bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of therapy and strain type on outcomes in urinary tract infections caused by carbapenem-resistant Klebsiella pneumoniae
Authors: van Duin David , Cober Eric , Richter Sandra S. , Perez Federico , Kalayjian Robert C. , Salata Robert A. , Evans Scott , Fowler Vance G. , Kaye Keith S. , Bonomo Robert A.
Published: December 2014

Objectives

Carbapenem-resistant Klebsiella pneumoniae (CRKP) is an important healthcare-associated pathogen. We evaluated the impact of CRKP strain type and treatment on outcomes of patients with CRKP bacteriuria.

Patients and methods

Physician-diagnosed CRKP urinary tract infection (UTI)—defined as those patients who received directed treatment for CRKP bacteriuria—was studied in the multicentre, prospective Consortium on Resistance against Carbapenems in Klebsiella pneumoniae (CRaCKle) cohort. Strain typing by repetitive extragenic palindromic PCR (rep-PCR) was performed. Outcomes were classified as failure, indeterminate or success. Univariate and multivariate ordinal analyses to evaluate the associations between outcome, treatment and strain type were followed by binomial analyses.

Results

One-hundred-and-fifty-seven patients with physician-diagnosed CRKP UTI were included. After adjustment for CDC/National Healthcare Safety Network (NHSN)-defined UTI, critical illness and receipt of more than one active antibiotic, patients treated with aminoglycosides were less likely to fail therapy [adjusted OR (aOR) for failure 0.34, 95% CI 0.15–0.73, P = 0.0049]. In contrast, patients treated with tigecycline were more likely to fail therapy (aOR for failure 2.29, 95% CI 1.03–5.13, P = 0.0425). Strain type data were analysed for 55 patients. The predominant clades were ST258A (n = 18, 33%) and ST258B (n = 26, 47%). After adjustment for CDC/NHSN-defined UTI and use of tigecycline and aminoglycosides, infection with strain type ST258A was associated with clinical outcome in ordinal analysis (P = 0.0343). In multivariate binomial models, strain type ST258A was associated with clinical failure (aOR for failure 5.82, 95% CI 1.47–28.50, P = 0.0113).

Conclusions

In this nested cohort study of physician-diagnosed CRKP UTI, both choice of treatment and CRKP strain type appeared to impact on clinical outcomes.
Added value of whole-genome sequencing for management of highly drug-resistant TB
Authors: Outhred Alexander C. , Jelfs Peter , Suliman Basel , Hill-Cawthorne Grant A. , Crawford Archibald B. H. , Marais Ben J. , Sintchenko Vitali
Published: December 2014

Objectives

Phenotypic drug susceptibility testing (DST) for Mycobacterium tuberculosis takes several weeks to complete and second-line DST is often poorly reproducible, potentially leading to compromised clinical decisions. Following a fatal case of XDR TB, we investigated the potential benefit of using whole-genome sequencing to generate an in silico drug susceptibility profile.

Methods

The clinical course of the patient was reviewed, assessing the times at which phenotypic DST data became available and changes made to the therapeutic regimen. Whole-genome sequencing was performed on the earliest available isolate and variants associated with drug resistance were identified.

Results

The final DST report, including second-line drugs, was issued 10 weeks after patient presentation and 8 weeks after initial growth of M. tuberculosis. In the interim, the patient may have received a compromised regimen that had the potential to select for further drug resistance. The in silico susceptibility profile, extrapolated from evolving evidence in the literature, provided comparable or superior data to the DST results for second-line drugs and could be generated in a much shorter timeframe.

Conclusions

We propose routine whole-genome sequencing of all MDR M. tuberculosis isolates in adequately resourced settings. This will improve individual patient care, monitor for transmission events and advance our understanding of resistance-associated mutations.
Chemical variation in molecular cloud cores in the Orion A Cloud. III
Authors: Ohashi Satoshi , Tatematsu Ken'ichi , Choi Minho , Kang Miju , Umemoto Tomofumi , Lee Jeong-Eun , Hirota Tomoya , Yamamoto Satoshi , Mizuno Norikazu
Published: December 2014

We carried out mapping observations of N2H+, CCS, cyclic C3H2, H13CO+, HCO+, and HCN lines toward six cores in the Orion A cloud with the Nobeyama 45 m telescope and the KVN (Korean VLBI Network) 21 m telescope. The N2H+ and CCS data were observed with the Nobeyama 45 m and the other lines were observed with the KVN 21 m telescope. We examined the chemical characteristics of the cores and found a tendency for the column density ratio, N(c-C3H2)/N(CCS), to be low in starless regions while it is high in star-forming regions. We also found that N(H13CO+) is enhanced in cluster-forming regions compared with those in isolated star-forming regions. Furthermore, we found that the N(NH3)/N(CCS) and N(NH3)/N(HC3N) ratios are high in star-forming cores and low in starless cores in the Orion A cloud for a wide range of kinetic temperature, Tk = 10 to 60 K. We suggest that the N(NH3)/N(CCS), N(NH3)/N(HC3N), and N(N2H+)/N(CCS) ratios may be indicators of chemical evolution in giant molecular clouds, including warmer regions. From a comparison between cores associated with protostars and cores without protostars through virial analysis, we also suggest that the dissipation of turbulence initiates star formation. Finally, we found that the N(NH3)/N(CCS) ratio increases with the dissipation of turbulence. This may suggest that the chemical evolution can be an indicator of the dynamical evolution of the core.
Chronic Recurrent Multifocal Osteomyelitis and Inflammatory Bowel Disease
Authors: Audu Grace K. , Nikaki Kornilia , Crespi Daniel , Spray Christine , Epstein Jenny
Published: December 2014

Chronic recurrent multifocal osteomyelitis (CRMO) has been reported in association with inflammatory bowel disease (IBD), mostly in children. We describe the UK paediatric experience of CRMO and IBD and review the global literature. Three cases of CRMO and IBD were identified in UK children during the last 10 years. This adds to the previously published 24 cases worldwide (15 children). We provide further evidence for the true association of CRMO and IBD, and a greater understanding of disease course. CRMO may be considered a rare extraintestinal complication of IBD.
Collective sensing and collective responses in quorum-sensing bacteria
Authors: Popat R. , Cornforth D. M. , McNally L. , Brown S. P.
Published: December 2014

Bacteria often face fluctuating environments, and in response many species have evolved complex decision-making mechanisms to match their behaviour to the prevailing conditions. Some environmental cues provide direct and reliable information (such as nutrient concentrations) and can be responded to individually. Other environmental parameters are harder to infer and require a collective mechanism of sensing. In addition, some environmental challenges are best faced by a group of cells rather than an individual. In this review, we discuss how bacteria sense and overcome environmental challenges as a group using collective mechanisms of sensing, known as ‘quorum sensing’ (QS). QS is characterized by the release and detection of small molecules, potentially allowing individuals to infer environmental parameters such as density and mass transfer. While a great deal of the molecular mechanisms of QS have been described, there is still controversy over its functional role. We discuss what QS senses and how, what it controls and why, and how social dilemmas shape its evolution. Finally, there is a growing focus on the use of QS inhibitors as antibacterial chemotherapy. We discuss the claim that such a strategy could overcome the evolution of resistance. By linking existing theoretical approaches to data, we hope this review will spur greater collaboration between experimental and theoretical researchers.
Single cell profiling of surface carbohydrates on
Bacillus cereus
Authors: Wang Congzhou , Ehrhardt Christopher J. , Yadavalli Vamsi K.
Published: December 2014

Cell surface carbohydrates are important to various bacterial activities and functions. It is well known that different types of
Bacillus
display heterogeneity of surface carbohydrate compositions, but detection of their presence, quantitation and estimation of variation at the single cell level have not been previously solved. Here, using atomic force microscopy (AFM)-based recognition force mapping coupled with lectin probes, the specific carbohydrate distributions of
N
-acetylglucosamine and mannose/glucose were detected, mapped and quantified on single
B. cereus
surfaces at the nanoscale across the entire cell. Further, the changes of the surface carbohydrate compositions from the vegetative cell to spore were shown. These results demonstrate AFM-based ‘recognition force mapping’ as a versatile platform to quantitatively detect and spatially map key bacterial surface biomarkers (such as carbohydrate compositions), and monitor
in situ
changes in surface biochemical properties during intracellular activities at the single cell level.
Bridging psychology and genetics using large-scale spatial analysis of neuroimaging and neurogenetic data
Authors: Fox Andrew S. , Chang Luke J. , Gorgolewski Krzysztof J. , Yarkoni Tal
Published: December 2014

Understanding how microscopic molecules give rise to complex cognitive processes is a major goal of the biological sciences. The countless hypothetical molecule-cognition relationships necessitate discovery-based techniques to guide scientists toward the most productive lines of investigation. To this end, we present a novel discovery tool that uses spatial patterns of neural gene expression from the Allen Brain Institute (ABI) and large-scale functional neuroimaging meta-analyses from the Neurosynth framework to bridge neurogenetic and neuroimaging data. We quantified the spatial similarity between over 20,000 genes from the ABI and 48 psychological topics derived from lexical analysis of neuroimaging articles, producing a comprehensive set of gene/cognition mappings that we term the Neurosynth-gene atlas. We demonstrate the ability to independently replicate known gene/cognition associations (e.g., between dopamine and reward), and subsequently use it to identify a range of novel associations between individual molecules or genes and complex psychological phenomena such as reward, memory and emotion. Our results complement existing discovery-based methods such as GWAS, and provide a novel means of generating hypotheses about the neurogenetic substrates of complex cognitive functions.
Host-parasite coevolution in populations of constant and variable size
Authors: Song Yixian , Gokhale Chaitanya S. , Papkou Andrei , Schulenburg Hinrich , Traulsen Arne
Published: December 2014

The matching-allele and gene-for-gene models are widely used in mathematical approaches that study the dynamics of host-parasite interactions. Agrawal and Lively (Evolutionary Ecology Research 4:79-90, 2002) captured these two models in a single framework and numerically explored the associated time discrete dynamics of allele frequencies. Here, we present a detailed analytical investigation of this unifying framework in continuous time and provide a generalization. We extend the model to take into account changing population sizes, which result from the antagonistic nature of the interaction and follow the Lotka-Volterra equations. Under this extension, the population dynamics become most complex as the model moves away from pure matching-allele and becomes more gene-for-gene-like. While the population densities oscillate with a single oscillation frequency in the pure matching-allele model, a second oscillation frequency arises under gene-for-gene-like conditions. These observations hold for general interaction parameters and allow to infer generic patterns of the dynamics. Our results suggest that experimentally inferred dynamical patterns of host-parasite coevolution should typically be much more complex than the popular illustrations of Red Queen dynamics. A single parasite that infects more than one host can substantially alter the cyclic dynamics.
Compton scattering imaging of a working battery using synchrotron high-energy X-rays
Authors: Itou Masayoshi , Orikasa Yuki , Gogyo Yuma , Suzuki Kosuke , Sakurai Hiroshi , Uchimoto Yoshiharu , Sakurai Yoshiharu
Published: December 2014

Results of studies on Compton scattering imaging using synchrotron high-energy X-rays are reported. The technique is applied to a discharging coin cell, and the intensity of Compton scattered X-rays from the inside of the cell has been measured as a function of position and time. The position–time intensity map captures the migration of lithium ions in the positive electrode and reveals the structural change due to the volume expansion of the electrode. This experiment is a critical step in developing synchrotron-based Compton scattering imaging for electrochemical cells at a product level.
One device, one equation: The simplest way to objectively evaluate psoriasis severity
Authors: Choi Jae Woo , Kim Bo Ri , Choi Chong Won , Youn Sang Woong
Published: December 2014

The erythema, scale and thickness of psoriasis lesions could be converted to bioengineering parameters. An objective psoriasis severity assessment is advantageous in terms of accuracy and reproducibility over conventional severity assessment. We aimed to formulate an objective psoriasis severity index with a single bioengineering device that can possibly substitute the conventional subjective Psoriasis Severity Index. A linear regression analysis was performed to derive the formula with the subjective Psoriasis Severity Index as the dependent variable and various bioengineering parameters determined from 157 psoriasis lesions as independent variables. The construct validity of the objective Psoriasis Severity Index was evaluated with an additional 30 psoriasis lesions through a Pearson correlation analysis. The formula is composed of hue and brightness, which are sufficiently obtainable with a Colorimeter alone. A very strong positive correlation was found between the objective and subjective psoriasis severity indexes. The objective Psoriasis Severity Index is a novel, practical and valid assessment method that can substitute the conventional one. Combined with subjective area assessment, it could further replace the Psoriasis Area and Severity Index which is currently most popular.
Weather‐driven dynamics in a dual‐migrant system: moths and bats
Authors: Krauel Jennifer J. , Westbrook John K. , McCracken Gary F.
Published: December 2014

Animal migrations generate large spatial and temporal fluctuations in biomass that provide a resource base for many predator–prey interactions. These interactions are often driven by continent‐scale weather patterns and are difficult to study. Few studies have included migratory animals on more than a single trophic level or for periods spanning multiple entire seasons.

We tracked migrations of three species of agricultural pest noctuid moths over the 2010–2012 autumn seasons as the moths travelled past a large colony of migratory Brazilian free‐tailed bats (Tadarida brasiliensis) in Texas.

Increases in moth abundance, mass of bats and duration of bat activity outside of the cave were correlated with passage of cold fronts over the study area and related increases in northerly wind. Moth responses to weather patterns varied among species and seasons, but overall moth abundances were low in late summer and spiked after one or more cold front passages in September and October.

Changes in bat mass and behaviour appear to be consequences of bat migration, as cave use transitioned from summer maternity roost to autumn migratory stopover sites.

Weather‐driven migration is at considerable risk from climate change, and bat and moth responses to that change may have marked impacts on agricultural systems and bat ecosystem services.
Variations in Guideline‐Concordant Breast Cancer Adjuvant Therapy in Rural Georgia
Authors: Guy Gery P. , Lipscomb Joseph , Gillespie Theresa W. , Goodman Michael , Richardson Lisa C. , Ward Kevin C.
Published: December 2014

Objective

To examine factors associated with guideline‐concordant adjuvant therapy among breast cancer patients in a rural region of the United States and to present an advancement in quality‐of‐care assessment in the context of multiple treatments.

Data Sources

Chart abstraction on initial therapy received by 868 women diagnosed with primary, invasive, early‐stage breast cancer in a largely rural region of southwest Georgia.

Study Design

Using multivariable logistic regression, we examined predictors of adjuvant chemo‐, radiation, and hormonal therapy regimens defined as guideline‐concordant according to the 2000 National Institutes of Health Consensus Development Conference Statement.

Principal Findings

Overall, 35.2 percent of women received guideline‐concordant care for all three adjuvant therapies. Higher socioeconomic status was associated with receiving guideline‐concordant care for all three adjuvant therapies jointly, and for chemotherapy. Compared with private insurance, having Medicaid was associated with guideline‐concordant chemotherapy. Unmarried women were more likely to be nonconcordant for chemotherapy and radiation therapy. Increased age predicted nonconcordance for adjuvant therapies jointly, for chemotherapy, and for hormonal therapy.

Conclusions

A number of factors were independently associated with receiving guideline‐concordant adjuvant therapy. Identifying and addressing factors that lead to nonconcordance may reduce disparities in treatment and survival.
Quantifying “Dog Days”
Authors: Dixon Janine M. , Dixon Peter B. , Giesecke James A. , Rimmer Maureen T.
Published: December 2014

In Dog Days, Garnaut (2013) portrays Australia's immediate future as characterised by the end of the mining investment boom, declining terms of trade, a decline in labour input per head of population, slow multifactor productivity growth, fiscal consolidation and rising world interest rates. We quantify the consequences of these developments using a detailed general equilibrium model. Consistent with Garnaut, we find that wage and demand restraint will be required to steer Australia through the difficult period ahead. Public understanding of Dog Days will help move expectations to match current unfavourable conditions and thereby promote an orderly adjustment with minimum damage to employment and standards of living.
The Placental Immune Milieu is Characterized by a Th2‐ and Anti‐Inflammatory Transcription Profile, Regardless of Maternal Allergy, and Associates with Neonatal Immunity
Authors: Abelius Martina S. , Janefjord Camilla , Ernerudh Jan , Berg Göran , Matthiesen Leif , Duchén Karel , Nilsson Lennart J. , Jenmalm Maria C.
Published: December 2014

Problem

How maternal allergy affects the systemic and local immunological environment during pregnancy and the immune development of the offspring is unclear.

Method of study

Expression of 40 genes was quantified by PCR arrays in placenta, peripheral blood mononuclear cells (PBMC), and cord blood mononuclear cells (CBMC) from 7 allergic and 12 non‐allergic women and their offspring.

Results

Placental gene expression was dominated by a Th2‐/anti‐inflammatory profile, irrespectively of maternal allergy, as compared to gene expression in PBMC. p35 expression in placenta correlated with fetal Tbx21 (ρ = −0.88, P < 0.001) and IL‐5 expression in PBMC with fetal galectin1 (ρ = 0.91, P < 0.001). Increased expression of Th2‐associated CCL22 in CBMC preceded allergy development.

Conclusions

Gene expression locally and systemically during pregnancy was partly associated with the offspring's gene expression, possibly indicating that the immunological milieu is important for fetal immune development. Maternal allergy was not associated with an enhanced Th2 immunity in placenta or PBMC, while a marked prenatal Th2 skewing, shown as increased CCL22 mRNA expression, might contribute to postnatal allergy development.
The development of emotion recognition from facial expressions and non‐linguistic vocalizations during childhood
Authors: Chronaki Georgia , Hadwin Julie A. , Garner Matthew , Maurage Pierre , Sonuga‐Barke Edmund J. S.
Published: December 2014

Sensitivity to facial and vocal emotion is fundamental to children's social competence. Previous research has focused on children's facial emotion recognition, and few studies have investigated non‐linguistic vocal emotion processing in childhood. We compared facial and vocal emotion recognition and processing biases in 4‐ to 11‐year‐olds and adults. Eighty‐eight 4‐ to 11‐year‐olds and 21 adults participated. Participants viewed/listened to faces and voices (angry, happy, and sad) at three intensity levels (50%, 75%, and 100%). Non‐linguistic tones were used. For each modality, participants completed an emotion identification task. Accuracy and bias for each emotion and modality were compared across 4‐ to 5‐, 6‐ to 9‐ and 10‐ to 11‐year‐olds and adults. The results showed that children's emotion recognition improved with age; preschoolers were less accurate than other groups. Facial emotion recognition reached adult levels by 11 years, whereas vocal emotion recognition continued to develop in late childhood. Response bias decreased with age. For both modalities, sadness recognition was delayed across development relative to anger and happiness. The results demonstrate that developmental trajectories of emotion processing differ as a function of emotion type and stimulus modality. In addition, vocal emotion processing showed a more protracted developmental trajectory, compared to facial emotion processing. The results have important implications for programmes aiming to improve children's socio‐emotional competence.
Per a 10 protease activity modulates CD40 expression on dendritic cell surface by nuclear factor-kappaB pathway
Authors: Goel C , Kalra N , Dwarakanath B S , Gaur S N , Arora N
Published: December 2014

Serine protease activity of Per a 10 from Periplaneta americana modulates dendritic cell (DC) functions by a mechanism(s) that remains unclear. In the present study, Per a 10 protease activity on CD40 expression and downstream signalling was evaluated in DCs. Monocyte-derived DCs from cockroach-allergic patients were treated with proteolytically active/heat-inactivated Per a 10. Stimulation with active Per a 10 demonstrated low CD40 expression on DCs surface (P < 0·05), while enhanced soluble CD40 level in the culture supernatant (P < 0·05) compared to the heat-inactivated Per a 10, suggesting cleavage of CD40. Per a 10 activity reduced the interleukin (IL)-12 and interferon (IFN)-γ secretion by DCs (P < 0·05) compared to heat-inactivated Per a 10, indicating that low CD40 expression is associated with low levels of IL-12 secretion. Active Per a 10 stimulation caused low nuclear factor-kappa B (NF-κB) activation in DCs compared to heat-inactivated Per a 10. Inhibition of the NF-κB pathway suppressed the CD40 expression and IL-12 secretion by DCs, further indicating that NF-κB is required for CD40 up-regulation. CD40 expression activated the tumour necrosis factor (TNF) receptor-associated factor 6 (TRAF6), thereby suggesting its involvement in NF-κB activation. Protease activity of Per a 10 induced p38 mitogen-activated protein kinase (MAPK) activation that showed no significant effect on CD40 expression by DCs. However, inhibiting p38 MAPK or NF-κB suppressed the secretion of IL-12, IFN-γ, IL-6 and TNF-α by DCs. Such DCs further reduced the secretion of IL-4, IL-6, IL-12 and TNF-α by CD4+T cells. In conclusion, protease activity of Per a 10 reduces CD40 expression on DCs. CD40 down-regulation leads to low NF-κB levels, thereby modulating DC-mediated immune responses.
Positioning resilience for 2015: the role of resistance, incremental adjustment and transformation in disaster risk management policy
Authors: Matyas David , Pelling Mark
Published: December 2014

Resilience is a ubiquitous term in disaster risk management and is an increasingly prominent concept in early discussions focused on elaborating the post‐2015 international policy landscape. Riddled with competing meanings and diverse policy implications, however, it is a concept caught between the abstract and operational. This paper provides a review of the rise to prominence of the concept of resilience and advances an elaboration of the related concepts of resistance, incremental adjustment and transformation. We argue that these concepts can contribute to decision‐making by offering three distinct options for risk management policy. In order to deliberately and effectively choose among these options, we suggest that critical reflexivity is a prerequisite, necessitating improved decision‐making capacity if varied perspectives (including those of the most vulnerable) are to be involved in the selection of the best approach to risk management.
A climate‐compatible approach to development practice by international humanitarian NGOs
Authors: Clarke Matthew , de Cruz Ian
Published: December 2014

If current climate‐change predictions prove accurate, non‐linear change, including potentially catastrophic change, is possible and the environments in which international humanitarian NGOs operate will change figuratively and literally. This paper proposes that a new approach to development is required that takes changing climate into account. This ‘climate‐compatible approach’ to development is a bleak shift from some of the current orthodox positions and will be a major challenge to international humanitarian NGOs working with the most vulnerable. However, it is necessary to address the challenges and context such NGOs face, and the need to be resilient and adaptive to these changes.
Engendering development and disasters
Authors: Bradshaw Sarah
Published: December 2014

Over the last two decades the different impacts of disasters on women and men have been acknowledged, leading to calls to integrate gender into disaster risk reduction and response. This paper explores how evolving understandings of ways of integrating gender into development have influenced this process, critically analysing contemporary initiatives to ‘engender’ development that see the inclusion of women for both efficiency and equality gains. It has been argued that this has resulted in a ‘feminisation of responsibility’ that can reinforce rather than challenge gender relations. The construction of women affected by disasters as both an at‐risk group and as a means to reduce risk suggests similar processes of feminisation. The paper argues that if disaster risk reduction initiatives are to reduce women's vulnerability, they need to focus explicitly on the root causes of this vulnerability and design programmes that specifically focus on reducing gender inequalities by challenging unequal gendered power relations.
White matter tract integrity and developmental outcome in newborn infants with hypoxic‐ischemic encephalopathy treated with hypothermia
Authors: Massaro An N , Evangelou Iordanis , Fatemi Ali , Vezina Gilbert , Mccarter Robert , Glass Penny , Limperopoulos Catherine
Published: December 2014

Aim

To determine whether corpus callosum (CC) and corticospinal tract (CST) diffusion tensor imaging (DTI) measures relate to developmental outcome in encephalopathic newborn infants after therapeutic hypothermia.

Method

Encephalopathic newborn infants enrolled in a longitudinal study underwent DTI after hypothermia. Parametric maps were generated for fractional anisotropy, mean, radial, and axial diffusivity. CC and CST were segmented by DTI‐based tractography. Multiple regression models were used to examine the association of DTI measures with Bayley‐II Mental (MDI) and Psychomotor Developmental Index (PDI) at 15 months and 21 months of age.

Results

Fifty‐two infants (males n=32, females n=20) underwent DTI at median age of 8 days. Two were excluded because of poor magnetic resonance imaging quality. Outcomes were assessed in 42/50 (84%) children at 15 months and 35/50 (70%) at 21 months. Lower CC and CST fractional anisotropy were associated with lower MDI and PDI respectively, even after controlling for gestational age, birth weight, sex, and socio‐economic status. There was also a direct relationship between CC axial diffusivity and MDI, while CST radial diffusivity was inversely related to PDI.

Interpretation

In encephalopathic newborn infants, impaired microstructural organization of the CC and CST predicts poorer cognitive and motor performance respectively. Tractography provides a reliable method for early assessment of perinatal brain injury.
Measuring participation for children with mobility limitations: a modified Delphi survey for those who use power mobility
Authors: Butler Charlene
Published: December 2014

This commentary is on the original article by Field et al. on pages 556–563 in this issue.
Can the results of the OSCE predict the results of clinical assessment in dental education?
Authors: Näpänkangas R. , Karaharju‐Suvanto T. , Pyörälä E. , Harila V. , Ollila P. , Lähdesmäki R. , Lahti S.
Published: December 2014

Introduction

The aims of this study were to evaluate the correlation between the results of the objective structured clinical examination (OSCE) and clinical assessment and to test the reliability of OSCE test stations.

Material and methods

All 4th year undergraduate dental students (n = 47, 100%) attended the OSCE in April 2010. The students were divided into two groups (morning group, group 1; afternoon group, group 2). Groups 1 and 2 were also divided into two subgroups that attended the stations in two concurrent sessions (A and B). The OSCE included 12 10‐min test stations. Clinical assessment was based on long‐term observation during the semesters. The disciplines assessed were cross‐infection control, endodontics, paediatric dentistry, periodontology, prosthodontics and restorative dentistry.

Results

Statistical analysis using Cronbach's alpha indicated good reliability of the OSCE. The correlation between the results of the OSCE and clinical assessment in the 4th year was statistically significant in cross‐infection control (ρ = 0.340, P = 0.022), endodontics (ρ = 0.298, P = 0.047), prosthodontics (ρ = 0.296, P = 0.048) and restorative dentistry (ρ = 0.376, P = 0.011). Clinical assessment in the 5th year correlated with the OSCE results statistically significant in restorative dentistry (ρ = 0.522, P = 0.001).

Conclusion

Both the OSCE and constant longitudinal assessment are needed in clinical assessment, as they both play an important role in the overall assessment.
Creating the New Man: Coercion and Torture in Eginald Schlattner's Novel Rote Handschuhe (2001)
Authors: Petrescu Corina L.
Published: December 2014

At the center of this article lies the idea of creating the New Man, a formative idea in any authoritarian regime. I claim that, in their drive to create the New Man by any means necessary, decision‐makers of Communist regimes strove to transform those who did not adhere to their ideal into non‐persons. To illustrate this, I focus on Eginald Schlattner's autobiographical novel, Rote Handschuhe (2001), which depicts the process by which the Securitate (Communist Romania's secret police) re‐educates the first‐person narrator of Transylvanian‐Saxon ethnicity and bourgeois origins and trains him to be a loyal Communist. The nameless narrator succumbs to the violent pressure exerted by the Securitate and becomes a witness for the prosecution in a trial against fellow ethnic German writers in Romania in the late 1950s. Yet he finds that the very system that required his re‐education as a means to ensure its absolute control excludes him from full membership after he has served his purpose. In so doing, however, the regime undermines its own tactics and opens up the possibility of the individual's survival.
Are Latin America's corporate elites transnationally interconnected? A network analysis of interlocking directorates
Authors: CÁRDENAS JULIÁN
Published: December 2014

Conflicting perspectives appear when thinking about the emergence of a cohesive transnational corporate network in Latin America. On the one hand, regional political integration, foreign investment growth, increased cross‐border mergers and acquisitions, and cultural and linguistic homogeneity may have fostered transnational networks among Latin America's corporate elites. On the other hand, domestic‐based business groups, family control and trade orientation to the USA may have hindered the emergence of a cohesive transnational corporate network in Latin America. Based on a network analysis of interlocking directorates among the 300 largest corporations in Latin America, I ask whether the region's corporate elites interconnect at the transnational level and form a cohesive transnational corporate network. I found few transnational interlocks, a lack of cohesion in the transnational corporate network and no regional leaders. Corporate elites in Latin America are not transnationally interconnected and so a cohesive transnational corporate network has not emerged. I discuss implications and avenues of future research.
Emotional streaming and transconnectivity: Skype and emotion practices in transnational families in Ireland
Authors: KING‐O'RIAIN REBECCA CHIYOKO
Published: December 2014

In this article I explore how transnational families, living in Ireland, use Skype to stay in touch with their loved ones. From 2010 to 2012, data were collected from a purposive, but broad sample of 36 qualitative ethnographic interviews with mixed couples (one partner identifies as Irish and one does not), throughout various parts of the Republic of Ireland. I outline how the use of Skype allows transnational families to create spaces of transconnectivity as they practise simultaneous and ongoing belonging across significant temporal and geographic distances. This affects how people ‘do’ emotions. These emotion practices often consist not only of ‘affect storage’ but also of what I call emotional streaming, promoting ongoing interaction over distance, which includes keeping Skype turned on for long periods of time. Through these attempts to try to recreate everyday practices via continuous use of Skype, transnational emotions of love and longing are deintensified.
The GeoPT Proficiency Testing Scheme for Laboratories Routinely Analysing Silicate Rocks: A Review of the Operating Protocol and Proposals for its Modification
Authors: Thompson Michael , Webb Peter C. , Potts Philip J.
Published: December 2014

The GeoPT proficiency testing programme for geochemical laboratories has been operating for nearly 20 years. This review, based on an analysis of accumulated data and extensive experience, examines whether the protocol followed during this period continues to be appropriate. Possible changes that might be considered for future implementation are examined, in particular the procedures for calculating assigned values, target values, z‐scores and the applicability of dual fitness‐for‐purpose criteria. We conclude that the existing protocol remains largely appropriate and effective, but propose that a single fitness‐for‐purpose criterion be adopted, with an option for laboratories to recalculate their z‐scores if the criterion is inappropriate for their requirements.
Enhanced Dielectric and Ferroelectric Properties of Pb(Mg1/3Nb2/3)0.65Ti0.35O3 Ceramics by ZnO Modification
Authors: Promsawat Methee , Watcharapasorn Anucha , Ye Zuo‐Guang , Jiansirisomboon Sukanda
Published: December 2014

Phase formation, microstructures, dielectric, and ferroelectric properties of ZnO‐modified Pb(Mg1/3Nb2/3)0.65Ti0.35O3 (PMNT/xZnO, where x = 0, 0.4, 2.0, 4.0, and 11.0 mol%) ceramics were studied. A coexistence of rhombohedral and tetragonal ferroelectric phases was observed at room temperature in all samples. The ceramics with the relative densities of 93%–95% were prepared. The modification by ZnO led to an increase in grain sizes of PMNT ceramics. The maximum dielectric constant of the pure PMNT ceramic was increased with x = 0.4–4.0 mol% ZnO doping, with the highest value being observed in the 2.0 mol% sample. Both the temperature at which the transition between rhombohedral and tetragonal ferroelectric phases took place (TR‐T) and the Curie temperature of the ceramics tended to increase with increasing x. The ferroelectric properties were enhanced with increased remanent polarization and P(E) loop squareness in the compositions with x = 0.4–4.0 mol%. However, the ferroelectric properties were attenuated with x = 11.0 mol%.
Phase Structure Evolution and Thermo‐Physical Properties of Nonstoichiometry Nd2−xZr2+xO7+x/2 Pyrochlore Ceramics
Authors: Guo Lei , Zhang Yu , Ye Fuxing
Published: December 2014

Nonstoichiometry pyrochlore composites of Nd2−xZr2+xO7+x/2 (x = 0, 0.1, 0.2) were synthesized by chemical‐coprecipitation and calcination method. The phase structure evolution and thermo‐physical properties of Nd2−xZr2+xO7+x/2 were investigated. Structural analysis by Raman spectroscopy showed that Nd2−xZr2+xO7+x/2 underwent an ordering degree decrease and a lattice distortion increase with increasing x value. Nd1.9Zr2.1O7.05 and Nd1.8Zr2.2O7.1 exhibited lower thermal conductivities than Nd2Zr2O7, which might be related to the lower ordering degree and the enhanced phonon scattering due to lattice distortion. As ZrO2 content increasing, the thermal expansion coefficients of Nd2−xZr2+xO7+x/2 increased, which possibly arised from the decreased crystal energy due to reduced ordering degree.
Spark Plasma Sintering and Densification Mechanisms of Conductive Ceramics under Coupled Thermal/Electric Fields
Authors: Chen Fei , Yang Shuang , Wu Junyan , Galaviz Perez Jorge A. , Shen Qiang , Schoenung Julie M. , Lavernia Enrique J. , Zhang Lianmeng
Published: December 2014

In spark plasma sintering (SPS), thermal and electric fields are applied simultaneously as a material is densified under pressure. The interactions between these two types of physical fields influence the densification behavior during SPS. Moreover, the uniformity and spatial distribution of these fields are also influenced by sample size. In the current investigation, the densification behavior of electrically conductive aluminum‐doped zinc oxide (AZO) ceramics is studied to provide insight into the role played by the thermal and electric fields on densification mechanisms, as a function of sample size. Our results demonstrate that field uniformity and densification behavior depend on sample size, and that ultimately, this behavior can be rationalized in terms of the electrical conductivity characteristics. Our results show that in small samples with a diameter of 20 mm, both thermal and electric fields are spatially uniform, which result in homogeneous microstructure. In large samples with a diameter of 80 mm, however, spatial variations in both thermal and electric fields lead to microstructural inhomogeneities, such as incomplete particle–particle bonding. Furthermore, as the density of the AZO sample increases, the effective electrical conductivity increases due to a decrease in void/pore volume, which changes the densification mechanisms, especially for the larger sample. Thus, for effective sintering of larger samples, a two‐stage sintering sequence is proposed, which relies on the thermal field that evolves once the effective electrical conductivity increases in the sample. We provide experimental confirmation to this suggestion on the basis of results which demonstrate that by extending the hold time from 3 to 30 min, high‐density (99.4%), homogeneous AZO ceramic samples with a diameter of 80 mm can be achieved after sintering at 1200°C.
Perceived mother and father acceptance‐rejection predict four unique aspects of child adjustment across nine countries
Authors: Putnick Diane L. , Bornstein Marc H. , Lansford Jennifer E. , Malone Patrick S. , Pastorelli Concetta , Skinner Ann T. , Sorbring Emma , Tapanya Sombat , Uribe Tirado Liliana Maria , Zelli Arnaldo , Alampay Liane Peña , Al‐Hassan Suha M. , Bacchini Dario , Bombi Anna Silvia , Chang Lei , Deater‐Deckard Kirby , Di Giunta Laura , Dodge Kenneth A. , Oburu Paul
Published: December 2014

Background

It is generally believed that parental rejection of children leads to child maladaptation. However, the specific effects of perceived parental acceptance‐rejection on diverse domains of child adjustment and development have been incompletely documented, and whether these effects hold across diverse populations and for mothers and fathers are still open questions.

Methods

This study assessed children's perceptions of mother and father acceptance‐rejection in 1,247 families from China, Colombia, Italy, Jordan, Kenya, the Philippines, Sweden, Thailand, and the United States as antecedent predictors of later internalizing and externalizing behavior problems, school performance, prosocial behavior, and social competence.

Results

Higher perceived parental rejection predicted increases in internalizing and externalizing behavior problems and decreases in school performance and prosocial behavior across 3 years controlling for within‐wave relations, stability across waves, and parental age, education, and social desirability bias. Patterns of relations were similar across mothers and fathers and, with a few exceptions, all nine countries.

Conclusions

Children's perceptions of maternal and paternal acceptance‐rejection have small but nearly universal effects on multiple aspects of their adjustment and development regardless of the family's country of origin.
Moderate to severe psoriasis patients' subjective future expectations regarding health‐related quality of life and longevity
Authors: Rencz F. , Holló P. , Kárpáti S. , Péntek M. , Remenyik É. , Szegedi A. , Balogh O. , Herédi E. , Herszényi K. , Jókai H. , Brodszky V. , Gulácsi L.
Published: December 2014

Background

Unrealistic expectations regarding treatments and clinical outcomes may lead to disappointment about therapy and sub‐optimal compliance; nonetheless, these expectations have not been studied in psoriasis patients yet.

Objective

To evaluate psoriasis patients' subjective future expectations regarding health‐related quality of life (HRQOL) and life expectancy, and to explore clinical features associated with under‐ or overestimating behaviour.

Methods

A cross‐sectional questionnaire survey of consecutive adult patients with moderate to severe psoriasis was conducted. HRQOL expectations were recorded by applying the EQ‐5D descriptive system for 6 months ahead and for future ages of 60, 70, 80 and 90 respectively.

Results

In total, 167 patients (71% males) were included in the analysis with mean age of 50.4 ± 12.4 years and mean EQ‐5D score of 0.71 ± 0.30. Overall 65% had chronic plaque psoriasis, 35% nail psoriasis, 35% scalp involvement, 29% psoriatic arthritis, 9% inverse psoriasis and 5% palmoplantar psoriasis respectively (combinations occurred). Participants expected 0.1 ± 0.23 mean improvement in EQ‐5D within 6 months (P < 0.001) that achieves the minimum clinically important difference. Overall 37% expected improvement and 13% decline; however, 49% expected no changes in any of the five dimensions of EQ‐5D within 6 months. Female gender, inverse or palmoplantar involvement and more severe psoriasis were likely associated with higher expectations. Patients at the initiation of their first biological at the time of the survey expected 0.18 ± 0.24 increase that seems to be realistic compared to the EQ‐5D utility gain achieved in randomized controlled trials. Males expected by 2.7 ± 11.1 more, while females expected by 5.2 ± 9.3 less life years compared to the average statistical gender‐ and age‐matched life expectancy (P < 0.05). Patients who expected to be alive at ages of 60, 70, 80 and 90 scored their future EQ‐5D at ages of 60 to 90: 0.59 ± 0.46, 0.48 ± 0.41, 0.42 ± 0.41 and 0.22 ± 0.47 respectively.

Conclusion

Our findings highlight the importance of exploring expectations that might help to increase patients' compliance.
A multifaceted intervention: no increase in general practitioners' competence to diagnose skin cancer (minSKIN) – randomized controlled trial
Authors: Badertscher N. , Tandjung R. , Senn O. , Kofmehl R. , Held U. , Rosemann T. , Hofbauer G.F.L. , Wensing M. , Rossi P.O. , Braun R.P.
Published: December 2014

Background

General practitioners (GPs) play crucial roles in early detection of skin cancer. A pilot‐study found a positive short‐term effect of a 1‐day dermatologic education programme on GPs' diagnostic competence.

Objective

To determine effects of a multifaceted intervention, including technical equipment and continuing feedback by a dermatologist, on GPs' diagnostic skills regarding skin cancer.

Methods

Randomized controlled trial with 78 GPs of the Canton of Zurich, Switzerland. Intervention: GPs in intervention group received a 1‐day training, a Lumio© (magnifying glass with polarized light, 3Gen), a Nikon digital camera and – during 1 year – feedback on skin lesion pictures sent to the dermatologist. GPs in control group only received the 1‐day training. Main outcome and measures: Primary outcome: structured assessment of GP's diagnostic skills in correctly diagnosing images of skin lesions regarding skin cancer. At baseline prior to intervention (T0), after the full‐day training course in both groups (T1), and after 1 year of continuing feedback (T2) to the intervention group. Measures: Non‐parametric unpaired (Wilcoxon–Mann–Whitney) tests were used to compare numbers of correctly classified skin lesions between both groups at T2 and for the change between T1 and T2.

Results

At T0, both groups classified a median of 23 skin lesions of the 36 images correctly. This value rose to 28 for both groups at T1 and fell to 24 for both groups at T2. No difference between control and intervention group at T2. Furthermore, we compared differences in the sum scores per GP between T1 and T2 for each group. Also in this comparison, no difference between control and intervention group was found.

Conclusion and relevance

No long‐term effect of the multifaceted intervention was found on the competence to diagnose skin cancer by GPs. The positive short‐term effect of the 1‐day dermatologic education programme did not persist over 12 months.
The role of phenotype, body mass index, parental and sun exposure factors in the prevalence of melanocytic nevi among schoolchildren in Lithuania
Authors: Kontautiene S. , Stang A. , Gollnick H. , Valiukeviciene S.
Published: December 2014

Background

The occurrence and number of melanocytic nevi (MN) are among the most important known risk factors for the development of cutaneous melanoma (CM).

Objectives

To estimate the prevalence of MN among schoolchildren and its relationship with phenotype, body mass index (BMI), parental and sun exposure factors.

Methods

A cross‐sectional study was conducted on N = 1277 schoolchildren aged 7–19 years old in Kaunas city, Lithuania. Subjects were interviewed using a self‐administered questionnaire and were assessed by a dermatologist. MN of all sizes and ≥2 mm in diameter were counted; phenotypic features and skin phototype were defined. BMI and body surface area (BSA) were calculated. Whole‐body MN counts were expressed both as totals and as counts per unit of BSA – MN density (MND). Biological parents completed questionnaires regarding nevus counts, family history of skin cancer and CM.

Results

The numbers of all sizes and ≥2 mm MN increased according to age, respectively, from median values of 44 (IQR 28, 60) and 5 (IQR 2, 8) at the age of 7–9 years to 85 (IQR 55, 128) and 16 (IQR 8, 30) at the age of 16–19 years. A higher MND was found in children with light skin colour (P < 0.001), I‐II skin phototype (P < 0.001), extensive facial freckling (P < 0.005) and multiple nevi on the father's and mother's arms (P < 0.05). 20.2% of pupils were overweight or obese, 130 males and 118 females. Overweight and obese children had a higher all sizes MND (P = 0.033, P = 0.044). Acquired suntan at the end of summer was associated with a higher all sizes MND (P < 0.05), outdoor activities at midday – with a higher ≥2 mm MND (P = 0.047) respectively.

Conclusions

The prevalence of MN among schoolchildren is age‐dependent and strongly determined by skin colour, skin phototype, facial freckling and BMI. Parental nevus numbers, acquired suntan and outdoor activities at midday must be considered.