bluuebunny/crossref_metadata_2025 huggingface dataset:
Nursing competency standards in primary health care: an integrative review
Authors: Halcomb Elizabeth , Stephens Moira , Bryce Julianne , Foley Elizabeth , Ashley Christine
Published: March 2016

Aims and objectives

This paper reports an integrative review of the literature on nursing competency standards for nurses working in primary health care and, in particular, general practice.

Background

Internationally, there is growing emphasis on building a strong primary health care nursing workforce to meet the challenges of rising chronic and complex disease. However, there has been limited emphasis on examining the nursing workforce in this setting.

Design

Integrative review.

Methods

A comprehensive search of relevant electronic databases using keywords (e.g. ‘competencies’, ‘competen*’ and ‘primary health care’, ‘general practice’ and ‘nurs*’) was combined with searching of the Internet using the Google scholar search engine. Experts were approached to identify relevant grey literature. Key websites were also searched and the reference lists of retrieved sources were followed up. The search focussed on English language literature published since 2000.

Results

Limited published literature reports on competency standards for nurses working in general practice and primary health care. Of the literature that is available, there are differences in the reporting of how the competency standards were developed. A number of common themes were identified across the included competency standards, including clinical practice, communication, professionalism and health promotion. Many competency standards also included teamwork, education, research/evaluation, information technology and the primary health care environment.

Conclusion

Given the potential value of competency standards, further work is required to develop and test robust standards that can communicate the skills and knowledge required of nurses working in primary health care settings to policy makers, employers, other health professionals and consumers.

Relevance to clinical practice

Competency standards are important tools for communicating the role of nurses to consumers and other health professionals, as well as defining this role for employers, policy makers and educators. Understanding the content of competency standards internationally is an important step to understanding this growing workforce.
Combating antibiotic resistance, mitigating future threats and ongoing initiatives
Authors: Velez Roseann , Sloand Elizabeth
Published: March 2016

Aims and objectives

To emphasise the impact of antibiotic resistance as a persistent, global health threat and highlight efforts to improve this complex problem.

Background

Political agendas, legislation, development of therapies and educational initiatives are essential to mitigate the increasing rate of antibiotic resistance.

Design

Original manuscript.

Results

Prescribers, policymakers and researchers are charged with the complex task of mitigating antibiotic resistance in an era when new treatments for bacterial infections are limited.

Conclusions

Monitoring, surveillance and incentivising of practice, policy and new treatments provide solutions to antibiotic resistance in both the human and agricultural sectors.

Relevance to clinical practice

This article emphasises the complexity of antibiotic resistance and highlights the need for a multifaceted approach to improve health care outcomes.
Transfemoral temporary aortic balloon occlusion in surgical treatment of second trimester intramural ectopic pregnancy
Authors: Li Shuhong , Liu Honjie , Li Xiaoyan , Liu Zhifen , Li Yan , Li Ning
Published: March 2016

Intramural ectopic pregnancy is a rare type of ectopic pregnancy that may lead to life‐threatening hemorrhage. In the present case, a 20‐year‐old woman at 18.5 weeks of gestation, G1P0, was diagnosed with intramural ectopic pregnancy on ultrasound and magnetic resonance imaging, which showed a 14‐cm × 14‐cm gestational sac on the right posterior lateral side of the uterus fundus, surrounded completely by myometrium. Considering the increased risk of bleeding during surgery, transfemoral temporary aortic balloon occlusion was performed during laparotomy. The intramural ectopic gestational sac was successfully resected without life‐threatening obstetric hemorrhage. This procedure could offer an alternative approach to classic uterine artery embolization in reducing intraoperative bleeding thus avoiding blood transfusion. Aortic balloon occlusion is the temporary occlusion of the aorta, therefore it does not influence future fertility. In conclusion, transfemoral temporary aortic balloon occlusion is an effective procedure in the surgical treatment of intramural ectopic pregnancy diagnosed beyond the first trimester.
A Revelation Mechanism for Soft Information under Moral Hazard
Authors: ROGER GUILLAUME
Published: March 2016

This paper constructs a revelation mechanism to address a problem of moral hazard under soft information. The agent alone observes the stochastic outcome of her action, which she reports to the principal. Therefore the principal also faces a problem of ex post adverse selection. Economically relevant restrictions induce constraints on the principal's choice of mechanism and the Revelation Principle fails to apply. Specifically, a direct mechanism induces some pooling, which does not replicate the allocation obtained using a larger message space. Pooling also weakens the ex ante incentives. The Revelation Principle is extended to obtain type separation. A better audit relaxes frictions.
Regulated Competition under Increasing Returns to Scale
Authors: GREVE THOMAS , KEIDING HANS
Published: March 2016

In the classical models of regulation economics, a mechanism that secures truthful revelation involves paying a subsidy to the firm. In this paper, we investigate whether it is possible to create a regulatory mechanism under a no‐subsidy constraint that induces the firm to report its private information truthfully. We consider a number of firms operating under regulated competition and with increasing returns to scale technology. It is shown that in equilibrium each firm chooses to report truthfully without receiving any subsidy. The use of competition may give rise to an efficiency loss due to the increasing returns to scale. However, we show that our mechanism may still be better, from a social welfare point of view, than the case of monopoly regulation that involves no subsidy.
Cost‐effectiveness of preventing dental caries and full mouth dental reconstructions among Alaska Native children in the Yukon–Kuskokwim delta region of Alaska
Authors: Atkins Charisma Y. , Thomas Timothy K. , Lenaker Dane , Day Gretchen M. , Hennessy Thomas W. , Meltzer Martin I.
Published: March 2016

Objective

We conducted a cost‐effectiveness analysis of five specific dental interventions to help guide resource allocation.

Methods

We developed a spreadsheet‐based tool, from the healthcare payer perspective, to evaluate the cost effectiveness of specific dental interventions that are currently used among Alaska Native children (6‐60 months). Interventions included: water fluoridation, dental sealants, fluoride varnish, tooth brushing with fluoride toothpaste, and conducting initial dental exams on children <18 months of age. We calculated the cost‐effectiveness ratio of implementing the proposed interventions to reduce the number of carious teeth and full mouth dental reconstructions (FMDRs) over 10 years.

Results

A total of 322 children received caries treatments completed by a dental provider in the dental chair, while 161 children received FMDRs completed by a dental surgeon in an operating room. The average cost of treating dental caries in the dental chair was $1,467 (∼258,000 per year); while the cost of treating FMDRs was $9,349 (∼1.5 million per year). All interventions were shown to prevent caries and FMDRs; however tooth brushing prevented the greatest number of caries at minimum and maximum effectiveness with 1,433 and 1,910, respectively. Tooth brushing also prevented the greatest number of FMDRs (159 and 211) at minimum and maximum effectiveness.

Conclusions

All of the dental interventions evaluated were shown to produce cost savings. However, the level of that cost saving is dependent on the intervention chosen.
Timing of primary tooth emergence among U.S. racial and ethnic groups
Authors: Warren John J. , Fontana Margherita , Blanchette Derek R. , Dawson Deborah V. , Drake David R. , Levy Steven M. , Kolker Justine L. , Phipps Kathy R.
Published: March 2016

Objectives

To compare timing of tooth emergence among groups of American Indian (AI), Black and White children in the United States at 12 months of age.

Methods

Data were from two sources – a longitudinal study of a Northern Plains tribal community and a study with sites in Indiana, Iowa and North Carolina. For the Northern Plains study, all children (n = 223) were American Indian, while for the multisite study, children (n = 320) were from diverse racial groups. Analyses were limited to data from examinations conducted within 30 days of the child's first birthday.

Results

AI children had significantly more teeth present (Mean: 7.8, Median: 8.0) than did Whites (4.4, 4.0, P < 0.001) or Blacks (4.5, 4.0, P < 0.001). No significant differences were detected between Black and White children (P = 0.58). There was no significant sex difference overall or within any of the racial groups.

Conclusions

Tooth emergence occurs at a younger age for AI children than it does for contemporary White or Black children in the United States.
Melatonin attenuates postharvest physiological deterioration of cassava storage roots
Authors: Ma Qiuxiang , Zhang Ting , Zhang Peng , Wang Zhen‐Yu
Published: March 2016

Melatonin reportedly increases abiotic and biotic stress tolerance in plants, but information on its in vivo effects during postharvest physiological deterioration (PPD) in cassava is limited. In this study, we investigated the effect of melatonin in regulating cassava PPD. Treatment with 500 mg/L melatonin significantly delayed cassava PPD and reduced the accumulation of hydrogen peroxide (H2O2) while increasing the activity of superoxide dismutase (SOD), catalase (CAT), and glutathione reductase (GR), but not ascorbate peroxidase (APX). Transcript analysis further showed that expression of copper/zinc SOD (MeCu/ZnSOD), MeCAT1, glutathione peroxidase (MeGPX), peroxidase 3 (MePX3), and glutathione S‐transferases (MeGST) was higher in cassava roots sliced treated with 500 mg/L melatonin than in those not exposed to exogenous melatonin. These data demonstrate that melatonin delays cassava PPD by directly or indirectly maintaining homoeostasis of cellular reactive oxygen species (ROS). We also found that accumulation of endogenous melatonin and the transcript levels of melatonin biosynthesis genes changed dynamically during the PPD process. This finding suggested that endogenous melatonin acts as a signal modulator for maintaining cassava PPD progression and that manipulation of melatonin biosynthesis genes through genetic engineering might prevent cassava root deterioration.
Bacteria may induce the secretion of mucin‐like proteins by the diatom Phaeodactylum tricornutum
Authors: Buhmann Matthias T. , Schulze Birgit , Förderer Alexander , Schleheck David , Kroth Peter G.
Published: March 2016

Benthic diatoms live in photoautotrophic/heterotrophic biofilm communities embedded in a matrix of secreted extracellular polymeric substances. Closely associated bacteria influence their growth, aggregation, and secretion of exopolymers. We have studied a diatom/bacteria model community, in which a marine Roseobacter strain is able to grow with secreted diatom exopolymers as a sole source of carbon. The strain influences the aggregation of Phaeodactylum tricornutum by inducing a morphotypic transition from planktonic, fusiform cells to benthic, oval cells. Analysis of the extracellular soluble proteome of P. tricornutum in the presence and absence of bacteria revealed constitutively expressed newly identified proteins with mucin‐like domains that appear to be typical for extracellular diatom proteins. In contrast to mucins, the proline‐, serine‐, threonine‐rich (PST) domains in these proteins were also found in combination with protease‐, glucosidase‐ and leucine‐rich repeat‐domains. Bioinformatic functional predictions indicate that several of these newly identified diatom‐specific proteins may be involved in algal defense, intercellular signaling, and aggregation.
Gender differences in patients with obesity hypoventilation syndrome
Authors: BaHammam Ahmed S. , Pandi‐Perumal Seithikurippu R. , Piper Amanda , Bahammam Salman A. , Almeneessier Aljohara S. , Olaish Awad H. , Javaheri Shahrokh
Published: March 2016

The role of gender and menopause in obstructive sleep apnoea is well known; however, no study has reported the impact of gender on the clinical presentation and the nocturnal respiratory events in patients with obesity hypoventilation syndrome. Therefore, this study prospectively evaluated differences in the clinical characteristics of women and men with obesity hypoventilation syndrome in a large cohort of patients with obstructive sleep apnoea. During the study period, a total of 1973 patients were referred to the sleep clinic with clinical suspicion of obstructive sleep apnoea. All patients underwent overnight polysomnography, during which time spirometry, arterial blood samples and thyroid tests were routinely obtained. Among 1973 consecutive patients, 1693 (617 women) were diagnosed with obstructive sleep apnoea, among whom 144 suffered from obesity hypoventilation syndrome (96 women). The prevalence of obesity hypoventilation syndrome among women and men was 15.6% and 4.5%, respectively (P < 0.001). Women with obesity hypoventilation syndrome were significantly older than men with obesity hypoventilation syndrome (61.5 ± 11.9 years versus 49.1 ± 12.5 years, P < 0.001). Although there were no significant differences between genders regarding symptoms, body mass index, spirometric data or daytime PaCO2, women with obesity hypoventilation syndrome suffered significantly more from hypertension, diabetes and hypothyroidism. The prevalence of obesity hypoventilation syndrome was higher in post‐menopausal (21%) compared with pre‐menopausal (5.3%) women (P < 0001). HCO3 and duration of SpO2 <90% were the only independent predictors of obesity hypoventilation syndrome. In conclusion, this study reported that among subjects referred to the sleep disorders clinic for evaluation of obstructive sleep apnoea, obesity hypoventilation syndrome is more prevalent in women than men, and that women with obesity hypoventilation syndrome suffer from significantly more co‐morbidities. Post‐menopausal women with obstructive sleep apnoea have the highest prevalence of obesity hypoventilation syndrome.
Spontaneous Course of Biliary Sludge Over 12 Months in Dogs with Ultrasonographically Identified Biliary Sludge
Authors: DeMonaco S.M. , Grant D.C. , Larson M.M. , Panciera D.L. , Leib M.S.
Published: March 2016

Background

Biliary sludge is associated with gallbladder (GB) dysmotility and mucus hypersecretion suggesting a link between biliary sludge and the formation of GB mucoceles (GBM). If biliary sludge progresses to GBM, treatment to reduce the production and progression of sludge is warranted.

Hypothesis/Objectives

The objective of this study was to determine the course of biliary sludge in dogs.

Animals

Seventy‐seven healthy, client‐owned dogs ≥4 years of age screened for biliary sludge; 45 affected dogs identified.

Methods

Prospective, observational design. Serial ultrasound examinations were evaluated at 3, 6, 9, and 12 months to monitor degree of sludge based on proportion of GB filled with sludge (mild [0.01–24.4%], moderate [24.5–49.4%], moderate to severe [49.5–74.4%], severe [74.5–100%]), gravity dependency of sludge, and GB dimensions.

Results

After 1 year of follow‐up, the degree of sludge was mild (34%), moderate (47%), moderate to severe (13%), severe (3%), or absent (3%). There was no significant difference in median degree of sludge over 1 year (P = .36). There were no significant changes in the gravity dependency of sludge over 1 year. A subset of dogs, 24%, with initial gravity‐dependent sludge developed a combination of nondependent and dependent sludge. Dogs had resolved (2%), decreased (19%), static (40%), increased (29%), or recurrent (10%) sludge at the conclusion of the study.

Conclusions and Clinical Importance

Biliary sludge was prevalent, affected dogs remained asymptomatic, and it rarely resolves in healthy dogs over a period of 1 year. Some dogs developed nongravity‐dependent sludge within 1 year, which might indicate changes in consistency of sludge.
Effect of propranolol on survival in patients with decompensated cirrhosis: a nationwide study based Danish patient registers
Authors: Bang Ulrich C. , Benfield Thomas , Hyldstrup Lars , Jensen Jens‐Erik B. , Bendtsen Flemming
Published: March 2016

Background & Aims

We assessed the impact of propranolol on death, risk of hepatorenal syndrome and peritonitis in patients with cirrhosis.

Methods

This study was a retrospective observational study and data were retrieved from Danish databases. We used our own criteria to stratify the patients into groups of patients with mildly decompensated cirrhosis or severely decompensated cirrhosis. A subgroup of patients with a history of peritonitis was also analyzed. Follow‐up time was limited to 2 years from cohort entry. The reported hazard ratios (HR) with 95% confidence interval (CI) were based on a propensity score matched cohort.

Results

Among 3719 patients, we found 3075 patients with mildly and 644 with severely decompensated cirrhosis. Propranolol was used by 20% of the patients. Among the patients with mildly decompensated cirrhosis, propranolol use vs. non‐propranolol was related with a HR of 0.7 (95% CI 0.6–0.9) and among the patients with severely decompensated cirrhosis, the HR was 0.6 (95% CI 0.4–0.9). Reduced mortality was found for doses of propranolol lower than 160 mg/day only. Among 361 patients with peritonitis, we found reduced mortality in the propranolol group with a HR of 0.5 (95% CI 0.3–0.8). The use of propranolol was associated with a HR of 0.4 (95% CI 0.2–0.9) for developing peritonitis during follow‐up among patients with severely decompensated cirrhosis.

Conclusions

In patients with decompensated cirrhosis, we found an association between propranolol use and reduced mortality risk for doses lower than 160 mg/day.
X‐ray computed tomography imaging: A not‐so‐nondestructive technique
Authors: Sears Derek W. G. , Sears Hazel , Ebel Denton S. , Wallace Sean , Friedrich Jon M.
Published: March 2016

X‐ray computed tomography has become a popular means for examining the interiors of meteorites and has been advocated for routine curation and for the examination of samples returned by missions. Here, we report the results of a blind test that indicate that CT imaging deposits a considerable radiation dose in a meteorite and seriously compromises its natural radiation record. Ten vials of the Bruderheim L6 chondrite were placed in CT imager and exposed to radiation levels typical for meteorite studies. Half were retained as controls. Their thermoluminescence (TL) properties were then measured in a blind test. Five of the samples had TL data unaltered from their original (~10 cps) while five had very strong signals (~20,000 cps). It was therefore very clear which samples had been in the CT scanner. For comparison, the natural TL signal from Antarctic meteorites is ~5000–50,000 cps. Using the methods developed for Antarctic meteorites, the apparent dose absorbed by the five test samples was calculated to be 83 ± 5 krad, comparable with the highest doses observed in Antarctic meteorites and freshly fallen meteorites. While these results do not preclude the use of CT scanners when scientifically justified, it should be remembered that the record of radiation exposure to ionizing radiations for the sample will be destroyed and that TL, or the related optically stimulated luminescence, are the primary modern techniques for radiation dosimetry. This is particularly important with irreplaceable samples, such as meteorite main masses, returned samples, and samples destined for archive.
Feasibility Study of Transthoracic Echocardiography for Coronary Slow Flow Phenomenon Evaluation: Validation by Coronary Angiography
Authors: Li Yijia , Fang Fang , Ma Ning , Li Rongjuan , Sun Qiwei , Yang Jiao , Nie Shaoping , Yu Cheuk‐man , Yang Ya
Published: March 2016

Objective

This study aimed to assess echocardiography parameters in CSFP evaluation.

Methods

This study enrolled 79 consecutive patients with CSFP validated by coronary angiography and control individuals with normal coronary flow. Coronary flow rates were determined by corrected CTFC. Clinical and coronary angiography data and coronary parameters assessed by echocardiography using the CFI were recorded.

Results

Baseline characteristics were similar between the two groups. Patients with CSFP were predominantly males, with higher BMI values, weights and triglyceride levels (p < 0.05), but lower platelet counts (p < 0.05). Conventional echocardiography parameters were similar in the two groups. However, echocardiographic measurements of the LAD, including PDV, MDV, PDP, MDP and VTI, in the CSFP group were lower compared with control values (p < 0.05). BMI was positively correlated with CSFP. LAD's CTFC showed strong inverse correlations with PDV, MDV, PDP, and MDP in CSFP groups. ROC curve analysis revealed that coronary artery flow‐related parameters occupied more than half of the AUC.

Conclusions

CSFP could be identified with the help of echocardiography.
A new genus and species of demodecid mites from the tongue of a house mouse Mus musculus: description of adult and immature stages with data on parasitism
Authors: IZDEBSKA J. N. , ROLBIECKI L.
Published: March 2016

The study of the parasitofauna of the house mouse Mus musculus (Rodentia: Muridae) Linnaeus is particularly important owing to its multiple relationships with humans – as a cosmopolitan, synanthropic rodent, bred for pets, food for other animals or laboratory animal. This article proposes and describes a new genus and species of the parasitic mite based on adult and immature stages from the house mouse. Glossicodex musculi gen. n., sp. n. is a medium‐sized demodecid mite (adult stages on average 199 µm in length) found in mouse tissue of the tongue. It is characterized by two large, hooked claws on each tarsus of the legs; the legs are relatively massive, consisting of large, non‐overlapping segments. The palps consist of three slender, clearly separated, relatively narrow segments, wherein their coxal segments are also quite narrow and spaced. Also, segments of the palps of larva and nymphs are clearly isolated, and on the terminal segment, trident claws that resemble legs' claws can be found. On the ventral side, in immature stages, triangular scuta, topped with sclerotized spur, can be also observed. Glossicodex musculi was noted in 10.8% of mice with a mean infection intensity of 2.2 parasites per host.
Cousinia brevicaulis sp. nov. (sect. Lasiandra) for the flora of Iran
Authors: Attar Farideh , Mozaffarian Valiollah , Mirtadzadini Mansour
Published: March 2016

Cousinia brevicaulis is described and illustrated as a new species from eastern Iran. This species belongs to the C. sect. Lasiandra Bunge as defined by hairy anther tube, yellow, pale yellow or rarely milky flowers, monocarpic growth form and corymbose branching of stem. It is easily distinguished from other species of the section by its very short‐stemmed habit. The new species is distributed in the same region as other species of C. sect. Lasiandra.
Why is gynodioecy a rare but widely distributed sexual system? Lessons from the Lamiaceae
Authors: Rivkin L. Ruth , Case Andrea L. , Caruso Christina M.
Published: March 2016

Gynodioecy, a sexual system where females and hermaphrodites co‐occur, is found in << 1% of angiosperm species. To understand why gynodioecy is rare, we need to understand why females are maintained in some lineages, but not in others.

We modelled the evolution of gynodioecy in the Lamiaceae, and investigated whether transition rates between gynodioecious and nongynodioecious states varied across the family. We also investigated whether the evolution of gynodioecy was correlated with the evolution of a herbaceous growth form and temperate distribution.

Transition rates differed between Lamiaceae subfamilies. In the Nepetoideae, there were many transitions towards gynodioecy (n = 11), but also many reversions to nongynodioecy (n = 29). In addition, a herbaceous growth form, but not a temperate distribution, affected the rate of transitions both towards and away from gynodioecy; transitions towards gynodioecy occurred ˜16 times more frequently and transitions away from gynodioecy occurred ˜11 times more frequently in herbaceous lineages than in woody lineages.

Within the Lamiaceae, lineages in which gynodioecy has frequently evolved also have a high rate of reversions to the nongynodioecious state. Consequently, to understand why gynodioecy is rare, we need to understand why sexual systems are more evolutionarily labile in some lineages than in others.
Curriculum change, challenges and teacher responsibility
Authors: Fastier Murray
Published: March 2016

The New Zealand Curriculum (NZC), Realigned Geography Achievement Standards and Social Science Teaching and Learning Guidelines‐Geography combined are playing a key role in transforming senior school geography into a subject suited for 21st century learners. While they provide geography teachers with the permissiveness to plan coherent school‐based geography programmes that are relevant and responsive to students' needs, the implementation process can prove challenging. Adjusting to the increased trust and responsibility assigned to teachers, as they undertake the role of curriculum makers, is a key focus of this paper.
Maintaining grassroots activism: Transition Towns in Aotearoa New Zealand
Authors: Cretney Raven Marie , Thomas Amanda C , Bond Sophie
Published: March 2016

As a result of burgeoning social and environmental issues, localisation movements such as Transition Towns are emerging. However, tension exists as to the best scale and method to create and maintain this community activism. In this study, we explore the activities of two Transition Towns in Aotearoa New Zealand through a qualitative mixed methodology, and argue that relational notions of scale and the notion of progressive localisms enable an appreciation of the locally rooted but outward looking nature of Transition activities. In turn, this creates space to acknowledge the diffuse nature of change, redefine success and sustain momentum.
A systematic review and meta‐analysis of workplace intervention strategies to reduce sedentary time in white‐collar workers
Authors: Chu A. H. Y. , Ng S. H. X. , Tan C. S. , Win A. M. , Koh D. , Müller‐Riemenschneider F.
Published: March 2016

Prolonged sedentary behaviour has been associated with various detrimental health risks. Workplace sitting is particularly important, providing it occupies majority of total daily sedentary behaviour among desk‐based employees. The aim of this systematic review and meta‐analysis was to examine the effectiveness of workplace interventions overall, and according to different intervention strategies (educational/behavioural, environmental and multi‐component interventions) for reducing sitting among white‐collar working adults. Articles published through December 2015 were identified in five online databases and manual searches. Twenty‐six controlled intervention studies published between 2003 and 2015 of 4568 working adults were included. All 26 studies were presented qualitatively, and 21 studies with a control group without any intervention were included in the meta‐analysis. The pooled intervention effect showed a significant workplace sitting reduction of −39.6 min/8‐h workday (95% confidence interval [CI]: −51.7, −27.5), favouring the intervention group. Multi‐component interventions reported the greatest workplace sitting reduction (−88.8 min/8‐h workday; 95% CI: −132.7, −44.9), followed by environmental (−72.8 min/8‐h workday; 95% CI: −104.9, −40.6) and educational/behavioural strategies −15.5 min/8‐h workday (95% CI:−22.9,−8.2). Our study found consistent evidence for intervention effectiveness in reducing workplace sitting, particularly for multi‐component and environmental strategies. Methodologically rigorous studies using standardized and objectively determined outcomes are warranted. © 2016 World Obesity
Incorporating seed fate into plant–frugivore networks increases interaction diversity across plant regeneration stages
Authors: Donoso Isabel , García Daniel , Rodríguez‐Pérez Javier , Martínez Daniel
Published: March 2016

Plant–animal mutualistic interactions, such as pollination and seed dispersal, affect ecosystem functioning by driving plant population dynamics. However, little is known of how the diversity of interactions in these mutualistic networks determines plant regeneration dynamics. To fill this gap, interaction networks should not only account for the number of seeds dispersed by animals, but also for seed fate after dispersal. Here, we compare plant–animal networks at both the seed dispersal and seedling recruitment stage to evaluate how interaction diversity, represented by different network metrics, changes throughout the process of plant regeneration. We focused on a system with six species of frugivorous birds and three species of fleshy‐fruited trees in the temperate secondary forest of the Cantabrian Range (northern Iberian Peninsula). We considered two plant cohorts corresponding to two fruiting years showing strong differences in fruit and frugivore abundance. Seed dispersal interactions were estimated from a spatially‐explicit, field‐validated model predicting tree and bird species‐specific seed deposition in different microhabitats. These interactions were further transformed into interactions at the seedling recruitment stage by accounting for plant‐ and microhabitat‐specific seed fates estimated from field sampling. We found that network interaction diversity varied across plant regeneration stages and cohorts, both in terms of the evenness and the number of paired interactions. Tree–bird interactions were more evenly distributed across species pairs at the recruitment stage than at the seed deposition stage, although some interactions disappeared in the seed‐to‐seedling transition for one plant cohort. The variations in interaction diversity were explained by between‐plant differences in post‐dispersal seed fate and in inter‐annual fruit production, rather than by differences between frugivores in seed deposition patterns. These results highlight the need for integrating plant traits and disperser quality to predict the functional outcome of plant–animal mutualistic networks.
Comparison of six disease severity scores for allergic rhinitis against pollen counts a prospective analysis at population and individual level
Authors: Florack Jakob , Brighetti Maria Antonia , Perna Serena , Pizzulli Antonio , Pizzulli Antje , Tripodi Salvatore , Costa Corrado , Travaglini Alessandro , Pelosi Simone , Bianchi Annamaria , Tsilochristou Olympia , Gabrielli Francesca , Matricardi Paolo Maria
Published: March 2016

Background

Many different symptom (medication) scores are nowadays used as measures of allergic rhinoconjunctivitis severity in individual patients and in clinical trials. Their differences contribute to the heterogeneity of the primary end‐point in meta‐analyses, so that calls for symptom (medication) score harmonization have been launched.

Objective

To prospectively compare six different severity scores for allergic rhinitis (AR) against pollen counts at both population and individual levels.

Methods

Two groups of children with seasonal AR and grass pollen sensitization were recruited in Ascoli, Italy (n = 76) and Berlin, Germany (n = 29). Symptoms and drug intake were monitored daily for 40 and 30 days of the grass pollen season in 2011 (Ascoli) and 2013 (Berlin), respectively, through an Internet‐based platform (AllergyMonitor™, TPS Production srl, Rome, Italy). From the gathered data, the informatics platform automatically generated one symptom score (RTSS) and five symptom–medication scores (RC‐ACS©, ACS, RTSS[LOCF], RTSS[WC] and AdSS). Values were then statistically normalized for reciprocal comparison and matched against the daily variations of local grass pollen counts (Spearman's rank correlation).

Results

The grass pollen counts were higher in Ascoli than in Berlin (peak values 194 vs. 59 grains/m3). At population level, the trajectories of the normalized average values of the six scores differed only slightly in both studies and correlated well with the pollen counts (ranges r2: 0.38–0.50 in Ascoli, 0.41–0.56 in Berlin). By contrast, in individual patients, trajectories of different scores were often quite heterogeneous. The RTSS[WC] had a very low discriminatory power and generated in many patients long, flat horizontal segments.

Conclusions

Disease severity scores for seasonal AR, as evaluated via an Internet‐based platform, tend to provide similar results at population level but can often produce heterogeneous slopes in individual patients. The choice of the disease severity score might have only a low impact on the outcome of a very large clinical trial, but it may be crucial in the management of individual patients.
Current Status of Malignant Neuropathic Pain in Chinese Patients with Cancer: Report of a Hospital‐based Investigation of Prevalence, Etiology, Assessment, and Treatment
Authors: Lu Fan , Song Li , Xie Tian , Tian Jie , Fan Yuchao , Liu Hui
Published: March 2016

Objectives

This study investigated the prevalence, etiology, assessment, treatment of pain in patients with cancer as well as their quality of life (QOL).

Methods

Patients at the West China Hospital Cancer Center were invited to complete a questionnaire under the guidance of pain specialists. The questionnaire included general information, cancer pain status, its assessment, use of analgesics, and the effects of pain on QOL.

Results

In total, 1,050 patients were enrolled in the study. Of these, valid data were collected from 919 patients, among whom 454 (49.4%) suffered from pain, including 333 (36.2%) patients who had neuropathic pain symptoms. On average, the visual analog scale (VAS) score of patients with cancer pain was 3.30 ± 1.68. Significant differences in the VAS score and pain frequency between patients with nociceptive and neuropathic pain were observed (both P < 0.05). Dull pain ranked first (64, 52.9%) among the patients with nociceptive pain, whereas pins and needles pain (97, 64.7%) was the most common type of pain in patients with neuropathic pain. There was a significant difference in QOL between the nociceptive and neuropathic pain groups (P < 0.05). Only 183 of 454 patients with cancer pain used analgesics. Compared with the patients with pain not using any analgesics, those receiving analgesics had a significantly lower average pain relief rate (P = 0.027). Adjuvant analgesics were inadequately used (9.3%) in patients with neuropathic cancer pain.

Conclusion

This study revealed the prevalence of neuropathic cancer pain in Chinese patients with cancer. Malignant neuropathic pain significantly impaired the patients' QOL. Insufficient assessment and inadequate analgesia still exist. These require more awareness and attention from both doctors and patients.
Establishing Clinically Relevant Severity Levels for the Central Sensitization Inventory
Authors: Neblett Randy , Hartzell Meredith M. , Mayer Tom G. , Cohen Howard , Gatchel Robert J.
Published: March 2016

Objectives

The aim of this study was to create and validate severity levels for the central sensitization inventory (CSI), a valid and reliable patient‐reported outcome instrument designed to identify patients whose presenting symptoms may be related to a central sensitivity syndrome (CSS; eg, fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome), with a proposed common etiology of central sensitization (CS).

Methods

Based on CSI score means and standard deviations from previously published subject samples, the following CSI severity levels were established: subclinical = 0 to 29; mild = 30 to 39; moderate = 40 to 49; severe = 50 to 59; and extreme = 60 to 100. The concurrent validity of the CSI severity levels was then confirmed in a separate chronic pain patient sample (58% with a CSS diagnosis and 42% without) by demonstrating associations between CSI scores and (1) the number of physician‐diagnosed CSSs; (2) CSI score distributions in both CSS and non‐CSS patient samples; (3) patient‐reported history of CSSs; and (4) patient‐reported psychosocial measures, which are known to be associated with CSSs.

Results

Compared to the non‐CSS patient subsample, the score distribution of the CSS patient subsample was skewed toward the higher severity ranges. CSI mean scores moved into higher severity levels as the number of individual CSS diagnoses increased. Patients who scored in the extreme CSI severity level were more likely to report previous diagnoses of fibromyalgia, chronic fatigue syndrome, temporomandibular joint disorder, tension/migraine headaches, and anxiety or panic attacks (P < 0.01). CSI severity levels were also associated with patient‐reported depressive symptoms, perceived disability, sleep disturbance, and pain intensity (P ≤ 0.02).

Conclusion

This study provides support for these CSI severity levels as a guideline for healthcare providers and researchers in interpreting CSI scores and evaluating treatment responsiveness.
Dynamic quantitative trait loci underlies isoflavone accumulation in soybean seed
Authors: Han Yingpeng , Li Dongmei , Zhao Guiyun , Zhao Xue , Jiang Zhenfeng , Hu Haibo , Wu Lin , Wang Yan , Gao Yuan , Li Yongguang , Zeng Guoliang , Meng Fanli , Teng Weili , Li Wenbin
Published: March 2016

Most of quantitative trait loci (QTL) underlying soybean seed isoflavone contents were derived from the harvest stage of plant development, which uncover the genetic effects that were expressed in earlier seed developmental stages. The aim of this study was to detect conditional QTL associated with isoflavone accumulation during the entire seed development. A total of 112 recombinant inbred lines developed from the cross between ‘Zhongdou 27’ (higher seed isoflavone content) and ‘Jiunong 20’ (lower seed isoflavone content) were used for the conditional QTL analysis of daidzein (DZ), genistein (GT), glycitein (GC) and total isoflavone (TI) accumulations through composite interval mapping with mixed genetic model. The results indicated that the number and type of QTL and their additive effects for individual and total isoflavone accumulations were different among R3 to R8 developmental stages. Three unconditional QTL and six conditional QTL for DZ, four unconditional QTL and five conditional QTL for GT, six unconditional QTL and five conditional QTL for GC, six unconditional QTL and seven conditional QTL for TI were identified at different developmental stages, respectively. Unconditional and conditional QTL that affect individual and total isoflavone accumulations exhibited multiple expression patterns, implying that some QTL are active for long period and others are transient. Two genomic regions, Satt144‐Satt569 in linkage group F (LG F; chromosome 13, chr 13) for DZ, GC, GT and TI accumulations and Satt540‐Sat_240 in LG M (chr 07) for TI and GC accumulations, were found to significantly affect individual and total isoflavone accumulations in multiple developmental stages, suggesting that the accumulation of soybean seed isoflavones is governed by time‐dependent gene expression.
Altitudinal and climatic associations of seed dormancy and flowering traits evidence adaptation of annual life cycle timing in Arabidopsis thaliana
Authors: Vidigal Deborah S. , Marques Alexandre C. S. S. , Willems Leo A. J. , Buijs Gonda , Méndez‐Vigo Belén , Hilhorst Henk W. M. , Bentsink Leónie , Picó F. Xavier , Alonso‐Blanco Carlos
Published: March 2016

The temporal control or timing of the life cycle of annual plants is presumed to provide adaptive strategies to escape harsh environments for survival and reproduction. This is mainly determined by the timing of germination, which is controlled by the level of seed dormancy, and of flowering initiation. However, the environmental factors driving the evolution of plant life cycles remain largely unknown. To address this question we have analysed nine quantitative life history traits, in a native regional collection of 300 wild accessions of Arabidopsis thaliana. Seed dormancy and flowering time were negatively correlated, indicating that these traits have coevolved. In addition, environmental–phenotypic analyses detected strong altitudinal and climatic clines for most life history traits. Overall, accessions showing life cycles with early flowering, small seeds, high seed dormancy and slow germination rate were associated with locations exposed to high temperature, low summer precipitation and high radiation. Furthermore, we analysed the expression level of the positive regulator of seed dormancy DELAY OF GERMINATION 1 (DOG1), finding similar but weaker altitudinal and climatic patterns than seed dormancy. Therefore, DOG1 regulatory mutations are likely to provide a quantitative molecular mechanism for the adaptation of A. thaliana life cycle to altitude and climate.
Recent advances in prostate cancer pathology: Gleason grading and beyond
Authors: Shah Rajal B , Zhou Ming
Published: March 2016

Since its initial description in 1966 by Dr Donald Gleason, Gleason grading has become the cornerstone in the management of prostate cancer (PCa). With widespread use of Prostate Specific Antigen (PSA) screening and needle core biopsy, the diagnosis and management of PCa have dramatically evolved. In addition, better understanding of the morphological spectrum of prostate cancer and its clinical significance have prompted the refinement of the grading criteria and reporting guidelines commensurate to contemporary practice. The modification of the Gleason grading system implemented by the International Society of Urological Pathology in 2005 and subsequent revision in 2014 has profoundly impacted how PCa is graded and managed. This review aims to provide a concise update on the refinement of the histological criteria for various Gleason patterns and problem areas of Gleason grading, and provide recommendations on how to improve the grading reproducibility. The new proposal to group Gleason scores into clinically meaningful “grade groups” will also be discussed. Finally, we will discuss how magnetic resonance imaging (MRI)‐targeted biopsy and emerging genetic markers may help improve the Gleason grading accuracy and risk stratification currently based on clinicopathological parameters.
Simulated herbivory does not constrain phenotypic plasticity to shade through ontogeny in a relict tree
Authors: Pardo A. , García F. M. , Valladares F. , Pulido F.
Published: March 2016

Ecological limits to phenotypic plasticity (PP), induced by simultaneous biotic and abiotic factors, can prevent organisms from exhibiting optimal plasticity, and in turn lead to decreased fitness. Herbivory is an important biotic stressor and may limit plant functional responses to challenging environmental conditions such as shading. In this study we investigated whether plant functional responses and PP to shade are constrained by herbivory, and whether such constraints are due to direct effects based on resource limitation by considering ontogeny. We used as a model system the relict tree Prunus lusitanica and implemented an indoor experiment to quantify the response of saplings of different ages to shade and herbivory. We measured five functional traits and quantitatively calculated PP. Results showed that herbivory did not constrain functional responses or PP to shade except for shoot:root ratio (SR), which, despite showing a high PP in damaged saplings, decreased under shade instead of increasing. Damaged saplings of older age did not exhibit reduced constraints on functional responses to shade and generally presented a lower PP than damaged saplings of younger age. Our findings suggest that herbivory‐mediated constraints on plant plasticity to shade may not be as widespread as previously thought. Nonetheless, the negative effect of herbivory on SR plastic expression to shade could be detrimental for plant fitness. Finally, our results suggest a secondary role of direct effects (resource‐based) on P. lusitanica plasticity limitation. Further studies should quantify plant resources in order to gain a better understanding of this seldom‐explored subject.
Identification of an A2 population of Phythophthora andina attacking tree tomato in Peru indicates a risk of sexual reproduction in this pathosystem
Authors: Forbes G. A. , Gamboa S. , Lindqvist‐Kreuze H. , Oliva R. F. , Perez W.
Published: March 2016

Tree tomato, Solanum betaceum, is an Andean fruit crop previously shown to be attacked by Phytophthora andina in Ecuador and Colombia. Blight‐like symptoms were discovered on tree tomato plants in the central highlands of Peru in 2003 and shown to be caused by P. andina. Isolates of P. andina, collected from three different plantations in Peru over a 6‐year time span (2003–2008), were compared genetically with P. andina isolates from Colombia and Ecuador to test whether the pathogen population is geographically structured in the Andes. Restriction fragment length polymorphism (RFLP), mitochondrial DNA and simple sequence repeat (SSR) genetic markers, and mating type behaviour indicated that the Peruvian P. andina population from tree tomato is genetically distinct from populations infecting tree tomato in Colombia (CO‐1) and Ecuador (EC‐3, Ia, A1), but is more similar to the population infecting solanaceous hosts of the Anarrhichomenum complex (EC‐2, Ic, A2). Such geographic substructuring within this pathogen species could result from spatial isolation. Most strikingly, in contrast to the Ecuadorian and Colombian P. andina isolates from tree tomato, the Peruvian isolates have the A2 mating type. The presence of both mating types in the Andean population of P. andina attacking tree tomato indicates a risk of sexual reproduction and the presence of long‐lasting oospores in this pathosystem.