bluuebunny/crossref_metadata_2025 huggingface dataset:
Initial electrocardiogram as determinant of hospital course in ST elevation myocardial infarction
Authors: Millard Michael A. , Nagarajan Vijaiganesh , Kohan Luke C. , Schutt Robert C. , Keeley Ellen C.
Published: January 2017

Background

A proportion of patients with ST elevation myocardial infarction (STEMI) have an initial electrocardiogram (ECG) that is nondiagnostic and are definitively diagnosed on a subsequent ECG. Our aim was to assess whether patients with a nondiagnostic initial ECG are different than those with a diagnostic initial ECG.

Methods

We collected demographic, ECG, medication, angiographic, and in‐hospital clinical outcome data in consecutive patients undergoing primary percutaneous coronary intervention for STEMI at our institution from June 2009 to June 2013.

Results

A total of 334 patients were included, 285 (85%) diagnosed on the initial ECG and 49 (15%) on a subsequent ECG. Patients with a nondiagnostic initial ECG had more comorbidities including prior congestive heart failure (14% vs. 3%, p < .001), coronary artery disease (47% vs. 24%, p = .001), diabetes (37% vs. 16%, p = .001), and hyperlipidemia (55% vs. 40%, p = .048); higher rates of chronic medication use including aspirin (47% vs. 27%, p = .005), beta‐blocker (47% vs. 22%, p < .001), and statins (53% vs. 28%, p = .001); longer door‐to‐balloon times (106 min vs. 45 min, p < .001); lower peak troponin levels (25 ng/ml vs. 50 ng/ml, p = .004), longer diagnostic ECG to balloon times (84 min vs. 75 min, p = .006); and higher rates of a patent infarct‐related artery on baseline angiography (41% vs. 24%, p = .018) which remained significant in a multivariable logistic regression model.

Conclusions

Approximately one in seven STEMI patients had an initial ECG that was nondiagnostic for STEMI. These patients had more comorbidities, higher rates of medication use, and received delayed intervention (even after the diagnosis was definitive).
Donor CYP3A5 genotype influences tacrolimus disposition on the first day after paediatric liver transplantation
Authors: Calvo Pier Luigi , Serpe Loredana , Brunati Andrea , Nonnato Antonello , Bongioanni Daniela , Olio Dominic Dell' , Pinon Michele , Ferretti Carlo , Tandoi Francesco , Carbonaro Giulia , Salizzoni Mauro , Amoroso Antonio , Romagnoli Renato , Canaparo Roberto
Published: January 2017

Aim

The aim of the present study was to investigate the influence of the cytochrome P450 (CYP) 3A4/5 genotype in paediatric liver transplant recipients and donors, and the contribution of age and gender to tacrolimus disposition on the first day after transplantation.

Methods

The contribution of the CYP3A4/5 genotype in paediatric liver transplant recipients and donors to the tacrolimus blood trough concentrations (C0) and the tacrolimus concentration/weight‐adjusted dose ratio on day 1 was evaluated in 67 liver‐transplanted children: 33 boys and 34 girls, mean age 4.5 years.

Results

Donor CYP3A5 genotype appears to be significantly associated with tacrolimus disposition on the first day after liver transplantation (P < 0.0002). Other physiological factors, such as recipient age and donor gender may also play a role and lead to significant differences in tacrolimus C0 and tacrolimus concentration/weight‐adjusted dose ratio on day 1. However, according to the general linear model, only recipient age appears to be independently associated with tacrolimus disposition on the first day after liver transplantation (P < 0.03). Indeed, there was a faster tacrolimus metabolism in children under 6 years of age (P < 0.02).

Conclusions

Donor CYP3A5 genotype, recipient age and, to a lesser extent, donor gender appear to be associated with tacrolimus disposition on day 1 after transplant. This suggests that increasing the starting tacrolimus doses in paediatric patients under 6 years of age who receive a graft from a male extensive metabolizer may enhance the possibility of their tacrolimus levels reaching the therapeutic range sooner.
The Role of Organizational Vision in Guiding Idea Generation within SME Contexts
Authors: Perkins Graham , Lean Jonathan , Newbery Robert
Published: January 2017

New ideas are required if our organizations are going to survive and grow. Without the ability to think differently, firms can quickly stagnate and decline. A key contributor to the success (or otherwise) of the ideation process is the extent to which organizations provide effective control mechanisms, with existing literature drawing tentative links between this and the subject of organizational vision. The aim of this paper is to explore the control of idea generation in SME contexts, examining the interaction between organizational vision and the guidance of ideation in these settings. Through in‐depth qualitative research with a range of SMEs, this study shows that structure in the form of an outlining framework assists in opening a liminal space for ideation. More importantly, this paper provides empirical evidence, which demonstrates that organizational visions provide this framework by acting as a target, assisting the development of relevant ideas. Ideation, within the SME, is argued to be fundamentally subject to, and contingent upon, the direction of the organization.
Programmed death-1 ligands 1 and 2 expression in cutaneous squamous cell carcinoma and their relationship with tumour- infiltrating dendritic cells
Authors: Jiao Q , Liu C , Li W , Li W , Fang F , Qian Q , Zhang X
Published: January 2017

The programmed death-1 (PD-1) receptor ligands, PD-L1 and PD-L2, are co-stimulatory molecules that contribute to the negative regulation of T lymphocyte activation. It is still unclear whether there is correlation between PD-L1 or PD-L2 and tumour-infiltrating dendritic cells (TIDCs) in cutaneous squamous cell carcinoma (CSCC). The aim of this study was to analyse PD-L1 and PD-L2 expression and dendritic cells infiltration in tumour tissue of CSCC patients and investigate their clinical significance. Immunohistochemical analysis was used to evaluate the expression of PD-L1, PD-L2, CD1a and CD83 in 61 CSCC tissues. The immunofluoresence double-labelling technique was performed to detect the co-expression of PD-L1 or PD-L2 and CD1a or CD83 in tumour tissues. We found that 25 of 61 cases CSCC (40·98%) exhibited positivity for PD-L1, whereas 37 of 61 cases CSCC (60·66%) exhibited positivity for PD-L2. A higher percentage of CD1a-positive cases were observed on both PD-L1-positive and PD-L2-positive specimens compared with that of CD83-positive cases (92·29% versus 37·60%, 83·20% versus 33·16%). The expression of PD-L1 and PD-L2 on CD1a+ cells was significantly higher than that on CD83+ cells in tumour tissues of CSCC patients. Furthermore, the expression rate of PD-L1 was associated with UICC stage, and the expression rate of PD-L2 was associated with predominant differentiation and tumour size in CSCC. Our results indicated that higher expression of PD-L1 and PD-L2 on CD1a+ cells than that on CD83+ cells in CSCC tumour tissues may contribute to negative regulation in anti-tumour immune responses.
Properdin deficiency protects from 5-fluorouracil-induced small intestinal mucositis in a complement activation-independent, interleukin-10-dependent mechanism
Authors: Jain U , Midgen C A , Woodruff T M , Schwaeble W J , Stover C M , Stadnyk A W
Published: January 2017

Intestinal mucositis is a serious complication of chemotherapy that leads to significant morbidity that may require dose or drug adjustments. Specific mitigating strategies for mucositis are unavailable, due partly to an incomplete understanding of the pathogenic mechanisms. We have previously shown an effect of properdin, a positive regulator of complement activation, in models of colitis. Here we use properdin-deficient (PKO) mice to interrogate the role of properdin and complement in small intestinal mucositis. Mucositis was induced by five daily injections of 5-fluorouracil (5-FU) in wild-type (WT), PKO, interleukin (IL)-10–/– and properdin/IL-10–/– double knock-out (DKO) mice. At the time of euthanasia their jejunum was collected for histology, immunohistochemistry and cytokine and complement activation measurements. Complement became activated in mice receiving 5-FU, indicated by increased intestinal levels of C3a and C5a. Compared to WT, PKO mice experienced significantly less mucositis, despite C3a levels as high as inflamed WT mice and slightly less C5a. Conversely, PKO mice had higher intestinal levels of IL-10. IL-10 expression was mainly by epithelial cells in both uninflamed and inflamed PKO mice. IL-10–/– mice proved to be highly susceptible to mucositis and DKO mice were equally susceptible, demonstrating that a lack of properdin does not protect mice lacking IL-10. We interpret our findings to indicate that, to a significant extent, the inflammation of mucositis is properdin-dependent but complement activation-independent. Additionally, the benefit achieved in the absence of properdin is associated with increased IL-10 levels, and IL-10 is important in limiting mucositis.
When everyday life is double looped. Exploring children's (and parents’) perspectives on post‐divorce family life with two households
Authors: Marschall Anja
Published: January 2017

This article explores children's perspectives on post‐divorce family life with time‐sharing arrangements, focusing on the children's experiences of dilemmas and constraints, but also on new possibilities. In many ways, the everyday lives of children who commute between two households are double looped. These children have to be attentive to the routines, expectations and demands of each household. By assessing their conduct of everyday life, this article elucidates what children do to adapt to and make sense of this double‐looped situation. This article examines how differences between households affect children's ways of understanding themselves and their family lives.
Ocular Nerve Growth Factor Administration Modulates Brain‐derived Neurotrophic Factor Signaling in Prefrontal Cortex of Healthy and Diabetic Rats
Authors: Rosso Pamela , De Nicolò Sara , Carito Valentina , Fiore Marco , Iannitelli Angela , Moreno Sandra , Tirassa Paola
Published: January 2017

Aims

Nerve growth factor (NGF) eyedrops (ed‐NGF) activate brain neurons, stimulate growth factors, including brain‐derived neurotrophic factor (BDNF), and exert neuroprotection in the forebrain of streptozotocin‐induced diabetic rats (STZ rats). In this study, the effects of ed‐NGF on BDNF signaling in the prefrontal cortex (PFC) were explored in healthy and STZ‐diabetic rats, in which cortical neuronal and axonal loss, and altered circulating BDNF associated with depressive phenotype are also described.

Methods

STZ and healthy (CTR) adult rats received ed‐NGF twice a day for 2 weeks. Depressive phenotype was identified by force swimming test (FST). Proteins extracted from PFC were processed for ELISA and Western blot analyses to measure the expression of BDNF, proBDNF, and their receptors and intracellular signals.

Results

ed‐NGF treatment modulates BDNF pathway in PFC and normalizes the STZ‐induced BDNF alterations by stimulating TRK‐mediated survival mechanism. A decreased latency in FST was also found in STZ rats, while no change was observed comparing CTR + NGF and STZ + NGF with CTR.

Conclusion

The present data confirm the capacity of ed‐NGF treatment to affect brain neurons and lead to brain damage recovery by activating protective and remodeling pathways triggered by BDNF. We suggest that the ed‐NGF‐induced changes in BDNF signaling might influence the manifestation of depressive phenotype in diabetic rats.
Abnormal Resting‐State Neural Activity and Connectivity of Fatigue in Parkinson's Disease
Authors: Zhang Jie‐Jin , Ding Jian , Li Jun‐Yi , Wang Min , Yuan Yong‐Sheng , Zhang Li , Jiang Si‐Ming , Wang Xi‐Xi , Zhu Lin , Zhang Ke‐Zhong
Published: January 2017

Aims

Fatigue is a common burdensome problem in patients with Parkinson's disease (PD), but its pathophysiological mechanisms are poorly understood. This study aimed at investigating the neural substrates of fatigue in patients with PD.

Methods

A total of 17 PD patients with fatigue, 32 PD patients without fatigue, and 25 matched healthy controls were recruited. The 9‐item fatigue severity scale (FSS) was used for fatigue screening and severity rating. Resting‐state functional magnetic resonance imaging (RS‐fMRI) data were obtained from all subjects. Amplitude of low‐frequency fluctuations (ALFF) was used to measure regional brain activity, and functional connectivity (FC) was applied to investigate functional connectivity at a network level.

Results

PD‐related fatigue was associated with ALFF changes in right middle frontal gyrus within the attention network and in left insula as well as right midcingulate cortex within the salience network. FC analysis revealed that above three regions showing ALFF differences had altered functional connectivity mainly in the temporal, parietal, and motor cortices.

Conclusion

Our findings do reveal that abnormal regional brain activity within attention and salience network and altered FC of above abnormal regions are involved in neural mechanism of fatigue in patients with PD.
Do Voluntary Clawback Adoptions Curb Overinvestment?
Authors: Lin Yu‐Chun
Published: January 2017

Manuscript Type

Empirical

Research Question/Issue

This study tests whether the adoption of clawback provisions mitigates overinvestment. A clawback provision is a recoupment policy that allows certain bonuses previously paid to executives to be cancelled or “clawed back” if financial statements are restated.

Research Findings/Insights

This study focuses on 1,093 voluntary clawback adopters in the United States during 2006–2012 and uses propensity score matching to obtain a matched sample. We then perform a difference‐in‐differences analysis to assess pre‐ and post‐adoption changes in overinvestment. The empirical results show that (i) clawback provisions mitigate overinvestment, and (ii) overinvestment decreases most for those executives identified as overconfident or receiving higher option compensation.

Theoretical/Academic Implications

Agency conflict between shareholders and executives distorts a firm's investment decisions. According to the agency‐based explanation, better financial reporting quality decreases information asymmetry. Clawback provisions improve financial reporting and mitigate potential overinvestment under agency conflict. To the best of our knowledge, no other published study has discussed executives’ investment behavior or has reported that one benefit of clawback provisions is mitigating ex post overinvestment. It is important for regulators and academics to understand how clawback provisions impact executives’ behavior.

Practitioner/Policy Implications

The results of this study provide political implications for mandatory clawback provisions under Section 954 of the Dodd‐Frank Act after 2016 in the US. Given that we show that voluntarily adopting clawback provisions curbs overinvestment, it is important to examine whether this new act should place restrictions on the form of executive pay.
Thrips counts and disease incidence in response to reflective particle films and conservation tillage in cotton and peanut cropping systems
Authors: Knight Ian A. , Rains Glen C. , Culbreath Albert K. , Toews Michael D.
Published: January 2017

Feeding damage to seedling cotton and peanut inflicted by adult and immature thrips may result in stunted growth and delayed maturity. Furthermore, adult thrips can transmit Tomato spotted wilt virus (TSWV) to seedling peanut, which reduces plant growth and yield. The objective of this research was to assess the efficacy of inert particle films, calcium carbonate or kaolin, in combination with conservation tillage, to reduce adult and immature thrips counts in cotton and peanut crops. Planting cotton or peanut into strip tillage utilizing a rolled rye winter cover crop significantly reduced immature thrips counts. Furthermore, plant damage ratings in cotton as well as TSWV incidence in peanut significantly decreased under conservation tillage. Aboveground cotton biomass and plant stand in cotton and peanut were unaffected by calcium carbonate or kaolin particle film applications. Within each week, immature thrips counts were unaffected by particle films, regardless of application rate. In cotton plots treated with kaolin, total Frankliniella fusca (Hinds) (Thysanoptera: Thripidae) counts summed across weeks were significantly greater compared to the untreated control. For adult F. fusca counts at 3 weeks after planting, an interaction between tillage and particle film treatments was observed with fewer adult thrips in particle film and strip tillage treated peanut. Similarly, reduced TSWV incidence was observed in particle film‐treated peanut grown using conservation tillage. Neither cotton nor peanut yields were affected by particle film treatments.
Oral health improvements in Switzerland over 20 years
Authors: Schneider Cornelia , Zemp Elisabeth , Zitzmann Nicola U.
Published: January 2017

While the time trends in oral health are favourable, differences still persist in dental status and in prosthetic dental restorations (PDR) between population subgroups. This study aimed to identify changes in oral health in Switzerland over two decades and to describe their relationship to sociodemographic factors in 2012. Swiss Health Surveys were conducted in 1992, 2002, and 2012. The mean number of missing teeth and the prevalence of PDR were calculated at each time point. Logistic regression analysis was performed to assess associations between the prevalence of PDR and sociodemographic factors. The mean number of missing teeth decreased from five in 1992 to three in 2012. Dental status – as indicated by the number of teeth present – improved across all sociodemographic groups, with the greatest improvements being found in obese participants and in participants with the lowest incomes and educational levels. The prevalence of implant‐based restorations increased from 3.2% in 2002 to 9.8% in 2012, and the shift from fixed to removable restorations occurred in the age group being 10 years older. The overall prevalence of PDR decreased in middle‐aged people. In conclusion, over the two decades of the study, the oral health of the Swiss population substantially improved. Although sociodemographic differences persisted, they decreased considerably in terms of the number of missing teeth and percentage of the population with a functional dentition.
Regional climate on the breeding grounds predicts variation in the natal origin of monarch butterflies overwintering in Mexico over 38 years
Authors: Flockhart D. T. Tyler , Brower Lincoln P. , Ramirez M. Isabel , Hobson Keith A. , Wassenaar Leonard I. , Altizer Sonia , Norris D. Ryan
Published: January 2017

Addressing population declines of migratory insects requires linking populations across different portions of the annual cycle and understanding the effects of variation in weather and climate on productivity, recruitment, and patterns of long‐distance movement. We used stable H and C isotopes and geospatial modeling to estimate the natal origin of monarch butterflies (Danaus plexippus) in eastern North America using over 1000 monarchs collected over almost four decades at Mexican overwintering colonies. Multinomial regression was used to ascertain which climate‐related factors best‐predicted temporal variation in natal origin across six breeding regions. The region producing the largest proportion of overwintering monarchs was the US Midwest (mean annual proportion = 0.38; 95% CI: 0.36–0.41) followed by the north‐central (0.17; 0.14–0.18), northeast (0.15; 0.11–0.16), northwest (0.12; 0.12–0.16), southwest (0.11; 0.08–0.12), and southeast (0.08; 0.07–0.11) regions. There was no evidence of directional shifts in the relative contributions of different natal regions over time, which suggests these regions are comprising the same relative proportion of the overwintering population in recent years as in the mid‐1970s. Instead, interannual variation in the proportion of monarchs from each region covaried with climate, as measured by the Southern Oscillation Index and regional‐specific daily maximum temperature and precipitation, which together likely dictate larval development rates and food plant condition. Our results provide the first robust long‐term analysis of predictors of the natal origins of monarchs overwintering in Mexico. Conservation efforts on the breeding grounds focused on the Midwest region will likely have the greatest benefit to eastern North American migratory monarchs, but the population will likely remain sensitive to regional and stochastic weather patterns.
Prediction of Remediation of a Heterogeneous Aquifer: A Case Study
Authors: Moreno Ziv , Paster Amir
Published: January 2017

Contaminant plumes whose characteristic length is smaller than the horizontal integral scale of the hydraulic conductivity, K, are abundant in shallow, phreatic aquifers. In such cases, the aquifer can be regarded as layered, with K being only a function of the vertical coordinate. The heterogeneity of K has a critical role upon the efficiency of remediation of such sites, for example, by Pump and Treat schemes. The expected efficiency is a random variable, with uncertainty. Quantifying this uncertainty can be of great importance to decision making. In this study, we focus on a case study in the coastal aquifer of Israel and compare two different approaches for constructing realizations of K: continuous and indicator. We observe a significant difference between the constructed realizations, which results in a considerable difference in the predicted remediation efficiency and its uncertainty. Furthermore, we study the effect of conditioning the realizations by a rather limited number of K data points. We find that the conditioning results in a major reduction of the uncertainty. In addition, we compare the results of the transport model to a simplified semi‐analytical solution that is based on assuming radial flow. We find a good agreement with the three‐dimensional numerical model. This result illustrates that the simplified solution can be used for prediction of the remediation efficiency when the flow at the plume vicinity can be regarded as radial.
Time‐extended local rtPA infiltration for acutely thrombosed hemodialysis fistulas
Authors: Regus Susanne , Lang Werner , Heinz Marco , Rother Ulrich , Meyer Alexander , Almási‐Sperling Veronika , Uder Michael , Schmid Axel
Published: January 2017

Introduction: This study describes results of a modified local thrombolysis technique for acutely thrombosed hemodialysis (HD) arteriovenous fistulas (AVF), which is characterized by prolonged recombinant tissue plasminogen activator (rtPA) local exposure times. Contrary to the standard lyse‐ and‐ wait (L&W) technique with local reaction times of 20–40 minutes, the modified protocol allows timing of challenging angioplasty maneuvers to the next regular working day.

Methods: From February 2009 to April 2014, 84 patients on HD presented with 152 acutely thrombosed AVF. They proceeded to local thrombolysis including a single shot infiltration of rtPA, local reaction time up to 40 hours and finally percutaneous stenosis angioplasty. Success rates, major adverse events and need for temporary catheter placements (TCP) were retrospectively analyzed.

Findings: The local thrombolysis time after single shot infiltration was 18.6 ± 6.2 (range 2–40) hours. Mean rtPA‐ dosage was 2.7 mg ± 1.2. The overall success rate was 89.5% and the major complication rate was 3.3%, whereas TCP was necessary in 12.5%. The PP/SP at 1, 3, 6, 12, 18, and 24 month were 86% ± 3%/95% ± 2%, 68% ± 4%/92% ± 2%, 43% ± 4%/90% ± 2%, 28% ± 4%/82% ± 3%, 12% ± 3%/82% ± 3%, 7% ± 2%/63% ± 4%, respectively.

Conclusion: The modified L&W technique with prolonged local rtPA reaction times is a safe and effective declotting procedure. The need for TCP was not increased and therefore comparable to the standard technique.
Comparison between real‐time tissue elastography and vibration‐controlled transient elastography for the assessment of liver fibrosis and disease progression in patients with primary biliary cholangitis
Authors: Koizumi Yohei , Hirooka Masashi , Abe Masanori , Tokumoto Yoshio , Yoshida Osamu , Watanabe Takao , Nakamura Yoshiko , Imai Yusuke , Yukimoto Atsushi , Kumagi Teru , Takeshita Eiji , Ikeda Yoshiou , Hiasa Yoichi
Published: January 2017

Aim

Assessing disease progression in patients with primary biliary cholangitis (PBC) is necessary in order to evaluate therapeutic effectiveness. Therefore, the aims of this study were to evaluate both the diagnostic accuracy of both real‐time tissue elastography (RTE) and vibration‐controlled transient elastography (VCTE), and the usefulness of hepatic and splenic elasticity as predictive markers for the progression of symptomatic PBC.

Methods

The study participants were 44 patients with PBC. We assessed hepatic and splenic elasticity using RTE and VCTE and measured serum markers related to fibrosis and hepatic and splenic blood flow using Doppler ultrasonography. We then compared RTE and VCTE for diagnostic accuracy. Patients with asymptomatic PBC were followed every 1–3 months.

Results

Both RTE and VCTE performed well and had superior diagnostic accuracy compared with biochemical markers. The areas under the receiver operating characteristic curve for RTE and VCTE were 0.92 and 0.92, 0.95 and 0.91, and 0.97 and 0.91 for F ≥ 2, F ≥ 3, and F = 4, respectively. During follow‐up, nine patients (25.0%) developed liver‐related symptoms. Multivariate analysis revealed that splenic elasticity assessed using RTE was a significant independent factor for the development of liver‐related symptoms (odds ratio, 2.19; P = 0.024).

Conclusions

Real‐time tissue elastography offered better diagnostic accuracy for severe fibrosis and cholangitis than VCTE. Splenic elasticity determined using RTE is a useful parameter for evaluating liver‐related symptoms and an effective predictive marker of disease progression in patients with asymptomatic PBC.
Market strategy for promoting green consumption: Consumer preference and policy implications for laundry detergent
Authors: Jo Manseok , Shin Jungwoo
Published: January 2017

Green consumption is a very common phrase in our daily lives, yet product characteristics that mainly contribute to the diffusion of green products are largely unknown. Based on microeconomic theory, we conduct a conjoint survey of consumer preferences for a ubiquitous green product—laundry detergent. We analyze the correlation between consumers' demographic variables and attributes of laundry detergents through a hierarchical Bayesian mixed logit model. We find that consumer preferences for attributes display significant heterogeneity. Age and income significantly influence the marginal preferences for attributes. An examination of consumer willingness to pay and of the relative importance of each attribute reveals that price and base material are the most important attributes. Green attributes, such as skin irritation potential and biodegradability, tend to be less important. This study also examines preference heterogeneity based on previous purchase experience. To promote green consumption, we emphasize the need for policies that reduce the value‐action gap.
Modulation of alloimmune response by commensal gut microbiota and potential new avenues to influence the outcome of allogeneic transplantation by modification of the ‘gut culture’
Authors: Kanangat S.
Published: January 2017

Host defence response against microbial infections was the foundation for the Science of Immunology. Now, we know the mechanisms of such host defence which include innate immune responses that is generally nonspecific but effective in many cases and lead to more specific responses called adaptive immune response. The gene loci of class I, II and III of the major histocompatibility complex (MHC) play a major role in directing the adaptive immune responses by presenting processed antigens to T and B cells to induce appropriate antigen‐specific cellular and or humoral immune responses. In humans, these are commonly referred to as human leucocyte antigens class I/II‐HLA I/II). The class III region, the gamma region in the MHC complex, is mostly associated with regulation of immune responses along with genes associated with complement activation. The adaptive immune responses are orchestrated by T and B cells that are tuned to respond to antigens that are normally foreign to the body, because these cells are educated to avoid self‐antigens by a process of thymic education and selection of the T cells that are mostly non‐self‐reactive which also helps the B cells in eliciting specific immune responses to non‐self‐antigens. A by‐product of this is the ability of the T and B cells to elicit strong immune responses to foreign HLA/MHC (alloimmune response), which developed into the field of histocompatibility testing for allogeneic transplantation of stem cells and organs. Now, we are beginning to learn that such alloimmune responses can be influenced by the microbiota that symbiotically live in our body especially on the mucosal surfaces and on the skin. This review deals with new and emerging data on how the commensal mucosal and skin microbiota influence the immune homeostasis, and how manipulating the commensal microbiota of the mucosa and skin could influence the survival and long‐term functions of the allografts. Also, alterations of the microbiota by the inevitable immunosuppression prior to and following allogeneic transplantation could contribute towards the outcome of the allografts by alloimmune responses generated due to microbial antigen vs HLA cross‐reactivity.
Identification and characterization a novel HLA‐A allele, A*02:355, by sequence‐based typing in a Chinese potential donor
Authors: Nie X‐M. , Zhang Y. , Qiao W‐B. , Zhu C‐F. , Zhao Y‐R.
Published: January 2017

The new allele A*02:355 differs from A* 02:03:01 at positions 98 (T→A) and 102(A→C) resulting in an amino acid exchange F9→T. Interallelic sequence exchange is more likely the mechanism of its origination. The amino acid replacement influences the HLA peptide binding cleft and might have significant functional effects.
Managerial competence of first‐line nurse managers: A concept analysis
Authors: Gunawan Joko , Aungsuroch Yupin
Published: January 2017

A variety of terms are used interchangeably to define managerial competence of first‐line nurse managers. This has resulted in a degree of ambiguity in the way managerial competence is described. The aim of this concept analysis is to clarify what is meant by managerial competence of first‐line nurse managers internationally, what attributes signify it, and what its antecedents and consequences are. The Walker and Avant concept analysis approach was applied. The attributes of managerial competence include developing self, planning, organizing, leading, managing legal and ethical issues, and delivering health care. Antecedents to managerial competence include internal and external factors. Consequences include nurse performances, nurse and patient outcomes, intention to stay of nurses, and nurse and patient satisfaction. This analysis helps first‐line nurse managers to understand the concept and determine where the responsibility lies in establishing a definition of managerial competence. It is recommended that middle and top managers should be aware of the internal and external factors as antecedents of the concept. Further research is needed to illuminate the attributes of managerial competence in relation to antecedents and the potential effect upon the consequences, and the need to establish managerial competence evaluation.
Long‐term treatment outcomes in immature permanent teeth by revascularisation using MTA and GIC as canal‐sealing materials: a retrospective study
Authors: Peng Chufang , Yang Yuan , Zhao Yuming , Liu He , Xu Zheng , Zhao Dianhong , Qin Man
Published: January 2017

Background

Pulp revascularisation with MTA sealing has been accepted as an alternative treatment for non‐vital immature permanent teeth. Successful revascularisation cases with GIC sealing were also reported, but lack of long‐term researches.

Aim

To evaluate long‐term outcomes of revascularisation using MTA and GIC as canal‐sealing materials in non‐vital immature permanent teeth.

Design

Clinical and radiographic data of 60 non‐vital immature permanent teeth treated with revascularisation (36.8 ± 12.4 months of follow‐up) were reviewed. Of these, 28 teeth were sealed with MTA, and 32 with GIC. Tooth survival, success rate, and increases in root length and dentine wall thickness were evaluated.

Results

Teeth in MTA group showed a similar survival rate (96%) to GIC group (100%). The success rate in MTA group (93%) was greater than that in GIC group (59%). Eight of fourteen failed teeth due to recurrent apical disease (seven teeth in GIC group and one in MTA group) achieved complete root development. There was no statistically significant difference in root length or dentine wall thickness increase between the groups.

Conclusions

Long‐term outcome of revascularisation in non‐vital immature permanent teeth sealed with GIC was not as good as that with MTA. Although more recurrent apical disease developed, results on root development were acceptable in GIC sealed cases.
Public primary and secondary skin cancer prevention, perceptions and knowledge: an international cross‐sectional survey
Authors: Seité S. , del Marmol V. , Moyal D. , Friedman A.J.
Published: January 2017

Background

The incidence of melanoma and non‐melanoma skin cancer is continuing to increase worldwide, with sun exposure serving as the primary external aetiologic force in its development. Despite noticeable public health efforts, there continue to be gaps in public awareness and primary and secondary prevention mechanisms. This survey study sought to investigate preventative behaviours regarding sun exposure and skin cancer detection at an international scale.

Methods

A questionnaire was submitted, both online and by telephone, to a representative sample (based on official demographic statistics on gender, age and region) of people aged from 15 to 65 originating from 23 countries. Questions dealt with demographics, sun exposure and protection, risk knowledge, self‐examination, medical advice seeking. Data were then gathered and analysed at different levels.

Results

A total of 19 569 respondents were recruited. Overall, sunscreen and sunglasses were the most used measures for sun protection. There were however difference between countries and geographical areas. Some high‐risk countries in terms of sun exposure (according to their location to Equator) exhibited higher rates of primary preventative behaviours, in particular Australia, Chile and Greece. There were also discrepancies between countries regarding secondary prevention through self‐examination and medical advice seeking. Young people, men, individuals belonging to a lower socio‐economic class or having a lower education level were all least likely to know or follow primary and secondary preventive measures.

Conclusion

We found imperfections and geographical inequality both regarding primary and secondary prevention of skin cancer. Our study provides insights that could help to target populations more effectively through information campaigns embedded into the global needed endeavour aiming to reduce mid‐ and long‐term development of skin cancer.
The Two Hundred and Fifty Year Transition: How the American Empire Became Capitalist
Authors: Parisot James
Published: January 2017

This paper aims to rethink United States history from the colonial era through the Civil War and Reconstruction by examining how capitalism and empire joined together as the logic of expansion increasingly became driven by the logic of capital over approximately two hundred and fifty years. Specifically, it argues that (what became) the United States originated as a ‘society with capitalism’ and became a ‘capitalist society’. This transition was a highly complex and uneven process as a variety of social forms developed and interacted, and in which there was not one road to capitalism, but a variety, depending on the historical circumstance. To accomplish this, first, the article reviews the Marx‐Weber debate to develop a theoretical and methodological approach to the historical sociology of capitalism. The remainder of the paper focuses on narrating an empirical interpretation of the transition to capitalism including the diversity of labor forms capital historically utilized.
Relationship between motor proficiency and body composition in 6‐ to 10‐year‐old children
Authors: Marmeleira José , Veiga Guida , Cansado Hugo , Raimundo Armando
Published: January 2017

Aim

The aim of this study is to examine the relationship between motor skill competence and body composition of 6‐ to 10‐year‐old children.

Methods

Seventy girls and 86 boys participated. Body composition was measured by body mass index and skinfold thickness. Motor proficiency was evaluated through the Bruininks‐Oseretsky Test of Motor Proficiency‐Short Form, which included measures of gross motor skills and fine motor skills.

Results

Significant associations were found for both sexes between the percentage of body fat and (i) the performance in each gross motor task, (ii) the composite score for gross motor skills and (iii) the motor proficiency score. The percentage of body fat was not significantly associated with the majority of the fine motor skills items and with the respective composite score. Considering body weigh categories, children with normal weight had significantly higher scores than their peers with overweight or with obesity in gross motor skills and in overall motor proficiency.

Conclusions

Children's motor proficiency is negatively associated with body fat, and normal weight children show better motor competence than those who are overweight or obese. The negative impact of excessive body weight is stronger for gross motor skills that involve dynamic body movements than for stationary object control skills; fine motor skills appear to be relatively independent of the constraints imposed by excessive body weight.
Documenting family history in children with hypercholesterolaemia: A lost opportunity
Authors: Sorubarajan Tharmarajah , Lewis Barry D , Burnett John R , Martin Andrew C
Published: January 2017

Aim

To determine whether information about a family history of hypercholesterolaemia or early cardiovascular disease was documented by paediatricians in children and adolescents with elevated low‐density lipoprotein (LDL)‐cholesterol levels.

Methods

Retrospective chart review of all children with a LDL‐cholesterol level ≥95th percentile (3.4 mmol/L) and ≥99th percentile (3.8 mmol/L) at a tertiary paediatric hospital in 2014.

Results

Of 86 children with a LDL‐cholesterol level ≥3.4 mmol/L, only 18 (20.9%) had documentation of a family history of hypercholesterolaemia or early cardiovascular disease. In those 18, 13 (72.2%) had a family history of hypercholesterolaemia and 11 (61.1%) a family history of early cardiovascular disease. Increasing the LDL‐cholesterol cut‐off level to ≥3.8 mmol/L (n = 46) did not improve documentation of a family history (9/46, 19.6%).

Conclusions

In patients with elevated LDL‐cholesterol levels, paediatricians rarely document a positive or negative family history of hypercholesterolaemia or early cardiovascular disease. This represents a lost opportunity to diagnose children and adolescents with familial hypercholesterolaemia.
In-vitro cytotoxicity and combination effects of the docetaxel-conjugated and doxorubicin-conjugated poly(lactic acid)-poly(ethylene glycol)-folate-based polymeric micelles in human ovarian cancer cells
Authors: Hami Zahra , Rezayat Seyed Mahdi , Gilani Kambiz , Amini Mohsen , Ghazi-Khansari Mahmoud
Published: January 2017

Objectives

The pH-sensitive doxorubicin (DOX)-conjugated and docetaxel (DTX)-conjugated poly(lactic acid)-poly(ethylene glycol)-folate (PLA-PEG-FOL)-based polymeric micelles were developed and characterized in this study.

Key findings

The drugs were released from the micelles (particle size, ~185 nm) in a pH-dependent manner. The drug-conjugated PLA-PEG-FOL micelles showed higher cellular uptake than nontargeting ones. Single agent and combination in-vitro cytotoxicity studies were also performed using the two drugs in both free and their micellar forms in SKOV3 human ovarian cancer cells using three different cytotoxicity assays. Like the free drugs, DOX-conjugated and DTX-conjugated targeting micelles showed significant cytotoxic effects in SKOV3 cell line. Moreover, the drug-conjugated targeting micelles improved cytotoxicity compared to the FOL-free ones. Different ratios of IC50 of free drugs were used for combination therapy, and synergistic, additive or antagonistic effects were evaluated. The synergistic effect was observed in specific DOX : DTX mixing ratios, which result in the increase in therapeutic efficacy using low doses of each test compound without formulation related side effects.

Conclusions

The prepared micelles may provide appropriate delivery systems for doxorubicin and docetaxel in both single and combination therapies.
The Effect of increasing levels of date palm (Phoenix dactylifera L.) seed on the performance, ruminal fermentation, antioxidant status and milk fatty acid profile of Saanen dairy goats
Authors: Sharifi M. , Bashtani M. , Naserian A. A. , Farhangfar H.
Published: January 2017

This study was conducted to examine the effect of date palm (Phoenix dactylifera L.) seed (DPS) on the performance, ruminal fermentation, antioxidant status and milk fatty acid (FA) profile of dairy goats. Eight multiparous Saanen dairy goats, averaging 97 ± 7 days in milk (DIM) and 2150 ± 130 g of milk production, were used in a 4 × 4 replicated Latin square design. Experimental diets contained 0% (control), 6% (DPS6), 12% (DPS12) and 18% (DPS18) of DPS. Dry matter intake (DMI), milk production, and the composition and digestibility of the dry matter (DM), organic matter (OM), neutral detergent fibre (NDF) and crude protein (CP) were not affected by the diets. Adding DPS to the diet increased linearly total antioxidant capacity (TAC) in milk and blood (p < 0.05). No significant difference was found in the malondialdehyde (MDA) content in milk and blood. Superoxide dismutase (SOD) and glutathione peroxidase (GSH‐Px) activities in the blood, ruminal pH, NH3‐N, ruminal total volatile fatty acid (VFA), acetate, butyrate, isovalerate and valeric acid concentration had no significant effect among the diets. The propionate acid concentration decreased linearly as DPS was added to the diet, and DPS18 had minimum propionate acid concentration (p < 0.05). The inclusion of DPS18 to diets increased linearly the proportion of C18:0 (compared to control) as well as cis‐18:1, trans‐18:1 (compared to control and DPS6) and decreased C14:1 (compared to control) in milk fat (p < 0.05). The concentration of conjugated linoleic acid (CLA) in DPS18 was higher than other diets (p = 0.04). The results of this study implied that replacing DPS with a part of dairy goats’ ration had no negative effects on the performance of the animals and could also improve the antioxidant activity and increase the concentration of CLA in their milk.
Quality of Colonoscopy Performed in Rural Practice: Experience From the Clinical Outcomes Research Initiative and the Oregon Rural Practice‐Based Research Network
Authors: Holub Jennifer L. , Morris Cynthia , Fagnan Lyle J. , Logan Judith R. , Michaels LeAnn C. , Lieberman David A.
Published: January 2017

Purpose

Colon cancer screening is effective. To complete screening in 80% of individuals over age 50 years by 2018 will require adequate colonoscopy capacity throughout the country, including rural areas, where colonoscopy providers may have less specialized training. Our aim was to study the quality of colonoscopy in rural settings.

Methods

The Clinical Outcomes Research Initiative (CORI) and the Oregon Rural Practice‐based Research Network (ORPRN) collaborated to recruit Oregon rural practices to submit colonoscopy reports to CORI's National Endoscopic Database (NED). Ten ORPRN sites were compared to non‐ORPRN rural (n = 11) and nonrural (n = 43) sites between January 2009 and October 2011. Established colonoscopy quality measures were calculated for all sites.

Results

No ORPRN physicians were gastroenterologists compared with 82% of nonrural physicians. ORPRN practices reached the cecum in 87.4% of exams compared with 89.3% of rural sites (P = .0002) and 90.9% of nonrural sites (P < .0001). Resected polyps were less likely to be retrieved (84.7% vs 91.6%; P < .0001) and sent to pathology (77.1% vs 91.3%; P < .0001) at ORPRN practices compared to nonrural sites. The overall polyp detection (39.0% vs 40.3%) was similar (P = .217) between ORPRN and nonrural practices. Of exams with polyps, the rate for largest polyp on exam 6‐9 mm was 20.8% at ORPRN sites, compared to 26.8% at nonrural sites (P < .0001), and for polyps >9mm 16.6% vs 18.7% (P = .106).

Conclusion

ORPRN sites performed well on most colonoscopy quality measures, suggesting that high‐quality colonoscopy can be performed in rural settings.
Support and Sabotage: A Qualitative Study of Social Influences on Health Behaviors Among Rural Adults
Authors: Sriram Urshila , Morgan Emily H. , Graham Meredith L. , Folta Sara C. , Seguin Rebecca A.
Published: January 2017

Purpose

Social environments exert an important influence on health behaviors, yet evidence from rural‐specific contexts is limited. This study explored how social relationships influence health‐related behaviors among midlife and older rural adults at increased risk of chronic disease.

Methods

Seventeen focus groups were conducted with 125 sedentary, overweight/obese adults (aged 40‐91 years) residing in “medically underserved” rural Montana towns in 2014. Groups were stratified by age (40‐64 and ≥65) and gender. Transcripts were examined thematically using NVivo software according to social influences on diet, physical activity, and tobacco use. Analyses were conducted in 2015‐2016.

Results

Attitudes and actions of family members and friends were key influences on health behaviors, in both health‐promoting and health‐damaging ways. In these small, isolated communities, support from and accountability to family and friends were common facilitators of behavior change and maintenance. However, expectations to conform to social norms and traditional gender roles (eg, caregiving duties) often hindered healthy lifestyle changes.

Conclusions

These findings suggest that health behavior interventions targeting adults in rural settings need to consider and, if possible, integrate strategies to address the impact of social relationships in both supporting and sabotaging behavior change and maintenance.
Why a Data‐Based Decision‐Making Intervention Works in Some Schools and Not in Others
Authors: Keuning Trynke , Van Geel Marieke , Visscher Adrie
Published: January 2017

The use of data for adaptive, tailor‐made education can be beneficial for students with learning difficulties. While evaluating the effects of a data‐based decision‐making (DBDM) intervention on student outcomes, considerable variation between intervention effects, ranging from high‐intervention effects to small or even negative intervention effects, across schools was found. The main purpose of this study was to investigate whether educator and school organizational characteristics are related to the effects of a DBDM intervention on student achievement growth by comparing 10 primary schools with strong intervention effects with 10 primary schools with no intervention effects on student achievement. Supportive and hindering factors were studied by means of surveys and interviews with school management teams, and by examining school reports from the project trainers. Results indicate that schools with strong intervention effects differed from schools with no intervention effects with regard to their teachers’ teaching quality, staff's attitude toward DBDM, and the school data culture.