bluuebunny/crossref_metadata_2025 huggingface dataset:
“Juggling many balls”: Working and studying among first‐year nursing students
Authors: Christiansen Angela , Salamonson Yenna , Crawford Ruth , McGrath Belinda , Roach David , Wall Peter , Kelly Mandy , Ramjan Lucie M.
Published: July 2019

Aims and objectives

To explore the experiences of first‐year nursing students, their motivations for working and how they juggled study and other commitments while engaging in paid work.

Background

There has been a global rise in the number of students balancing full‐time study, paid work and other commitments, with the main antecedent financial reasons.

Design

Qualitative exploratory study.

Methods

Drawn from a larger Australasian sequential exploratory mixed‐method study, this qualitative study was conducted with fifty first‐year undergraduate nursing and midwifery students who commenced their nursing studies in 2017. Telephone or face‐to‐face interviews were conducted with purposively selected students engaged in either nursing or non‐nursing fields of work. Interviews were conducted from April–July 2017. Interviews lasted from 15–40 min. Results were thematically analysed. EQUATOR guidelines for qualitative research (COREQ) applied.

Findings

Two main themes and accompanying subthemes were identified. The first theme explored students’ motivation behind combining work and study and identified the need for financial security and “me time”. The second theme “Juggling many balls” provided insights into the benefits students perceived, how they kept the “balls” in the air and at times dropped “balls” while balancing work, study and other commitments.

Conclusions

The motivation behind paid work was mainly financial; however, students also reported work allowed an escape and time for self which had social and health benefits. Working provided a range of positive benefits, including a sense of achievement, improved self‐esteem and financial independence.

Relevance to clinical practice

Being able to juggle and multi‐task improved skills such as organisation and the ability to prioritise, all skills that have applicability for the role as registered nurse.
Does health guidance concerning lifestyle disease prevention spread to spouses? A qualitative study
Authors: Kiryu Ikue , Sato Yumi
Published: July 2019

Aims and objectives

To describe how a health guidance programme provided to one person influences change in their spouse's health behaviours.

Background

Individuals are indirectly affected by the health behaviours of those close to them; therefore, it is likely that guidance on the prevention of lifestyle disease modifies the behaviour of targeted individuals and their family members. In a previous study, approximately 30% of families displayed positive health changes because one individual family member received health guidance.

Design

This study used an inductive, exploratory, qualitative design.

Methods

Semi‐structured interviews were conducted with spouses of persons who participated in a health guidance programme for lifestyle‐related disease prevention. Data were analysed from 11 spouses (all women; Mage = 61.0 ± 9.1 years) using a modified grounded theory approach. This study was conducted according to the consolidated criteria for reporting qualitative research (COREQ; see Appendix S1).

Results

The process of change in each spouse was a result of their partner's influence, which changed from a stage of assisting, where the spouse contemplated {I am just a supporter} to the partner, to a stage where the spouse thought {I am also a player}, and she engaged in her own health improvement practices.

Conclusions

For a spouse to change from assisting their partner to becoming a practitioner of their own health improvement, the spouse needed to experience a sense of surprise at the changes in her partner, through calm observation of the partner's attitude. Through the spreading effect of health guidance utilisation, indirect encouragement could be expected, even when people have difficulty accessing healthcare services.

Relevance to clinical practice

This type of spreading effect from one participant to a family member could perhaps assist health guidance provisions so that disease prevention becomes more efficient.
Effectiveness of health education by telephone follow‐up on self‐efficacy among discharged patients with rheumatoid arthritis: A randomised control trial
Authors: Zhao Shangping , Chen Hong
Published: July 2019

Aims and objectives

To explore the effectiveness of a health education programme by telephone follow‐up on the self‐efficacy of patients with rheumatoid arthritis (RA).

Background

Self‐efficacy is increasingly perceived to be a cornerstone in improving the capacity of self‐management. However, a paucity of research has demonstrated the effectiveness of health education by the use of a telephone follow‐up for RA patients in China.

Design

This study was a randomised control trial.

Methods

Recruited patients were randomly divided into control and intervention groups. The intervention group accepted health education by telephone follow‐up four times after the patients were discharged. The patients in the control group only accepted telephone follow‐up once after they were discharged. Self‐efficacy was measured by the use of the Rheumatoid Arthritis Self‐Efficacy Questionnaire (RASE), and data were collected at the day before the discharge, the 12th week and the 24th week after patients were discharged. The CONSORT checklist was used to check the procedure.

Results

A total of 92 discharged patients with rheumatoid arthritis were enrolled. The sociodemographic indexes of the control and intervention groups had no significant differences at baseline (p > .05). The RASE score of the intervention group was higher than that of the control group (p < .05) at the 12th week and the 24th week.

Conclusion

The HET improved the self‐efficacy of the discharged patients with RA in the 12th week and the 24th week after discharge. This study demonstrated that our HET can improve the short‐term and long‐term effects of self‐efficacy, which implies that the clinical nursing staff should increase the frequency of HET to improve the patients’ knowledge and abilities of self‐management.

Relevance to clinical practice

Patients with RA will benefit from a health education programme by telephone follow‐up; thus, it is necessary for nursing managers to implement this programme.
Effect of viral load on pregnancy outcomes in chronic hepatitis B infection
Authors: Unal Canan , Tanacan Atakan , Ziyadova Gunel , Fadiloglu Erdem , Beksac Mehmet S.
Published: July 2019

Aim

This study aimed to evaluate perinatal and neonatal outcomes in pregnant women with chronic hepatitis B virus infection based on infection status and to identify cut‐off values based on hepatitis B virus DNA viral load to predict composite adverse perinatal/neonatal outcomes.

Methods

Pregnant women with chronic hepatitis B virus who delivered at Hacettepe University between 2010 and 2018 were evaluated retrospectively. We included 95 patients. The patients were classified into two groups based on laboratory findings and viral load: group 1 (n = 63), immune inactive; and group 2 (n = 32), immune active. Maternal age, gravidity, parity, gestational week at birth, birth weight, 5th minute APGAR scores and composite perinatal and neonatal outcomes were compared between groups.

Results

Gestational week at birth, birth weight and 5th minute APGAR score in group 2 were lower than those in group 1 (P < 0.001, P < 0.005 and P < 0.001, respectively). The rates of composite adverse perinatal/neonatal outcome, preterm birth, fetal growth restriction, oligohydramnios, pre‐eclampsia, admission to the neonatal intensive care unit, small for gestational age and 5th minute APGAR score less than 7 were significantly higher in group 2 (P < 0.001). Hepatitis B virus DNA viral load of 17 515 IU/mL (72.7% sensitivity, 78.1% specificity) and 17 515 IU/mL (81.8% sensitivity, 80.8% specificity) were determined to be cut‐off values for composite adverse perinatal and neonatal outcomes, respectively.

Conclusion

Care should be taken in patients with a viral load of greater than 17 515 IU/mL, and pregnancy should be postponed until the inactive phase of the disease for optimal results.
Assessment of oral health‐related quality of life, measured by OHIP‐14 and GOHAI, and psychological profiling in burning mouth syndrome: A case‐control clinical study
Authors: Adamo Daniela , Pecoraro Giuseppe , Fortuna Giulio , Amato Massimo , Marenzi Gaetano , Aria Massimo , Mignogna Michele Davide
Published: July 2019

Objectives

To evaluate the oral health‐related quality of life (OHRQoL) of patients with burning mouth syndrome (BMS) by comparing the Oral Health Impact Profile‐14 (OHIP‐14) and Geriatric Oral Health Assessment Index (GOHAI) tests, assessing their dependence with pain, anxiety and depression and, secondly, to analyse the changes in time after treatment with psychotropic drugs.

Methods

Twenty‐six patients and 26 controls were included. The GOHAI, OHIP‐14, visual analogue scale (VAS) and the Hamilton Rating Scales for Depression and Anxiety (HAM‐D and HAM‐A) were performed at baseline (time 0) and after 6 months of treatment (time 1). Descriptive statistics, the Mann‐Whitney non‐parametric test for two independent samples and the Wilcoxon non‐parametric test for two paired samples were used.

Results

The scores from all outcome measurements were statistically significantly different between the cases and controls (P < .001) with a strong correlation between the GOHAI and the OHIP‐14 (P < .001). The BMS patients showed a statistically significant improvement in the VAS, HAM‐D and HAM‐A scores from time 0 to time 1 (P < 0.001), and in the OHIP‐14 scores (P < .004**) after the treatment, but no statistically significant difference in the GOHAI score (.464).

Conclusions

Burning mouth syndrome patients showed poorer scores on all scales compared to the healthy subjects with a lower OHRQoL. OHIP‐14 gives a greater weight to psychological and behavioural outcomes in evaluating oral health than GOHAI, and therefore, it is a more effective questionnaire in terms of the evaluation of the treatment response. The management of BMS can improve pain, anxiety and depression and the OHRQoL.
Loudness registers: Normalizing cosmopolitan identities in a narrative of ethnic othering
Authors: Singh Jaspal Naveel
Published: July 2019

An analysis of one narrative shows how loudness of voice acquires indexical meaning in interaction and becomes a resource for the narrator to position himself along an axis of social differentiation defined in terms of morality. The narrative was collected among young, male, migrant hip hop artists in Delhi who experienced ethnic othering. In the narrative, loudness registers are used to establish voice contrasts between two antagonistic characters: the racist people of Delhi and the cosmopolitan hip hop self. The racist people speak in soft (piano) and loud (forte) registers, while the cosmopolitan self speaks in normal‐volume registers. The prosodic normalization of the self allows the narrator to differentiate himself from racist others, take moral stances on global solidarity, and construct his cosmopolitan identity.
Hepatitis B and C virus infection and risk of haematological malignancies
Authors: Marrone Aldo , Ciotti Marco , Rinaldi Luca , Adinolfi Luigi Elio , Ghany Marc
Published: July 2019

Hepatitis B virus (HBV) and hepatitis C virus (HCV) are classified as oncogenic human viruses. Chronic HBV and HCV infections are associated with higher risk of haematological malignancy development. Direct and indirect oncogenic mechanisms have been demonstrated for both HBV and HCV in several studies. HCV and overt/occult HBV infections in patients with oncohaematological disease constitute an impediment and a threat during immunosuppressive chemotherapy treatment. We review the HBV and HCV oncogenic mechanisms and the impact and the safety of antiviral treatment in patients with haematological malignancies.
Pharmacokinetics and tissue residues of enrofloxacin in the largemouth bass (Micropterus salmoides) after oral administration
Authors: Shan Qi , Wang Jingxin , Zheng Guangming , Zhu Xinping , Yang Yuanhao , Ma Lisha , Zhao Cheng , Li Lichun , Yin Yi
Published: July 2019

The study was carried out to evaluate the pharmacokinetic disposition of enrofloxacin (ENF) with a single dose of 20 mg/kg after oral administration in largemouth bass (Micropterus salmoides) at 28°C. The concentrations of ENF and of its metabolite ciprofloxacin (CIP) in plasma, liver, and muscle plus skin in natural proportions were determined using HPLC. The concentration–time data for ENF in plasma were best described by a two‐compartment open model. After oral administration, the maximum ENF concentration (Cmax) of 10.99 μg/ml was obtained at 0.60 hr. The absorption half‐life (T1/2Ka) of ENF was calculated to be 0.07 hr whereas the elimination half‐life (T1/2β) of the drug was 90.79 hr. The estimates of area under the plasma concentration–time curve (AUC) and apparent volume of distribution (Vd/F) were 1,185.73 μg hr/ml and 2.21 L/kg, respectively. ENF residues were slowly depleted from the liver and muscle plus skin of largemouth bass with the T1/2β of 124.73 and 115.14 hr, respectively. Very low levels of ciprofloxacin were detected in the plasma and tissues. A withdrawal time of 24 days was necessary to ensure that the residues of ENF + CIP in muscle plus skin were less than the maximal residue limit (MRL) of 100 μg/kg established by the European Union.
Allometric growth of limb and body proportions in crocodylians
Authors: Iijima M. , Kubo T.
Published: July 2019

Crocodylia is the sole extant remnant of quadrupedal archosaurs playing a pivotal role in understanding the evolution of growth allometry in the archosaur locomotor apparatus. However, among crocodylians, the postnatal growth of the postcranial skeleton has almost exclusively been examined in Alligator mississippiensis, and whether other species share the same growth pattern is unknown. Here, we tested whether the following allometric trends are conserved across Crocodylia: (1) forelimb length grows isometrically relative to hindlimb length; (2) fore‐ and hindlimb lengths become relatively shorter with increasing body size; and (3) long bone cross‐sectional geometry becomes more robust relative to body size. We examined the relationships of limb lengths, stylopodial circumferences and presacral length (body size proxy) in extant crocodylians using reduced major axis regressions and compared the slopes among species. The result revealed non‐uniform growth patterns of limb architecture among living crocodylians. Generally, the hindlimb grows with negative allometry against the forelimb in non‐gavialid crocodylians, whereas two gavialids (Gavialis gangeticus and Tomistoma schlegelii) showed isometry in hind‐ vs. forelimb length scaling, potentially reflecting their unique locomotor ecology. Femur circumference scales negatively against humerus circumference in most of the species examined, which may be related to the anterior shift of the center of mass during growth. Stylopodial circumferences scale variously against stylopodial lengths and presacral length in crocodylians, lending little support to hypotheses that these allometries correlate with adult body size or metabolism (i.e. ectothermic or endothermic) in tetrapods.
The roles of sex and morphology in burrowing depth of Iberian spadefoot toads in different biotic and abiotic environments
Authors: Zamora‐Camacho F. J. , Medina‐Gálvez L. , Zambrano‐Fernández S.
Published: July 2019

Hiding behavior is key for most animals’ fitness, but it entails costs that must be balanced with benefits. Most research on this potential trade‐off focuses on hiding time. However, other features that might mirror an actual energy investment on hiding behavior, such as burrowing depth, have long been neglected. In this work, we examined energy‐demanding burrowing behavior of Iberian spadefoot toads (Pelobates cultripes), which hide in burrows they dig with the aid of a hard spade on each hindlimb. Namely, we tested whether toads increased burrowing depth as a response to soil dryness and predator kairomones, in search for subterranean humidity and predator avoidance, respectively. To do so, we measured burrowing depth of adult toads under three different treatments in a repeated‐measures design: damp sand, dry sand and sand with boar predator kairomones. We also checked potential effects of sex and morphology (snout–vent length, body mass, hindlimb length and spade length) on burrowing depth. Morphometric variables measured were not good predictors of burrowing depth: Mainly, body mass showed a negative relationship with burrowing depth. However, despite their greater body mass, females burrowed deeper than males in the damp sand treatment. Albeit, contradicting our hypothesis, males did not respond to the presence of predator kairomones, while females reduced their burrowing depth. This result could be a consequence of predator‐induced stress affecting burrowing ability. Also, both females and males burrowed shallower in the dry‐sand treatment than in the others, which could be due to substrate instability or to dehydration.
Public Debt Consolidation and its Distributional Effects
Authors: Sakkas Stelios , Varthalitis Petros
Published: July 2019

We build a dynamic general equilibrium model with heterogeneous households, namely Rich and Poor, and capital–skill complementarity structure in the production function, to study aggregate and distributional implications of fiscal consolidation policies when the government uses a rich set of spending and tax instruments. Fiscal policy is conducted through constrained optimized fiscal rules. Our results show that, in the long run, fiscal consolidation enhances both aggregate efficiency and equity; however, it may hurt Rich households depending on which fiscal instrument takes advantage of the fiscal space created. Along the transition, wage inequality significantly increases due to the capital–skill complementarity structure of the production function. Specifically, this happens because debt consolidation crowds in capital and this favors Rich (skilled) households. On the other hand, the reduction in interest rates and government bonds lead to a decrease in Rich households’ income coming from capital and government bonds which eventually decrease income inequality. Finally, a rather novel finding is that the combination of asset and skill heterogeneity amplifies the increase in wage inequality in the early phase of fiscal consolidation.
Amazon fish bacterial communities show structural convergence along widespread hydrochemical gradients
Authors: Sylvain François‐Étienne , Holland Aleicia , Audet‐Gilbert Émie , Luis Val Adalberto , Derome Nicolas
Published: July 2019

The world's richest freshwater fish community thrives in gradients of contrasting environments in Amazonia, ranging from ion‐poor acidic black waters, to ion‐rich circumneutral white waters. These hydrochemical gradients structure Amazonian fish assemblages via ecological speciation events. Fish bacterial communities contain an important genetic heritage essential for their hosts' survival and are also involved in adaptive divergence via niche adaptation processes, but the extent to which they evolve in response to hydrochemical gradients in Amazonia is unknown. Here we investigated bacterial communities (gut and skin mucus) of two ecologically and phylogenetically divergent host species (Mesonauta festivus and Serrasalmus rhombeus) distributed throughout these hydrochemical gradients. The goal was to characterize intra‐ and interspecific Amazonian fish microbiome variations across multiple scales. Using a 16S metabarcoding approach, we investigated the microbiota of 43 wild M. festivus, 32 S. rhombeus and seven water samples, collected at seven sampling sites encompassing both water colours. Taxonomical structures of bacterial communities from both host species were significantly correlated to the environmental continua of magnesium, sodium, dissolved organic carbon, calcium, dissolved O2, pH, potassium, hardness and chloride. Analysis of discriminating features in community structures across multiple scales demonstrated intra‐ and interspecific structural parallelisms in the response to the hydrochemical gradients. Together, these parallelisms suggest the action of selection on bacterial community structures along Amazonian hydrochemical gradients. Functional approaches along with reciprocal transplant experiments will provide further insights on the potential contribution of Amazonian fish microbiomes in host adaptation and ecological speciation events.
Elevated CO2‐induced improvement of mycorrhization – which players lie in‐between?
Authors: Hause Bettina
Published: July 2019

This article is a Commentary on Zhou et al. 224: 106–116.
Newly depolymerized large organic N contributes directly to amino acid uptake in young maize plants
Authors: Enggrob Kirsten Lønne , Jakobsen Charlotte Marie , Pedersen Ingeborg Frøsig , Rasmussen Jim
Published: July 2019

The contribution of large molecular size organic nitrogen (N) to plant N uptake is unclear.

Soils with and without maize, at three pH levels, were treated with (carbon‐14 and ‐13 (14C, 13C), 15N) triple‐labelled > 100 kDa organic N. After 48 h, soil and maize were sampled for bulk and compound specific isotope analysis to study the turnover in soil and plant 13C and 15N uptake.

Mineralization of > 100 kDa organic N increased with higher pH only in soil without maize. The > 100 kDa organic N disappeared rapidly in soils with and without maize, but surprisingly more > 100 kDa organic N derived amino acids remained in soil with than without maize – most likely in the microbial biomass. Total 15N uptake in maize increased with higher soil pH. The organic N uptake was estimated to account for 20–30% of the total 15N uptake. Organic N uptake was confirmed by the presence of 13C‐labelled amino acids in maize roots.

The study suggests that the importance of plant organic N uptake increases when N is derived from complex molecules such as proteins compared to studies using single amino acids as N source, and that rhizosphere microorganisms increase anabolic utilization of organic N compared to microorganisms in the bulk soil.
Time to talk knowledge
Authors: Taylor Mike
Published: July 2019

As part of the secondary school qualification repackaging, the Ministry of Education has requested the geography education community define what constitutes their “critical body of knowledge.” In this article, I discuss three knowledge‐oriented themes focused on: (a) recent assessment trends in geography; (b) the predictive value of NCEA Level 3 geography with 100‐level success and (c) the nature of knowledge as expressed by the New Zealand Curriculum and assessment. Taken together, these themes suggest a need for a serious conversation about knowledge in school geography, as a pre‐cursor to the re‐design of the geography standards matrix.
The use of Animals at Roman Roadside Settlements in Britain: Contextualizing some new Results from Ware, Hertfordshire
Authors: Wright Elizabeth , Tecce Sofia , Albarella Umberto
Published: July 2019

Recent analysis of a large faunal assemblage from a Roman roadside settlement at Ware, Hertfordshire has indicated potentially strong links between the nature of animal exploitation on site and its location on Ermine Street. Animal husbandry was focused on the production of cattle and sheep, both of which had experienced stock ‘improvement’ by the late Roman period. Relatively high proportions of horse, and the presence of young horses, suggest the importance of this animal and the potential for its local breeding; the site could have acted as a station for changing or selling horses. The presence of marine fish and black rat also indicate clear links to the wider trade network. This was not an isolated settlement, outside the sphere of Roman influence, as rural Roman sites are often considered to be, but well‐connected to wider economic networks. This paper places these new results in context, by providing a review of faunal assemblages from Roman roadside settlements across Britain. The review indicates that most of the characteristics of animal exploitation at Ware are shared with other roadside settlement sites, though interesting differences also emerge.
Use of continuous subcutaneous insulin infusion (CSII) therapy in pediatric diabetes patients in the perioperative period
Authors: Vanderhoek Samuel M. , Wolf Risa M.
Published: July 2019

Diabetes mellitus is one of the most common endocrinopathies encountered in the perioperative period, and the pediatric population is increasingly using continuous subcutaneous insulin infusions for diabetes management. As these patients present for procedures or surgery requiring anesthesia, the anesthesia provider is charged with the task of managing these pumps perioperatively. Here, we review our experience from a large tertiary care academic medical center and propose recommendations for the perioperative management of children and adolescents with diabetes who use insulin pumps.
Characterization of four polymorphic genes controlling red leaf colour in lettuce that have undergone disruptive selection since domestication
Authors: Su Wenqing , Tao Rong , Liu Wenye , Yu Changchun , Yue Zhen , He Shuping , Lavelle Dean , Zhang Weiyi , Zhang Lei , An Guanghui , Zhang Yu , Hu Qun , Larkin Robert M. , Michelmore Richard W. , Kuang Hanhui , Chen Jiongjiong
Published: July 2019

Anthocyanins protect plants from biotic and abiotic stressors and provide great health benefits to consumers. In this study, we cloned four genes (Red Lettuce Leaves 1 to 4: RLL1 to RLL4) that contribute to colour variations in lettuce. The RLL1 gene encodes a bHLH transcription factor, and a 5‐bp deletion in some cultivars abolishes its function to activate the anthocyanin biosynthesis pathway. The RLL2 gene encodes an R2R3‐MYB transcription factor, which was derived from a duplication followed by mutations in its promoter region. The RLL3 gene encodes an R2‐MYB transcription factor, which down‐regulates anthocyanin biosynthesis through competing with RLL2 for interaction with RLL1; a mis‐sense mutation compromises the capacity of RLL3 to bind RLL1. The RLL4 gene encodes a WD‐40 transcription factor, homologous to the RUP genes suppressing the UV‐B signal transduction pathway in Arabidopsis; a mis‐sense mutation in rll4 attenuates its suppressing function, leading to a high concentration of anthocyanins. Sequence analysis of the RLL1‐RLL4 genes from wild and cultivated lettuce showed that their function‐changing mutations occurred after domestication. The mutations in rll1 disrupt anthocyanin biosynthesis, while the mutations in RLL2, rll3 and rll4 activate anthocyanin biosynthesis, showing disruptive selection for leaf colour during domestication of lettuce. The characterization of multiple polymorphic genes in this study provides the necessary molecular resources for the rational breeding of lettuce cultivars with distinct levels of red pigments and green cultivars with high levels of health‐promoting flavonoids.
Obesity and underweight: Serious health problems in Iranian primary school children
Authors: Emamian Mohammad Hassan , Hashemi Hassan , Fotouhi Akbar
Published: July 2019

Background

Childhood obesity is increasing around the world. Compared with developed countries, the rate of increase is 30% higher in developing countries, where the monitoring of obesity and overweight is essential. This study investigated the prevalence of obesity, overweight, thinness, and stunting in primary school students in Shahroud, Iran.

Methods

A total of 5,620 primary students were enrolled during 2015. In rural areas all students were invited to participate, while cluster sampling was used in urban areas and 200 classrooms were selected randomly as clusters. Height, weight and body mass index Z‐scores for age (HAZ,WAZandBAZ) were calculated based on World Health Organization standard. The mean indices and prevalence of obesity, overweight, thinness, and stunting were calculated by education level, gender, and place of residence. Prevalence of obesity and overweight was estimated also by international obesity task force definition.

Results

The meanWAZ,HAZ, andBAZwere 0.050 ± 1.25, 0.005 ± 0.98, and 0.076 ± 1.35, respectively. These indices in rural areas were significantly lower than those in urban areas (P< 0.001). Overall, 25.7% of children in urban areas (95%CI: 24.1–27.4) and 14.8% in rural areas (95%CI: 12.3–17.3) were overweight or obese, and 5.1% of rural girls (95%CI: 3.1–7.0) were stunted.

Conclusions

Compared with previous studies, obesity and overweight are still rising in Iranian school children, thus more serious interventions are needed. These interventions must also deal with underweight and stunting, particularly in rural areas.
Diagnostic errors in pediatric bacterial osteomyelitis
Authors: Otani Yuki , Aizawa Yuta , Hataya Hiroshi , Horikoshi Yuho
Published: July 2019

Background

Clinical evidence for improving diagnostic accuracy in pediatric medicine is still scarce. Septic osteomyelitis is sometimes challenging for physicians to diagnose. The aim of this study was to improve patient care through identifying the incidence and reasons for errors in the diagnosis of bacterial osteomyelitis in pediatric patients.

Methods

We retrospectively identified patients younger than 16 years with acute or chronic osteomyelitis at Tokyo Metropolitan Children's Medical Center between April 2010 and September 2017. We extracted data on patient demographics, clinical course, symptoms, locus of the lesions, and diagnosis at presentation and discharge. The patients were categorized into the misdiagnosis and non‐misdiagnosis groups following a review by two pediatricians. Misdiagnosis was defined as a difference between the initial and discharge diagnosis. The factors in the two groups were compared, and the types of error in the misdiagnosis group were examined.

Results

In total 71 patients were enrolled. The median age and proportion of boys was 7.6 years (IQR, 1.4–11.2 years) and 66%, respectively. Misdiagnosis occurred in 27 patients (38.0%). Precedent antibiotic use was independently associated with misdiagnosis (P = 0.044). A cognitive error was observed in 88.3% of the misdiagnosis group. The median number of types of error per case was 2.0 (IQR, 2.0–3.0).

Conclusions

The misdiagnosis of septic osteomyelitis in pediatric patients was common and chiefly caused by cognitive errors. Eliminating cognitive errors in diagnosis is highly likely to improve the care of patients with osteomyelitis.
Collaborative Brazilian pediatric renal transplant registry (CoBrazPed‐RTx): A report from 2004 to 2018
Authors: de Souza Vandrea Carla , Garcia Clotilde Druck , Pestana Jose Medina , Stopa Martins Suelen Bianca , Porini Custódio Luciana de Fátima , Bittencourt Viviane , Rohde Roberta , Simões Pires Izadora , Camargo Maria Fernanda de , Koch Nogueira Paulo , Feltran Luciana de Santis , Esmeraldo Ronaldo de Matos , Souza Costa Rebeca Carvalho , Schvartsman Benita , Watanabe Andreia , Cunha Mariana Faucz Munhoz da , Santos Romilda , Prates Liliane Cury , Belangero Vera Maria Santoro , Palma Lilian , Takase Henrique Mochida , de Andrade Luiz Gustavo Mondelli , Benini Vanda , Laranjo Martins Simone Paiva , Abbud‐Filho Mario , Fernandes‐Charpiot Ida , Ramalho Horacio , Quaresma Mendonça Ana Carmen , Vasconcelos Mariana Affonso , Andrade Nunes Claudia , Penido de Paula Mariana Guimaraes , Moura Diniz Ferreira Leite Carolina , Russo Enzo Ricardo , Facincani Inalda , Wagner Mario Bernardes
Published: July 2019

The Brazilian collaborative registry for pediatric renal transplantation began in 2004 as a multicenter initiative aimed at analyzing, reporting, and disseminating the results of pediatric renal transplantation in Brazil. Data from all pediatric renal transplants performed from January 2004 to May 2018 at the 13 participating centers were analyzed. A total of 2744 pediatric renal transplants were performed in the thirteen participating centers. The median age at transplantation was 12.2 years, with the majority being male recipients (56%). The main underlying diseases were CAKUT (40.5%) and glomerulopathy (28%). 1981 (72%) of the grafts were from deceased donors (DD). Graft survival at one year (censored by death) was 94% in the live donor group (LD) and 91% in the DD group (log‐rank test P < 0.01). The patient’s survival at one and 5 years was 97% and 95% for the LD group and 96% and 93% for the DD group (log‐rank test P = 0.02). The graft loss rate was 19% (n = 517), more frequently caused by vascular thrombosis (n = 102) and chronic graft nephropathy (n = 90). DD recipients had 1.6 (1.0‐2.2) times greater chance of death and 1.5 (1.2‐1.8) times greater chance of graft loss compared to LD recipients. The mortality rate was 5.4% (n = 148), mainly due to infection (n = 69) and cardiovascular disease (n = 28). The results of this collaborative pediatric renal transplant record are comparable to other international registries, although we still have a high infection rate as a cause of death.
To Share or Not to Share? Capacity Reservation in a Shared Supplier
Authors: Qi Anyan , Ahn Hyun‐Soo , Sinha Amitabh
Published: July 2019

When a supplier serves multiple buyers, the buyers often reserve the supplier's capacity in advance to secure the supply to fulfill their demand. In this study, we analyze two common types of capacity reservation: exclusive and first‐priority reservations. Both reservations give a buyer first access to its reserved capacity, but the reservations differ in how the leftovers (if any) are used. In most cases, as long as the buyer gets to use the reserved capacity first, it does not pay attention to how the leftover capacity is utilized, leaving that to the supplier's discretion ( first‐priority). However, in a number of cases, buyers prohibit discretionary use of the reserved capacity (“no one touches my leftovers”) and implement the restriction by placing an employee at the supplier or installing monitoring devices ( exclusive). One potential benefit of first‐priority capacity is resource pooling: allowing access to one another's leftovers can reduce the amount of capacity reserved by the buyers while enabling the supplier to satisfy buyers’ orders better in some cases. The Operations Management literature suggests that the benefit of resource pooling is greater when the demand correlation is negative and smaller when the correlation is positive. We investigate the capacity reservation type and level that each buyer chooses facing uncertain (and correlated) demand. We investigate how the reservation price and demand correlation affect the equilibrium outcome. We also examine the supplier's decision to set the optimal reservation prices. We find that at least one firm reserves first‐priority capacity in equilibrium as long as the supplier offers a discount for first‐priority capacity (or charges a premium for exclusive capacity). Depending on the reservation price difference and demand correlation, we find that the equilibrium outcome is inefficient (i.e., not Pareto optimal) for the buyers when they settle in a free‐rider or a prisoner's dilemma equilibrium. We show that the supplier always induces both buyers to reserve a large amount of exclusive capacity so that the supplier can make profits from both capacity reservation and production. While this seems like the best scenario for the supplier, we show that, allowing bilateral capacity transfer (e.g., the buyers trading their reserved capacity) can improve not only the buyers’ profits but also the supplier's profit.
On the Competition between Two Modes of Product Recovery: Remanufacturing and Refurbishing
Authors: Chen Yao , Chen Fangruo
Published: July 2019

The markets for recovered products in China typically consist of both remanufactured and refurbished products. The government requires that the remanufactured product match the quality level of the new product, while no such requirements exist for the refurbished product. Furthermore, remanufacturing is a relatively new phenomenon in China, whereas the refurbishing industry is old, widespread, and largely unregulated. Compared to the new product, the two types of recovered products enjoy a cost advantage, but they suffer from a lower willingness‐to‐pay in the consumer market. These observations lead to a game‐theoretic model consisting of three players: an original equipment manufacturer (OEM) providing the new product, a remanufacturing firm, and a refurbishing firm. The goal is to understand what equilibrium market structure may arise and how the equilibrium outcome depends on some of the key model parameters. It is found that (1) the entry barrier for the remanufacturer is always higher than that for the refurbisher; (2) remanufacturing almost always reduces the environmental and social (E/S) impact of the secondary market (for spare parts), such as the consumption of raw materials and energy during parts production, emissions and safety concerns during product use, and the E/S impact incurred during product disposal; and (3) the OEM has a natural tendency to discourage any form of product recovery by a third party, refurbishing or remanufacturing. These findings have potential policy implications for the government’s effort in cultivating the remanufacturing industry.
Explaining Heterogeneity in Environmental Management Practice Adoption across Firms
Authors: Hardcopf Rick , Shah Rachna , Mukherjee Ujjal
Published: July 2019

There is extensive academic research examining why firms adopt environmental management practices (EMPs), reflecting an increasing focus on firm environmental activity in research and practice. However, there is little understanding of why firms vary within and across industries in the number of EMPs they adopt (EMP adoption). In this study, we seek to identify the sources of variation and quantify the relative importance of each source. Using Hierarchical Linear Modeling (HLM) and a 12‐year panel data including 880 firms from 258 industries, we show that temporality (variation over time), firm‐specific choices and characteristics, and industry membership account for 40%, 26%, and 34% of the observed variation in EMP adoption, respectively. Additional analysis shows that the explanatory power of each source is contingent on the “ type” of EMP adopted; suggesting that approaches to incent increased adoption should be aligned with EMP type. Finally, we identify which specific firm characteristics and industry attributes impact the observed heterogeneity. As the first study to focus on identifying and estimating sources of variation in EMP adoption, it makes a fundamental contribution to theory and practice by showing how annual increases in adoption can be accelerated by better understanding the levers which influence firm‐level EMP adoption decisions.
Identification ofColletotrichum siamensecausing litchi pepper spot disease in mainland China
Authors: Ling J. F. , Song X. B. , Xi P. G. , Cheng B. P. , Cui Y. P. , Chen X. , Peng A. T. , Jiang Z. D. , Zhang L. H.
Published: July 2019

Litchi (Litchi chinensis) pepper spot disease results in black spotting symptoms on litchi fruits. This disease was first observed on litchi cultivar Guiwei, in Guangzhou, China, in 2009, and then found widespread in other litchi‐growing regions of China.Colletotrichumisolates were consistently recovered from typical black spot lesions of diseased fruits with frequency ranging from 83% to 100%. Three representativeColletotrichumisolates from Maoming, Guangzhou and Shenzhen were selected for identification and pathogenicity testing in the field. Based on morphology and phylogenetic analysis using the ribosomal internal transcribed spacer region (ITS), glyceraldehyde‐3‐phosphate dehydrogenase (GAPDH), calmodulin (CAL), actin (ACT), β‐tubulin (TUB2) and glutamine synthetase (GS) gene sequences, the three isolates were identified asC. siamense. In the pathogenicity experiments, typical symptoms appeared on the inoculated litchi fruits, including black spots and green patches around these black spots. These symptoms were consistent with the symptoms originally observed in the field.Colletotrichum siamensewas successfully reisolated from the typical black spot lesions of the inoculated litchi fruits. To the authors' knowledge, this is the first report on characterization ofC. siamenseas the causal agent of litchi pepper spot disease in mainland China by successful inoculation on fruits under field conditions.
Biological and biochemical characteristics of male reproductive system, serum metabolites and carcass quality of Japanese quails by the supplementation of Pinus ponderosa leaves and α‐tocopherol acetate
Authors: Shah Assar Ali , Khan Irfan Ullah , Sahibzada Fayaz Ahmed , Tauseef Isfahan , Kalsoom Umm‐e‐ , Sultana Nighat
Published: July 2019

The aim of the current study was to evaluate the effect of dietary supplementation of Pinus ponderosa leaves (pine leaves) and α‐tocopherol acetate (vitamin E) powder on male reproductive system, serum metabolites and carcass characteristics of Japanese quails. A total of 360‐day‐old male quails were purchased from the open market and kept at poultry shed for ninety‐four days. After ten days of adaptation, all quails were randomly assigned into 4 groups, control (IC); supplemented with α‐tocopherol acetate (IE) at the rate of 150 mg/L; Pinus ponderosa leaves (IP) at the rate of 150 mg/L; and 70 mg α‐tocopherol acetate and 70 mg Pinus ponderosa leaves (IEP). Pinus ponderosa leaves and α‐tocopherol acetate supplementation had not significantly (p > .05) effected on final body weight gain, feed intake and feed conversion ratio of quails. The high‐density lipoprotein cholesterol (HDLC) and total cholesterol (TC) were significantly (p > .05) affected by IE and IP groups as compared to IC and IEP groups. Triglyceride (TG), glutathione peroxidase (GPx) and superoxide dismutase (SOD) significantly (p < .05) increased in all treatment groups except for the IC group. Aspartate transaminase (AST) significantly (p > .05) decreased in treatment groups as compared to control group. Overall, the mineral levels significantly (p < .05) increased in treatment groups as compared to control. Cloacal gland index values, the quantity of foam production and testis weight were significantly (p < .05) increased in treatment groups. It was concluded that the supplementation of Pinus ponderosa leaves and α‐tocopherol acetate improved the testis weight, foam production, serum antioxidant enzymes and mineral level especially zinc in Japanese quail considered an indicative characteristic of higher sperm production rate and improved sexual activity. Further, higher gametogenesis rate, sperm production or reproductive behaviour including different hormonal level will be analysed in future study.
MiR‐183 delivery attenuates murine lupus nephritis‐related injuries via targeting mTOR
Authors: Li Xiuzhen , Luo Feng , Li Jie , Luo Congjuan
Published: July 2019

MicroRNAs (miRNAs) play a vital role in the occurrence and development of many human diseases, including systemic lupus erythematosus (SLE). SLE is an autoimmune disease characterized by the production of autoantibodies against nuclear antigens and multiorgan involvement. Study of miRNAs involved in SLE provides new insights into the pathogenesis of SLE and might lead to the identification of new therapeutic interventions. The aim of this study was to investigate the effect of miR‐183 injection on the progression of SLE by using MRL/lpr mouse model. The expression levels of miR‐183 and mTOR mRNA were detected by quantitative real‐time PCR assay. The effect of miR‐183 on the course of spontaneous disease progression in the MRL/lpr mice was examined by intraperitoneal injection of miR‐183 into mice and followed by monitoring lifespan, anti‐dsDNA antibody levels, urinary albumin levels, blood urea nitrogen (BUN) levels, and Tregs and Th17 cell population. We found that miR‐183 injection resulted in reduction of anti‐DNA antibody and immune complex component levels, restoration of Tregs and Th17 cell population and prolongation of survival. Our findings suggest that miR‐183 injection may serve as an effective therapeutic treatment for delaying or easing pathologic features of SLE.
School anxiety and depression among immigrant youth in America: Differences by region of birth and language proficiency
Authors: Kremer Kristen P. , House Nathaniel
Published: July 2019

This study sought to examine school anxiety and depression by parents’ immigrant status and identify differences by region of birth and language proficiency. Data were used from the Early Childhood Longitudinal Study‐Kindergarten Cohort, a nationally representative and longitudinal study of students in the United States. The analytic sample included 6,156 youth. Linear regression models predicted school anxiety and depression of American eighth grade students from English proficiency and parents’ region of birth. Controlling for demographic covariates, there was no significant difference in school anxiety or depression between youth with American‐born parents and those with parents born in any major world region. With the inclusion of an interaction between language proficiency and region of birth, children with limited English proficiency from Europe (B = 2.86, 95% CI = 2.16, 3.55), Central America (B = 1.52, 95% CI = 0.73, 2.31), Asia (B = 1.48, 95% CI = 0.55, 2.40), and South America (B = 0.85, 95% CI = 0.08, 1.61) had significantly heightened school anxiety compared to native‐English speakers with native‐born parents. When considering sources of school anxiety, it was revealed that over 60% of these youth worried about doing well in school. Future research should explore interventions to increase English proficiency and ease school‐related stress among children of immigrants.
Prolonged and persistent diarrhoea is not restricted to children with acute malnutrition: an observational study in Ethiopia
Authors: Zangenberg Mike , Johansen Øystein H. , Abdissa Alemseged , Eshetu Beza , Kurtzhals Jørgen A. L. , Friis Henrik , Sommerfelt Halvor , Langeland Nina , Hanevik Kurt
Published: July 2019

Objectives

To assess the prevalence of prolonged and persistent diarrhoea, to estimate their co‐occurrence with acute malnutrition and association with demographic and clinical factors.

Methods

Case–control study where cases were children under 5 years of age with diarrhoea and controls were children without diarrhoea, frequency‐matched weekly by age and district of residency. Controls for cases 0–11 months were recruited from vaccination rooms, and controls for cases 12–59 months were recruited by house visits using random locations in the catchment area of the study sites. Data were analysed by mixed model logistic regression.

Results

We enrolled 1134 cases and 946 controls. Among the cases, 967 (85%) had acute diarrhoea (AD), 129 (11%) had ProD and 36 (3.2%) had PD. More cases had acute malnutrition at enrolment (17% vs. 4%, P < 0.0001) and more were born prematurely (5.7% vs. 1.8%, P < 0.0001) than controls. About 75% of ProPD cases did not have acute malnutrition. Cases with AD and ProPD had different symptomatology, even beyond illness duration.

Conclusions

ProPD is common among children presenting with diarrhoea and is not confined to children with acute malnutrition. There is an urgent need for studies assessing causes of ProPD with and without acute malnutrition to develop treatment guidelines for these conditions.
Dual-Notch Void Model to Explain the Anisotropic Strengths of 3D Printed Polymers
Authors: Roy Xu L. , Leguillon Dominique
Published: July 2019

Based on the unique additive manufacturing process, a dual-notch void model is proposed to explain three tensile strengths of a 3D printed polymer along three major directions. This model incorporates the strength/notch angle relation and provides a relative magnitude of three tensile strengths, i.e., Sx (axial strength) > Sy (transverse strength) ≥ Sz (inter-layer strength).