bluuebunny/crossref_metadata_2025 huggingface dataset:
Between fairness and fear—Dental undergraduates’ attitudes towards objective structured clinical examinations
Authors: Puryer James , Neville Patricia , Fowler Ellayne
Published: February 2019

Introduction

Objective structured clinical examinations (OSCEs) are an established method of assessment for dental undergraduates. There is little published dental education research exploring the views of undergraduates towards OSCEs.

Aim

To explore and describe the views of dental undergraduates towards OSCEs.

Method

A sequential mixed methods design was applied. This included a cross‐sectional survey of all 204 dental undergraduates in Years 2, 3 and 4 within a UK dental school using an anonymous self‐report online questionnaire (response rate 57%), which was followed by two focus group interviews of n = 10 Year‐2 students.

Results

Most students gave positive views regarding the OSCE form of assessment. Questionnaire data highlighted that students felt that the OSCE tested their diagnostic, clinical and communication skills, and covered a wide range of skills and disciplines. Students also generally saw them as a useful educational exercise that went beyond testing recall of facts. Most students thought that the OSCEs were “fair” assessments. Negative views focused around student lack of preparation for them, especially in earlier years. Focus group data explored further these concerns but also emphasised the need for more student‐centred support pre‐OSCE.

Conclusion

Objective structured clinical examinations can be an anxiety‐inspiring form of assessment for students in the early years of the programme. Dental educators need to be more aware of these concerns to develop strategies to increase student preparedness for OSCEs without increasing stress.
Deep soil flipping increases carbon stocks of New Zealand grasslands
Authors: Schiedung Marcus , Tregurtha Craig S. , Beare Michael H. , Thomas Steve M. , Don Axel
Published: February 2019

Sequestration of soil organic carbon (SOC) has been recognized as an opportunity to off‐set global carbon dioxide (CO2) emissions. Flipping (full inversion to 1–3 m) is a practice used on New Zealand's South Island West Coast to eliminate water‐logging in highly podzolized sandy soils. Flipping results in burial of SOC formed in surface soil horizons into the subsoil and the transfer of subsoil material low in SOC to the “new” topsoil. The aims of this study were to quantify changes in the storage and stability of SOC over a 20‐year period following flipping of high‐productive pasture grassland. Topsoils (0–30 cm) from sites representing a chronosequence of flipping (3–20 years old) were sampled (2005/07) and re‐sampled (2017) to assess changes in topsoil carbon stocks. Deeper samples (30–150 cm) were also collected (2017) to evaluate the changes in stocks of SOC previously buried by flipping. Density fractionation was used to determine SOC stability in recent and buried topsoils. Total SOC stocks (0–150 cm) increased significantly by 69 ± 15% (179 ± 40 Mg SOC ha‐1) over 20 years following flipping. Topsoil burial caused a one‐time sequestration of 160 ± 14 Mg SOC ha‐1 (30–150 cm). The top 0–30 cm accumulated 3.6 Mg SOC ha‐1 year‐1. The chronosequence and re‐sampling revealed SOC accumulation rates of 1.2–1.8 Mg SOC ha‐1 year‐1 in the new surface soil (0–15 cm) and a SOC deficit of 36 ± 5% after 20 years. Flipped subsoils contained up to 32% labile SOC (compared to <1% in un‐flipped subsoils) thus buried SOC was preserved. This study confirms that burial of SOC and the exposure of SOC depleted subsoil results in an overall increase of SOC stocks of the whole soil profile and long‐term SOC preservation.
Spatial patterns and determinants of trait dispersion in freshwater fish assemblages across Europe
Authors: Côte Jessica , Kuczynski Lucie , Grenouillet Gaël
Published: February 2019

Aim

Understanding how species assemble into assemblages and identifying the determinants of assembly processes remains a key challenge in ecology. Within assemblages, functional trait dispersion can be used to infer assembly processes, but this inference could depend on the trait considered. Here, using both single and multiple trait‐based approaches, we analysed dispersion patterns for alpha (i.e., related to niche partitioning) and beta (i.e., related to environmental tolerance) traits in freshwater fish assemblages and characterized how trait dispersion patterns vary along environmental gradients at large spatial scale.

Location

Western Palaearctic, 290 river catchments.

Time period

Contemporary.

Major taxa studied

Freshwater fish.

Methods

Based on freshwater fish occurrence records in 290 European river catchments, we computed dispersion indices (mean pairwise distance) using standardized effect sizes for each single trait and multiple traits. We then used linear models including climatic, geo‐morphological, biotic and human‐related factors to determine the key drivers shaping freshwater fish dispersion patterns across Europe.

Results

We highlighted spatial variation in trait dispersion, with both underdispersion and overdispersion simultaneously observed for a given trait, but also distinct patterns of trait dispersion, even within beta and alpha traits. We provided evidence that elevation range and current and past climatic conditions mainly structured trait dispersion patterns. Finally, our results revealed that spatial patterns in trait dispersion based on multiple traits were less pronounced than those based on individual traits.

Main conclusions

Our results highlighted that traits showed different spatial and environmental patterns, reflecting different ecological patterns. This could lead to potential problems when using functional indices computed on multiple traits and challenges their relevance to describe diversity patterns and to infer the assembly processes shaping community structure.
Codetermination, Price Competition and the Network Industry
Authors: Fanti Luciano , Gori Luca
Published: February 2019

This research develops a tractable two-stage non-cooperative game with complete information describing the behaviour of price-setting firms that must choose to be profit maximisers or bargainers under codetermination in a network industry with horizontal product differentiation. The existing theoretical literature has already shown that codetermination might arise as the endogenous market outcome in a strategic competitive quantity-setting duopoly. In sharp contrast with this result, the present article shows that codetermination does never emerge as a Nash equilibrium in a price-setting non-network duopoly. Then, it aims at highlighting the role of network externalities in determining changes of paradigm of the game and letting codetermination become a sub-game perfect Nash equilibrium when prices are strategic substitutes or strategic complements. This equilibrium may be Pareto efficient. Results allow distinguishing between mandatory codetermination and voluntary codetermination. The article also proposes a model of endogenous codetermination according to which every firm may choose to bargain with its own corresponding union bargaining unit only whether the firm’s bargaining strength is exactly the profit-maximising one. The equilibrium outcomes emerging in this case range from a uniform Nash equilibrium, in which both firms are codetermined, to mixed Nash equilibria, in which only one of them chooses to be codetermined. These results are ‘network depending’ and do not hold in a non-network duopoly.
Neuromuscular control during gait in people with haemophilic arthropathy
Authors: Cruz‐Montecinos Carlos , Pérez‐Alenda Sofía , Cerda Mauricio , Maas Huub
Published: February 2019

Introduction

Effects of haemophilic arthropathy on neuromuscular control during gait are currently unknown.

Aims

(a) To assess how haemophilic arthropathy affects the complexity of neuromuscular control during gait; (b) To investigate the relationship between complexity of neuromuscular control and joint impairment.

Methods

Thirteen control subjects (CG) walked overground at their preferred and a slow velocity and thirteen people with haemophilic arthropathy (PWHA) walking at their preferred velocity. Surface electromyography (EMG) was collected from eleven leg muscles. Electromyography variance explained by muscle synergies (sets of co‐activated muscles that can be recruited by a single signal) was calculated by the total variance accounted (tVAF). Three measures were used to evaluate complexity of neuromuscular control: (a) the number of synergies required for tVAF > 90%, (b) tVAF as a function of the number of muscle synergies, and (c) the dynamic motor control index (Walk‐DMC). Impairment of ankle and knee joints was determined by the Haemophilia Joint Health Score (HJHS).

Results

The same number of the muscle synergies was found for each group (P > 0.05). For both walking velocities tested, tVAF1 was higher in PHWA (P < 0.05). The Walk‐DMC of PWHA was lower than that of the CG for both walking velocities (P < 0.05). For PWHA, no significant correlation was found between HJHS (sum knee and ankle) and Walk‐DMC index (r = −0.32, P = 0.28).

Conclusions

These results indicate differences between PWHA and CG in the neuromuscular control of gait. The Walk‐DMC and tVAF1 may be useful measures to assess changes in neuromuscular control in response to treatment.
Mycobacterium fortuitum infection of a hemodialysis catheter in a pediatric patient
Authors: Morgans Heather A. , Mallett Kathleen F. , Sebestyen Vansickle Judith F. , Warady Bradley A.
Published: February 2019

This case report discusses a pediatric patient who developed a hemodialysis catheter line infection from an uncommon etiology, Mycobacterium fortuitum. The initial presentation revealed a well appearing patient with a slow growing skin lesion near the site of the hemodialysis catheter. The treatment course was complicated by resistance to initial antibiotics leading to continued spread of the lesion. The diagnosis was confirmed via skin biopsy of the lesion that required 2 weeks to grow the atypical Mycobacterium. Treatment was successful after hemodialysis catheter removal, transition to peritoneal dialysis, and a prolonged antibiotic course. Mycobacterium fortuitum is a rare cause of dialysis catheter infections that is resistant to standard antibiotic treatment. Treatment success is improved after removal of the dialysis catheter and prolonged antibiotics based on susceptibilities. This case highlights the importance of keeping atypical Mycobacterium in the differential for patients with slow growing skin lesions near dialysis catheter sites with resistance to initial treatment.
CaZrTi2O7 zirconolite synthesis: From ceramic to glass‐ceramic
Authors: Kong Linggen , Karatchevtseva Inna , Chironi Ilkay , Wei Tao , Zhang Yingjie
Published: February 2019

The formation of CaZrTi2O7 zirconolite and its crystallization in sodium alumino‐borosilicate glass has been investigated via sintering in air. The ceramic precursor is prepared using a soft chemistry route to ensure ultimate mixing of the reactants at the molecular level. A nearly phase pure CaZrTi2O7 zirconolite is formed after sintering the ceramic precursor at 1400°C for 12 hours. In order to form zirconolite glass‐ceramics, various processing conditions are investigated including sintering temperatures, different glass composition precursors, and ceramic to glass weight ratios. Zirconolite crystallization on the surface and inside of glass‐ceramic‐pelletized samples is investigated. Higher ceramic to glass weight ratio leads to the formation of zirconolite as crystalline phase, which is quite dominant in glass.
Effects of sintering temperature on microstructure, properties, and crushing behavior of ceramic proppants
Authors: Ma Haiqiang , Tian Yuming , Li Guomin
Published: February 2019

Ceramic proppants with excellent performance were successfully prepared by second grade bauxite. The phase structure and the microstructure were investigated via X‐Ray diffraction and scanning electron microscopy. The results suggested that bulk density and apparent density constantly increased, while the breakage ratio gradually decreased with the increasing in sintering temperature. When the sintering temperature reached to 1500°C, the breakage ratio obtained lowest value of 3.6% under 52 MPa closed pressure, which satisfied the requirement of Chinese Petroleum and Gas Industry standard. Furthermore, the mode of fracture for ceramic proppants was transformed from intergranular fracture into transgranular fracture and open pores had larger influence than closed pores for breakage ratio of ceramic proppants.
Approaches to palliative oxygen therapy in chronic obstructive pulmonary disease: a multi‐national survey of specialists
Authors: Smallwood Natasha , Currow David , Booth Sara , Spathis Anna , Irving Louis , Philip Jennifer
Published: February 2019

As palliative oxygen therapy (POT) is beneficial only to a minority of patients with chronic breathlessness, it is no longer routinely recommended. This multi‐national, online survey of respiratory and palliative medicine specialists, with 440 participants, identified that prescription of POT has decreased over the past decade; however a sizeable proportion of doctors, particularly within palliative care, still support and recommend POT. Further education and research regarding the optimal management of chronic breathlessness are required.
Factors predicting quality of nursing care among nurses in tertiary care hospitals in Mongolia
Authors: Gaalan K. , Kunaviktikul W. , Akkadechanunt T. , Wichaikhum O.‐A. , Turale S.
Published: February 2019

Background

An increasing nursing shortage, high workloads and poor working environments are affecting the quality of nursing care in many countries including Mongolia.

Aim

To explore the level of quality of nursing care, nursing competency and nursing practice environment, as well as the predictability of nurses’ personal factors, nursing competency and nursing practice environment on quality of nursing care as perceived by nurses in Mongolia.

Methods

We collected data from 346 registered nurses, randomly selected and working in seven general public tertiary care hospitals in the capital city of Ulaanbaatar, and four regions of Mongolia. Instruments used were the Good Nursing Care Scale, the Competency Inventory for Registered Nurses and the Practice Environment Scale of Nursing Work Index. Data were analysed using descriptive statistics and multiple regression analysis.

Results

The overall quality of nursing care and nursing competency was perceived to be at a high level, whereas nursing practice environment was at a favourable level. Nursing competency and nursing practice environment were found as significant predictors of nursing care quality, while personal factors were found as non‐significant predictors.

Discussion

Improving nursing competency and practice environment enhances the quality of nursing care. However, a study limitation is that self‐reporting may not have reflected the accuracy of variables.

Conclusion

Findings provide important evidence for the use of measures and strategies to enhance the quality of nursing care by improving nursing competency and the nursing practice environment.

Implications for nursing and health policy

Policymakers, administrators and nurses need to work together to develop and implement policies to enhance and support the competency and practice environments of the Mongolian nurses.
Powder characteristics, sinterability, and mechanical properties of TiB2 prepared by three reduction methods
Authors: Zeng Ling‐Yong , Wei Wan‐Xin , Sun Shi‐Kuan , Guo Wei‐Ming , Li Hao , Lin Hua‐Tay
Published: February 2019

Reaction processes, powder characteristics, sinterability, and mechanical properties of TiB2 prepared by borothermal reduction, B4C reduction, and boro/carbothermal reduction were compared. Results showed that TiBO3 and Ti2O3 as the intermediate phases existed in the three reduction processes. The temperature where TiB2 became major phase was lowest during borothermal reduction, resulting in the finest TiB2 particle size, in contrast to the other two methods, especially boro/carbothermal reduction. However, TiB2 powders prepared by B4C reduction and boro/carbothermal reduction after pressureless sintering at 1800°C for 2 hours showed the relatively higher sinterability, due to the lower oxygen content and higher carbon content. Finally, using 5 wt% Ni as sintering additive, hot‐pressed TiB2 ceramics from B4C reduction demonstrated higher densification, more fine‐grained microstructure and higher mechanical properties, due to the better balance of oxygen/carbon content.
Single crystal growth of CoTi2O5 by solid state reaction synthesis
Authors: Anderson Kevin P. , Giri Anit K. , Vinci Richard P. , Chan Helen M.
Published: February 2019

Materials in single crystal form are often sought after because the absence of grain boundaries can result in unique properties relative to the polycrystal, but producing these materials is typically a slow and complex process. In this work, pseudo single crystals of the pseudobrookite compound CoTi2O5 were synthesized by solid‐state reaction from a duplex grain mixture of CoTiO3 and TiO2. The size of the crystallites was >250 µm. The transformation and subsequent microstructural evolution of the CoTi2O5 was studied by scanning electron microscopy (SEM), electron backscatter diffraction (EBSD), transmission electron microscopy (TEM), scanning transmission electron microscopy (STEM), and X‐ray diffraction (XRD). A novel growth mechanism was identified whereby a single crystal CoTi2O5 front advances simultaneously along multiple CoTiO3/TiO2 diphasic boundaries. The single crystal domains were composed of subgrains approximately 5 µm in diameter; differences in the subgrain size and misorientation were related to the growth mechanism and the initial grain size of the duplex CoTiO3–TiO2 mixture. CoTi2O5 is a little characterized compound, and this study represents the most significant microstructural study of CoTi2O5 to date. The findings may be applied to similar pseudobrookite compounds such as MgTi2O5 and Al2TiO5.
Limited influence of landscape on the genetic structure of three small mammals in a heterogeneous arid environment
Authors: Levy Esther , Byrne Margaret , Huey Joel A. , Hillyer Mia J. , Firman Renée C. , Ottewell Kym M.
Published: February 2019

Aim

The complexity and biologically challenging nature of arid landscapes can generate high inter‐ and intra‐species diversity, although these biomes remain poorly studied. We investigated whether prominent geomorphic features in an Australian arid landscape had similar influences on patterns of intra‐specific genetic diversity of three small mammals with different distribution and life history traits. Specifically, we tested (a) whether mountain ranges harbour high diversity and act as refugia, (b) the extent to which ephemeral river systems pose barriers to gene flow or (c) whether environmental differences explain genetic structure in these species.

Location

The topographically complex Pilbara bioregion of the Australian arid zone.

Taxa

Two rodents, the Western pebble‐mound mouse, Pseudomys chapmani and the Sandy inland mouse, Pseudomys hermannsburgensis and a dasyurid, Ningaui timealeyi.

Methods

We used maximum parsimony networks of mitochondrial haplotypes and spatially‐explicit Bayesian clustering analysis of microsatellite genotypes to identify historical and contemporary genetic structure in each species. Based on measures of individual diversity and genetic distance, we distinguished ‘hotspots’ and ‘coldspots’ (>1.5 standard deviations from the mean) of genetic diversity and genetic connectivity and assessed their concordance with landscape features. The influence of environmental dissimilarity on observed genetic differentiation was evaluated using generalized dissimilarity modelling.

Results

Patterns of genetic diversity and connectivity were complex, with few consistent patterns across species. Both microsatellite and mitochondrial diversity were high across species, with limited spatial genetic structure. Rivers had the most influence on genetic patterns but were not consistently identified as barriers. Environmental dissimilarity amongst sampling sites had low explanatory power.

Main Conclusions

Limited genetic structure in each of the three species suggests that the structurally complex Pilbara landscape remains relatively permeable to species with high dispersal capacity. Additionally, population responses to boom‐bust cycles in arid environments are likely to obscure spatial genetic patterns.
Analysing computational thinking in collaborative programming: A quantitative ethnography approach
Authors: Wu Bian , Hu Yiling , Ruis A.R. , Wang Minhong
Published: February 2019

Computational thinking (CT), the ability to devise computational solutions for real‐life problems, has received growing attention from both educators and researchers. To better improve university students' CT competence, collaborative programming is regarded as an effective learning approach. However, how novice programmers develop CT competence through collaborative problem solving remains unclear. This study adopted an innovative approach, quantitative ethnography, to analyze the collaborative programming activities of a high‐performing and a low‐performing team. Both the discourse analysis and epistemic network models revealed that across concepts, practices, and identity, the high‐performing team exhibited CT that was systematic, whereas the CT of the low‐performing team was characterized by tinkering or guess‐and‐check approaches. However, the low‐performing group's CT development trajectory ultimately converged towards the high‐performing group's. This study thus improves understanding of how novices learn CT, and it illustrates a useful method for modeling CT based in authentic problem‐solving contexts.
Commentary to ‘Minimal clinically important difference (MCID) for work productivity and activity impairment (WPAI) questionnaire in psoriasis patients’ by J.J. Wu et al.
Authors: John S.M.
Published: February 2019

Linked article: This is a commentary on J.J.Wu et al., pp. 318–324 in this issue. To view this article visit https://doi.org/10.1111/jdv.15098.
Specificity and seasonal prevalence of anther smut disease Microbotryum on sympatric Himalayan Silene species
Authors: Tang Hui , Hood Michael E. , Ren Zong‐Xin , Li Hai‐Dong , Zhao Yan‐Hui , Wolfe Lorne M. , Li De‐Zhu , Wang Hong
Published: February 2019

Host sympatry provides opportunities for cross‐species disease transmission and compounded disease effects on host population and community structure. Using the Silene–Microbotryum interaction (the castrating anther smut disease), eleven Himalayan Silene species were assessed in regions of high host diversity to ascertain levels of pathogen specificity. We also investigated disease prevalence, seasonal dynamics of infection and flowering patterns in five co‐blooming Silene species. We identified several new Microbotryum lineages with varying degrees of specialization that is likely influenced by degrees of host divergence and ecological similarities (i.e. shared pollinator guilds). Affected species had 15%–40% of plants infected by anther smut. Flowering was seasonally overlapping among host species (except for the species pair S. asclepiadea and S. atrocastanea), but diseased flowering onset was earlier than healthy plants, leading to dramatic seasonal shifts in observed disease prevalence. Overlapping distributions and flowering provides opportunities for floral pathogen movement between host species, but host specialization may be constrained by the plant phylogenetic relatedness, adaptation to micro‐habitats and difference in pollinator/vector guilds.
Who determines sustainability?
Authors: Agnew David J.
Published: February 2019

Over the past 20 years many different certification or rating schemes for sustainable fisheries have evolved, that attempt to influence consumer tastes and preferences and thereby incentivise better fisheries practices. This short review paper aims to document the history of such schemes, to consider their apparent differences and the basis upon which sustainability standards were developed. While there is some consistency between schemes in terms of the elements that should be considered as part of sustainability, and the general outcomes that sustainable fisheries should strive for, with the exception of maximum sustainable yield (MSY) there is less agreement on the specific details of how this should be measured or what reference points should be considered as sustainable. This arises from a lack of specific consideration or agreement on these issues in the international policy community.
Assessing the Scope and Appropriateness of Prescribing Cascades
Authors: McCarthy Lisa M. , Visentin Jessica D. , Rochon Paula A.
Published: February 2019

As originally defined, the term “prescribing cascade” describes a sequence of events that begins when an adverse drug event (ADE) occurs, is misinterpreted as a new medical condition, and a subsequent drug is then inadvertently prescribed to treat the new condition. We refine the definition to encompass both recognized and unrecognized ADEs because they can both contribute to problematic prescribing practices. In addition, we discuss that although prescribing cascades are most commonly viewed as problematic, they may be appropriate and therapeutically beneficial in certain clinical situations. We differentiate between appropriate and problematic prescribing cascades by adopting a similar approach to the framework proposed in the highly acclaimed King's Fund report Polypharmacy and Medicines Optimization. Practical considerations are also presented to aid clinicians in preventing the propagation of problematic prescribing cascades within their clinical practice. Providing new perspectives on the scope and appropriateness of the prescribing cascade concept is an important step in describing clinically relevant cascades and in encouraging safe prescribing practices. J Am Geriatr Soc 67:1023–1026, 2019.
Complications associated with ventriculoperitoneal shunts in dogs and cats with idiopathic hydrocephalus: A systematic review
Authors: Gradner Gabriele , Kaefinger Rose , Dupré Gilles
Published: February 2019

Background

Several case series and case reports have been published about idiopathic hydrocephalus treatment in dogs and cats using ventriculoperitoneal shunts (VPS).

Objectives

To determine the risk and type of complications in dogs and cats after VPS placement.

Animals

Sixteen papers were included. Sixty dogs and 13 cats with idiopathic hydrocephalus treated by VPS placement were identified.

Methods

The databases CAB, Scopus, and Medline were used. Idiopathic/congenital hydrocephalus, feline/canine patients, ventriculoperitoneal shunting, complications, and outcomes were inclusion criteria. The focus was on complication type and time frame within which they arose.

Results

Complications in dogs (n = 60) were shunt obstruction (6/60; 10%), pain (4/60; 5.5%), shunt infection (3/60; 4.1%), disconnection (3/60; 4.1%), excessive shunting (2/60; 2.7%), and kinking (1/60; 1.6%). Complications in cats (n = 13) were coiling of the shunt in the SC tissue (2/13; 15.4%); kinking (1/13; 7.7%); and shunt obstruction (1/13; 7.7%). Complications were most likely during the first 6 months after shunt placement.

Conclusion and Clinical Importance

Ventriculoperitoneal shunting is considered a viable treatment option for patients with hydrocephalus. Potential complications should be discussed with the owner. Early diagnosis of complications is essential.
The frequency of oral famotidine administration influences its effect on gastric pH in cats over time
Authors: Golly Elizabeth , Odunayo Adesola , Daves Maggie , Vose Julie , Price Josh , Hecht Silke , Steiner Joerg M. , Hillsman Shanna , Tolbert M. Katherine
Published: February 2019

Background

Famotidine is commonly administered to cats. Prolonged famotidine administration results in decreased efficacy in humans, dogs, and cows, but the long‐term effects in cats are unknown.

Objectives

To compare the effect of 2 oral administration frequencies of famotidine, twice daily (Group 1) and twice daily every second day (Group 2), on intragastric pH and serum gastrin concentrations in cats. We hypothesized a diminished effect on intragastric pH would be observed over time in Group 1 but not Group 2.

Animals

Sixteen healthy cats.

Methods

Randomized, 2‐factor repeated measures crossover design. Cats received 0.5‐1.24 mg/kg (median, 0.87 mg/kg) famotidine twice daily or twice daily every second day for 14 consecutive days. Intragastric pH monitoring was used to record intragastric pH on treatment days 1‐3 and 11‐13. Mean pH and mean percentage time (MPT) intragastric pH was ≥3 and 4 were compared between and within treatment groups by analysis of variance.

Results

Significant treatment group by time interactions were observed for mean intragastric pH, MPT intragastric pH ≥3 and 4 (P = .009, P = .02, P = .005, respectively). Interaction post hoc tests identified significant decreases in mean intragastric pH (P = .001), MPT ≥3 (P = .001), and MPT ≥4 (P = .001) on day 13 compared to day 1 in Group 1 but not in Group 2.

Conclusions and Clinical Importance

Oral famotidine administration results in a diminished effect on intragastric pH in healthy cats when given twice daily every day.
The revitalization and scale‐up of the Baby‐Friendly Hospital Initiative in Malawi
Authors: Kavle Justine A. , Welch Patricia R. , Bwanali Florence , Nyambo Kanji , Guta Janet , Mapongo Natalia , Straubinger Sarah , Kambale Susan
Published: February 2019

The Baby‐Friendly Hospital Initiative (BFHI) has shown to strengthen health providers' skills in the provision of breastfeeding counselling and support, which have led to improvements in breastfeeding outcomes. In Malawi, where BFHI was introduced in 1993 but later languished due to losses in funding, the Maternal and Child Survival Program supported the Malawi Ministry of Health (MOH) in the revitalization and scale‐up of BFHI in 54 health facilities across all 28 districts of the country. This paper describes the revitalization and scale‐up process within the context of an integrated health project; successes, challenges, and lessons learned with BFHI implementation; and the future of BFHI in Malawi. More than 80,000 mothers received counselling on exclusive breastfeeding following childbirth prior to discharge from the health facility. Early initiation of breastfeeding was tracked quarterly from baseline through endline via routine MOH health facility data. Increases in early initiation of breastfeeding were seen in two of the three regions of Malawi: by 2% in the Central region and 6% in the Southern region. Greater integration of BFHI into Malawi's health system is recommended, including improved preservice and in‐service trainings for health providers to include expanded BFHI content, increased country financial investments in BFHI, and integration of BFHI into national clinical guidelines, protocols, and nutrition and health policies.
Multiple parapatric pollinators have radiated across a continental fig tree displaying clinal genetic variation
Authors: Yu Hui , Tian Enwei , Zheng Linna , Deng Xiaoxia , Cheng Yufen , Chen Lianfu , Wu Wei , Tanming Wattana , Zhang Dayong , Compton Stephen G. , Kjellberg Finn
Published: February 2019

The ways that plant‐feeding insects have diversified are central to our understanding of terrestrial ecosystems. Obligate nursery pollination mutualisms provide highly relevant model systems of how plants and their insect associates have diversified and the over 800 species of fig trees (Ficus) allow comparative studies. Fig trees can have one or more pollinating fig wasp species (Agaonidae) that breed within their figs, but factors influencing their number remain to be established. In some widely distributed fig trees, the plants form populations isolated by large swathes of sea, and the different populations are pollinated by different wasp species. Other Ficus species with continuous distributions may present genetic signatures of isolation by distance, suggesting more limited pollinator dispersal, which may also facilitate pollinator speciation. We tested the hypothesis that Ficus hirta, a species for which preliminary data showed genetic isolation by distance, would support numerous pollinator species across its range. Our results show that across its range F. hirta displays clinal genetic variation and is pollinated by nine parapatric species of Valisia. This is the highest number of pollinators reported to date for any Ficus species, and it is the first demonstration of the occurrence of parapatric pollinator species on a fig host displaying continuous genetic structure. Future comparative studies across Ficus species should be able to establish the plant traits that have driven the evolution of pollinator dispersal behaviour, pollinator speciation and host plant spatial genetic structure.
Killing of Candida auris by UV‐C: Importance of exposure time and distance
Authors: de Groot Theun , Chowdhary Anuradha , Meis Jacques F. , Voss Andreas
Published: February 2019

Background

Candida auris is a globally emerging yeast, causing severe infections in patients with underlying diseases. This yeast is responsible for several outbreaks within healthcare facilities, where it can be found on hospital surfaces and patient care devices. Spread from these fomites may be prevented by improving the decontamination of hospital surfaces. UV‐C decontamination may constitute an effective adjunct to routine room cleaning.

Objectives

Our aim was to investigate the effect of different UV‐C exposure times and distance in killing C auris, using strains from different countries.

Methods

Candida auris was seeded on glass slides and exposed to UV‐C for 5, 10, 20 and 30 minutes at 2 and 4 m.

Results

A maximal effect of C auris killing was found after 30 minutes of UV‐C exposure at 2 m. With half the time or twice the distance, the efficacy strongly diminished to ~10 and ~50 fold, respectively. At suboptimal exposure times and distances, the C auris strains from Japan/Korea were more sensitive to UV‐C killing than C auris strains originating from Venezuela, Spain and India.

Conclusions

Altogether, UV‐C exposure times and distance are the most critical parameters to kill C auris, while strain variations of C auris also determine UV‐C efficacy. Future studies should aim to determine the effect and place of UV‐C on surface decontamination in hospital setting.
Changes in the chlorophyll content of grape leaves could provide a physiological index for responses and adaptation to UV‐C radiation
Authors: Luo Y. Y. , Li R. X. , Jiang Q. S. , Bai R. , Duan D.
Published: February 2019

Stilbenes are a group of phytoalexins that play an important role in grapevine (Vitis) basal immunity and can be induced by biotic and abiotic stresses. The levels of chlorophylls, the main pigments in plant cells, can also indicate the tolerance of plants to various stresses. Here, the response of different grapevine genotypes to UV‐C radiation treatment was tested and the abundance of chlorophyll in the Hoe29 and Ke53 genotypes was observed to increase significantly within 6 h of UV‐C treatment. Conversely, chlorophyll levels decreased markedly in the Augster Weiss and Müller–Thurgau genotypes. Furthermore, stilbene abundance increased substantially in the Hoe29, Ke53, Ke83 and Pinot Blanc genotypes, but increased only slightly in Augster Weiss and Müller–Thurgau. The expression of resveratrol synthase, which encodes a key enzyme in the stilbene synthesis pathway, increased in Hoe29, Ke53, Ke83 and Pinot Blanc following UV‐C treatment, in a manner consistent with stilbene accumulation. In addition, we observed that reactive oxygen species (ROS) provide a key trigger in physiological responses and changes in secondary metabolite contents. In summary, the results from this study support a link between ROS, chlorophyll levels and genetic diversity for stilbene abundance in different grape genotypes, providing insights into mechanisms for plant physiological and biochemical responses and adaptations to stress.
Pediatric lichen nitidus: A single‐center experience
Authors: Kundak Selcen , Çakır Yasemin
Published: February 2019

Objective

Lichen nitidus (LN) is an uncommon inflammatory skin eruption. The present study aims to describe a case series of children with LN seen at a tertiary‐care health center.

Methods

Retrospective study of 17 children with biopsy‐proven LN between January 2007 and March 2017. Data related with epidemiologic, clinical, and histopathologic characteristics were recorded.

Results

The mean age for the onset of LN was 9 years (range: 5‐17 years), and the mean duration of the skin lesions was 13 months (range: 1‐48 months). Fifteen were boys (88.2%). Seven children had a generalized form of LN (41.1%) and of these, two children had severe pruritus (11.8%). Seven children had a history of co‐morbid skin conditions (41.1%), including lichen planus in one patient (5.9%), lichen striatus in one patient (5.9%), psoriasis and longitudinal ridges in the nails in one patient (5.9%), and cutaneous features of atopic skin in four patients (23.5%). All of the reviewed patients had lymphohistiocytic infiltration in the dermis and basal vacuolar degeneration. Multinucleated giant cells were present in 11 (64.7%).

Conclusion

This case series found LN in a generalized form as well as other concurrent dermatologic conditions in nearly half of those reported. The boy predominance was also noteworthy.
Health care utilization following a homeless medical respite pilot program
Authors: Biederman Donna J. , Gamble Julia , Wilson Sally , Douglas Christian , Feigal Jacob
Published: February 2019

Objective

The purpose of this study was to evaluate a homeless medical respite pilot program to determine if program participants had health care utilization pattern changes and improved connection to income, housing, and health care resources post program.

Design

This is a quantitative descriptive pre‐/post‐program evaluation.

Sample

A total of 29 patients experiencing homelessness and discharged from an acute care hospital in the southeastern United States were provided with housing and nursing case management.

Measurements

Demographics including age, sex, race, and ethnicity were collected. Connection to primary care, mental health, substance abuse services, income, insurance, and housing were assessed at program entry and completion. Health care utilization and charge and payment data were collected 1 year prior and 1 year post‐respite stay.

Results

Participants demonstrated reduced hospital admissions (−36.7%) and when admitted, fewer inpatient days (−70.2%) and increased outpatient provider visits (+192.6%). Health care charges for the cohort decreased by 48.6% from the year prior to the program. Housing and income improved.

Conclusions

The medical respite pilot program was successful in guiding patients to community resources for more appropriate health care at a demonstrated cost savings. Participants also derived benefits in the form of improved housing and income.
Sucrose and starch metabolism during Fargesia yunnanensis shoot growth
Authors: Wang Shuguang , Pei Jialong , Li Juan , Tang Guojian , Zhao Jingwei , Peng Xiaopeng , Nie Shuangxi , Ding Yulong , Wang Changming
Published: February 2019

Bamboo is one of the fastest growing plants in the world, but their shoot buds develop very slowly. Information about the sugar storage and metabolism during the shoot growth is lacking. In the present study, we determined the activity of sucrose and starch metabolizing enzymes during the developmental period of Fargesia yunnanensis from shoot buds to the young culms that have achieved their full height. The soluble sugars and starch contents were also determined and analyzed in shoot buds and shoots at different developmental stages. The results showed that there were higher sucrose contents in shoot buds than shoots, which coincides with the sweeter taste of shoot buds. As the shoot buds sprouted out of the ground, the starch and sucrose were depleted sharply. Coupled with this, the activity of soluble acid invertase (SAI), cell wall‐bound invertase (CWI), sucrose synthase at cleavage direction (SUSYC) and starch phosphorylase (STP) increased significantly in the rapidly elongating internodes. These enzymes dominated the rapid elongation of internodes. The activities of SAI, CWI, SUSYC and STP and adenosine diphosphate‐glucose pyrophosphorylase were higher as compared to other enzymes in the shoot buds, but were far lower than those in the developing shoots. The slow growth of shoot buds was correlated with the low activity of these enzymes. These results complement our understanding of the physiological differences between shoot buds and elongating shoots and ascertain the physiological mechanism for the rapid growth of bamboo shoots.
Multidimensional training among Latin America's restoration professionals
Authors: Meli Paula , Schweizer Daniella , Brancalion Pedro H. S. , Murcia Carolina , Guariguata Manuel R.
Published: February 2019

The ambitious restoration commitments made by Latin American countries have increased the demand for professionals having multidimensional training in ecological restoration; however, little is known about the kind of training that professionals are currently receiving. Through an online survey, we explored whether restoration professionals in Latin America have been trained on the ecological, socioeconomic, and management dimensions of ecological restoration, and their perceptions of training constraints and curricula needs. Half of the 411 respondents simultaneously work in academia, governments, and nongovernmental organizations, lessening the typical division between the science and practice of restoration, and suggesting the need for stronger multidimensional training to adequately respond to different needs and expectations. Over 80% received formal academic training in fields relevant for restoration and most respondents also reported attending interdisciplinary courses. Training was more focused on the ecological dimension of restoration compared to socioeconomic or management dimensions. Respondents have similar education levels (i.e. most respondents have postgraduate degrees), independently from the organization type in which respondents work, and multidimensionality among organization types was slight. Professionals expressed a need for training opportunities not demanding full‐time dedication. Although increasing training opportunities in socioeconomic and management dimensions is needed, we highlight opportunities to reinforce multidimensional training on restoration through organizational and institutional training, and collaborations among organizations.
Microparticles in systemic sclerosis: Potential pro‐inflammatory mediators and pulmonary hypertension biomarkers
Authors: Lammi Matthew R. , Saketkoo Lesley Ann , Okpechi Samuel C. , Ghonim Mohamed A. , Wyczechowska Dorota , Bauer Natalie , Pyakurel Kusma , Saito Saito , deBoisblanc Bennett P. , Boulares A. Hamid
Published: February 2019

Background and objective

Endothelial microparticles (EMP) are submicron vesicles released from endothelial cells. We aimed to determine the utility of EMP as biomarkers of pulmonary arterial hypertension (PAH) in systemic sclerosis (SSc) patients and the pathogenic role of microparticles (MP) in vascular inflammation.

Methods

Levels of EMP (CD144+, CD31+, CD62E+ and CD143+) were compared between three groups (10 SSc patients with PAH, 10 SSc patients without pulmonary hypertension (no‐PH) and 10 healthy age‐ and sex‐matched controls). Human pulmonary artery endothelial cells (HPAEC) were exposed in vitro to MP obtained from SSc patients or healthy controls, and levels of cytokines and inflammatory adhesion molecules were compared.

Results

CD144+ EMP were significantly higher in the SSc‐PAH group compared to either the SSc‐no PH or healthy controls (diagnostic accuracy 80%, P = 0.02). Compared to controls, SSc patients had higher CD31+/CD62E+ ratios, indicating larger contributions of apoptosis to EMP release (P = 0.04). Patients with limited SSc had significantly higher levels of CD143+ EMP compared to those with diffuse subtype (P = 0.008). When HPAEC were exposed to MP from SSc patients, there was a significant increase in inflammatory cytokines and adhesion molecules. Interestingly, exposure to healthy control MP caused a reduction in inflammatory markers.

Conclusion

EMP (particularly CD144+) are promising biomarkers of PAH in SSc but require further study. MP isolated from SSc patients induced an increase in endothelial cell inflammation and may be an important pathogenic factor in SSc.
Molecular breath analysis for IPF: Can we make a few breaths count?
Authors: Yanagihara Toyoshi , Kolb Martin
Published: February 2019

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Ambulatory oxygen delivery—an answer: But what is the question?
Authors: McDonald Christine F.
Published: February 2019

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On mean flow generation due to oblique reflection of internal waves at a slope
Authors: Kataoka Takeshi , Akylas T. R.
Published: February 2019

Small‐amplitude expansions are utilized to discuss the mean flow induced by the reflection of a weakly nonlinear internal gravity wave beam at a uniform rigid slope, in the case where the beam planes of constant phase meet the slope at an arbitrary direction, not necessarily parallel to the isobaths, and the flow cannot be taken as two dimensional. Along the vertical, the Eulerian mean flow, due to such an oblique reflection, is equal and opposite to the Stokes drift so the Lagrangian mean flow vanishes, similar to a two‐dimensional reflection. The horizontal Eulerian mean flow, however, is controlled by the mean potential vorticity (PV) and the corresponding Lagrangian mean flow is generally nonzero, in contrast to two‐dimensional flow where PV identically vanishes. For an oblique reflection, furthermore, viscous dissipation can trigger generation of horizontal mean flow via irreversible production of mean PV, a phenomenon akin to streaming.
Empirical likelihood and Wilks phenomenon for data with nonignorable missing values
Authors: Zhao Puying , Wang Lei , Shao Jun
Published: February 2019

Wilks's theorem is useful for constructing confidence regions. When applying the popular empirical likelihood to data with nonignorable nonresponses, Wilks's phenomenon does not hold. This paper unveils that this is caused by the extra estimation of the nuisance parameter in the nonignorable nonresponse propensity. Motivated by this result, we propose an adjusted empirical likelihood for which Wilks's theorem holds. Asymptotic results are presented and supplemented by simulation results for finite sample performance of the point estimators and confidence regions. An analysis of a data set is included for illustration.
Science, technology, and sexuality: New directions in the study of sexual knowledge
Authors: Vogler Stefan
Published: February 2019

The sociology of sexualities and the sociology of science, knowledge, and technology share many areas of theoretical and empirical interest, yet engagements between the fields have been limited. Work that has spanned both fields has tended to focus on sexuality from a biomedical perspective, neglecting other forms of knowledge production. This paper critically reviews existing areas of convergence between the fields, including measurement and classification, medicalization and risk, reproduction and families, politics and the state, and social movements. I offer suggestions for new avenues of research in these areas in addition to considering how greater theoretical exchange between the two fields could enrich both. I ultimately contend that analyzing forms of social knowledge making—such as law, religion, and the humanities and social sciences—and adopting a broader understanding of STS as method can provide a fresh direction in studying the production and circulation of sexual knowledge.