. This model can help to select efficient demand options taking advantage of the information available on the website, improving the overall efficiency of exchange in this sector.
Representing and intervening in Swedish education—Mediating and adjudicating by grading numbers
Authors: Hasselbladh Hans , Bejerot Eva
Published: August 2019

Educational reforms are attempts to transform and reconstitute conceptions of knowledge, the practice of teaching and the forms of subjectivity associated with being a teacher, pupil, and parent. We will investigate a particular aspect of the extensive changes that have swept across the landscape of Swedish education over the last decades. We will show how the grading system has come to fulfill a mediating role between progressivist educational ideas and neo‐liberal notions of individual choice and entrepreneurship, by way of adjudicating and mediating educational performance for individual pupils, schools, and the education system at large. The aggregated output of the grading system is used for instrumental purposes such as performance management, quality management, and bench marking in the school system. Grading and its associated practices extend throughout the entire school system, defining success and failure from individual classrooms to the national level as the dominant form of representing school performance. The grading system was initially intended to reshape the inner workings of education in Sweden but subsequently became the “gold standard” deployed in various managerial practices. Our analysis demonstrate the performative powers when seemingly innocent techniques are put to use in public sector reforms and new worlds are made and unmade by complex constellations of seemingly mundane techniques and ideational frameworks.
Different determinants of radiation use efficiency in cold and temperate forests
Authors: Balzarolo Manuela , Valdameri Nadia , Fu Yongshuo H. , Schepers Lennert , Janssens Ivan A. , Campioli Matteo
Published: August 2019

Aim

To verify which vegetation and environmental factors are the most important in determining the spatial and temporal variability of average and maximum values of radiation use efficiency (RUEann and RUEmax, respectively) of cold and temperate forests.

Location

Forty‐eight cold and temperate forests distributed across the Northern Hemisphere.

Major taxa studied

Evergreen and deciduous trees.

Time period

2000–2011.

Methods

We analysed the impact of 17 factors as potential determinants of mean RUE (at 8 days interval, annual and interannual level) and RUEmax (at annual and interannual level) in cold and temperate forests by using linear regression and random forests models.

Results

Mean annual RUE (RUEann, c. 1.1 gC/MJ) and RUEmax (c. 0.8 gC/MJ) did not differ between cold and temperate forests. However, for cold forests, RUEann was affected by temperature‐related variables, while for temperate forests RUEann was affected by drought‐related variables. Leaf area index (LAI) was important for both forest types, while N deposition only for cold forests and cloud cover only for temperate forest. RUEmax of cold forests was mainly driven by N deposition and LAI, whereas for temperate forests only a weak relationship between RUEmax and CO2 concentration was found. Short‐term variability of RUE was strongly related to the meteorological variables and varied during the season and was stronger in summer than spring or autumn. Interannual variability of RUEann and RUEmax was only weakly related to the interannual variability of the environmental drivers.

Main conclusions

Cold and temperate forests show different relationships with the environment and vegetation properties. Among the RUE drivers observed, the least anticipated was N deposition. RUE is strongly related to short‐term and seasonal changes in meteorological variables among seasons and among sites. Our results should be considered in the formulation of climate zone‐specific tools for remote sensing and global models.
Graded evolution of anisotropic microstructure during sintering from crystal‐oriented powder compact
Authors: Baba Shoko , Maître Alexandre , Pradeilles Nicolas , Antou Guy , Saito Nobuo , Tanaka Satoshi
Published: August 2019

Anisotropic sintering, including shrinkage and grain growth, was examined for c‐axis‐oriented (Sr,Ca)2NaNb5O15 (SCNN) ceramics, which were prepared by colloidal processing under a magnetic field. In the c‐axis‐oriented SCNN powder compact, shrinkage and grain growth along the c‐axis were higher than those along the a‐axis. The anisotropic microstructural development was clearly associated with anisotropic sintering shrinkage. X‐ray diffraction, scanning electron microscopy, and energy back scattering diffraction showed that the grain growth of oriented particles by including random grains contribute to the development of the oriented microstructure. Finally, the highly crystal‐oriented SCNN ceramics with a densified microstructure were obtained through anisotropic sintering. These results clearly showed the potential to develop a well‐defined anisotropic microstructure during sintering by designing and controlling the particle packing structure in a powder compact.
Effects of different salts on the gelation behaviour and mechanical properties of citric acid‐induced tofu
Authors: Zhao Yan‐Yan , Cao Feng‐Hong , Li Xing‐Jiang , Mu Dong‐Dong , Zhong Xi‐Yang , Jiang Shao‐Tong , Zheng Zhi , Luo Shui‐Zhong
Published: August 2019

To elucidate the effects of salts on the properties of citric acid‐induced tofu gel, gelation was induced in the presence of KCl, CaCl2 or CaSO4, and gypsum tofu was used as a reference. The textural properties, water‐holding capacity (WHC), rheological behaviour, aggregate size distribution and microstructure of the tofu were evaluated. The results indicated that the addition of 0.10 g/100 mL KCl,0.05 g/100 mL CaCl2 and 0.15 g/100 mL CaSO4 yields more elastic tofu with high water‐holding capacity. The WHC of tofu induced in the presence of salts was similar to that of gypsum tofu, while the tofu was firmer and less elastic than gypsum tofu. The maximum elasticity of citric acid‐induced tofu was obtained with addition of 0.15 g/100 mL CaSO4. These results are useful to understand the effects of different salts on soymilk gelation and provide a theoretical base for the quality improvement of citric acid‐induced tofu.
Real‐time PCR based on single‐copy housekeeping genes for quantitative detection of goat meat adulteration with pork
Authors: Wang Zhicheng , Wang Zhiying , Li Tingting , Qiao Lu , Liu Rui , Zhao Yan , Xu Zhenzhen , Chen Gang , Yang Shuming , Chen Ailiang
Published: August 2019

Adulteration of goat meat with cheaper meat such as pork has been frequently found. Conventional PCR methods to distinguish goat meat from adulteration are qualitative, which easily produce false‐positive results due to contamination but not adulteration. To address this problem, real‐time PCR based on single‐copy housekeeping genes encoding replication protein A1 was developed for goat meat and pork. By calculating the Ct ratio of goat meat/pork, the goat meat content in a suspected adulteration could be deduced by a good linear correlation (R2 = 0.9868) in a range from 5% to 80%. Analysis of the simulated samples of goat meat showed high accuracy with recoveries of 104.91% and 105.00% for the goat meat contents of 40% and 60%, respectively, and coefficient of variations were as low as 9.24% and 9.09%. Thus, the developed assay supplied a useful tool for food regulation authorities to achieve quantitative authentication of goat meat.
Establishment of reference intervals for complete blood count parameters in venous blood for children in the Xiamen area, China
Authors: Li Jiming , Zhang Huifen , Huang Xiaoli , Zhang Jiyong , Wu Xingdong
Published: August 2019

Objectives

To observe changes in the complete blood count (CBC) venous blood parameters of healthy children and establish appropriate reference intervals (RIs).

Methods

Overall, 4066 healthy children were selected and divided into four groups: infants, toddlers, preschool‐age children and school‐age children. Venous blood was analysed for 17 parameters. Outlier data for each parameter were eliminated and RIs were established based on the Clinical and Laboratory Standards Institute C28‐A3c guideline.

Results

The RIs for certain parameters differed among the different age groups. The white blood cell (WBC) count differed among the four age groups. The variation trends for absolute neutrophil count in all age groups were opposite to those for WBC and absolute lymphocyte count. The mean absolute eosinophil count values were significantly higher in the infant group than in the other groups. The RIs for red blood cell were identical across all age groups except in infants. The mean Hb level for infants was significantly lower than that for the other age groups. The mean and RI for platelet count were significantly higher in the infant group than in the other groups.

Conclusions

There are dynamic variations in the values reported for measurements of most CBC parameters in children. Hence, such results should always be interpreted according to the child's age. Thus establishing appropriate RIs for different age groups in paediatrics is essential.
Specific stressors relate to nurses' job satisfaction, perceived quality of care, and turnover intention
Authors: Bautista John Robert , Lauria Percy Aiggie S. , Contreras Maria Cecilia S. , Maranion Maheni Micarla G. , Villanueva Hermeliza H. , Sumaguingsing Robert C. , Abeleda Ronne D.
Published: August 2019

Aims

To determine which stressor has the highest occurrence and what stressors are related to nurse outcomes, such as job satisfaction, perceived quality of care, and turnover intention.

Background

Numerous stressors have been identified in nursing practice, but it is unclear if specific stressors are related to nurse outcomes.

Design

The study used a cross‐sectional and descriptive‐correlational research design.

Methods

In July and August 2017, survey data were collected from 427 staff nurses employed in a large tertiary‐level private hospital in Metro Manila, Philippines. The Nursing Stress Scale was used to measure stress frequency. Structural equation modelling was used to determine the relationship of stressors and nurse outcomes.

Results

Exploratory and confirmatory factor analyses indicate nine Nursing Stress Scale factors. Workload is the most frequent stressor. Moreover, workload was negatively related to job satisfaction and perceived quality of care. Workload and conflict with nurses were positively related to turnover intention.

Conclusions

The Nursing Stress Scale has a different factor structure based on a survey of nurses in the Philippines. Only workload and conflict with nurses were related to specific nurse outcomes. Nurse managers should identify and mitigate stressors experienced by nurses since these can lead to turnover and poor quality of care.
Laboratory‐derived early warning score for the prediction of in‐hospital mortality, intensive care unit admission, medical emergency team activation and cardiac arrest in general medical wards
Authors: Ratnayake Hasanka , Johnson Douglas , Martensson Johan , Lam Que , Bellomo Rinaldo
Published: August 2019

Background

General medical wards admit a varied cohort of patients from the emergency department, some of whom deteriorate during their hospital stay. Currently, we use vital signs based warning scores to predict patients at risk of imminent deterioration, but there is now a growing body of literature that commonly available laboratory results may also help to identify those at risk.

Aim

To assess whether a laboratory‐based admission score can predict in hospital mortality, intensive care unit (ICU) admission, medical emergency team (MET) activation or cardiac arrest in a cohort of Australian general medical patients admitted through the emergency department (ED).

Methods

We performed a retrospective observational study of all general medical admissions to hospital through the ED in 2015. Admission pathology was used to calculate a risk score. In‐patient outcomes of death, ICU transfer, MET call activation or cardiac arrest were collected from hospital records.

Results

We studied 2942 admissions derived from 2521 patients, with a median age of 81 years. There were 143 in‐patient deaths, 82 ICU admissions, 277 MET calls and 14 cardiac arrest calls. The laboratory‐based admission score had an area under the receiver operating characteristic curve (AUC‐ROC) of 0.76 (95% confidence interval (CI): 0.72–0.80) for inpatient death, an AUC‐ROC of 0.79 (95% CI: 0.66–0.93) for inpatient cardiac arrest, an AUC‐ROC of 0.64 (95% CI: 0.58–0.70) for ICU transfer and an AUC‐ROC of 0.59 (95% CI: 0.55–0.62) for MET call activation. When patients aged over 75 were analysed separately, the AUC‐ROC for prediction of in‐patient death was 0.74 (95% CI: 0.70–0.78) and increased to 0.86 (95% CI: 0.73–0.98) for the prediction of in‐patient cardiac arrest.

Conclusion

A simple laboratory‐derived score obtained at patient admission is a fair to good predictor of subsequent in‐patient death or cardiac arrest in general medical patients and in the older patient cohort. Prospective interventional studies are required to ascertain the clinical utility of this admission score.
BNT‐based ferroelectric ceramics: Electrical properties modification by Ta2O5 oxide addition
Authors: Han Jihui , Yin Jie , Wu Jiagang
Published: August 2019

Due to their superior piezo‐responses (strain S > 0.3%), bismuth sodium titanate (BNT)‐based relaxor ferroelectrics have received much attention. Compared to other chemical elements, tantalum (Ta) doping provides superior electro‐strain for these ferroelectrics, while the effect of Ta2O5 as oxide additive has been rarely reported. Herein, lead‐free piezoceramics of Bi0.5(Na0.72K0.22Li0.06)0.5TiO3‐xTa2O5 (BNKLT‐xTa2O5, x = 0‐0.015) are synthesized. We study the effects of Ta2O5 addition on the crystal structure, piezoelectric responses, dielectric properties, and ferroelectric properties of BNKLT ceramics. All of the ceramics exhibit a typical perovskite structure, and Ta2O5 diffuses into the BNKLT lattice to form a uniform solid solution. The addition of Ta2O5 can make the grains more regular and uniform, while excess Ta2O5 result in finer grains. The undoped BNKLT ceramics show good ferroelectric and piezoelectric properties (remnant polarization Pr = 22.5 μC/cm2 and piezoelectric coefficient d33 = 250 pC/N); however, the addition of Ta2O5 leads to an clear degradation in d33 and Pr. Meanwhile, the addition of an appropriate Ta2O5 amount leads to an increase in the electro‐strain, and the unipolar strain reaches 0.385% under 60 kV/cm for x = 0.003, together with a higher normalized strain (d33*=Smax/Emax) of 633 pm/V (x = 0.003). The enhanced strain behaviors can be attributed to the coexistence of the ferroelectric and relaxor states, and an excellent electrostriction coefficient Q33 (Q33 = S/P2) value of 0.038 m4C−2 is obtained under 60 kV/cm for x = 0.003.
The prescribing needs of community practitioner nurse prescribers: A qualitative investigation using the theoretical domains framework and COM‐B
Authors: Chater Angel M. , Williams Jane , Courtenay Molly
Published: August 2019

Aim

With a number of qualified community practitioner nurse prescribers (CPNPs) not prescribing, this research aimed to understand what influences this behaviour.

Design

A qualitative research design.

Methods

Semi‐structured interviews, based on the theoretical domains framework (TDF) were conducted with 20 CPNPs. Data collection took place between March‐July 2018 and continued until data saturation was reached.

Results

Nine themes inductively explained prescribing behaviour: 1) ‘Knowledge and experience’; 2) ‘Consultation and communication skills’; 3) ‘Professional confidence and identity’; 4) ‘Wanting the best outcome’; 5) ‘NHS versus patient cost’; 6) ‘Emotion‐led decisions’; 7) ‘Time allocation’; 8) ‘Formulary access’ and 9) ‘Supporting environment for patient‐centred care’. Themes were then deductively mapped to the TDF and COM‐B.

Conclusion

There is an ongoing need to support community practitioner nurse prescribers’ ‘Capability’ to prescribe in terms of knowledge and aquired skills; ‘Opportunity’ to make prescribing easier, such as access to a wider and up to date nurse formulary alongside effective clinical support; and ‘Motivation’ to feel confident in prescribing behaviour, highlighting positive patient outcomes while reducing perceived issues such as cost and non‐adherence.

Impact

Findings show that Capability, Opportunity and Motivation all influence the decision to prescribe. Those responsible for professional regulation and training should ensure community practitioner nurse prescribers have access to the relevant knowledge, skills and formulary to facilitate their prescribing behaviour. Professional confidence and identity as a prescriber should be encouraged, with acknowledgment of influences such as cost and emotion. An environment that allows for patient‐centred care and the best outcome should be supported, this may mean increasing time allocated to consultations.
Experimental verification of the value of the Tpeak–Tend interval in ventricular arrhythmia inducibility in an early repolarization syndrome model
Authors: Yoon Namsik , Hong Seo Na , Cho Jeong Gwan , Jeong Hyung Ki , Lee Ki Hong , Park Hyung Wook
Published: August 2019

Introduction

In patients with early repolarization patterns on ECG, many researchers have studied to find predictors of fatal arrhythmia. However, there are no satisfying clinical predictors. We evaluated the value of the Tpeak–Tend interval on pseudo‐ECG in canine myocardial wedge preparation models of early repolarization syndrome.

Methods and Results

Transmural pseudo‐ECG and endocardial/epicardial action potentials were recorded from coronary‐perfused canine left ventricular wedge preparations (n = 34). The Ito agonist NS5806 (8‐10 µM), the calcium channel blocker verapamil (3 µM) and acetylcholine (2‐3 µM) were used to mimic the disease model. A ventricular arrhythmia induction test was performed. QTpeak, QTend, Tpeak–Tend, and Tpeak–Tend/QTend were measured at 15 to 20 minutes after the provocative agent infusion. Polymorphic ventricular tachycardias (pVT) developed in 23 of the 34 preparations (67%). The maximal values of Tpeak–Tend and Tpeak–Tend/QTend were recorded just before pVT induction. At baseline, without the provocative agents, Tpeak–Tend and Tpeak–Tend/QTend were not different between pVT‐induced and pVT‐noninduced preparations. The Tpeak–Tend of the pVT‐induced preparations was longer than that of non‐induced preparations (58 ± 26.8 msec vs 33 ± 6.8 msec, P < .001). The Tpeak–Tend/QTend of pVT‐ induced preparations was larger than that of noninduced preparations (0.220 ± 0.1017 vs 0.128 ± 0.0312, P < .001). The transmural and epicardial dispersion of repolarization of pVT‐induced preparations were larger than those of pVT‐noninduced preparations. The transmural dispersion of repolarization showed a positive correlation with Tpeak–Tend.

Conclusion

Tpeak–Tend predicted malignant ventricular arrhythmias in early repolarization syndrome models. Tpeak–Tend reflects the repolarization heterogeneity of ventricular myocardium.
circCPA4 acts as a prognostic factor and regulates the proliferation and metastasis of glioma
Authors: Peng Hao , Qin Chaoying , Zhang Chao , Su Jun , Xiao Qun , Xiao Yao , Xiao Kai , Liu Qing
Published: August 2019

Circular RNAs (circRNAs) are reported to play vital roles in tumour process and might be potential prognostic biomarkers and therapeutic targets for tumours. But the expression and function of circRNAs in glioma remain unclear. Here, we performed circRNA microarray analysis of glioma tissues and matched normal brain tissue samples to explore the circRNA profile in glioma. GO analysis, KEGG and Reactom pathway analysis of linear mRNA transcripts corresponding to circRNAs were performed to study the involved biological process and pathways. The clinical significance of the selected circRNA was investigated by Kaplan‐Meier survival analysis. Relevant biological function, such as cell proliferation and metastasis, was detected in vitro and in vivo. And possible mechanism of the regulatory function of the selected circRNA in glioma was explored. We found that circCPA4 (hsa_circ_0082374) up‐regulated the most in glioma tissues and high levels of circCPA4 were positively related to poor outcome of glioma. And knockdown of circCPA4 suppresses cell proliferation and metastasis in glioma. Moreover, circCPA4 interacts with let‐7 and serves as a sponge for let‐7. Through the competitive endogenous RNA (ceRNA) mechanism, circCPA4 sponges let‐7 to regulate the expression of CPA4 and glioma progression. The circCPA4/let‐7/CPA4 axis regulates glioma progression by ceRNA mechanism, and circCPA4 could be a novel prognostic biomarker and target for glioma treatment.
Establishment the critical control point methodologies of seven major food processes in the catering industry to meet the core concepts of ISO 22000:2018 based on the Taiwanese experience
Authors: Chen Hsinjung , Chen Yijuan , Liu Shihlun , Yang Huiting , Chen Chinshuh , Chen Yuhshuen
Published: August 2019

This study focused on significant hazard analysis, the determination and establishment of prerequisite programs, and the role of critical control point (CCP) based on ISO 22000:2018, providing guidelines and experiences related to the incorporation of significant hazard analysis and the use of the CCP decision tree approach to determine and update the possible CCPs of seven primary food processes in the catering industry so as to adhere to the core concept of ISO 22000:2018.

Practical Applications

The revised ISO 22000:2018 guideline regarding food safety management systems has been widely implemented by small‐ and medium‐sized catering companies around the world because it suggests appropriate measures for risk management, corporate operations, and the reinforcement of autonomous management that help companies to nip food catering service safety risks in the bud.
Preoperative prediction of futile surgery in patients with radiologically resectable or borderline resectable pancreatic adenocarcinoma
Authors: Lee Hee Seung , An Chansik , Hwang Ho Kyoung , Roh Yun Ho , Kang Huapyong , Jo Jung Hyun , Chung Moon Jae , Park Jeong Youp , Kang Chang Moo , Park Seung Woo , Yoon Dong Sup , Lee Woo Jung , Song Si Young , Bang Seungmin
Published: August 2019

Background and Aim

The aim of this study is to identify the predictive factors for futile surgery in patients with radiologically resectable or borderline resectable pancreatic cancer and to develop a prediction model.

Methods

This retrospective study included patients who underwent pancreatic surgery for pancreatic cancer between 2006 and 2017. To identify independent risk factors for futile surgery, logistic regression and random forest analyses were performed in the training cohort, based on which a nomogram was established. The predictive accuracy and discriminative ability of the nomogram were validated in the validation cohort.

Results

Of 389 patients who underwent pancreatic surgery, the laparotomy was futile in 40 patients (10.3%). In the training cohort, the univariate and multivariate logistic regression analyses revealed that serum carbohydrate antigen 19‐9 level of ≥ 150 U/mL (P = 0.003), the presence of suspicious lymph node (P = 0.013), and more extensive peripancreatic tumor infiltration (P < 0.001) were independent predictive factors for futile surgery. The bootstrap‐corrected concordance index of the nomogram was high in the training cohort, 0.826 with a 95% confidence interval of 0.745–0.907. This model also showed a good discriminative performance in the validation cohort, with a concordance index of 0.831.

Conclusions

We established and validated a novel nomogram that predicts the risk of futile surgery due to occult distant metastasis in patients with radiologically resectable or borderline resectable pancreatic cancer.
Health Literacy Matters More Than Experience for Advance Care Planning Knowledge Among Older Adults
Authors: Nouri Sarah S. , Barnes Deborah E. , Volow Aiesha M. , McMahan Ryan D. , Kushel Margot , Jin Chengshi , Boscardin John , Sudore Rebecca L.
Published: August 2019

BACKGROUND

Advance care planning (ACP) engagement is low among vulnerable populations, including those with limited health literacy (LHL). Limited knowledge about ACP may be a modifiable mediator of the relationship between LHL and ACP. Our goal was to determine whether health literacy is associated with ACP knowledge.

DESIGN

Cross‐sectional design.

SETTING

A public health delivery system and Veterans Affairs Medical Center in San Francisco, CA.

PARTICIPANTS

English‐ and Spanish‐speaking patients (N = 1400).

MEASUREMENTS

ACP knowledge was assessed with seven validated multiple‐choice questions. Health literacy was measured using a validated scale. Sociodemographic measures included age, sex, language, education, race, health status, and social support. Prior ACP experience was defined as having documented legal forms and/or goals‐of‐care discussions in the medical record. We used Kruskal‐Wallis tests and linear regression to examine associations of ACP knowledge with LHL, prior ACP experience, and sociodemographic factors.

RESULTS

Mean age of participants was 65 (±10) years, 48% were women, 34% had LHL, 32% were Spanish speaking, 47% had high school education or less, and 70% were nonwhite. Mean 7‐point knowledge scores were lower for those with limited vs adequate health literacy (3.8 [SD = 1.9 vs 5.5 (SD = 1.7); P < .001). In multivariable analysis, ACP knowledge scores were 1.0 point lower among those with LHL; 0.6 points lower among Spanish speakers and those with high school education or less; and 0.5 points lower among individuals of nonwhite race (P < .001 for all). Knowledge scores were 0.02 points lower per year of older age (P = .007) and 0.01 points higher per point of greater social support (P = .005). Prior ACP experience was not associated with knowledge after adjustment (P = .7).

CONCLUSIONS

Health literacy and sociodemographics are stronger predictors than prior ACP experience of ACP knowledge. This study suggests that providing easy‐to‐understand ACP materials is paramount and should be offered even if patients have previous experience with the ACP process. J Am Geriatr Soc 67:2151–2156, 2019
Procedural Innovation and the Surreptitious Creation of Judicial Supremacy in the United Kingdom
Authors: Campbell David , Allan James
Published: August 2019

In Re an Application by the Northern Ireland Human Rights Commission for Judicial Review, the Supreme Court made unfavourable comments about Northern Irish abortion legislation in a way which showed complete disregard for elements of civil procedure which are a foundation of proper adjudication within the context of respect for democracy. This was but the latest of a number of cases in which the senior judiciary has made unaccountable procedural innovations furthering judicial supremacy in defiance of the sovereignty of Parliament. In addition to Re Northern Ireland Human Rights Commission, two other of these cases, Simmons v. Castle and R (Miller and another) v. The Secretary of State for Exiting the European Union, will be discussed. These cases reveal an effort to create judicial supremacy by means which we are obliged to call surreptitious.
Socio‐legal Studies in Poland: Great Heritage, Empirical Accomplishments, Contemporary Challenges
Authors: Skąpska Grażyna
Published: August 2019

This article is the fifth in an occasional series dealing with the development, current status, and future of socio‐legal studies in selected countries. It follows articles by Kim Economides (Aotearoa/New Zealand), Harry Arthurs and Annie Bunting (Canada), Renaud Colson and Stewart Field (France), and Alfons Bora (Germany).