bluuebunny/crossref_metadata_2025 huggingface dataset:
Acute Cholestatic Liver Injury From Hydralazine Intake
Authors: Harati Hadi , Rahmani Maziar , Taghizadeh Sassan
Published: August 2015

Hydralazine is a commonly used oral antihypertensive agent. We report a rare case of hydralazine-induced hepatotoxicity in the form of subacute hepatic necrosis. A 75-year-old African American woman presented with jaundice of 7-day duration. She was started on hydralazine 100 mg 3 times a day 10 weeks before presentation. On physical examination, scleral icterus was noted. Workup revealed elevated liver transaminases, alkaline phosphatase, and conjugated bilirubin. She had no history of liver disease, and liver function tests had been normal before starting hydralazine. Other etiologies, including viruses, common toxins, drugs, autoimmune, and copper-induced hepatitis, were excluded. Abdominal imaging studies did not show any evidence of intrahepatic or extrahepatic biliary ductal dilatation, and no pathologies were seen in the liver and pancreas. The patient's liver biopsy revealed extensive lobular hepatitis, significant necrosis, mixed inflammatory infiltrate, and no significant fibrosis, supporting a diagnosis of drug-induced liver injury. Hydralazine was immediately discontinued. She showed improvement of clinical and laboratory abnormalities within 5 days after discontinuation of hydralazine. To establish the diagnosis of hydralazine-induced liver injury, we used assessment tool outlined by the Council for International Organization of Medical Sciences (CIOMS) scale that led to “high probable” relationship. Although rare, clinically significant, and potentially life-threatening liver injury can result from use of hydralazine. Both clinical and histological presentations in our patient suggest acute liver injury. The hydralazine-induced hepatitis seems to be reversible as discontinuation of the drug improves clinical outcomes. We highly recommend monitoring of the liver function during hydralazine treatment.
Paenibacillus panaciterrae sp. nov., isolated from ginseng-cultivated soil
Authors: Nguyen Ngoc-Lan , Kim Yeon-Ju , Hoang Van-An , Kang Jong-Pyo , Singh Priyanka , Yang Deok-Chun
Published: August 2015

A novel bacterium, designated DCY95T, was isolated from ginseng-cultivated soil in Quang Nam province, Vietnam. On the basis of 16S rRNA and gyrB gene sequence analysis, this isolate was assigned to the genus Paenibacillus and found to be closely related to Paenibacillus sacheonensis SY01T (97.1 % 16S rRNA gene sequence similarity) and Paenibacillus taihuensis THMBG22T (96.4 %). The partial gyrB gene of DCY95T possessed 69.6–83.9 % sequence identity to those of other members of the genus Paenibacillus. Strain DCY95T was Gram-reaction-negative, catalase-negative, oxidase-positive, strictly aerobic, rod-shaped and motile by means of peritrichous flagella. Ellipsoidal free spores or subterminal endospores were produced in sporangia. MK-7 was the diagnostic menaquinone. The cell-wall peptidoglycan contained meso-diamonopimelic acid as the diamino acid. Whole-cell sugars comprised ribose, mannose and glucose. The major cellular fatty acids were anteiso-C15 : 0, iso-C16 : 0 and C16 : 0. The major polar lipids were phosphatidylethanolamine, phosphatidylglycerol, three unidentified aminophospholipids, and two unidentified phospholipids. The genomic DNA G+C content was 60.7 ± 0.9 mol%. Phenotypic and chemotaxonomic results placed strain DCY95T within the genus Paenibacillus. However, DNA–DNA relatedness values between strain DCY95T and P. sacheonensis KACC 14895T or P. taihuensis NBRC 108766T were lower than 36 %. The low DNA relatedness data in combination with phylogenetic and (GTG)5-PCR analyses, as well as biochemical tests, indicated that strain DCY95T could not be assigned to any recognized species. In conclusion, the results in this study support the classification of strain DCY95T as a representative of a novel species within the genus Paenibacillus, for which the name Paenibacillus panaciterrae is proposed. The type strain is DCY95T ( = KCTC 33581T = DSM 29477T).
Thalassocola ureilytica gen. nov., sp. nov., of the family Phyllobacteriaceae isolated from seawater
Authors: Lin Shih-Yao , Hameed Asif , Young Chiu-Chung , Liu You-Cheng , Hsu Yi-Han , Chung Wei-Ching , Young Li-Sen
Published: August 2015

A Gram-stain-negative, aerobic, rod-shaped, non-flagellated marine bacterium, designated strain LS-861T, was isolated from seawater of the South China Sea (Taiwan). Strain LS-861T grew optimally at pH 7.0 and 30 °C in the presence of 3 % (w/v) NaCl. The novel strain shared highest 16S rRNA gene sequence similarity (91.5 % each) with ‘Nitratireductor shengliensis’ CGMCC 1.12519 and Hoeflea halophila JG120-1T and lower sequence similarity ( < 91.5 %) with other species. Phylogenetic analyses based on 16S rRNA gene sequences revealed a distinct taxonomic position attained by strain LS-861T within the clade that accommodated members of the family Phyllobacteriaceae. The major fatty acids were C16 : 0, iso-C17 : 1ω10c, C18 : 0 3-OH and C18 : 1ω7c/C18 : 1ω6c. The polar lipid profile was relatively simple as compared with other representatives of Phyllobacteriaceae, by having major amounts of diphosphatidylglycerol, phosphatidylglycerol and an unidentified glycolipid, and moderate amounts of three unidentified phospholipids and an unidentified aminolipid. The DNA G+C content was 61.2 mol%. The predominant quinone system was ubiquinone-10 (Q-10). The data in general and phylogenetic and polar lipid data in particular clearly distinguish the novel strain from related species at the genus level. Thus, strain LS-861T is suggested to represent a novel species of a new genus of the family Phyllobacteriaceae, for which the name Thalassocola ureilytica gen. nov., sp. nov. is proposed. The type strain of Thalassocola ureilytica is LS-861T ( = BCRC 80818T = JCM 30682T).
Enterobacter muelleri sp. nov., isolated from the rhizosphere of Zea mays
Authors: Kämpfer Peter , McInroy John A. , Glaeser Stefanie P.
Published: August 2015

A beige-pigmented, oxidase-negative bacterial strain (JM-458T), isolated from a rhizosphere sample, was studied using a polyphasic taxonomic approach. Cells of the isolate were rod-shaped and stained Gram-negative. A comparison of the 16S rRNA gene sequence of strain JM-458T with sequences of the type strains of closely related species of the genus Enterobacter showed that it shared highest sequence similarity with Enterobacter mori (98.7 %), Enterobacter hormaechei (98.3 %), Enterobacter cloacae subsp. dissolvens, Enterobacter ludwigii and Enterobacter asburiae (all 98.2 %). 16S rRNA gene sequence similarities to all other Enterobacter species were below 98 %. Multilocus sequence analysis based on concatenated partial rpoB, gyrB, infB and atpD gene sequences showed a clear distinction of strain JM-458T from its closest related type strains. The fatty acid profile of the strain consisted of C16 : 0, C17 : 0 cyclo, iso-C15 : 0 2-OH/C16 : 1ω7c and C18 : 1ω7c as major components. DNA–DNA hybridizations between strain JM-458T and the type strains of E. mori, E. hormaechei and E. ludwigii resulted in relatedness values of 29 % (reciprocal 25 %), 24 % (reciprocal 43 %) and 16 % (reciprocal 17 %), respectively. DNA–DNA hybridization results together with multilocus sequence analysis results and differential biochemical and chemotaxonomic properties showed that strain JM-458T represents a novel species of the genus Enterobacter, for which the name Enterobacter muelleri sp. nov. is proposed. The type strain is JM-458T ( = DSM 29346T = CIP 110826T = LMG 28480T = CCM 8546T).
Considering critical turns in research on educational leadership and policy
Authors: Diem Sarah , Young Michelle D.
Published: August 2015

Purpose

– The purpose of this paper is to explore the use of critical policy analysis (CPA) in the fields of educational leadership and policy. In addition to exploring how CPA compares to traditional research approaches in educational leadership and policy, the authors consider the influence of long-established ways of knowing, why scholars choose to engage in CPA and how and why scholars who utilize this approach decide on specific methods.

Design/methodology/approach

– The exploration draws primarily on the use of CPA in the USA, though the authors also examine how scholars working within the UK utilize CPA.

Findings

– In the review of critical policy literature, the authors identified a number of assumptions common to traditional and critical policy research theories and approaches. For example, systems theory and analysis, structural analysis, cost-benefit analysis, technicist models, and political models were commonly used within traditional literature. In comparison, critical policy researchers relied on theoretical perspectives informed by critical theory, feminist theories, and critical race perspectives, among others. Critical policy researchers used these perspectives to engage in critique, interrogate policy processes, and epistemological roots of policy work, reveal policy constructions, and examine players involved in the policy development, interpretation, and implementation processes. Notably, the work of critical educational leadership and policy scholars also emphasizes the importance of context, the theory-method relationship and methodology.

Originality/value

– While there is a growing movement occurring in the education leadership and policy fields toward critical analyses of educational research, little is known about how scholars decide what methods to employ when conducting such analyses. The authors discuss the possibilities for scholars utilizing these methods in order to explore the complexities of education leadership and policy problems.
Qualitative research and educational leadership
Authors: Brooks Jeffrey S. , Normore Anthony H.
Published: August 2015

Purpose

– The purpose of this paper is to highlight issues relayed to appropriate design and conduct of qualitative studies in educational leadership.

Design/methodology/approach

– The paper is a conceptual/logical argument that centers around the notion that while scholars in the field have at times paid attention to such dynamics, it is important that issues special to the field are considered by all.

Findings

– The major findings indicate that researchers/analysts need to determine not only the existence and accessibility of the qualitative research design and its various data collection strategies for leadership studies but also its authenticity and usefulness, taking into account the original purpose, the context in which it is produced and the intended audience.

Originality/value

– Certain aspects of the paper relate to general issues of sound and generally accepted standards of research practice, but the authors also consider several issues that make educational leadership scholarship unique. The originality of the paper draws attention to certain dynamics that scholars should consider when designing and conducting qualitative research on educational leadership. In doing so, the authors not only draw on the literature but also on their own experience designing, conducting and publishing qualitative research on educational leadership.
A sales process framework to regain B2B customers
Authors: Liu Annie , Leach Mark , Chugh Richa
Published: August 2015

Purpose

– The purpose of this study is to develop a sales process framework to facilitate business-to-business (B2B) customer reacquisition. A comprehensive CRM process needs to include reacquisition strategies. Yet, very few firms have formal procedures to guide reacquisition efforts. This gap in the sales process reflects the relatively sparse literature on B2B customer reacquisition models. The present research intends to fill this gap and creates a sales process model to guide salespeople to regain B2B lost customers.

Design/methodology/approach

– Using critical incident technique (CIT), this study conducted in-depth interviews with 54 B2B salespeople. Each salesperson reported one successful and one unsuccessful reacquisition incidents. A total of 108 critical incidents were collected for analysis.

Findings

– A four-step sales process model to regain B2B customers was developed and empirically supported, including: Segment lost customers; Assess reasons for loss; Develop reacquisition activities; and Implement reacquisition strategies.

Research limitations/implications

– This study is qualitative and exploratory in nature; future research should develop dyadic surveys to validate the results.

Practical implications

– This four-step reacquisition process allows sales firms to identify essential elements and establish protocols/policies to train and motivate salespeople. The framework can facilitate salespeople develop problem-focused solutions to correctly diagnose the situation and effectively re-negotiate with defected customers. Thus, this process may help reduce inefficiency in the reacquisition process and increase reacquisition ratios.

Social implications

– By considering justice/fairness from customer’s perspective, sales firm may properly recover lost business relationship, and do so in ways that are considered both just and ethical.

Originality/value

– This is one of the first studies to examine the reacquisition of lost B2B customers. It expands on the traditional sales process to include four steps that enable a sales reacquisition process.
Case study of an Australian residential college
Authors: Siew Renard Y.J.
Published: August 2015

Purpose

– This paper aims to share the success story of a residential college based in Australia through a case study approach.

Design/methodology/approach

– The paper discusses the setup of the college in terms of its management structure, demographics of residents, sustainability initiatives and the resident life programs which run every semester. A survey was conducted to gather feedback from the residents and identify areas for future improvement.

Findings

– Generally, residents are satisfied with the living conditions. Affordability, the collegiate experience and the convenience of living on campus are primary factors affecting the decision of residents to move into a residential college.

Originality/value

– The paper provides an insight into the management of a residential college which has not been discussed in the literature.
Microeconomic optimization and what-if analysis for facilities renewal
Authors: Saad Dina A. , Hegazy Tarek
Published: August 2015

Purpose

– The purpose of this paper is to propose a microeconomic-based approach to support fund-allocation decisions for a large number of assets. Under the prevailing financial constraints and rapid deterioration of facilities, arriving at optimum fund allocation for capital renewal projects has become very challenging. Due to the complexity of modeling multi-year life cycle cost analysis, existing fund-allocation methods have serious drawbacks when handling a large portfolio of assets, and their results are difficult to justify.

Design/methodology/approach

– This paper adopts well-established theories from microeconomics and proposes a new microeconomic-based decision support framework that has two novel components: a heuristic procedure to optimize and justify fund-allocation decisions by balancing the funding among the different asset categories; and a visual what-if analysis approach inspired by the economic indifference maps.

Findings

– Applying the proposed framework on a real case study of 800 building components proved that optimum decisions can be achieved through an equilibrium state at which fair and equitable allocations are made such that the utility per dollar is balanced for all asset categories. The visual what-if analysis approach presented a powerful graphical tool to visualize decisions, along with their costs and benefits, and facilitate sensitivity analysis under changes in budget levels.

Originality/value

– This paper, using the proposed microeconomic framework, sheds a new light on how fund-allocation optimization problems can be simplified, from an economic perspective, to arrive at accurate and justifiable decisions for a large portfolio of facilities.
The impact of information and communication technologies on informal scientific communication
Authors: Shehata Ahmed Maher khafaga , Ellis David , Foster Allen
Published: August 2015

Purpose

– This study aims to accomplish three objectives: first, to investigate the role and impact of information and communication technologies on the practice of science in the UK; second, to examine and characterise changes in scholarly communication activities such as information seeking, publishing and collaboration; and third, to investigate the validity of the current scholarly communication models and to determine whether there is a need for a new model.

Design/methodology/approach

– The study deployed a naturalistic inquiry approach using semi-structured interviews as a qualitative research tool. A theoretical sample of 40 researchers in four universities were interviewed to gather data regarding informal scholarly communication practices, factors that affect the researchers’ decisions and changes in the scholarly communication system.

Findings

– The results of the interviews suggest that there are three types of scholars who engage in scholarly communication activities. First, the “orthodox scholar”, who only uses formal and traditional scholarly communication approaches. Second, the “moderate scholar”, who prioritises formal communication approaches but, at the same time, is trying to get benefits from informal channels. Finally, the “heterodox scholar”, who uses all channels available in scholarly communication. The study also proposes a model of scholarly communication that reflects the current changes in scholarly research.

Research limitations/implications

– The paper describes the changes in informal scholarly communication practices in four universities in the UK. However, because the study used a naturalistic inquiry approach, the results cannot be generalised to a different population.

Originality/value

– There is limited literature investigating the changes in informal scholarly communication practices. The value of the current study lies in being the first study in this area that uses a naturalistic inquiry approach to investigate the changes in informal scholarly communication practices, and to develop a new model of scholarly communication.
A discussion of problems in implementing organisational cultural change
Authors: Limwichitr Saowapha , Broady-Preston Judith , Ellis David
Published: August 2015

Purpose

– The purpose of this paper is to review the literature on organisational cultural change and problems in its implementation, focussing on the case of building a learning organisation (LO) within university library context.

Design/methodology/approach

– Key literature published within Library and Information Science, Business and Management and other related fields were reviewed to identify themes regarding organisational cultural change in relation to development of an LO emerging in the recent years.

Findings

– Reviewed literature in this paper highlights key challenges in examining organisational cultural change for the purpose of building an LO. These include a lack of an agreed definition of the LO concept, practical approaches and measure for assessing achievement of the cultural change. A need for in-depth studies which focus on current practices and related problems in this regard is also revealed, and the systems approach is proposed as a suitable approach for holistic investigation of all critical elements that possibly affect establishment of an LO.

Originality/value

– The paper raises awareness of the importance of examining organisational cultural change as a critical supportive influence of developing an LO. Problems to be considered in its implementation are synthesised and served as a basis for further investigation in the author’s doctoral research project.
Trends in urinary incontinence in women between 4 and 24 months postpartum in the EDEN cohort
Authors: Quiboeuf E , Saurel‐Cubizolles M‐J , Fritel X ,   the EDEN Mother‐Child Cohort Study Group
Published: August 2015

Objective

Our aim was to study risk factors associated with the prevalence, incidence and remission of urinary incontinence (UI) between 4 and 24 months postpartum.

Design

Longitudinal study (EDEN cohort).

Setting

Two French university hospitals.

Population

1643 women completed the questionnaire at 4 months and 1409 at 24 months, including 1354 who completed it both times.

Methods

Multivariate analyses identified risk factors for UI prevalence at 24 months postpartum, persistent UI versus remission, de novo UI versus continence, de novo UI versus persistent UI, and changes in IU severity between 4 and 24 months postpartum.

Main outcome measures

Postnatal UI and Sandvik UI severity score.

Results

UI prevalence was 20.7% (340/1643) at 4 months and 19.9% (280/1409) at 24 months. Significant factors associated with UI at 24 months were older age [OR = 1.07/year (95%CI 1.04–1.11)], BMI [2.35 (1.44–3.85) ≥30 versus <25 kg/m²], higher parity [1.77 (1.14–2.76) ≥3 versus 1], breastfeeding [1.54 (1.08–2.19) ≥3 versus < 3 months], pregnant at follow up [3.44 (2.25–5.26)], and caesarean delivery [0.62 (0.40–0.97) versus vaginal] [OR, odds ratio (CI, confidence interval)]. The likelihood of UI remission at 24 months was 51.9% (149/287). Caesarean delivery was associated with increased likelihood of UI remission [0.43 (0.19–0.97)]. The risk of de novo UI at 24 months was 12.5% (135/1067) and was associated with a new pregnancy [3.63 (2.13–6.20)].

Conclusions

Between 4 and 24 months postpartum UI, remission occurred in half of the cases. These postnatal UI changes were essentially related to mode of delivery and subsequent pregnancy.

Tweetable abstract

Postnatal urinary incontinence progression is mostly related with mode of delivery and subsequent pregnancy.
Cisplatin combined with irinotecan or etoposide for untreated extensive‐stage small cell lung cancer: A multicenter randomized controlled clinical trial
Authors: Shi Yuankai , Hu Yi , Hu Xingsheng , Li Xue , Lin Lin , Han Xiaohong
Published: August 2015

Background

This study evaluated the efficacy and safety of irinotecan/cisplatin (IP) and etoposide/cisplatin (EP) in extensive‐stage small cell lung cancer (ES‐SCLC) and the distribution of uridine diphosphate glucuronosyltransferase (UGT1A1). The relationship between UGT1A1 genotypes and patient outcomes was also assessed.

Method

Patients with untreated ES‐SCLC were randomly assigned to receive either IP or EP, and blood specimens were collected to test the genotypes of UGT1A1*28 and UGT1A1*6. The association of efficacy and toxicity of an IP regimen with UGT1A1 genotype was analyzed.

Results

Of the 62 patients enrolled from three institutions, 30 patients were in the IP and 32 patients were in the EP arms, respectively. Disease control rates with IP and EP were 83.3% and 71.9%, respectively (P = 0.043). Median progression‐free survival for IP and EP were both six months. Median overall survival for IP and EP were 18.1 and 15.8 months respectively, without significant difference. Grade 3‐4 thrombocytopenia was more common with EP (18.8% vs. 6.7%; P = 0.035), while the incidence of diarrhea was higher with IP (70% vs. 15.6%; P = 0.008). The incidence of grade 1‐4 late‐onset diarrhea of wild‐type, heterozygous, and homozygous UGT1A1*28 were 65.0%, 85.7%, and 66.7%, respectively (P = 0.037). UGT1A1*28 polymorphisms, Eastern Cooperative Oncology Group performance status, and chemotherapy cycles were essential factors affecting grade 1‐4 late‐onset diarrhea in logistic regression analysis.

Conclusions

The efficacy of the IP regimen was similar to the EP regimen for untreated ES‐SCLC. UGT1A1 polymorphisms were associated with late‐onset diarrhea; however, there was no influence on efficacy.
Reexamining Growth Effects: Are All Types of Asset Growth the Same?
Authors: Cao Sean Shun
Published: August 2015

Asset growth has been shown to be negatively associated with future returns. Cooper, Gulen, and Schill (2008) argue that an aggregation of all asset growth components as total asset (TA) growth leads to the strongest association with future negative returns. Based on their study, the literature now employs TA growth as an umbrella proxy for “the growth effect.” I hypothesize that not all types of growth imply negative future returns. Specifically, I show that growth financed by suppliers is positively associated with future performance and returns. Removing this growth component from TA growth makes it evident that the TA growth anomaly is simply a noisy manifestation of the net operating asset growth anomaly. Consequently, I suggest caution when using TA growth to control for the growth effect.
Corporate Governance and the Information Content of Earnings Announcements: A Cross‐Country Analysis
Authors: Lau Sie Ting , Shrestha Keshab , Yu Jing
Published: August 2015

Using firm‐level data from 23 developed markets, we document a positive association between overall firm‐level governance quality and the informativeness of earnings announcements measured by abnormal stock return variance. This finding is robust after controlling for the potential endogeneity of firm‐level corporate governance. Further analyses reveal that firms with strong governance show little evidence of earnings management, appoint Big 4 auditing firms, and attract analyst following, implying a positive link between strong corporate governance and the information quality of earnings announcements. Finally, there is some evidence that the relation between firm‐level governance and market reactions around the announcements exists only in countries characterized by a transparent information environment and strong legal investor protection.
Understanding Audit Quality: Insights from Audit Professionals and Investors
Authors: Christensen Brant E. , Glover Steven M. , Omer Thomas C. , Shelley Marjorie K.
Published: August 2015

Projects seeking to define, measure, and evaluate audit quality are on the agendas of auditing standards setters as well as audit firms. The Public Company Accounting Oversight Board (PCAOB) currently provides information regarding audit quality through the release of inspection reports, and the Board intends to establish and report audit quality indicators. To provide additional perspective on audit quality, we obtain auditors' and investors' views, definitions, and indicators of audit quality. We find that investors' definitions of audit quality focus more on inputs to the audit process than do auditors', and that investors view the number of PCAOB deficiencies as an indicator of overall firm quality. We find a consensus that auditor characteristics may be the most important determinants of audit quality, and that restatements may be the most readily available signal of low audit quality. We relate responses to a general audit quality framework, provide support for archival audit research, and identify additional disclosures that participants suggest could signal audit quality. Taken together, we provide evidence regarding the construct of audit quality in the post‐SOX environment, evaluate many of the audit quality indicators proposed by the PCAOB, and suggest avenues for future research.
Just‐in‐Time to Save Lives: A Pilot Study of Layperson Tourniquet Application
Authors: Goolsby Craig , Branting Andrew , Chen Elizabeth , Mack Erin , Olsen Cara
Published: August 2015

Objectives

The objective was to determine whether just‐in‐time (JiT) instructions increase successful tourniquet application by laypersons.

Methods

This was a randomized pilot study conducted in August 2014. The study occurred at the Uniformed Services University campus in Bethesda, Maryland. A total of 194 volunteers without prior military service or medical training completed the study. The participant stood in front of a waist‐down mannequin that had an exposed leg. An observer read a scenario card aloud that described a mass casualty event. The observer then asked the participant to apply a Combat Application Tourniquet (C‐A‐T) to the mannequin. Test participants received a 4 × 6‐inch card, with JiT instructions, in addition to their C‐A‐T; controls received no instructions. Participants were randomized in a 3:1 ratio of instructions to no instructions. The study's primary outcome was the proportion of successfully applied tourniquets by participants receiving JiT instructions compared to participants not receiving instructions. Secondary outcomes included the time for successful tourniquet placement, reasons for failed tourniquet application, and participants' self‐reported willingness and comfort using tourniquets in real‐life settings.

Results

Just‐in‐time instructions more than doubled successful tourniquet placement. Participants supplied with JiT instructions placed a tourniquet successfully 44.14% of the time, compared to 20.41% of the time for controls without instructions (risk ratio = 2.16; 95% confidence interval = 1.21 to 3.87; p = 0.003).

Conclusions

Just‐in‐time instructions increase laypeople's successful application of C‐A‐T. This pilot study provides evidence that JiT instructions may assist the lay public in providing effective point‐of‐injury hemorrhage control.
A Novel Clinical Protocol for Placement and Management of Indwelling Urinary Catheters in Older Adults in the Emergency Department
Authors: Mulcare Mary R. , Rosen Tony , Clark Sunday , Viswanathan Kartik , Hayes Jaime Lynn , Stern Michael E. , Flomenbaum Neal E.
Published: August 2015

Objectives

Indwelling urinary catheters (IUCs) are placed frequently in older adults (age ≥ 65 years) in the emergency department (ED) and carry significant risks. The authors developed, implemented, and assessed a novel clinical protocol to assist ED providers with appropriate indications for placement, reassessment, and removal of IUCs in elders in the ED.

Methods

A comprehensive, evidence‐based clinical protocol was built from an extensive literature review and ED provider focus groups. It was implemented at a university‐based medical center with a 20‐minute scripted slide presentation. Written surveys were administered before, after, and at 6 months to assess providers' baseline practice and the protocol's effects. Surveys included asking providers for IUC management decisions in 25 unique clinical scenarios. Rates of IUC placement and catheter‐associated urinary tract infections (CAUTIs) were compared in ED older adult patients admitted to the hospital in the 6 months before and after protocol implementation.

Results

A total of 111 ED providers participated in the all three surveys. Immediately after protocol introduction, providers anticipated that this intervention would reduce rates of IUC use and increase patient safety. At 6‐month follow‐up, 81% felt the protocol had changed their practice, and 39% reported frequently referencing the protocol. In the clinical vignettes, ED providers correctly identified the appropriate approach for IUC placement in 63% of cases at baseline with an increase of 22% (95% confidence interval [CI] = 19% to 25%) postintervention and an increase of 8% (95% CI = 6% to 12%) between baseline and 6 months. An absolute reduction in the use of IUCs of 3.5% (p < 0.001) for older adults admitted to the hospital was observed after implementation of the protocol. There were three CAUTIs attributable to the ED in the 6 months prior to implementation and none in the 6 months after.

Conclusions

This comprehensive, evidence‐based clinical protocol was well received by participants and was associated with a sustained change in self‐reported practice, as supported by a reduction in IUC placement in admitted older adults and a reduction in CAUTIs attributable to the ED for this vulnerable population over the 6‐month study period.
Iodine deficiency in a study population of pregnant women in Sweden
Authors: Granfors Michaela , Andersson Maria , Stinca Sara , Åkerud Helena , Skalkidou Alkistis , Sundström Poromaa Inger , Wikström Anna‐Karin , Filipsson Nyström Helena
Published: August 2015

Introduction

Iodine deficiency in utero may impair neurological development of the fetus. In Sweden, iodine nutrition is considered to be adequate in the general population. The aim of this study was to evaluate iodine nutrition during pregnancy in Sweden.

Material and methods

In this cross‐sectional study, the total study population (n = 459) consisted of two cohorts (Värmland County, n = 273, and Uppsala County, n = 186) of pregnant non‐smoking women without pre‐gestational diabetes mellitus or known thyroid disease before or during pregnancy. Spot urine samples were collected in the third trimester of pregnancy for median urinary iodine concentration (UIC) analysis.

Results

The median UIC in the total study population was 98 μg/L (interquartile range 57–148 μg/L).

Conclusions

According to WHO/UNICEF/IGN criteria, population‐based median UIC during pregnancy should be 150–249 μg/L. Thus, our results indicate insufficient iodine status in the pregnant population of Sweden. There is an urgent need for further assessments in order to optimize iodine nutrition during pregnancy.
Critical evaluation of national vital statistics: the case of preterm birth trends in Portugal
Authors: Correia Sofia , Rodrigues Teresa , Montenegro Nuno , Barros Henrique
Published: August 2015

Introduction

Using vital statistics, the Portuguese National Health Plan predicts that 14% of live births will be preterm in 2016. The prediction was based on a preterm birth rise from 5.9% in 2000 to 8.8% in 2009. However, the same source showed an actual decline from 2010 onwards. To assess the plausibility of national preterm birth trends, we aimed to compare the evolution of preterm birth and low birthweight rates between vital statistics and a hospital database.

Material and methods

A time‐trend analysis (2004–2011) of preterm birth (<37 gestational weeks) and low birthweight (<2500 g) rates was conducted using data on singleton births from the national birth certificates (n = 801 783) and an electronic maternity unit database (n = 21 392). Annual prevalence estimates, ratios of preterm birth:low birthweight and adjusted prevalence ratios were estimated to compare data sources.

Results

Although the national prevalence of preterm birth increased from 2004 (5.4%), particularly between 2006 and 2009 (highest rate was 7.5% in 2007), and decreased after 2009 (5.7% in 2011), the prevalence at the maternity unit remained constant. Between 2006 and 2009, preterm birth was almost 1.4 times higher in the national statistics (using the national or the catchment region samples) than in the maternity unit, but no differences were found for low birthweight.

Conclusion

Portuguese preterm birth prevalence seems biased between 2006 and 2009, suggesting that early term babies were misclassified as preterm. As civil registration systems are important to support public health decisions, monitoring strategies should be taken to assure good quality data.
Comparative teratogenicity analysis of valnoctamide, risperidone, and olanzapine in mice
Authors: Wlodarczyk Bogdan J , Ogle Krystal , Lin Linda Ying , Bialer Meir , Finnell Richard H
Published: August 2015

Objectives

Based on the recent findings from animal studies, it has been proposed that the therapeutic use of valnoctamide, an anxiolytic drug developed in the early 1960s, be extended to treat other neurological disorders such as epilepsy and bipolar disease. Given the scarcity of adequate data on its prenatal toxicity, a comparative teratogenicity study of valnoctamide and two of the most commonly used drugs to treat bipolar disorder, risperidone and olanzapine, was carried out in a mouse model system.

Methods

Pregnant dams were treated with the aforementioned three drugs at the dose levels calculated as an equal proportion of the respective LD50 values of these drugs. The main reproductive indices examined included the numbers of implantations and resorptions, viable and dead fetuses, and fetal gross, visceral and skeletal abnormalities.

Results

The outcomes of the present study indicated that olanzapine was the most teratogenic of the three drugs, inducing maternal‐, embryo‐, and fetotoxicity. Risperidone also exerted a significant prenatal toxicity, but its adverse effect was less pronounced than that induced by olanzapine. Valnoctamide did not show any teratogenic effect, even when used in relatively higher dosages than olanzapine and risperidone. The observed increased skeletal abnormalities in one of the valnoctamide treatment groups were nonspecific and, as such, signaled a modest developmental delay rather than an indication that the compound could induce structural malformations.

Conclusions

Under our experimental conditions, valnoctamide demonstrated the lowest prenatal toxicity of the three tested drugs.
A new insight into masticatory function and its determinants: a latent class analysis
Authors: Feizi Awat , Keshteli Ammar Hassanzadeh , Khazaei Saber , Adibi Peyman
Published: August 2015

Objective

Masticatory function is an important factor for preservation of general health. Epidemiologic data on masticatory function and its determinants among Iranian population are sparse, and no study has evaluated masticatory function using latent class analysis (LCA). This study was conducted to investigate the masticatory function and its determinants among a large sample of Iranian adults.

Methods

In a cross‐sectional study among 8691 adults, masticatory function was investigated using a validated questionnaire. LCA and latent class regression (LCR) were applied to identify classes of masticatory function and its potential determinants, respectively. In addition, multigroup LCA was conducted based on gender and age categories.

Results

In total, 11.24% and 24.87% of participants had poor and moderate masticatory function, respectively. Males (class size: 14.33%) were more likely to have poor masticatory function than females (class size: 2.35%) (P < 0.001). The results of LCR showed that higher age [adjusted odds ratio (OR): 1.09, 95% confidence interval (95% CI): 1.07–1.11, P < 0.001], male gender (OR: 1.37, 95% CI: 1.01–1.87, P < 0.05), and low physical activity (OR: 1.41, 95% CI: 1.08–1.85, P < 0.05) were associated with poor masticatory function. Nonsmokers had a lower chance of being in poor masticatory function class than heavy smokers (OR: 0.21, 95% CI: 0.11–0.38, P < 0.001).

Conclusion

The prevalence of poor masticatory function is high among Iranian adults. Aging, male gender, low levels of physical activity, and smoking were found to be associated with poor masticatory function.
Eosinophils: important players in humoral immunity
Authors: Berek C
Published: August 2015

Eosinophils perform numerous tasks. They are involved in inflammatory reactions associated with innate immune defence against parasitic infections and are also involved in pathological processes in response to allergens. Recently, however, it has become clear that eosinophils also play crucial non-inflammatory roles in the generation and maintenance of adaptive immune responses. Eosinophils, being a major source of the plasma cell survival factor APRIL (activation and proliferation-induced ligand), are essential not only for the long-term survival of plasma cells in the bone marrow, but also for the maintenance of these cells in the lamina propria which underlies the gut epithelium. At steady state under non-inflammatory conditions eosinophils are resident cells of the gastrointestinal tract, although only few are present in the major organized lymphoid tissue of the gut – the Peyer’s patches (PP). Surprisingly, however, lack of eosinophils abolishes efficient class-switching of B cells to immunoglobulin (Ig)A in the germinal centres of PP. Thus, eosinophils are required to generate and to maintain mucosal IgA plasma cells, and as a consequence their absence leads to a marked reduction of IgA both in serum and in the gut-associated lymphoid tissues (GALT). Eosinophils thus have an essential part in long-term humoral immune protection, as they are crucial for the longevity of antibody-producing plasma cells in the bone marrow and, in addition, for gut immune homeostasis.
Predicting consequences of climate change for ecosystem functioning: variation across trophic levels, species and individuals
Authors: Best Rebecca J. , Stone Michelle N. , Stachowicz John J.
Published: August 2015

Aim

Maintenance of ecosystem function under climate change may depend on variation in the way species within functional guilds and individuals within species respond to changes in temperature. What level of variation among and within species do we need to understand, and is it predictable from distribution and trait data?

Location

Northern California, USA.

Methods

We used a mesocosm experiment and a set of feeding trials to test the ability of a guild of marine invertebrate grazers to control benthic algal blooms along a local temperature gradient. We investigate links between the locally disjunct distributions of these species, their temperature tolerance traits and the temperature dependence of their population growth and grazing rates.

Results

We found that the effect of increased temperature on population growth rates is independent of species interactions, but strongly species specific. This variation among herbivores is only partly predictable from differences in species distributions and traits, but translated into large differences in their ability to control macroalgae. Further, these species effects were amplified at warmer temperatures. Finally, we found evidence for a strong response to temperature in the feeding rates of the most important consumer over the course of the experiment, resulting in almost as much variation in grazing rates within one species as the average difference between species.

Main conclusions

These results illustrate the importance of understanding the variation in responses to temperature among species within a trophic level, among populations within key species and potentially within populations over time. However, this variation is not easily predicted. Further research is needed to uncover links between individuals' thermal optima and their current and future temperature niche.
Predicting regional densities from bird occurrence data: validation and effects of species traits in a Macaronesian Island
Authors: Carrascal Luis M. , Aragón Pedro , Palomino David , Lobo Jorge M.
Published: August 2015

Aim

Quantifying species abundances is costly, especially when many species are involved. To overcome this problem, several studies have predicted local abundances (at the sample unit level) from species occurrence distribution models (SODMs), with differences in predictive performance among studies. Surprisingly, the ability of SODM to predict regional abundances of an entire area of interest has never been tested, despite the fact that it is an essential parameter for species conservation and management. We tested whether local and regional abundances of 21 terrestrial bird species could be predicted from SODMs in an exhaustively surveyed island, and examined the variation explained by species‐specific traits.

Location

La Palma Island, Canary Islands.

Methods

We firstly assessed two types of algorithms representing the two main families of SODMs. We built models using presence/absence (boosted classification trees) and presence/background (MaxEnt) data as a function of relevant environmental predictors and tested their ability to predict the observed local abundances. The predicted probabilities of occurrence (Pi) were translated into animal numbers (n′) using the revisited equation ni′ = −ln(1−Pi), and we obtained regional abundances (for the whole island).

Results

Predictive ability of presence/absence models was superior than that of MaxEnt. At the regional level, the observed average densities of all species were highly predictable from occurrence probabilities (R2 = 93.5%), without overall overestimation or underestimation. Interspecific variation in the accuracy of predicted regional density was largely explained (R2 = 73%), with habitat breath and variation in local abundance being the traits of greatest importance.

Main conclusions

Despite uncertainties associated with local predictions and the idiosyncrasies of each species, our procedures enabled us to predict regional abundances in an unbiased way. Our approach provides a cost‐effective tool when a large number of species are involved. Furthermore, the influence of species‐specific traits on the prediction accuracy provides insights into sampling designs for focal species.
Tissue Doppler Imaging predicts central sleep apnea in patients with chronic heart failure: data from the Daunia Registry
Authors: Correale Michele , Brunetti Natale Daniele , Forte Lucia , Passero Tommaso , Monaco Ilenia , Ferraretti Armando , Totaro Antonio , Carpagnano Giovanna Elisiana , Foschino Barbaro Maria Pia , Di Biase Matteo , Lacedonia Donato
Published: August 2015

Background

Tissue Doppler imaging (TDI) is used to improve risk stratification in patients with chronic heart failure (CHF). So far, few studies have used this method to investigate the characteristics of subjects with CHF and Cheyne–Stokes breathing (CSB). The aim of this study was therefore to evaluate whether TDI assessment may predict the presence of CSB in patients with CHF.

Materials and methods

A total of 41 consecutive patients with CHF enrolled in the Daunia Heart Failure Registry underwent echocardiography assessment and nocturnal polygraphy to evaluate the presence of sleep apnea and CSB. Conventional echocardiography and TDI parameters were calculated. We have also quantified by TDI a combined index (EAS index) of diastolic and systolic performance: E'/(A' × S').

Results

Subjects with evidence of CSB (N = 8) were characterized by lower values of A' (5·03 ± 2·64 vs. 7·88 ± 2·64 cm/s, P < 0·01). A' and EAS index values were related to Cheyne–Stokes episode rates (r = −0·49 and 0·52, P < 0·05 and <0·01 respectively), EAS index values also with the number of episodes of central apnea (r = 0·39, P < 0·05). A' values predicted the presence of CSB at poly‐somnography examination with an OR 0·62 (95% CI 0·40–0·96, P < 0·05) even after correction for age and gender.

Conclusions

Tissue Doppler imaging values (A') are associated with the presence of sleep apnea at nocturnal polygraphy.
Does Inter‐jurisdictional Competition Engender a “Race to the Bottom”? A Meta‐Regression Analysis
Authors: Costa‐Font Joan , De‐Albuquerque Filipe , Doucouliagos Hristos
Published: August 2015

A growing literature documents the existence of strategic political reactions to public expenditure between rival jurisdictions. These interactions can potentially create a downward expenditure spiral (“race to the bottom”) or a rising expenditure spiral (“race to the top”). However, in the course of identifying the existence of such interactions and ascertaining their underlying triggers, the empirical evidence has produced markedly heterogeneous findings. Most of this heterogeneity can be traced back to study design and institutional differences. This article contributes to the literature by applying meta‐regression analysis to quantify the magnitude of strategic inter‐jurisdictional expenditure interactions, controlling for study, and institutional characteristics. We find several robust results beyond confirming that jurisdictions do engage in strategic expenditure interactions, namely that strategic interactions: (i) are weakening over time, (ii) are stronger among municipalities than among higher levels of government, and (iii) appear to be more influenced from tax competition than yardstick competition, with capital controls and fiscal decentralization shaping the magnitude of fiscal interactions.