bluuebunny/crossref_metadata_2025 huggingface dataset:
The object‐orientated political subjectivities of McUniversity
Authors: Miller Jacob C , Golden Casey
Published: October 2015

Higher education has changed drastically in recent decades, leading to the emergence of what some have called ‘McUniversity’. This article adds a new perspective by exploring how the everyday lived experience of this kind of space constitutes a dense political field. We draw on our own experience of an emblematic architectural site on our own university campus – the Student Union building – to advance an analysis of the everyday built environment that includes both objects of design and the political subjectivities that emerge along with them. What unites this relationship is an affective experience through which political life emerges. This approach also allows us to expand the purview of what is political about the everyday spaces of McUniversity to include gender, sex and nationalism, rather than relying only on critical theories of capitalism to critique what has become of many college campuses.
Celecoxib interferes to a limited extent with aspirin‐mediated inhibition of platelets aggregation
Authors: Ruzov Mark , Rimon Gilad , Pikovsky Oleg , Stepensky David
Published: October 2015

Aims

The aim of the study was to analyze the interaction between celecoxib and low dose aspirin for COX‐1 binding and its consequences on the aspirin‐mediated antiplatelet effects.

Methods

We investigated ex vivo the interaction between celecoxib and aspirin for COX‐1 binding and measured the resulting antiplatelet effects. We applied mechanism‐based pharmacokinetic−pharmacodynamic (PKPD) modelling to analyze these data and to predict in vivo platelet aggregation for different doses and administration schedules of aspirin and celecoxib.

Results

The predictions of the PK‐PD model were consistent with results from previous studies that investigated interaction between aspirin and celecoxib. The modelling results indicate that celecoxib can attenuate to a limited extent the in vivo antiplatelet effects of low dose aspirin. The extent of this interaction can be substantial (up to 15% increase in platelet aggregation by 200 mg day−1 celecoxib when combined with low dose aspirin) during the first days of aspirin administration in patients who are already treated with celecoxib, and it cannot be prevented by separate administration of the interacting drugs.

Conclusions

At the recommended therapeutic doses, celecoxib can attenuate to a limited extent the in vivo antiplatelet effects of low dose aspirin. Patients receiving a combination of low dose aspirin and the recommended doses of celecoxib were not identified to have increased risk of cardiovascular and cerebrovascular events due to competition between these drugs for COX‐1 binding. Interaction between low dose aspirin and other COX‐2 inhibitors and its clinical consequences requires further investigation.
Hasse, Cathrine (2015) An anthropology of learning. Springer (Berlin) isbn 978‐94‐017‐9605‐7 320 pp £90 (ebook £72) http://www.springer.com/us/book/9789401796057#
Authors: Salmani Nodoushan Mohammad Ali
Published: October 2015

This book combines cultural models with practice‐based learning to develop a new theory of cultural learning. Drawing on insights from anthropology, it argues how collective and social cultures can emerge from an “engaged” learning process. The book opens a new window on human learning; however, you will probably find only parts of it of some interest or use.

Mohammad Ali Salmani Nodoushan
Jones, Christopher (2015) Networked learning. Springer (Berlin) isbn 978‐3‐319‐01934‐5 249 pp £90 boards (ebook £72) http://www.springer.com/us/book/9783319019338
Authors: Salmani Nodoushan Mohammad Ali
Published: October 2015

This book is largely about how people connect with each other and with digital technologies, and how this affects their learning. It reviews existing literature on networked learning and describes the role of universities and academics in that approach. Jones's book targets anyone interested in learning technology, and— if you are in that group—I recommend that you borrow a copy for a while.

Mohammad Ali Salmani Nodoushan
Magette, Kristin (2015) Embracing social media. Rowman & Littlefield (Lanham, MD & Plymouth, UK) isbn 978‐1‐4758‐1329‐6 99 pp £11.95 https://rowman.com/ISBN/9781475813289/Embracing‐Social‐Media‐A‐Practical‐Guide‐to‐Manage‐Risk‐and‐Leverage‐Opportunity
Authors: Janes Diane P
Published: October 2015

Written for teachers, administrators and anyone who has thought about helping learners safely use social media, Magette outlines the risks present in using this resource and how to manage them. She frames her small but vital book under the key ideas of 3 Ps—policy, procedures and professional development— as ways to manage social media risk. Does Magette's book relate closely to your work? You should buy a copy if it does!

Diane P Janes
Pritchard, Alan (2014) Ways of learning. Routledge (London & New York) isbn 978‐0‐415‐83493‐3 143 pp £19.99 https://www.routledge.com/products/9780415834933
Authors: Salmani Nodoushan Mohammad Ali
Published: October 2015

Written for teachers, who generally lack a sufficient knowledge of how people learn, Pritchard's book aims at enhancing the effectiveness and efficiency of education through raising teachers' understanding of learning theory. However, it does not do so very effectively: even if you are a keen teacher, you will probably find only parts of much interest or use.

Mohammad Ali Salmani Nodoushan
Extent of renal vein invasion influences prognosis in patients with renal cell carcinoma
Authors: Ball Mark W. , Gorin Michael A. , Harris Kelly T. , Curtiss Kevin M. , Netto George J. , Pavlovich Christian P. , Pierorazio Phillip M. , Allaf Mohamad E.
Published: October 2015

Objective

To compare oncological outcomes for segmental vs main renal vein invasion (RVI) in patients with renal cell carcinoma (RCC).

Patients Methods

Patients undergoing extirpative surgery for RCC at our institution between 2003 and 2013 were stratified into five groups according to clinical stage: T2 (n = 135), T3a with fat invasion (n = 185), T3a with segmental RVI (n = 87), T3a with main RVI (n = 64) and T3b (n = 40). Kaplan–Meier survival analysis and multivariable Cox regression were performed to determine the impact of segmental RVI on recurrence‐free survival (RFS) and cancer‐specific survival (CSS). Harrell's c index was used to compare the prognostic accuracy of current and proposed staging models.

Results

At a median follow‐up of 37 months, both RFS and CSS were significantly worse for patients with main RVI as compared with segmental RVI (P = 0.03 and P = 0.009, respectively). On multivariable analysis, main RVI had inferior RFS (hazard ratio [HR] 2.3, 95% confidence interval [CI] 1.1–4.4; P = 0.03] and CSS (HR 3.5, 95% CI 1.3–9.9; P = 0.02) compared with segmental RVI. Sub‐stratifying T3a disease by separating segmental and main RVI improved prognostic accuracy compared with the current staging system for CSS (c indices 0.66 vs 0.59) and RFS (0.70 vs 0.60).

Conclusions

Main RVI is independently associated with worse RFS and CSS than segmental RVI. These findings may have significance for patient counselling and future staging guidelines.
Collagen-induced arthritis increases inducible nitric oxide synthase not only in aorta but also in the cardiac and renal microcirculation of mice
Authors: Palma Zochio Tozzato G , Taipeiro E F , Spadella M A , Marabini Filho P , de Assis M R , Carlos C P , Girol A P , Chies A B
Published: October 2015

Rheumatoid arthritis (RA) may promote endothelial dysfunction. This phenomenon requires further investigation, especially in collagen-induced arthritis (CIA), as it is considered the experimental model most similar to RA. The objectives of this study were to identify CIA-induced changes in noradrenaline (NE) and acetylcholine (ACh) responses in mice aortas that may suggest endothelial dysfunction in these animals. Moreover, we characterize CIA-induced modifications in inducible nitric oxide synthase (iNOS) expression in the aortas and cardiac and renal tissues taken from these mice that may be related to possible endothelial dysfunction. Male DBA/1J mice were immunized with 100 μg of emulsified bovine collagen type II (CII) plus complete Freund's adjuvant. Twenty-one days later, these animals received a boost of an additional 100 μg plus incomplete Freund's adjuvant. Fifteen days after the onset of the disease, aortic rings from CIA and control mice were challenged with NE and ACh in an organ bath. In these animals, iNOS was detected through immunohistochemical analysis of aorta, heart and kidneys. Plasma nitrite concentration was determined using the Griess reaction. CIA did not change NE or ACh responses in mice aorta but apparently increased the iNOS expression not only in aorta, but also in cardiac and renal microcirculation. In parallel, CIA reduced nitrite plasma concentration. In mice, CIA appears to increase the presence of iNOS in aorta, as well as in heart and in kidney microcirculation. This iNOS increase occurs apparently in parallel to a reduction of the bioavailability of NO. This phenomenon does not appear to change NE or ACh responses in aorta.
Clinical Bonding of Resin Nano Ceramic Restorations to Zirconia Abutments: A Case Series within a Randomized Clinical Trial
Authors: Schepke Ulf , Meijer Henny JA , Vermeulen Karin M , Raghoebar Gerry M , Cune Marco S
Published: October 2015

Background

New dental materials are introduced and promoted in the field without extensive clinical testing. Using those materials in a clinical setting might result in unacceptable early failure rates.

Purpose

The purpose of this paper was to analyze bonding of a new dental restorative material to either zirconia stock abutments or zirconia customized abutments.

Materials and Methods

Fifty participants seeking single implant treatment were included in a prospective study. Resin Nano Ceramic (RNC, Lava Ultimate, 3M ESPE, Seefeld, Germany) crowns were digitally manufactured and extraorally bonded to either a stock or a customized zirconia abutment (ZirDesign and ATLANTIS, DENTSPLY Implants, Mölndal, Sweden) by means of a resin composite cement (RelyX Ultimate in combination with Scotchbond Universal, 3M ESPE), strictly following the manufacturer's recommendations. The final restorations were screw‐retained to the implants and followed during 12 months. Primary outcome parameter was uncompromised survival of the restoration, and secondary outcome parameter was mode of failure.

Results

No implants were lost. The uncompromised survival rate of the RNC crowns bonded to zirconia abutments after 1 year of clinical service was only 14% (n = 7). Catastrophic failure occurred in three cases (6%), whereas bonding failure between RNC crowns and zirconia abutments occurred in 80% of the cases (n = 40) within the first year of service. No statistical significant difference in uncompromised survival rate could be identified between abutment types (χ2 = 1.495, p = .209). Uncompromised survival rate after 1 year was highly significantly different (χ2 = 104.173, p < .001) from a reference standard, which was set at 95%.

Conclusion

RNC crowns luted to stock and customized zirconia implant abutments with the particular resin composite cement in this trial have a poor prognosis, regardless of the abutment type used.
Comparison of captopril (0.5%) cream with diltiazem (2%) cream for chronic anal fissure: a prospective randomized double‐blind two‐centre clinical trial
Authors: Ala S. , Enayatifard R. , Alvandipour M. , Qobadighadikolaei R.
Published: October 2015

Aim

This study compared the efficacy of topical captopril with topical diltiazem in the treatment of chronic anal fissure (CAF).

Method

Fifty patients aged between 15 and 75 years with CAF were included in a prospective randomized, double‐blind clinical trial. They were randomly allocated to either captopril (0.5%) cream or diltiazem (2%) cream in a dose of 2 cm of cream on the perianal skin every 12 h for 8 weeks. The intensity of pain upon defaecation was evaluated every 10 days using a visual analogue scale. Bleeding on defaecation, pruritus and the presence of perianal irritation were also recorded before and during the trial.

Results

The average pain scores were lower in the diltiazem group on the 20th and 30th days. From day 40 to the end of the trial the average pain scores of the two groups did not differ significantly. There were no significant differences in bleeding or perianal irritation between the groups, but the incidence of pruritus was considerably higher in the captopril group, and at the end of the trial 45.8% of the patients in this group still suffered from pruritus.

Conclusion

Topical captopril and diltiazem were found to be equally effective in the management of pain, bleeding and perianal irritation due to CAF, but due to the high incidence of pruritus observed with topical captopril this medication is not recommended for the treatment of CAF.
Low rate of advanced adenoma formation during a 5‐year colonoscopy surveillance period after adequate polypectomy of non‐advanced adenoma
Authors: Xu M. , Wang S. , Cao H. , Wang W. , Piao M. , Cao X. , Yan F. , Wang B.
Published: October 2015

Aim

Patients with non‐advanced adenoma (NAA) underwent surveillance colonoscopy at intervals shorter than the interval recommended by the guidelines. We aimed to assess the incidence of recurrent advanced adenoma (AA) over a 5‐year period and to identify risk factors for recurrence.

Method

Patients with and without NAA identified at baseline colonoscopy who had had at least two colonoscopy examinations during the subsequent 5 years were included in the study. Data on the patients’ demographics and colorectal findings were extracted from a specially designed colonoscopy database. The primary outcome was the finding of recurrent AA formation. Multivariate analysis was used to identify factors that predict subsequent AA formation at surveillance colonoscopy.

Results

Among 43 155 colonoscopy procedures, 828 cases were identified with NAA (374) and without an adenoma (454). Forty‐eight (51.1%) of 94 received a follow‐up colonoscopy within 1 year due to an inadequate baseline colonoscopy. Patients with NAA at baseline had a low incidence of AA at an interval of 1−5 years which was not statistically different from patients without adenoma formation at the initial baseline colonoscopy (1.5% vs 2.2%, P = 0.51). The incidence of AA at follow‐up colonoscopy performed at 1−3 years and 3−5 years in patients with a baseline NAA was 1.7% and 1.4% (P = 0.59). Age over 50 years and male gender were independent risk factors for AA recurrence within 5 years.

Conclusion

Surveillance colonoscopy within 5 years is of little benefit to patients who had an adequate polypectomy of an NAA at baseline. Too frequent reexamination due to concerns about AA recurrence should be avoided.
Going multilateral? Financial markets' access and the League of Nations loans, 1923–8
Authors: Flores Zendejas Juan H. , Decorzant Yann
Published: October 2015

Why are international financial institutions important? This article reassesses the role of the loans issued with the support of the League of Nations. These long‐term loans constituted the financial basis of the League's strategy to restore the productive basis of countries in central and eastern Europe in the aftermath of the First World War. In this article, it is argued that the League's loans accomplished the task for which they were conceived because they allowed countries in financial distress to access capital markets. The League adopted an innovative system of funds management and monitoring that ensured the compliance of borrowing countries with its programmes. Empirical evidence is provided to show that financial markets had a positive view of the League's role as an external, multilateral agent, solving the credibility problem of borrowing countries and allowing them to engage in economic and institutional reforms. This success was achieved despite the League's own lack of lending resources. It is also demonstrated that this multilateral solution performed better than the bilateral arrangements adopted by other governments in eastern Europe because of its lower borrowing and transaction costs.
Pestilence, poverty, and provision: re‐evaluating the role of thepopolaniin early modernVenice
Authors: Iordanou Ioanna
Published: October 2015

The labouring classes of early modernVenice, thepopolani, made up nearly 90 per cent of the city's population. To this point the relevant historiography has focused almost exclusively on their professional and civic role. It is the core contention of this article that the contribution of thepopolanito theVenetian economy and society far exceeded their documented professional and civic function. Using as a case study the homogeneous group of the shipbuilders and sailors ofVenice and drawing on newly discovered primary sources from theVenetianStateArchives, this article shows the distinct contributions of thepopolanito the city's economy and society through their charity to those in need. This took the form of sizeable dotal and charitable donations within and beyond the family. In one of the first attempts to explore the philanthropy of the Venetian workforce, this article challenges the existing scholarly view that charity was the sole responsibility of the government and the nobility in early modernVenice. It further shows that marriage was not merely a financial union for thepopolani; it was a sanctuary for lasting companionship. Ultimately, the article offers a fresh vista onto the socio‐economic role of thepopolaniin early modernVenice.
Multiscale modeling of spring phenology across Deciduous Forests in the Eastern United States
Authors: Melaas Eli K. , Friedl Mark A. , Richardson Andrew D.
Published: October 2015

Phenological events, such as bud burst, are strongly linked to ecosystem processes in temperate deciduous forests. However, the exact nature and magnitude of how seasonal and interannual variation in air temperatures influence phenology is poorly understood, and model‐based phenology representations fail to capture local‐ to regional‐scale variability arising from differences in species composition. In this paper, we use a combination of surface meteorological data, species composition maps, remote sensing, and ground‐based observations to estimate models that better represent how community‐level species composition affects the phenological response of deciduous broadleaf forests to climate forcing at spatial scales that are typically used in ecosystem models. Using time series of canopy greenness from repeat digital photography, citizen science data from the USA National Phenology Network, and satellite remote sensing‐based observations of phenology, we estimated and tested models that predict the timing of spring leaf emergence across five different deciduous broadleaf forest types in the eastern United States. Specifically, we evaluated two different approaches: (i) using species‐specific models in combination with species composition information to ‘upscale’ model predictions and (ii) using repeat digital photography of forest canopies that observe and integrate the phenological behavior of multiple representative species at each camera site to calibrate a single model for all deciduous broadleaf forests. Our results demonstrate variability in cumulative forcing requirements and photoperiod cues across species and forest types, and show how community composition influences phenological dynamics over large areas. At the same time, the response of different species to spatial and interannual variation in weather is, under the current climate regime, sufficiently similar that the generic deciduous forest model based on repeat digital photography performed comparably to the upscaled species‐specific models. More generally, results from this analysis demonstrate how in situ observation networks and remote sensing data can be used to synergistically calibrate and assess regional parameterizations of phenology in models.
Effects of traditional salt placement and strategically placed mineral mix supplements on cattle distribution in the Western Italian Alps
Authors: Pittarello M. , Probo M. , Lonati M. , Bailey D. W. , Lombardi G.
Published: October 2015

Effects of traditional salt placement (TS) and strategically placed mineral mix supplements (MMS) on cattle distribution were compared in the Italian Alps. Salt was placed within flat and herbaceous sites following the traditional method of farmers, whereas MMS blocks were placed on steep and shrub‐encroached sites within three large pastures (44 ha on average). Each TS and MMS site was paired with a control site, and eleven cows were tracked with GPS collars. Within 10 and 50 m of TS and MMS, treatment sites were used more than control sites (P < 0·05). No differences were detected (P > 0·05) in the number of visits by cows within 10 and 50 m of TS and MMS placements. No differences were detected in time spent within 10 m of TS and MMS placements, but cows spent more time (P < 0·05) within 50 m of TS. With either TS or MMS, cattle preferred areas with gentler terrain, higher forage pastoral value and closer to water (P < 0·001). When MMS was available cattle also preferred areas near MMS (P < 0·001). Shrub and herbaceous cover decreased near MMS placements (P < 0·05) from cattle grazing and trampling. Placement of MMS is a promising tool to enhance cattle distribution and potentially reduce shrub encroachment in rugged mountain pastures.
Nutritive value of desert wormwood (Artemisia desertorum Spreng.) silage in mixture with high‐moisture maize straw
Authors: Xue Y. L. , Yin G. M. , Zhao H. P. , Bai C. S. , Sun J. J. , Yu Z. , Sun Q. Z.
Published: October 2015

This study aimed to determine the fermentation characteristics, nutrient composition and in vitro digestibility of desert wormwood (DW, Artemisia desertorum Spreng.) silage as the sole ingredient, or mixed with high‐moisture maize (corn) straw (HMCS). Desert wormwood and HMCS were harvested and chopped (1–2 cm) then ensiled in laboratory silos (25 cm high with an internal diameter of 7·6 cm) at a density of 550 g L−1 at room temperature for 60 days. The proportions of DW in the DW/HMCS mixtures were 1, 0·75, 0·50, 0·25 and 0, based on fresh weight. The silages were analysed for fermentation characteristics, nutrient composition and in vitro digestibility. Desert wormwood ensiled with HMCS had lower pH and acetic acid concentration and higher lactic acid concentration as the proportion of DW decreased. As the proportion of DW decreased, the crude protein concentration and the in vitro digestibility of dry matter increased and the concentrations of neutral detergent fibre, acid detergent fibre and acid detergent lignin decreased. This study has indicated that mixing HMCS with DW can improve the fermentation quality and nutrient composition of these silage mixtures.
Sensitization to contact allergens and bronchial hyper‐responsiveness
Authors: Schnabel Eva , Schoefer Yvonne , Chen Chih‐Mei , Schäfer Torsten , Behrendt Heidrun , Ring Johannes , Wichmann H.‐Erich , Heinrich Joachim ,   for the KORA study group
Published: October 2015

Background: Exposure to contact allergens and specific allergic sensitization to them are common, but possible related health effects have been rarely studied.

Objectives: We aimed to analyse possible associations between contact sensitization to nickel sulfate and fragrance mix I and lung function parameters or bronchial hyper‐responsiveness.

Methods: Within a population‐based study in Augsburg, 1052 adults performed lung function tests, including forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC) and bronchial hyper‐responsiveness (BHR). Patch tests were performed, and information was assessed by medical examinations and interviews. Logistic regression models were applied to study associations between contact allergies and lung function parameters.

Results: Women were sensitized significantly more often than men to nickel [odds ratio (OR) 3.97, 95% confidence interval (CI) 2.50–6.29] and fragrance mix I (OR 2.28, 95% CI 1.50–3.46). Patch test results for nickel and fragrance mix I did not influence mean FEV1 and FVC % predicted values. However, in women, a higher rate of BHR was associated with positive patch test reactions to fragrance mix I (OR 2.24, 95% CI 1.11–4.52).

Conclusions: Contact sensitization to fragrance mix I is associated with a higher rate of BHR in women. Thus, in women with contact allergy to fragrances, airway obstruction should be considered as a possible co‐morbidity.
The development and psychometric testing of a theory‐based instrument to evaluate nurses’ perception of clinical reasoning competence
Authors: Liou Shwu‐Ru , Liu Hsiu‐Chen , Tsai Hsiu‐Min , Tsai Ying‐Huang , Lin Yu‐Ching , Chang Chia‐Hao , Cheng Ching‐Yu
Published: October 2015

Aim

The purpose of the study was to develop and psychometrically test the Nurses Clinical Reasoning Scale.

Background

Clinical reasoning is an essential skill for providing safe and quality patient care. Identifying pre‐graduates’ and nurses’ needs and designing training courses to improve their clinical reasoning competence becomes a critical task. However, there is no instrument focusing on clinical reasoning in the nursing profession.

Design

Cross‐sectional design was used. This study included the development of the scale, a pilot study that preliminary tested the readability and reliability of the developed scale and a main study that implemented and tested the psychometric properties of the developed scale.

Method

The Nurses Clinical Reasoning Scale was developed based on the Clinical Reasoning Model. The scale includes 15 items using a Likert five‐point scale. Data were collected from 2013–2014. Two hundred and fifty‐one participants comprising clinical nurses and nursing pre‐graduates completed and returned the questionnaires in the main study. The instrument was tested for internal consistency and test–retest reliability. Its validity was tested with content, construct and known‐groups validity.

Results

One factor emerged from the factor analysis. The known‐groups validity was confirmed. The Cronbach's alpha for the entire instrument was 0·9.

Conclusion

The reliability and validity of the Nurses Clinical Reasoning Scale were supported. The scale is a useful tool and can be easily administered for the self‐assessment of clinical reasoning competence of clinical nurses and future baccalaureate nursing graduates. Study limitations and further recommendations are discussed.
Improved Blood Pressure Control Using an Interactive Mobile Phone Support System
Authors: Bengtsson Ulrika , Kjellgren Karin , Hallberg Inger , Lindwall Magnus , Taft Charles
Published: October 2015

This explorative, longitudinal study evaluated the effect of the daily use of a mobile phone‐based self‐management support system for hypertension in reducing blood pressure (BP) among 50 primary care patients with hypertension over 8 weeks. The self‐management system comprises modules for (1) self‐reports of BP, pulse, lifestyle, symptoms, and well‐being; (2) delivery of reminders and encouragements; and (3) graphical feedback of self‐reports. Daily use of the support system significantly reduced BP (systolic BP −7 mm Hg, diastolic BP −4.9 mm Hg) between baseline and week 8, with daily improvements leveling off as the study progressed. Three homogenous subsets of patients were identified who, despite different initial BP levels, showed similar decreases in BP during the study, indicating that patients benefited irrespective of baseline BP. In showing significant reductions in BP, our results suggest that the self‐management support system may be a useful tool in clinical practice to help patients self‐manage their hypertension.
Improving Hypertension Screening in Childhood Using Modified Blood Pressure to Height Ratio
Authors: Dong Bin , Wang Zhiqiang , Wang Hai‐Jun , Ma Jun
Published: October 2015

Blood pressure to height ratio (BPHR) has been suggested as a simple method for screening children with hypertension, but its discriminatory ability in young children is not as good as that in older children. Using data of 89,664 Chinese children aged 7 to 11 years, the authors assessed whether modified BPHR (BP:eHT13) was better than BPHR in identifying young children with hypertension. BP:eHT13 was estimated as BP/(height+7×(13−age in years)). Using Youden's index, the thresholds of systolic/diastolic BP:eHT13 for identifying prehypertension and hypertension were 0.67/0.44 and 0.69/0.45, respectively. These proposed thresholds revealed high sensitivity, specificity, negative predictive value, and area under the curve (AUC), ranging from 0.874 to 0.999. In addition, BP:eHT13 showed better AUCs and fewer cutoff points than, if not similar to, two existing BPHR references. BP:eHT13 generally performed better than BPHR in discriminating BP abnormalities in young children and may improve early hypertension recognition and control.
Reconciling evidence‐based medicine and patient‐centred care: defining evidence‐based inputs to patient‐centred decisions
Authors: Weaver Robert R.
Published: October 2015

Evidence‐based and patient‐centred health care movements have each enhanced the discussion of how health care might best be delivered, yet the two have evolved separately and, in some views, remain at odds with each other. No clear model has emerged to enable practitioners to capitalize on the advantages of each so actual practice often becomes, to varying degrees, an undefined mishmash of each. When faced with clinical uncertainty, it becomes easy for practitioners to rely on formulas for care developed explicitly by expert panels, or on the tacit ones developed from experience or habit. Either way, these tendencies towards ‘cookbook’ medicine undermine the view of patients as unique particulars, and diminish what might be considered patient‐centred care. The sequence in which evidence is applied in the care process, however, is critical for developing a model of care that is both evidence based and patient centred. This notion derives from a paradigm for knowledge delivery and patient care developed over decades by Dr. Lawrence Weed. Weed's vision enables us to view evidence‐based and person‐centred medicine as wholly complementary, using computer tools to more fully and reliably exploit the vast body of collective knowledge available to define patients’ uniqueness and identify the options to guide patients. The transparency of the approach to knowledge delivery facilitates meaningful practitioner–patient dialogue in determining the appropriate course of action. Such a model for knowledge delivery and care is essential for integrating evidence‐based and patient‐centred approaches.
Motivating Action and Maintaining Change: The Time‐Varying Role of Homework Following a Brief Couples' Intervention
Authors: Hawrilenko Matt , Eubanks Fleming C. J. , Goldstein Alana S. , Cordova James V.
Published: October 2015

Studies regarding the effectiveness of homework assignments in cognitive‐behavioral treatments have demonstrated mixed results. This study investigated predictors of compliance with homework recommendations and the time‐varying relationship of recommendation completion with treatment response in a brief couples' intervention (N = 108). More satisfied couples and couples with more motivation to change completed more recommendations, whereas couples with children completed fewer. The association between recommendation completion and treatment response varied with the passage of time, with the strongest effect observed 6 months after the intervention, but no discernible differences at 1 year postintervention. Couples that completed more recommendations experienced more rapid treatment gains, but even those couples doing substantially fewer recommendations ultimately realized equivalent treatment effects, although they progressed more slowly. Implications are discussed.
Innovative quantitative testing of hand function in Charcot‐Marie‐Tooth neuropathy
Authors: Alberti Maria A. , Mori Laura , Francini Luca , Poggi Ilaria , Monti Bragadin Margherita , Bellone Emilia , Grandis Marina , Maggi Giovanni , Reni Lizia , Sormani Maria P. , Tacchino Andrea , Padua Luca , Prada Valeria , Bove Marco , Schenone Angelo
Published: October 2015

Abstract

To describe a new test to quantitatively evaluate hand function in patients affected by Charcot‐Marie‐Tooth neuropathy (CMT). The sensor‐engineered glove test (SEGT) was applied to CMT patients (N: 26) and compared with a cohort of healthy controls (HC, N: 26). CMT patients were further divided into subjects with clinically normal (group 1) or impaired hand (group 2) function. The SEGT parameters evaluated were touch duration, inter‐tapping interval, and movement rate parameters of two different sequences: finger tapping (FT) and index‐medium‐ring‐little (IMRL) performed at self‐paced mode (SPM) and maximum velocity (MV). Hand function and strength were assessed by the 9‐hole peg test (9HPT) and dynamometry. Disability of patients was measured by the CMT neuropathy score. CMT patients had significantly worst performances at SEGT than controls regarding the rate of execution of both FT (at MV) and IMRL sequences (at SPM and MV). The rate parameter at MV in IMRL sequence showed a significant trend of decreasing in its average between HC (n: 26, rate = 3.08 ± 0.52 Hz), group 1 (n: 9, rate = 2.64 ± 0.66 Hz) and group 2 (n: 17, rate = 2.19 ± 0.45 Hz) (p for trend <0.001). No correlations were found with either 9HPT, dynamometry, electrophysiology, and the CMT neuropathy score. The SEGT test is sensitive to show hand dysfunction in CMT patients, with and without clinically impaired hands.
Periodontitis contributes to aberrant metabolism in type 2 diabetes mellitus rats by stimulating the expression of adipokines
Authors: Luo S. , Yang X. , Wang D. , Ni J. , Wu J. , Xu Z. , Xuan D. , Zhang J.
Published: October 2015

Background

Periodontitis has been associated with type 2 diabetes mellitus. We investigated the effects of local aberrant secretion of adipokines in diabetic rats on systemic metabolism.

Material and Methods

Otsuka Long‐Evans Tokushima Fatty (OLETF) and non‐diabetic Long‐Evans Tokushima Otsuka rats were used as a diabetic model and associated control, respectively. Periodontitis was induced using a silk ligature for 36 wk. Rats were grouped into OLETF with (OP+) or without (OP−) periodontitis and Long‐Evans Tokushima Otsuka with (LP+) or without (LP−) periodontitis. Alveolar bone resorption and destruction were evaluated by micro‐computed tomography and hematoxylin and eosin staining. After 20 wk of periodontitis induction, lipids, insulin, interleukin‐1, leptin and plasminogen activator inhibitor‐1 were analyzed, and mRNA expressions of NF‐κB, Mark8, TLR2 and ‐4, IKBKB and Nampt were evaluated by quantitative polymerase chain reaction in adipose tissue.

Results

After ligation, OLETF rats exhibited typical periodontitis lesions with the clinical features of type 2 diabetes mellitus. When compared with the OP(−) group, the area under curve of the oral glucose tolerance test and homeostatic model assessment–insulin resistance values were significantly higher in the OP(+) group. Micro‐computed tomography showed that the OP(+) group had more bone resorption than the OP(−) group. When compared with the OP(−) group, the OP(+) group also exhibited higher total cholesterol (p < 0.05), leptin (p < 0.05), insulin (p > 0.05) and higher expression of Nampt (p < 0.05) and IKBKB (p < 0.05). The LP(+) group had a trend towards higher bone resorption when compared with the LP(−) group. Additionally, no difference in white adipose tissues or adipokines was found between LP(+) and LP(−) rats.

Conclusions

Chronic periodontitis can alter lipid profiles in affected rats, elevate adipose tissue expression of Nampt and affect the metabolism of adipose tissue through the NF‐κB pathway to inflame diabetes.
On the occurrence of false positives in tests of migration under an isolation‐with‐migration model
Authors: Hey Jody , Chung Yujin , Sethuraman Arun
Published: October 2015

The population genetic study of divergence is often carried out using a Bayesian genealogy sampler, like those implemented in ima2 and related programs, and these analyses frequently include a likelihood ratio test of the null hypothesis of no migration between populations. Cruickshank and Hahn (2014, Molecular Ecology, 23, 3133–3157) recently reported a high rate of false‐positive test results with ima2 for data simulated with small numbers of loci under models with no migration and recent splitting times. We confirm these findings and discover that they are caused by a failure of the assumptions underlying likelihood ratio tests that arises when using marginal likelihoods for a subset of model parameters. We also show that for small data sets, with little divergence between samples from two populations, an excellent fit can often be found by a model with a low migration rate and recent splitting time and a model with a high migration rate and a deep splitting time.
Transcription factor ART1 mediates starch hydrolysis and mycotoxin production in Fusarium graminearum and F. verticillioides
Authors: Oh Mira , Son Hokyoung , Choi Gyung Ja , Lee Chanhui , Kim Jin‐Cheol , Kim Hun , Lee Yin‐Won
Published: October 2015

Molecular mechanisms underlying the responses to environmental factors, such as nitrogen, carbon and pH, involve components that regulate the production of secondary metabolites, including mycotoxins. In this study, we identified and characterized a gene in the FGSG_02083 locus, designated as FgArt1, which was predicted to encode a Zn(II)2Cys6 zinc finger transcription factor. An FgArt1 deletion mutant of Fusarium graminearum exhibited impaired starch hydrolysis as a result of significantly reduced α‐amylase gene expression. The deletion strain was unable to produce trichothecenes and exhibited low Tri5 and Tri6 expression levels, whereas the complemented strain showed a similar ability to produce trichothecenes as the wild‐type strain. In addition, FgArt1 deletion resulted in impairment of germination in starch liquid medium and reduced pathogenicity on flowering wheat heads. To investigate the roles of the FgArt1 homologue in F. verticillioides, we deleted the FVEG_02083 gene, and the resulting strain showed defects in starch hydrolysis, similar to the FgArt1 deletion strain, and produced no detectable level of fumonisin B1. Fum1 and Fum12 expression levels were undetectable in the deletion strain. However, when the FvArt1‐deleted F. verticillioides strain was complemented with FgArt1, the resulting strain was unable to recover the production of fumonisin B1, although FgArt1 expression and starch hydrolysis were induced. Thus, our results suggest that there are different regulatory pathways governed by each ART1 transcription factor in trichothecene and fumonisin biosynthesis. Taken together, we suggest that ART1 plays an important role in both trichothecene and fumonisin biosynthesis by the regulation of genes involved in starch hydrolysis.
Gastrointestinal mucormycosis in immunocompromised hosts
Authors: Dioverti M. Veronica , Cawcutt Kelly A. , Abidi Maheen , Sohail M. Rizwan , Walker Randall C. , Osmon Douglas R.
Published: October 2015

Invasive mucormycosis is a rare fungal infection in immunocompromised hosts, but it carries a high mortality rate. Primary gastrointestinal disease is the least frequent form of presentation. Early diagnosis and treatment are critical in the management; however, symptoms are typically non‐specific in gastrointestinal disease, leading to delayed therapy. To describe the clinical presentation, diagnosis, treatment and outcomes of gastrointestinal mucormycosis in immunocompromised hosts, we reviewed all cases of primary gastrointestinal mucormycosis in immunocompromised hosts reported in English literature as well as in our Institution from January 1st 1991 to December 31st 2013 for a total of 31 patients. About 52% of patients underwent solid organ transplant (SOT), while the rest had an underlying haematologic malignancy. Abdominal pain was the most common presenting symptom, followed by gastrointestinal bleeding and fever. Gastric disease was more common in SOT, whereas those with haematologic malignancy presented with intestinal disease (P = 0.002). Although gastrointestinal mucormycosis remains an uncommon condition in immunocompromised hosts, it carries significant morbidity and mortality, particularly in cases with intestinal involvement. A high index of suspicion is of utmost importance to institute early and appropriate therapy and improve outcomes.
Comparing the efficacy of continuous erythropoietin receptor activator and darbepoetin Alfa treatments in Japanese patients with chronic kidney disease during the predialysis period: A propensity‐matched analysis
Authors: Koibuchi Kiyoto , Miyagi Moriatsu , Arai Taichi , Aoki Toshiyuki , Aikawa Atsushi , Sakai Ken
Published: October 2015

Aim

Erythropoiesis‐stimulating agent (ESA) treatment during the predialysis period can be a strategy to reduce cardiac mortality soon after initiation of dialysis. In this study, we compared the efficacy of continuous erythropoietin receptor activator (CERA) and darbepoetin alfa (DA) in patients with chronic kidney disease (CKD) over 6 months prior to initiation of dialysis.

Methods

This study was a retrospective propensity score‐matched study conducted at a single center in Japan that analyzed the effects of CERA and DA therapy on haemoglobin (Hb) changes, ESA resistance index (ERI) changes, and interval of ESA administration during a 6‐month observation period prior to initiation of dialysis. Propensity scores were used for matching the patients included in the CERA and DA groups.

Results

Among 680 screened, 74 pairs of patients (one in each group) were included in the present analysis after propensity score matching. Mean Hb significantly decreased over 6 months in the DA group compared to that in the CERA group (−0.70 ± 0.23 vs. –0.33 ± 0.22). In the DA group, mean ERI was significantly increased at 4, 3, 2, and 1 month before dialysis and initiation of dialysis, while in the CERA group, mean ERI was significantly increased only at 1 month before dialysis and initiation of dialysis. Moreover, patients administered CERA were required to visit the hospital significantly less frequently for ESA administration than those administered DA.

Conclusion

Our study showed that CERA may be more effective than DA for management of anaemia during the predialysis period in CKD patients.
Anaemia and early phase cardiovascular events on haemodialysis
Authors: Hayashi Toshihide , Joki Nobuhiko , Tanaka Yuri , Hase Hiroki
Published: October 2015

Although the mechanism of the cardio‐renal anaemia syndrome (CRAS) has been elucidated in considerable detail over the past decade, cardiovascular disease (CVD) remains a leading cause of death among patients with end‐stage kidney disease (ESKD) undergoing haemodialysis, and these patients' cardiovascular mortality is greater than that of the general population. Recent studies have reported that the CVD risk increases with advancing chronic kidney disease (CKD) stage. Furthermore, the incidence of cardiovascular events is highest during the first week after dialysis initiation, with increased risk in incident haemodialysis patients. This accumulated evidence demonstrates that how patients are managed during the pre‐dialysis phase may have important implications on long‐term outcomes in ESKD. Anaemia, a non‐traditional risk factor for CVD, advances exponentially along with declining kidney function due to insufficient erythropoietin production. Anaemia causes functional abnormalities of the heart, as represented by cardiac hypertrophy, which results from increased cardiac workload induced by an increased preload. Left ventricular hypertrophy (LVH), a traditional risk factor for CVD, is especially associated with advanced CKD stage and could be a major risk factor for cardiovascular complications such as ischaemic heart disease, heart failure, and sudden cardiac death. In ESKD, anaemia develops more severely and requires a higher amount of erythropoiesis‐stimulating agent (ESA) therapy before dialysis initiation. This suggests that improvement in anaemia management during the pre‐dialysis phase may have a beneficial effect on cardiac hypertrophy and contribute to reducing the CVD risk after initiating haemodialysis.
Treatment of renal anaemia with erythropoiesis‐stimulating agents in predialysis chronic kidney disease patients: Haemoglobin profile during the 6 months before initiation of dialysis
Authors: Kawahara Kazuhiko , Minakuchi Jun , Yokota Narushi , Suekane Hiroto , Tsuchida Kenji , Kawashima Shu
Published: October 2015

Aim

Erythropoiesis‐stimulating agents (ESAs) are all effective for renal anaemia in patients with chronic kidney disease (CKD). However, it was reported that the haemoglobin (Hb) concentration decreases to 8.4 g/dL during the initial phase of dialysis despite treatment with recombinant human erythropoietin (rHuEPO). This study compared Hb at the initiation of dialysis among patients treated with three different ESAs (rHuEPO, darbepoetin alfa [DA], and a continuous erythropoietin receptor activator [CERA]).

Methods

The subjects were 82 CKD patients who started dialysis at Kawashima Hospital between 1 January 2009 and 28 February 2015 and who received only one kind of ESA for at least 6 months before initiation of dialysis. Baseline characteristics and laboratory data at initiation of dialysis were compared among the three groups. Then changes of the Hb, ESA dose, and erythropoiesis resistance index were assessed over time during the 6 months before initiation of dialysis. Differences of Hb at the initiation of dialysis were also assessed.

Results

Among the 82 patients, 36 received rHuEPO, 13 received DA, and 33 received CERA. Baseline characteristics and laboratory data of the patients showed no significant differences among the three groups. The monthly Hb decreased gradually during the 6‐month period before initiation of dialysis in all three groups. Hb was significantly higher in the CERA group than the rHuEPO group at the initiation of dialysis.

Conclusion

Long‐acting ESAs may be more useful for predialysis patients with CKD because they do not attend hospital frequently, unlike haemodialysis patients.
Quality of life of family caregivers of children with orofacial clefts in Nigeria: a mixed‐method study
Authors: Awoyale T , Onajole AT , Ogunnowo BE , Adeyemo WL , Wanyonyi KL , Butali A
Published: October 2015

Background

Orofacial clefts (OFCs) are common birth defects that may impose a large burden on the health and psychosocioeconomic well‐being of affected individuals and families. This study aims to identify qualitative factors that affect the quality of life (QOL) of family caregivers of children with OFCs.

Methods

A mixed‐method study in which family caregivers of OFCs children were consecutively recruited from cleft clinics over a 3‐month period. Quantitative data were analyzed using SPSS version 17 and focus group discussion by framework analysis.

Results

A total of 107 caregivers participated in the entire study, and 24 caregivers participated in the focus group discussions. About 50% of the children had cleft lip and palate (CLP), 28% with cleft lips only (CL) and 23.4% with cleft palate only (CP). Poor access to specific information and lack of empathy of professionals affected the quality of life and delivery of family‐centered care.

Conclusions

To improve the quality of life of family caregivers, individual‐focused counseling sessions should be organized for caregivers soon after birth. This will provide an opportunity to discuss the laid out plans for supportive care. It will also be as an avenue to address the arising social issues by health professionals and counselors.