bluuebunny/crossref_metadata_2025 huggingface dataset:
Informal Hierarchy and Team Creativity: The Moderating Role of Empowering Leadership
Authors: Oedzes Jacoba J. , Rink Floor A. , Walter Frank , Van Der Vegt Gerben S.
Published: April 2018

Although there is growing evidence that strong informal influence hierarchies can enhance teams' core task performance, recent theorising suggests that such informal hierarchies may, at the same time, stifle team creativity. The current study draws from the Motivated Information Processing in Groups (MIP‐G) model to empirically examine this latter notion. Moreover, we build on functional leadership theories to propose that the link between informal hierarchy strength and team creativity hinges on a formal team leader's empowering leadership. Using a sample of 56 organisational work teams comprising 304 individuals from a wide range of industries, we found that stronger informal influence hierarchies related negatively with team creativity when the formal leader exhibited little empowering behaviour. When the formal leader acted in more empowering ways, by contrast, this negative relationship was dampened. These findings provide new knowledge on the role of informal influence hierarchies for team creativity and advance our understanding of how informal hierarchical relations and formal leadership processes can jointly shape important team outcomes.
Risk factors for nonreassuring fetal heart rate tracings after artificial rupture of membranes in spontaneous labor
Authors: Ganer Herman Hadas , Tamayev Liliya , Houli Rotem , Miremberg Hadas , Bar Jacob , Kovo Michal
Published: April 2018

Background

We aimed to characterize factors associated with nonreassuring fetal heart (FHR) tracings after artificial rupture of membranes (AROM), during the active phase of labor.

Methods

Delivery charts of patients who presented in spontaneous labor, at term, between 2015 and 2016 were reviewed. We identified cases in which AROM was performed during the active stage of labor. We compared deliveries with a normal FHR and those who developed nonreassuring FHR. Nonreassuring FHR was defined as fetal tracing that necessitated intrauterine resuscitation, which included: oxytocin withheld, amnioinfusion, or immediate instrumental or cesarean birth.

Results

Of 664 deliveries, nonreassuring FHR occurred in 141 (21.2%) and normal FHR in 523 (78.7%). Both groups were notable for similar maternal characteristics and a similar gestational age. Epidural block was significantly more common in the nonreassuring FHR group (P < .001), as was meconium during delivery (P = .01). Deliveries in the nonreassuring FHR group were characterized by significantly lower Bishop scores at AROM. Mean birthweight was significantly lower in the nonreassuring FHR group (3201 ± 418 vs 3342 ± 376 g, P < .001), yet, neonatal outcome did not differ between the groups. In a multivariate logistic regression model, nulliparity, AROM at a station lower than −2, and increased birthweight were all significantly associated with a decreased rate of nonreassuring FHR, while prolonged duration from AROM to delivery and oxytocin augmentation significantly increased the risk for nonreassuring FHR.

Discussion

Nonreassuring FHR after AROM during delivery is associated with parity, fetal station at AROM, birthweight, and oxytocin augmentation.
Midwifery and obstetrics: Factors influencing mothers’ satisfaction with the birth experience
Authors: Mattison Cristina A. , Dion Michelle L. , Lavis John N. , Hutton Eileen K. , Wilson Michael G.
Published: April 2018

Background

Satisfaction is a key component of the care experience and part of the health system “triple aim,” along with improving population health and reducing per capita health care costs, the other two parts of the “triple aim.” The objectives of the study were to examine birth‐experience satisfaction among women in Ontario, Canada, who received care from midwives, family physicians, and obstetricians.

Methods

We used Statistics Canada's 2006 national Maternity Experiences Survey. The sample includes 1900 Ontario women and is, with appropriate weighting, representative of an estimated population of 29 700 women who gave birth in Ontario to a singleton baby during the study period. Information was collected on respondents’ satisfaction with their health care providers, demographic characteristics, and a range of pregnancy, labor, birth, and postpartum experiences. We used logistic regression analysis to assess differences in patient/client satisfaction by type of health care provider.

Results

Women cared for by midwives were three times more likely to be satisfied with their care (OR 3.32 [95% CI 2.26‐4.86]) when compared with obstetrician‐led care. Depression symptoms, having to travel outside the respondents’ community to give birth, and being born in an East Asian country were associated with lower levels of satisfaction.

Conclusion

Given recent health system reforms emphasizing the importance of shifting from expensive acute hospital‐based care to community‐based care, our findings support empirically the importance of supporting women's access to midwifery services within their communities. Findings of ethnocultural differences in satisfaction with care can inform policy makers as health systems move to provide culturally appropriate care to increasingly diverse populations.
Obstetric interventions, trends, and drivers of change: A 20‐year population‐based study from Iceland
Authors: Swift Emma M. , Tomasson Gunnar , Gottfreðsdóttir Helga , Einarsdóttir Kristjana , Zoega Helga
Published: April 2018

Background

Population data on obstetric interventions is often limited to cesarean delivery. We aimed to provide a more comprehensive overview of trends in use of several common obstetric interventions over the past 2 decades.

Methods

The study was based on nationwide data from the Icelandic Medical Birth Register. Incidence of labor induction, epidural analgesia, cesarean, and instrumental delivery was calculated for all births in 1995‐2014. Change over time was expressed as relative risk (RR), using Poisson regression with 95% confidence intervals (CI) adjusted for several maternal and pregnancy‐related characteristics. Analyses were stratified by women's parity and diagnosis of diabetes or hypertensive disorder.

Results

During the study period, there were 81 389 intended vaginal births and 5544 elective cesarean deliveries. Among both primiparous and multiparous women, we observed a marked increase across time for labor induction (RR 1.78 [CI 1.67‐1.91] and RR 1.83 [CI 1.73‐1.93], respectively) and epidural analgesia (RR 1.40 [CI 1.36‐1.45] and RR 1.74 [CI 1.66‐1.83], respectively). A similar trend of smaller magnitude was observed among women with hypertensive disorders but no time trend was observed among women with diabetes. Incidence of cesarean and instrumental delivery remained stable across time.

Discussion

The use of labor induction and epidural analgesia increased considerably over time, while the cesarean delivery rate remained low and stable. Increases in labor induction and epidural analgesia were most pronounced for women without a diagnosis of diabetes or hypertensive disorder and were not explained by maternal characteristics such as advanced age.
Combined somatic mutation and copy number analysis in the survival of familial CLL
Authors: Zhou Weiyin , Goldin Lynn , Wang Mingyi , McMaster Mary L. , Jones Kristine , Burdett Laurie , Chanock Stephen J. , Yeager Meredith , Dean Michael , Caporaso Neil E.
Published: April 2018

Recurrent large‐scale somatic copy number alterations (SCNAs), and somatic point mutations can be analysed to stratify patients with chronic lymphocytic leukaemia (CLL) into distinct prognostic groups. To investigate the relationship between SCNAs and somatic mutations, we performed whole‐exome sequencing and single nucleotide polymorphism microarray analyses on 98 CLL patients from 40 families with a high burden of CLL. Overall, 69 somatic mutations in 29 CLL driver genes were detected among 45 subjects (46%), with the most frequently mutated genes being TP53 (8·2%), NOTCH1 (8·2%) and ATM (5·1%). Additionally, 142 SCNAs from 54 subjects (57%) were detected, including losses of chromosome 13q14 (28·9%), 11q (5·6%), 17p (2·1%), and gain of chromosome 12 (4·2%). We found that patients having both an adverse point mutation in a CLL driver gene and an unfavourable SCNA tended to have poorer survival (Hazard ratio [HR] = 3·17, 95% confidence interval [CI] = 0·97–10·35; P = 0·056) than patients having either a point mutation (HR = 1·34, 95%CI = 0·66–2·71; P = 0·42) or SCNAs (HR = 2·65, 95%CI = 0·77–9·13; P = 0·12). TP53 mutation carriers were associated with the poorest overall survival (HR = 4·39, 95%CI = 1·28–15·04; P = 0·018). Our study suggests that combining SCNA and mutational data could contribute to predicting outcome in familial CLL.
Enhanced expression of IFI16 and RIG-I in human third-trimester placentas following HSV-1 infection
Authors: Jabłońska A , Studzińska M , Suski P , Kalinka J , Paradowska E
Published: April 2018

The innate immune response in the placenta depends on the ability of maternal immune cells and fetal trophoblast cells to detect and eliminate invading pathogens through germline-encoded pattern recognition receptors (PRRs). In the present study, we analysed the transcripts and protein expression of interferon (IFN)-inducible protein (IFI)16, melanoma differentiation-associated protein 5 (MDA5), RIG-I-like receptor (RIG-I) and Toll-like receptor (TLR)-3 in third-trimester human placentas and investigated cytokine profiles generated during herpes simplex type 1 (HSV-1) infection. Decidual and chorionic villous biopsies (38–42 weeks of gestation) were obtained from healthy women immediately after a caesarean section. The expression of the DDX58 (RIG-I), IFIH1 (MDA5), IFI16 and TLR3 transcripts was measured using quantitative real-time polymerase chain reaction (qRT–PCR). Extracellular cytokine and PRRs levels were then quantified by enzyme-linked immunosorbent assays (ELISAs). All examined PRRs genes, including DDX58, IFIH1, IFI16 and TLR3, were expressed constitutively at the mRNA and protein levels in the placental biopsies. The concentration of the IFI16 protein was increased in HSV-1-infected decidual and chorionic villous explants compared to those of mock-infected tissues (P = 0·029). Higher protein expression levels of RIG-I in both the maternal and fetal parts of the placenta were found (P = 0·009 and P = 0·004, respectively). In addition, increased production of IFN-β by HSV-1-infected tissues was noticed (P = 0·004 for decidua, P = 0·032 for chorionic villi). No significant differences in the IFN-α, interleukin (IL)-6 and IL-8 levels were found. These results showed that HSV-1 infection can enhance the expression of IFI16 and RIG-I proteins in the human term placenta.
Conservation mycology in Australia and the potential role of citizen science
Authors: Irga Peter J. , Barker Katherine , Torpy Fraser R.
Published: April 2018

Fungi are undoubtedly important for ecosystem functioning; however, they have been omitted or given scant attention in most biodiversity policy documents, management plans, and formal conservation schedules throughout the world. This oversight may be due to a general lack of awareness in the scientific community and compounded by a scarcity of mycology‐associated curricula at the tertiary level and a lack of mycologists in research institutions. Although molecular techniques advance the systematic cataloging of fungi and facilitate insights into fungal communities, the scarcity of professional mycologists in the environmental sciences hampers conservation efforts. Conversely, citizen science initiatives are making significant contributions to the mycology discipline by increasing awareness and extending the scope of fungal surveys. Future research by professional and amateur mycologists into the distribution of fungi and their function in ecosystems will help identify wider and more effective conservation goals.
Young people's experiences of managing Type 1 diabetes at university: a national study of UK university students
Authors: Kellett J. , Sampson M. , Swords F. , Murphy H. R. , Clark A. , Howe A. , Price C. , Datta V. , Myint K. S.
Published: April 2018

Aim

Little is known about the challenges of transitioning from school to university for young people with Type 1 diabetes. In a national survey, we investigated the impact of entering and attending university on diabetes self‐care in students with Type 1 diabetes in all UK universities.

Methods

Some 1865 current UK university students aged 18–24 years with Type 1 diabetes, were invited to complete a structured questionnaire. The association between demographic variables and diabetes variables was assessed using logistic regression models.

Results

In total, 584 (31%) students from 64 hospitals and 37 university medical practices completed the questionnaire. Some 62% had maintained routine diabetes care with their home team, whereas 32% moved to the university provider. Since starting university, 63% reported harder diabetes management and 44% reported higher HbA1c levels than before university. At university, 52% had frequent hypoglycaemia, 9.6% reported one or more episodes of severe hypoglycaemia and 26% experienced diabetes‐related hospital admissions. Female students and those who changed healthcare provider were approximately twice as likely to report poor glycaemic control, emergency hospital admissions and frequent hypoglycaemia. Females were more likely than males to report stress [odds ratio (OR) 4.78, 95% confidence interval (CI) 3.19–7.16], illness (OR 3.48, 95% CI 2.06–5.87) and weight management issues (OR 3.19, 95% CI 1.99–5.11) as barriers to self‐care. Despite these difficulties, 91% of respondents never or rarely contacted university support services about their diabetes.

Conclusion

The study quantifies the high level of risk experienced by students with Type 1 diabetes during the transition to university, in particular, female students and those moving to a new university healthcare provider.
Regular low‐calorie sweetener consumption is associated with increased secretion of glucose‐dependent insulinotropic polypeptide
Authors: Chia Chee W. , Shardell Michelle , Gravenstein Kristofer S. , Carlson Olga D. , Simonsick Eleanor M. , Ferrucci Luigi , Egan Josephine M.
Published: April 2018

Low‐calorie sweeteners (LCSs) are widely used for weight control despite limited evidence of their effectiveness and studies linking LCS consumption with incident obesity. We tested the hypothesis that regular LCS consumption is associated with higher postprandial glucose‐dependent insulinotropic polypeptide (GIP) secretion, which has been linked to obesity. We used data from participants in the Baltimore Longitudinal Study of Aging who had completed a diet diary, had at least one visit during which they underwent an oral glucose tolerance test (OGTT), and had no diabetes. Of 232 participants, 166 contributed 1, 39 contributed 2, and 27 contributed 3 visits, and 96 (41%) reported using LCS. Plasma OGTT samples were analysed for glucose, insulin and GIP. Fasting glucose, insulin and GIP levels were no different between LCS users and non‐users. The association of LCS use with 2‐hour OGTT responses after adjustment for covariates was non‐significant for glucose (P = .98) and insulin (P = .18), but significant for greater increase in GIP in LCS users (P = .037). Regular consumption of LCSs was associated with greater increases in GIP secretion after food intake, which may potentially lead to weight gain through the lipogenic properties of GIP.
Semaglutide as a therapeutic option for elderly patients with type 2 diabetes: Pooled analysis of the SUSTAIN 1‐5 trials
Authors: Warren Mark , Chaykin Louis , Trachtenbarg David , Nayak Gurudutt , Wijayasinghe Nelun , Cariou Bertrand
Published: April 2018

The efficacy and safety of semaglutide vs comparators in non‐elderly (<65 years) and elderly (≥65 years) patients with type 2 diabetes (T2D) across the SUSTAIN 1‐5 trials were evaluated. Patients were randomized to once‐weekly subcutaneous semaglutide (0.5 or 1.0 mg) vs placebo, sitagliptin, exenatide or insulin. The primary objective was change in HbA1c and secondary objectives were changes in body weight and safety. Mean HbA1c decreased from baseline by 1.2%‐1.5% and 1.5%‐1.9% vs 0%‐0.9% (non‐elderly, n = 3045) and by 1.3%‐1.5% and 1.2%‐1.8% vs 0.2%‐1.0% (elderly, n = 854) with semaglutide 0.5 and 1.0 mg vs comparators. Similar reductions from baseline in mean body weight with semaglutide occurred in both age groups. Similar proportions of patients experienced adverse events; premature treatment discontinuations were higher in elderly vs non‐elderly patients. No increased risk of severe or blood glucose‐confirmed hypoglycaemia was seen with semaglutide vs comparators between age groups. Semaglutide had a comparable efficacy and safety profile in non‐elderly and elderly patients across the SUSTAIN 1‐5 trials, making it an effective treatment option for elderly patients with T2D.
Woody plants optimise stomatal behaviour relative to hydraulic risk
Authors: Anderegg William R. L. , Wolf Adam , Arango‐Velez Adriana , Choat Brendan , Chmura Daniel J. , Jansen Steven , Kolb Thomas , Li Shan , Meinzer Frederick C. , Pita Pilar , Resco de Dios Víctor , Sperry John S. , Wolfe Brett T. , Pacala Stephen
Published: April 2018

Stomatal response to environmental conditions forms the backbone of all ecosystem and carbon cycle models, but is largely based on empirical relationships. Evolutionary theories of stomatal behaviour are critical for guarding against prediction errors of empirical models under future climates. Longstanding theory holds that stomata maximise fitness by acting to maintain constant marginal water use efficiency over a given time horizon, but a recent evolutionary theory proposes that stomata instead maximise carbon gain minus carbon costs/risk of hydraulic damage. Using data from 34 species that span global forest biomes, we find that the recent carbon‐maximisation optimisation theory is widely supported, revealing that the evolution of stomatal regulation has not been primarily driven by attainment of constant marginal water use efficiency. Optimal control of stomata to manage hydraulic risk is likely to have significant consequences for ecosystem fluxes during drought, which is critical given projected intensification of the global hydrological cycle.
Local provenancing in subtropical rainforest restoration: For better or worse? A review of practitioners’ perspectives
Authors: Cooper Sally L. , Catterall Claudia , Bundock Peter C.
Published: April 2018

The adaptive potential of restored communities is important to their long‐term sustainability, particularly in the face of changing environmental conditions such as climate change. The genetic diversity of rainforest plants in restoration projects and their suitability to current and future environmental site conditions are important considerations for restoration practitioners and seed suppliers. Presented here are the results from a survey of rainforest restoration practitioners in North East New South Wales and South East Queensland, Australia. The survey canvassed practitioners’ perspectives on local provenancing, genetic diversity and other aspects of restoration that have the potential to influence the long‐term success of restored rainforest communities. All respondents to this survey typically included a planting component in their restoration projects (whether for reconstruction or to supplement assisted regeneration). Planting represents an anthropogenic selection and translocation of genotypes to a restoration site. As a result, considerations of genetic origin and the potential implications to the restored rainforest community are relevant to most restoration projects. This industry survey's results showed that genetic diversity and local provenancing are concepts of importance to practitioners. However, there seems to be a lack of clarity within the industry about how to define local provenance and how the concepts of local provenancing and genetic diversity influence each other. The results indicated that local provenancing remains the preferred provenancing strategy amongst practitioners, with inclusion of non‐local provenance seed not regarded as an effective means of improving genetic diversity. This is despite researchers highlighting the limitations of local provenancing, particularly in highly fragmented landscapes, and despite the publication of numerous alternative provenancing strategies. Rainforest restoration may benefit from practitioners questioning the appropriateness of local provenancing to their restoration projects and considering that in some circumstances exclusive reliance on local provenance stock may in fact be worse, not better, for the long‐term sustainability of restored communities.
Corvid interference with Canid Pest Ejectors in the southern rangelands of Western Australia
Authors: Kreplins Tracey L. , Kennedy Malcolm S. , Dundas Shannon J. , Adams Peter J. , Bateman Philip W. , Fleming Patricia A.
Published: April 2018

Canid Pest Ejectors (CPE) are a method of population management that has recently been approved for the control of wild dogs and foxes in Australia. A pilot trial of CPEs (n = 10) targeting wild dogs was conducted in the southern rangelands of Western Australia in the winter of 2017. CPEs were deployed for 81 days, which included periods of significant rainfall. CPEs were not serviced during deployment, which is a likely situation for remote areas where access may be limited. During deployment, all ejector units corroded and plastic capsules containing 1080 degraded (but did not leak). For CPEs to remain effective in the field, they require regular inspections and servicing, particularly in wet conditions. Interference by nontarget corvid species was observed. Six CPEs were interfered with by corvids, with the lures removed from three, partially removed from another two and one disassembled. Our data suggest that corvid interference with ejectors may have a significant impact on the efficiency and safety of their use. Further investigation into the usefulness of Canid Pest Ejectors as method of canid control is required for rangeland use.
Trends and values of ‘Land for Wildlife’ programs for private land conservation
Authors: Prado Joshua A. , Puszka Helena , Forman Alexander , Cooke Benjamin , Fitzsimons James A.
Published: April 2018

The Land for Wildlife program started in Victoria in 1981 as a voluntary program with the broad aim of supporting landholders in providing habitat for wildlife on their property. The program has since spread across Australia and is implemented in a range of guises, through a variety of governance approaches. This research collected qualitative and quantitative data on Land for Wildlife programs across Australia to conduct the first national review. Data were gathered on changes in program membership to assess different participation trends. In addition, phone interviews with Land for Wildlife coordinators throughout Australia were conducted to explore how the programs are positioned in delivering biodiversity outcomes in a range of different regions. Over 14,000 properties covering 2.3 million ha are currently registered under Land for Wildlife programs. with at least 500,000 ha of habitat managed for conservation. Limited resources present a large challenge faced by a number of programs, with generally low funding and staffing resulting in restricted biodiversity focus and conservation outcomes. We suggest options to enhance the programs and propose future research directions.
Taking proportionality seriously: The use of contextual integrity for a more informed and transparent analysis in EU data protection law
Authors: Guinchard Audrey
Published: April 2018

Difficulties abound as to where the boundary between legitimate and illegitimate processing of personal data should be set. The open‐ended wording of the EU Data Protection Directive (DPD) 95/46 leaves space for diverse interpretations. The European Court of Justice finds it difficult to establish methodically the contextual data flows associated with individuals’ rights and their processing, with cascading consequences for the proportionality analysis, thus echoing the wider debate on proportionality. Taking stock of the criticisms of the ECJ's decisions and of the changes introduced by the General Data Protection Regulation, this paper proposes to use contextual integrity, a framework of analysis developed by Helen Nissenbaum, largely implicit in EU data protection law, to provide a systematic method of interpretation that ensures more consistency in current EU legal practice. It recommends adopting a new formal three‐tier structure, so that all factors necessary to the discussion on proportionality are fully and systematically identified and proportionality is taken seriously.
No Place Like Home? Graduate Migration in Germany
Authors: Haussen Tina , Uebelmesser Silke
Published: April 2018

The aim of this paper is to identify migration patterns of the highly educated, placing special emphasis on imbalances across regions. For this, we use data from a representative and longitudinal graduate survey in Germany with information about the work and migration history during the first 5 years after graduation. With regional funding of higher education, the number of graduates who leave the university region and the resulting net balance matter. It is equally important to understand whether economically weak and strong regions are affected differently and if graduates of study programs which are more or less costly to provide display different migration patterns. The findings show that stronger regions are more attractive for graduates. However, graduates of expensive study fields are less attached to their university region than graduates of inexpensive study fields if the university region has an above‐average GDP per capita. There is no evidence, however, that this also holds for regions with a below‐average GDP per capita. These weaker regions thus face a number effect, but there is no composition effect as far as the fields of study are concerned.
Constitutive BiP protein accumulation in Arabidopsis mutants defective in a gene encoding chloroplast‐resident stearoyl‐acyl carrier protein desaturase
Authors: Iwata Yuji , Iida Tsukasa , Matsunami Toshihiro , Yamada Yu , Mishiba Kei‐ichiro , Ogawa Takumi , Kurata Tetsuya , Koizumi Nozomu
Published: April 2018

The unfolded protein response (UPR) occurs when protein folding and maturation are disturbed in the endoplasmic reticulum (ER). During the UPR, a number of genes including those encoding ER‐resident molecular chaperones are induced. In Arabidopsis, BiP3 has been used as a UPR marker gene whose expression is strongly induced in response to ER stress. In this study, we mutagenized Arabidopsis plants expressing β‐glucuronidase (GUS) gene under the control of BiP3 promoter and isolated a mutant that exhibits strong GUS activity without treatment with ER stress inducers. By whole genome sequencing, we identified a causal gene in the mutant as SUPPRESSOR OF SALICYLIC ACID INSENSITIVITY2 (SSI2), which encodes stearoyl‐acyl carrier protein desaturase that converts stearic acids to oleic acids in the chloroplasts. In addition to GUS proteins, the ssi2 mutant accumulates endogenous BiP3 proteins without treatment by any stress reagents. Interestingly, although the degree of endogenous BiP3 protein accumulation in the ssi2 mutant was comparable to that in wild‐type plants treated with the ER stress inducer tunicamycin, much less BiP3 transcripts were detected in the ssi2 mutant compared to tunicamycin‐treated wild‐type plants. Our finding suggests a genetic link between fatty acid metabolism in the chloroplasts and ER functions.
Novel approaches for molecular targeted therapy against hepatocellular carcinoma
Authors: Eso Yuji , Marusawa Hiroyuki
Published: April 2018

Systemic chemotherapy using a multitargeted tyrosine kinase inhibitor is an established treatment for advanced‐stage tumors in various organs. Comprehensive genomic analyses using next‐generation sequencing technology revealed the intra‐ and intertumor heterogeneity of human hepatocellular carcinomas (HCCs), and provided evidence for the use of therapeutic agents effective against multiple targets in tumor cells. Recently, the efficacy and safety of a multitargeted tyrosine kinase inhibitor, lenvatinib, was confirmed by a randomized global phase III trial; thus, lenvatinib was approved as first‐line therapy for HCC, providing a new therapeutic option for patients at an advanced stage. In this article, we introduce the application of molecular targeted therapy using lenvatinib and discuss future aspects of therapeutic options for advanced HCC.
A systematic review of risk of HIV transmission through biting or spitting: implications for policy
Authors: Cresswell FV , Ellis J , Hartley J , Sabin CA , Orkin C , Churchill DR
Published: April 2018

Objectives

The perceived threat of HIV transmission through spitting and biting is evidenced by the increasing use of “spit hoods” by Police Forces in the UK. In addition, a draft parliamentary bill has called for increased penalties for assaults on emergency workers, citing the risk of communicable disease transmission as one justification. We aimed to review literature relating to the risk of HIV transmission through biting or spitting.

Methods

A systematic literature search was conducted using Medline, Embase and Northern Lights databases and conference websites using search terms relating to HIV, AIDS, bite, spit and saliva. Inclusion and exclusion criteria were applied to identified citations. We classified plausibility of HIV transmission as low, medium, high or confirmed based on pre‐specified criteria.

Results

A total of 742 abstracts were reviewed, yielding 32 articles for full‐text review and 13 case reports/series after inclusion and exclusion criteria had been applied. There were no reported cases of HIV transmission related to spitting and nine cases identified following a bite, in which the majority occurred between family (six of nine), in fights involving serious wounds (three of nine), or to untrained first‐aiders placing fingers in the mouth of someone having a seizure (two of nine). Only four cases were classified as highly plausible or confirmed transmission. None related to emergency workers and none were in the UK.

Conclusions

There is no risk of transmitting HIV through spitting, and the risk through biting is negligible. Post‐exposure prophylaxis is not indicated after a bite in all but exceptional circumstances. Policies to protect emergency workers should be developed with this evidence in mind.
Hydrogen peroxide application improves quinoa performance by affecting physiological and biochemical mechanisms under water‐deficit conditions
Authors: Iqbal H. , Yaning C. , Waqas M. , Rehman H. , Shareef M. , Iqbal S.
Published: April 2018

Quinoa performance reduces under water‐limited conditions and can be improved through exogenous application of stress signalling molecule such as hydrogen peroxide (H2O2). This study was conducted to elucidate the role of H2O2 in quinoa at two water regimes maintained as full irrigated at 100% field capacity (FC~28% soil volumetric water contents; SVWC) and at 60% FC (~17% SVWC) as drought stress. Hydrogen peroxide concentrations, that is 80 mm for seed priming and 15 mm as foliar spray, were used from our preliminary experiments. Drought stress significantly reduced the plant growth, water status, photosynthetic activity and increased reactive oxygen species production (H2O2 and O2•−) resulting in higher oxidative damage in quinoa. Exogenous applied H2O2 as priming agent improved emergence attributes by earlier emergence and made quinoa more tolerant to upcoming drought stress. Nevertheless, exogenously applied H2O2 exhibited significantly higher stomatal conductance (34%), transpiration rate (39%), photosynthetic rate (42%), chlorophyll content index (36%), proline (19%) and total soluble sugar contents (14%) with respect to non‐treated plants under water‐deficit conditions. The H2O2 application regulated the Abscisic acid (ABA) concentration under both conditions and reduced it by 30% in drought‐stressed plants as compared to non‐treated stressed plants. The exogenous application also enhanced the enzymatic antioxidants activities, including SOD, POD, CAT and APX by 32%, 31%, 34% and 53%, respectively, in quinoa plants under drought stress. We conclude that exogenous applied H2O2 improved quinoa performance under drought stress is associated with higher accumulation of osmolytes, regulating ABA level and enhanced enzymatic antioxidant activities.
Sintering forces acting among particles during sintering by grain‐boundary/surface diffusion
Authors: Wakai Fumihiro , Guillon Olivier , Okuma Gaku , Nishiyama Norimasa
Published: April 2018

The microstructural evolution during sintering involves the formation and pinch‐off of pore channels. The sintering of 3 particles in 3 dimensions is a simple model for studying the pinch‐off of a pore channel. We simulate the solid‐state sintering of 3 particles by using Brakke's Surface Evolver program, which incorporates coupled grain‐boundary diffusion and surface diffusion. The pinch‐off of pore channel divides the sintering process into 2 stages; the initial stage and the later stage. The contact area has a noncircular shape bounded by both surface triple junction and triple junction in the later stage. A general method is presented to determine the sintering force acting on the noncircular contact. The mechanical approach of densification, where the relative motion of particles is driven by both sintering force and applied force, is applicable not only for the initial stage, but also for the later stage.
Attitudes Towards and Knowledge About Lesbian, Gay, Bisexual, and Transgender Patients Among Italian Nurses: An Observational Study
Authors: Della Pelle Carlo , Cerratti Francesca , Di Giovanni Pamela , Cipollone Francesco , Cicolini Giancarlo
Published: April 2018

Purpose

To assess Italian nurses’ knowledge and attitudes towards gay and lesbian sexual orientation and lesbian, gay, bisexual, and transgender (LGBT) patients, as there is currently no literature exploring the attitudes of nurses in Italy.

Methods

A multicenter, cross‐sectional study was conducted between May 2015 to January 2016, using a data collection tool composed of three validated questionnaires and a sociodemographic form.

Findings

Eight hundred twenty‐four nurses filled out the questionnaire. Despite their awareness of homosexuality as a “natural expression of one's sexuality,” Italian nurses showed only moderately positive attitudes towards lesbian and gay patients. A more positive attitude was displayed by women when compared with men (p < .001). Greater knowledge of homosexuality was associated with female gender (p = .042), moderate‐wing political affiliation (p = .014), and more affirmative behaviors (p = .008). Men were found to have greater awareness of being prepared to care for LGBT people (p = .022).

Conclusions

Although Italian nurses displayed moderately positive attitudes and affirmative behaviors, there is the need to increase their cultural competencies regarding sexual minorities.

Clinical Relevance

LGBT patients feel some discomfort in approaching physicians or nurses. It is important to know nurses’ attitudes in caring for LGBT patients in order to modify inappropriate and discriminatory behaviors.
Physical properties of a novel small‐particle hyaluronic acid filler: In vitro, in vivo, and clinical studies
Authors: Cho Sung Yeon , Park June Whan , An Hyoseok , Ko Hyun Ju , Kim Hyuk , Choi Jin Kyu , Choi Sun Young , Kim Sung Min , Ko Eun Jung , Kim Beom Joon
Published: April 2018

Background

Infraorbital region is one of the most important regions that show the signs of aging. In recent years, hyaluronic acid (HA) fillers have been used to correct this region for esthetic treatments. Although HA fillers with various physical properties are used, limited research has been performed to compare their efficacy.

Objective

We aimed to compare three HA fillers to determine which is the most appropriate filler for the correction of the infraorbital region and evaluate the correction of such by performing a clinical test using CLEVIEL Fine.

Methods

We performed in vitro and in vivo tests using one new HA filler and two other commercial HA fillers. We compared the rheological properties, resistance to degradation, and in vivo duration test results of the three fillers. Nine patients participated in the clinical test using CLEVIEL Fine for 24 weeks.

Results

CLEVIEL Fine showed good rheological and physical characteristics for the infraorbital region. It had a low elasticity and cohesiveness, low incidence of postinjection swelling, high tanδ, narrow particle distribution, and small particle size. Further, it showed better resistance to the enzymes and radicals in the in vitro test than the other two HA fillers and a similar duration in the mouse test. In the clinical test, all patients showed good elasticity and hydration in the infraorbital region for 24 weeks.

Conclusions

CLEVIEL Fine was proven to be safe and effective based on the in vitro, in vivo, and clinical study results.
Helmet use in bicycles and non‐motorised wheeled recreational vehicles in children
Authors: Ong Jessica SY , Soundappan Sannappa V , Adams Sarah , Adams Susan
Published: April 2018

Aim

Injuries involving non‐motorised wheeled recreational vehicles (NMWRV) and bicycles are a common cause for hospitalisation in children. Studies show that helmet use whilst bicycle riding can decrease mortality and morbidity due to head injury. However, there remains an important proportion of children who are non‐helmet users (NHU). This study aims to investigate helmet use and attitudes and injury patterns in children presenting with trauma after riding bicycles and other NMWRVs.

Methods

A prospective cohort study was undertaken over 8 months of children aged 0–16 years, who presented with injury secondary to bicycle or NMWRV to the emergency department of two tertiary paediatric centres. Demographics, incident, injury severity and attitudes towards helmet use were compared between helmet users and NHU.

Results

A total of 342 children were included – 41% (n = 139) scooter riders, 39% (n = 133) bicyclists, 18% (n = 61) skateboarders and 2% (n = 9) in‐line skaters. Of those interviewed (n = 161), 58% (n = 93) wore a helmet, with children riding bicycles significantly more likely to be helmeted than NMWRV (75 vs. 48%, P = 0.01). NHU were more likely to be admitted to hospital (P = 0.05) and to sustain a major head injury (P = 0.009). The main influence on helmet use was parental rules. The biggest factor influencing non‐helmet use was perceived low levels of danger.

Conclusions

Despite legislation mandating this, helmet use is not universal in cyclists, particularly younger riders. Even fewer NMWRV riders use them. To promote helmet use, a multifaceted approach aimed at altering community norms and individual behaviours and attitudes is required.
Simple menus of cost‐based contracts with monotone optimal effort
Authors: An Yonghong , Zhang Daiqiang
Published: April 2018

This paper extends the fixed‐price cost‐reimbursement (FPCR) menu by allowing the agent's cost‐reducing optimal effort to be monotone in the agent's cost type. We show that the performance of the optimal FPCR menu relies crucially on the monotonicity of optimal effort. In particular, in an optimal FPCR menu, if the optimal effort is increasing in type and only a portion of cost types are induced to exert effort, the performance of the optimal FPCR menu can be very poor relative to the fully optimal contract. Our results suggest that in designing an optimal FPCR menu it is important for the principal to take into account the cost structure or, more exactly, the monotonicity of optimal effort in type.
The anti‐inflammatory effect of 10‐oxo‐trans‐11‐octadecenoic acid (KetoC) on RAW 264.7 cells stimulated with Porphyromonas gingivalis lipopolysaccharide
Authors: Sulijaya B. , Takahashi N. , Yamada M. , Yokoji M. , Sato K. , Aoki‐Nonaka Y. , Nakajima T. , Kishino S. , Ogawa J. , Yamazaki K.
Published: April 2018

Background

There is rapidly developing interest into the role of several anti‐inflammatory agents to resolve inflammation in periodontal disease. A bioactive polyunsaturated fatty acid, 10‐oxo‐trans‐11‐octadecenoic acid (KetoC), is known to have various beneficial physiological effects; however, the effect of KetoC on inflammation remains unclear. Here, we investigated the effect of KetoC on RAW 264.7 cells stimulated with Porphyromonas gingivalis lipopolysaccharide, and explored the intracellular mechanism responsible for its anti‐inflammatory effects.

Methods

RAW 264.7 cells were pre‐treated with or without KetoC, and then stimulated with or without P. gingivalis lipopolysaccharide. Levels of tumor necrosis factor α (TNFα), interleukin (IL)‐6 and IL‐1β were determined by real‐time polymerase chain reaction and enzyme‐linked immunosorbent assay. Specific antagonists for G protein‐coupled receptor (GPR)40 and GPR120 were used to clarify the receptor for KetoC. The intracellular mechanism was investigated using western blotting analysis to separate nuclear and cytosolic NF‐κB p65 protein.

Result

KetoC (5 μmol/L) was not toxic to RAW 264.7 cells, and significantly reduced the expression of TNFα and IL‐6 mRNA and protein, and IL‐1β mRNA. No protein production of IL‐1β was observed. Additionally, when bound to GPR120, KetoC trended to downregulate nuclear NF‐κB p65 protein levels. However, the antagonist for GPR40 failed to diminish the action of KetoC.

Conclusion

KetoC suppressed the proinflammatory cytokines TNFα, IL‐6 and IL‐1β via NF‐κB p65, by binding to its receptor GPR120. KetoC is a promising candidate in future studies as a bioactive anti‐inflammatory agent in treating periodontal disease.
Power versus Ideology: Political Group Switching in the European Parliament
Authors: Hix Simon , Noury Abdul
Published: April 2018

Why do legislators switch party? We seek to identify whether “party switching” is mainly determined by power (to join a more influential party) or ideology (to join a party with closer policy goals). We focus on the 557 cases of political group switching in the European Parliament between 1979 and 2014. We find that most of these cases were from smaller, more marginal, and oppositional groups, to larger, more pivotal, and governing groups. Nevertheless, we also find that ideological congruence (between an MEP and his or her prospective group) was an important determinant of political group switching.
The diagnosis and treatment of invasive aspergillosis in Dutch haematology units facing a rapidly increasing prevalence of azole‐resistance. A nationwide survey and rationale for the DB‐MSG 002 study protocol
Authors: Schauwvlieghe Alexander F. A. D. , de Jonge Nick , van Dijk Karin , Verweij Paul E. , Brüggemann Roger J. , Biemond Bart J. , Bart Aldert , von dem Borne Peter A. , Verbon Annelies , van der Beek Martha T. , Demandt Astrid M. P. , Oudhuis Guy J. , Cornelissen Jan J. , van der Velden Walter J. F. M. , Span Lambert F. R. , Kampinga Greetje A. , Bruns Anke H. , Vonk Alieke G. , Haas Pieter–Jan A. , Doorduijn Jeanette K. , Rijnders Bart J. A.
Published: April 2018

Patients with haematological malignancies are at risk for invasive fungal diseases (IFD). A survey was conducted in all Dutch academic haematology centres on their current diagnostic, prophylactic and therapeutic approach towards IFD in the context of azole‐resistance. In all 8 centres, a haematologist and microbiologist filled in the questionnaire that focused on different subgroups of haematology patients. Fungal prophylaxis during neutropaenia was directed against Candida and consisted of fluconazole and/or amphotericin B suspension. Mould‐active prophylaxis was given to acute myeloid leukaemia patients during chemotherapy in 2 of 8 centres. All centres used azole prophylaxis in a subset of patients with graft‐versus‐host disease. A uniform approach towards the diagnosis and treatment of IFD and in particular azole‐resistant Aspergillus fumigatus was lacking. In 2017, all centres agreed to implement a uniform diagnostic and treatment algorithm regarding invasive aspergillosis with a central role for comprehensive diagnostics and PCR‐based detection of azole‐resistance. This study (DB‐MSG 002) will re‐evaluate this algorithm when 280 patients have been treated. A heterogeneous approach towards antifungal prophylaxis, diagnosis and treatment was apparent in the Netherlands. Facing triazole‐resistance, consensus was reached on the implementation of a uniform diagnostic approach in all 8 centres.
Does a glucose‐based hydrogen and methane breath test detect bacterial overgrowth in the jejunum?
Authors: Sundin O. H. , Mendoza‐Ladd A. , Morales E. , Fagan B. M. , Zeng M. , Diaz‐Arévalo D. , Ordoñez J. , McCallum R. W.
Published: April 2018

Background

Direct diagnosis of small intestinal bacterial overgrowth (SIBO) requires the collection and culture of fluid from the jejunal lumen, with a finding of over 105 viable bacteria per mL. More often, SIBO is diagnosed indirectly, using a non‐invasive test of the exhaled hydrogen and methane generated by microbial fermentation when ingested glucose reaches the jejunum. Our objective was to determine how well this breath test detects chronic overgrowth of jejunal bacteria that is unrelated to gastrointestinal surgery.

Methods

Eighteen patients reporting symptoms consistent with SIBO received a glucose breath test. On a later day, the jejunal lumen was sampled via aspiration during enteroscopy. Jejunal aspirates were cultured on aerobic and anaerobic media. DNA was extracted from the same samples and analyzed by quantitative pan‐bacterial PCR amplification of 16S ribosomal rRNA genes, which provided a culture‐independent bacterial cell count.

Key Results

Combined bacterial colony counts ranged from 5.7 x 103 to 7.9 x 106 CFU/mL. DNA‐based yields ranged from 1.5 x 105 to 3.1 x 107 bacterial genomes per mL. Microbial viability ranged from 0.3% to near 100%. We found no significant correlation of glucose breath test results with either the number of bacterial colonies or with the DNA‐based bacterial cell counts. Instead, higher signals in the hydrogen‐methane breath test were significantly correlated with a lower viability of jejunal bacteria, at a P‐value of .014.

Conclusions & Inferences

The glucose‐based hydrogen and methane breath test is not sensitive to the overgrowth of jejunal bacteria. However, a positive breath test may indicate altered jejunal function and microbial dysbiosis.