bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing the cost‐effectiveness of interventions within a humanitarian organisation
Authors: Puett Chloe
Published: April 2019

Cost‐effectiveness analysis is increasingly relevant in humanitarian action. The cost of response has increased exponentially in the past decade, alongside concurrent donor budget restrictions. However, there remains limited comprehension and application of these methods in this field. This paper documents methods developed for use within Action Against Hunger, an international humanitarian organisation, in response to a lack of understanding of this topic within the humanitarian community and limited evidence of the cost‐effectiveness of humanitarian action. These methods encompass costs to both implementing institutions and participating communities. Activity‐based cost analyses are conducted to assess resources per programme activity. Cost‐effectiveness is evaluated using successful programme outcomes, and uncertainty is appraised via sensitivity analysis. This paper aims to advance knowledge, stimulate discussion, and promote the adoption of cost‐effectiveness methods for building the evidence base for humanitarian action, including consideration of community costs, to enable analytical outputs that are useful for managers and policymakers alike.
Coronary microvascular dysfunction is associated with cardiac time intervals in women with angina and no obstructive coronary artery disease: An iPOWER substudy
Authors: Pena Adam , Michelsen Marie Mide , Mygind Naja Dam , Gustafsson Ida , Høst Nis , Bech Jan , Kastrup Jens , Hansen Henrik Steen , Hansen Peter Riis , Prescott Eva
Published: April 2019

Background

Coronary microvascular dysfunction (CMD) may cause angina in the absence of obstructive coronary artery disease (CAD) and increases the risk of future adverse cardiovascular events. Transthoracic Doppler echocardiography (TTDE) with pharmacological stress can assess coronary flow velocity reserve (CFVR), a measure of coronary microvascular function. However, simpler methods would be preferable for diagnosing CMD. Therefore, we examined the relationship between CFVR and cardiac time intervals measured by TTDE in a cohort of women with angina and no obstructive CAD.

Methods

In a prospective cohort study, we included 389 women with angina, left ventricular ejection fraction > 45%, and no obstructive CAD. CMD was defined as CFVR < 2.0. The study population was divided into three groups according to cutoff values of CFVR < 2, 2 ≤ CFVR ≤ 2.5, and CFVR > 2.5. Isovolumic contraction time (IVCT), ejection time (ET), and isovolumic relaxation time (IVRT) were measured by tissue Doppler M‐mode, and the myocardial performance index (MPI = (IVCT + IVRT)/ET) was calculated.

Results

Coronary microvascular dysfunction was associated with increasing age, hypertension, higher resting heart rate, and lower diastolic blood pressure. Moreover, CMD was associated with higher E/e′ ratio (P = 0.002) and longer IVCT (P < 0.001), higher MPI (P < 0.001) and shorter ET (P = 0.002), but not with IVRT or conventional measures of left ventricular geometry, mass, and function. In multivariable analysis, longer IVCT (P < 0.001) and higher MPI (P = 0.002) remained associated with CMD.

Conclusion

In women with angina and no obstructive CAD, CMD is associated with longer IVCT and higher MPI indicating a link between CMD and subtle alternations of systolic and combined measures of cardiac time intervals.
Look at me when I'm talking to you: Selective attention at a multisensory cocktail party can be decoded using stimulus reconstruction and alpha power modulations
Authors: O'Sullivan Aisling E. , Lim Chantelle Y. , Lalor Edmund C.
Published: April 2019

Recent work using electroencephalography has applied stimulus reconstruction techniques to identify the attended speaker in a cocktail party environment. The success of these approaches has been primarily based on the ability to detect cortical tracking of the acoustic envelope at the scalp level. However, most studies have ignored the effects of visual input, which is almost always present in naturalistic scenarios. In this study, we investigated the effects of visual input on envelope‐based cocktail party decoding in two multisensory cocktail party situations: (a) Congruent AV—facing the attended speaker while ignoring another speaker represented by the audio‐only stream and (b) Incongruent AV (eavesdropping)—attending the audio‐only speaker while looking at the unattended speaker. We trained and tested decoders for each condition separately and found that we can successfully decode attention to congruent audiovisual speech and can also decode attention when listeners were eavesdropping, i.e., looking at the face of the unattended talker. In addition to this, we found alpha power to be a reliable measure of attention to the visual speech. Using parieto‐occipital alpha power, we found that we can distinguish whether subjects are attending or ignoring the speaker's face. Considering the practical applications of these methods, we demonstrate that with only six near‐ear electrodes we can successfully determine the attended speech. This work extends the current framework for decoding attention to speech to more naturalistic scenarios, and in doing so provides additional neural measures which may be incorporated to improve decoding accuracy.
Lesslie Newbigin and Edinburgh’s Common Call
Authors: Robinson Eric
Published: April 2019

In a world where pluralism is the norm, interfaith encounter and dialogue are essential parts of the Christian experience. Lesslie Newbigin reflected extensively on a theological understanding of the Christian encounter with those of other faiths, emphasizing the importance of both a humble orientation toward God and others and a firm commitment to the uniqueness of Jesus Christ. This juxtaposition of humble witness and firm faith in interfaith encounter is also reflected in the Edinburgh 2010 mission conference’s Common Call. This article will explore Newbigin’s reflections on interfaith dialogue and consider their implications for the future of the ecumenical movement.
What Is Transforming Discipleship?
Authors: Ghazaryan Drissi Ani
Published: April 2019

In 2018, the Conference on World Mission and Evangelism of the World Council of Churches took place in Arusha, Tanzania, on the theme “Moving in the Spirit: Called to Transforming Discipleship.” This article considers how this injunction corresponds to the biblical call, namely to love God more than anyone else; to deny ourselves and to take up the cross; and to abandon all that we have. How well does The Arusha Call to Discipleship describe the ambitious demand of discipleship to which the apostles were called by Jesus Christ? This article offers a critical biblical assessment of the qualities a disciple should have; who can be a disciple; the conditions and requirements of being a disciple according to the gospel; and the path of transforming discipleship in the challenging world in which we live today.
Physical and Mental Health and Functioning Among Traumatic Brain Injury Close Relatives: The Role of Posttraumatic Stress Symptoms
Authors: Tsur Noga , Haller Chiara S.
Published: April 2019

Severe Traumatic brain injury (sTBI) often instigates widespread long‐lasting disability and is accompanied by extensive rehabilitation. Unsurprisingly, sTBI also holds malignant consequences for patients’ close relatives. The burden caused by the injury and its severity explains some of the ramifications for the relatives. Additionally, some findings demonstrate that patients with sTBI and their relatives develop posttraumatic stress (PTS) symptoms. However, although the link between PTS symptoms and physical and mental health is well‐documented in literature, the effect of PTS symptoms on relatives of patients with sTBI has barely been examined. This study examines the influence of PTS symptoms of patients with sTBI and their relatives on the physical and mental health and functioning of the relatives. Patients who sustained a severe sTBI (Abbreviated Injury Scale of the head region > 3) and close relatives were included in a multi‐center, prospective cohort study (TRAST‐MI). One‐hundred patients and their relatives were assessed at 2, 6, and 12 months post injury. Outcome variables included health‐related quality of life (SF‐12) as well as emotional, cognitive, interpersonal, and total functioning (PCRS). Relatives’ physical health was predicted by relatives’ PTS symptoms (Slope=−1.76; p = .043), and mental health was predicted by both patients’ (Slope=−2.77; p = .034) and relatives’ (Slope=−6.59; p < .001) PTS symptoms. Functioning level was only predicted by patients’ PTS symptoms (Slope=−.25; p<.001). The findings emphasize that TBI should be considered a comprehensive traumatic experience reaching further than mere physical damage to the brain and its direct consequences, affecting the injured individual and close relatives.
Endothelium‐dependent and endothelium‐independent effects of 1‐nitro‐2‐propylbenzene on rat aorta
Authors: Vasconcelos Thiago Brasileiro , Ribeiro‐Filho Helder Veras , Carvalho Emanuella Feitosa , Brito Teresinha Silva , Lahlou Saad , Magalhães Pedro Jorge Caldas
Published: April 2019

A group of nitro compounds contains a benzene ring in a short aliphatic chain with the NO2 group, property that supposedly favors its vasodilator profile. In this study, we evaluated in isolated rat aorta the effects of 1‐nitro‐2‐propylbenzene (NPB), a nitro compound containing the NO2 in the aromatic ring. In aorta precontracted with KCl, NPB (1‐3000 μm) induced full endothelium‐independent relaxation. In endothelium‐intact preparations, phenylephrine‐induced contractions were fully relaxed by NPB, effect unaltered by N(ω)‐nitro‐L‐arginine methyl ester (L‐NAME) or 1H‐[1,2,4]oxadiazolo[4,3‐a]quinoxalin‐1‐one (ODQ). In the concentration range of 30–300 μm, NPB slightly but significantly potentiated the phenylephrine‐induced contraction. Such potentiation was unaltered by the thromboxane‐prostanoid receptor antagonist seratrodast, but was abolished by endothelium removal or by preincubation of endothelium‐intact preparations with L‐NAME, ODQ or by ruthenium red and HC‐030031, blockers of subtype 1 of ankyrin transient receptor potential (TRPA1) channels. Verapamil exacerbated the potentiating effect of NPB. The potentiating effect was undetectable in preparations precontracted by 9,11‐dideoxy‐11α,9α‐epoxymethanoprostaglandin F2α (U‐46619). Relaxation was reduced by ruthenium red while it was enhanced by HC‐030031. In conclusion, NPB has vasodilator properties but with a mechanism of action distinct from its analogues. Contrary to other nitro compounds, its relaxing effects did not involve recruitment of the guanylyl cyclase pathway. NPB has also endothelium‐dependent potentiating properties on phenylephrine‐induced contractions, a phenomenon that putatively required a role of endothelial TRPA1 channels. The present findings reinforce the notion that the functional group NO2 in the aliphatic chain of these nitro compounds determines favorably their vasodilator properties.
Frameworks for supporting patient and public involvement in research: Systematic review and co‐design pilot
Authors: Greenhalgh Trisha , Hinton Lisa , Finlay Teresa , Macfarlane Alastair , Fahy Nick , Clyde Ben , Chant Alan
Published: April 2019

Background

Numerous frameworks for supporting, evaluating and reporting patient and public involvement in research exist. The literature is diverse and theoretically heterogeneous.

Objectives

To identify and synthesize published frameworks, consider whether and how these have been used, and apply design principles to improve usability.

Search strategy

Keyword search of six databases; hand search of eight journals; ancestry and snowball search; requests to experts.

Inclusion criteria

Published, systematic approaches (frameworks) designed to support, evaluate or report on patient or public involvement in health‐related research.

Data extraction and synthesis

Data were extracted on provenance; collaborators and sponsors; theoretical basis; lay input; intended user(s) and use(s); topics covered; examples of use; critiques; and updates. We used the Canadian Centre for Excellence on Partnerships with Patients and Public (CEPPP) evaluation tool and hermeneutic methodology to grade and synthesize the frameworks. In five co‐design workshops, we tested evidence‐based resources based on the review findings.

Results

Our final data set consisted of 65 frameworks, most of which scored highly on the CEPPP tool. They had different provenances, intended purposes, strengths and limitations. We grouped them into five categories: power‐focused; priority‐setting; study‐focused; report‐focused; and partnership‐focused. Frameworks were used mainly by the groups who developed them. The empirical component of our study generated a structured format and evidence‐based facilitator notes for a “build your own framework” co‐design workshop.

Conclusion

The plethora of frameworks combined with evidence of limited transferability suggests that a single, off‐the‐shelf framework may be less useful than a menu of evidence‐based resources which stakeholders can use to co‐design their own frameworks.
PD‐L1, B7‐H3 and VISTA are highly expressed in gestational trophoblastic neoplasia
Authors: Zong Liju , Zhang Ming , Wang Wenze , Wan Xirun , Yang Junjun , Xiang Yang
Published: April 2019

Aims

The B7 family check‐point molecules are potential therapeutic targets in cancer immunotherapy. However, their expression status in human gestational trophoblastic neoplasia (GTN) remains unknown. We investigated the expression profiles of the B7 family check‐point proteins PD‐L1, PD‐L2, B7‐H3, B7‐H4, VISTA and B7‐H6 in GTN and their clinical significance.

Methods and results

We identified 112 patients with GTN, including 68 with choriocarcinoma, 33 with placental‐site trophoblastic tumour (PSTT) and 11 with epithelioid trophoblastic tumour (ETT). Immunohistochemical staining was performed on whole‐tissue GTN sections using anti‐B7 family antibodies. VISTA expression was immunohistochemically analysed using microarrays of normal human tissues and of 20 common cancers. PD‐L1 and B7‐H3 were highly expressed in all GTN tumours, while PD‐L2 was expressed in 87.5% of the samples. B7‐H4 and B7‐H6 were negative in 100% and 98.2% of the samples, respectively. PD‐L1, B7‐H3 and VISTA levels were significantly higher in choriocarcinomas and PSTTs than in ETTs. There was no association between B7 family check‐point expression in tumour cells and disease stage, prognostic score or patient outcomes (complete remission versus death). VISTA protein was widely overexpressed in 98.2% of all the GTN, but its expression varied in other cancer types and was negative in normal adult and fetal tissues except placental trophoblasts and splenic lymphocytes.

Conclusions

The GTN trophoblast cells show high expression of PD‐L1, B7‐H3 and VISTA in a manner that is independent of clinical outcomes. These proteins may be potential immunotherapeutic targets when treating GTN.
STABILIZATION POLICY AT THE ZERO LOWER BOUND
Authors: Boel Paola , Waller Christopher J.
Published: April 2019

We construct a monetary economy with aggregate liquidity shocks and heterogeneous idiosyncratic preference shocks. In this environment, not all agents are satiated at the zero lower bound (ZLB) even when the Friedman rule is the best interest‐rate policy the central bank can implement. As a consequence, central bank stabilization policy, which takes the form of repo arrangements in response to aggregate demand shocks, temporarily relaxes the liquidity constraint of impatient agents at the ZLB. Due to a pecuniary externality, this policy may have beneficial general equilibrium effects for patient agents even if they are unconstrained in their money balances.
Understanding the difference of 4‐hydroxyhexenal and 4‐hydroxynonenal formation in various vegetable oils during thermal processes by kinetic and thermodynamic study
Authors: Ma Lukai , Liu Guoqin , Zhang Hua , Liu Xinqi
Published: April 2019

The formation of two toxic aldehydes, 4‐hydroxyhexenal (HHE) and 4‐hydroxynonenal (HNE) were monitored in five vegetable oils during thermal processing (100–200 °C) with the results modelled. HHE was only determined in rapeseed and linseed oil, while HNE was determined in all tested oils and the contents varied significantly depending on the oil type. For HHE/HNE‐detected oils, the evolution during heating was well described by the pseudo‐first‐order kinetic model. The equilibrium contents of HHE/HNE increased and the duration until equilibrium decreased as a function of temperature. The calculated reaction rate constants followed the Arrhenius law. The formation rate of HHE/HNE was remarkably oil‐dependent, which was also in accordance with the calculated kinetic and thermodynamic parameters. Accordingly, the above results can contribute to a prediction of HHE/HNE formation in different vegetable oils during thermal processing, especially the temperature/time required during frying, which is generally higher than 100 °C and 6 h., respectively.
A phase‐field model for the study of isothermal dissolution behavior of alumina particles into molten silicates
Authors: Xuan Changji , Mu Wangzhong
Published: April 2019

Particle dissolution process refers to the dissolving of one liquid or solid phase into another solvent phase. This process is of vital importance in the engineering material science, and chemical engineering, etc. Here, we develop a phase‐field model with diffusion‐controlled processes at interfaces for isothermal dissolution of alumina inclusion particles in molten silicates, referred as “slag,” with comprehensive compositions applied in process metallurgy. The interfacial energy between solid inclusion particle and molten silicate can vary with different temperatures and chemical compositions. This model is validated using experimental data of high‐temperature confocal laser scanning microscopy (HT‐CLSM) technique. Moreover, the developed model is applicable to predict the dissolution behavior of solid particle in a realistic size scale. The possibility of the model application is illustrated with studies of different physical parameters that affect particle dissolution behavior. The phase‐field simulations show that inclusion morphology influences both the dissolution profile and time, and the influence decreases with the increased temperature. Increasing same amount of Al2O3 component in slag, the increased degrees of the alumina dissolution time in silicates with different V‐ratio values, a ratio between the mass percent of CaO and that of SiO2, are almost the same. If the V‐ratio of slag is relatively small, an increased MgO component in the silicate will significantly decrease the particle dissolution time. On the contrary, the change in MgO component in the silicate will have a minor effect if the value of V‐ratio is quite large. In order to rapidly dissolve the inclusion, basicity index (BI) of molten silicate should be larger than 1.4. A balance between BI and MgO component in slag is suggested to be considered to design or optimize molten silicate (slag) for its application in the refining process of steel manufacturing.
Celluloid zombies: A research study of nurses in zombie‐focused feature films
Authors: Stanley David , Stanley Karen , Magee Deborah
Published: April 2019

Aim

To explore how nurses, who are the principal character of zombie‐focused feature films are portrayed.

Design

A mixed methods study with a quantitative exploration of 44,000 feature film synopsis and additional online material for films made between 1900 and 2018 was used. Zombie‐focused films (485) were reviewed for their genre, county, year of production, and plot‐lines. Ten zombie films featuring nurses in key roles were analysed via an interpretive, qualitative thematic analysis. The study was undertaken between May 2018 ‐ November 2018.

Method

A quantitative review of film synopses and relevant movie specific web sites or key literature for the word, ‘zombie’ and/or ‘zombie nurse’ and an interpretive, qualitative thematic analysis of nurse specific zombie films.

Results

Most of the 485 zombie‐focused films located were produced or co‐produced in the USA. Only 115 zombie‐focused feature films were identified with health professionals, of these, 27 films featured nurses, 10 with nurses in the main role. Nurses were portrayed as romantic, sexualized, caring, self‐sacrificial and strong or evil, however, the over‐arching representation of nurses in zombie films was tied to the depravity from which zombie sub‐culture is based.

Conclusion

Few zombie films feature nurses in the main role. However, the negative, violent and deprived nature of this genre offers a poor reflection on nursing.

Impact

How nurses are portrayed in films is important because it influences how the public, patients, and nurses themselves view their profession and role. Understanding the way nurses are portrayed may help professional bodies to better prepare recruitment material.
Stepping outside the consultation room. On nurse–patient relationships and nursing responsibilities during a type 2 diabetes walking project
Authors: Stuij Mirjam , Elling‐Machartzki Agnes , Abma Tineke A.
Published: April 2019

Aims

To examine the care practices of nurses during the organization of 20 weeks of walking sessions for people with type 2 diabetes and to reflect on implications for nurse–patient relationships and nursing responsibilities in the provision of physical activity (PA) care.

Design

Qualitative, ethnographic study.

Methods

Almost 70 hr of field work was completed by participant observations and informal conversations with nurses and participating patients of two different walking groups (April–October 2016). Analysis of field notes followed an inductive holistic‐content approach, using both within‐case and across‐case analysis.

Results

The analysis revealed four main themes related to the nurses’ care practices: (a) organizational efforts; (b) combining group and individual care; (c) stepping in‐ and outside the patient mode; and (d) implications back inside the consultation room. Underlying these themes was a process of relational development, both with and among patients.

Conclusion

Stepping outside the consultation room seems to offer more space for patients’ lifeworld narratives and contribute to more continuous and person‐centred care. However, it also raises new questions about the provision of PA care and nursing responsibilities in this.

Impact

Current nursing repertoires for PA counselling in type 2 diabetes care are insufficient and might be extended by organizing walking sessions for patients. Related nursing care practices impacted relationships both with and among participating patients. These have consequences for boundaries of both nursing responsibilities and care provision.
Perception of clinical deterioration cues among medical‐surgical nurses
Authors: Orique Sabrina B. , Despins Laurel , Wakefield Bonnie J. , Erdelez Sanda , Vogelsmeier Amy
Published: April 2019

Aim

To examine medical‐surgical nurses’ capacity and tendency to perceive cues indicating clinical deterioration and nursing characteristics influencing deterioration cue perception.

Design

Cross‐sectional, explorative study design.

Methods

Data were collected over 10 weeks between September–November 2017. Medical‐surgical nurses completed an online survey consisting of a demographic questionnaire, the Occupational Fatigue, Exhaustion Recovery scale and 50 detection trials. Descriptive statistics and statistical tests were used to describe and interpret data.

Findings

A significant association was found between nurses’ capacity and tendency to perceive deterioration cues. As nurses’ capacity to perceive deterioration cues increased, nurses were more likely to classify patient cues as indicators of deterioration. Fatigue, education, and certification were not identified as characteristics associated with deterioration cue perception. However, experience was observed to significantly influence nurses’ capacity to perceive deterioration cues based on levels of skills acquisition.

Conclusion

Study findings imply that future research should be directed at determining whether other individual factors and organizational system dynamics influence deterioration cue perception.

Impact

To better understand how nurses perceive deterioration cues, this study integrated concepts from the Situation Awareness model and Signal Detection Theory. Novice, advanced beginner and competent nurses were found to have a lower capacity to perceive deterioration cues compared with proficient and expert nurses. With simulation increasingly being used as a primary teaching modality in nursing, the development of a simulation‐based signal detection training intervention may be beneficial in enhancing deterioration cue perception.
The roles of dispositional coping style and social support in helping people with respiratory disease cope with a breathlessness crisis
Authors: Garcia Maja Villanueva , Luckett Tim , Johnson Miriam , Hutchinson Ann , Lal Sara , Phillips Jane L.
Published: April 2019

Aim

To explore the role of coping moderators in self‐management of breathlessness crises by people with advanced respiratory disease.

Design

A secondary analysis of semi‐structured interview data.

Methods

Interviews with patients who had advanced respiratory disease, chronic breathlessness and at least one experience where they considered presenting to Emergency but self‐managed instead (a “near miss”). Participants were recruited from New South Wales, Queensland, Victoria, South Australia or Tasmania. Eligible caregivers were those who contributed to Emergency‐related decision‐making. Interviews were coded inductively and then deductively against the coping moderators social support and dispositional coping style, defined by the Transactional Model of Stress and Coping.

Results

Interviews were conducted between October 2015 ‐ April 2016 with 20 patients and three caregivers. Social networks offered emotional and practical support but also had potential for conflict with patients' ‘hardy’ coping style. Patient hardiness (characterized by a sense of ‘commitment’ and ‘challenge’) promoted a proactive approach to self‐management but made some patients less willing to accept support. Information‐seeking tendencies varied between patients and were sometimes shared with caregivers. An optimistic coping style appeared to be less equivocally beneficial.

Conclusion

This study shows that social support and coping style may influence how people self‐manage through their breathlessness crises and identified ways coping moderators can facilitate or hinder effective self‐management.

Impact

This study confers insights into how social‐support and coping style can be supported and optimized to facilitate breathlessness self‐management. Acknowledging coping moderator interactions is beneficial for developing resources and strategies that recognise patient mastery.
Domains of planning for future long‐term care of adults with intellectual and developmental disabilities: Parent and sibling perspectives
Authors: Lindahl Jane , Stollon Natalie , Wu Katherine , Liang Angela , Changolkar Sujatha , Steinway Caren , Trachtenberg Symme , Coccia Audrey , Devaney Maureen , Jan Sophia
Published: April 2019

Background

Research shows that adults with intellectual and developmental disabilities (IDD) increasingly outlive caregivers, who often struggle to plan for the future and have little support and knowledge surrounding long‐term care planning.

Methods

The study team conducted interviews with parents and siblings of adults with IDD and performed qualitative coding using a modified grounded theory to explore domains of future planning and identify barriers and facilitators.

Results

Themes from the interviews revealed seven major domains of future planning that should be considered by caregivers of adults with IDD. These domains are housing, legal planning, identification of primary caregiver(s), financial planning, day‐to‐day care, medical management and transportation. Approaches to planning within each domain varied greatly.

Conclusions

The study team dentified the domain of “identification of primary caregiver(s)” as potentially the most important step for caregivers when planning for the future, but also observed that the domains identified are significantly interrelated and should be considered together.
Inverse association between physical activity and blood glucose is independent of sex, menopause status and first‐degree family history of diabetes
Authors: Hu Xiang , Yu Weihui , Yang Lijuan , Pan Wei , Si Qiya , Chen Xueqin , Li Qianqian , Gu Xuejiang
Published: April 2019

Aims/Introduction

Exercise training is a recognized strategy central to the prevention, treatment, and management of diabetes and prediabetes. The aim of the present study was to investigate the association between physical activity and blood glucose, as well as the influence of sex, menopause status and family history of diabetes.

Materials and Methods

Participants with normal weight were selected from Risk Evaluation of Cancers in Chinese Diabetic Individuals: A Longitudinal Study, and divided into inactive (moderate‐to‐vigorous‐intensity physical activity [MVPA] <30 min/week), low‐degree (MVPA ≥30 and ≤420 min/week) and high‐degree (MVPA >420 min/week) activity groups.

Results

A total of 2,601 individuals with an average age of 57.85 ± 8.39 years were enrolled. Multivariate anova uncovered that after adjustment for sex and menopause status, and family history of diabetes, respectively, fasting plasma glucose, 2‐h plasma glucose and glycated hemoglobin A1c decreased through inactive, low‐degree and high‐degree activity groups (all P for trend <0.05). The association of blood glucose indexes with physical activity was independent of this association with sex and menopause status, and first‐degree family history of diabetes, respectively. Multivariate linear regression analyses showed that MVPA was an independent factor associated negatively with fasting plasma glucose, 2‐h plasma glucose and glycated hemoglobin A1c, respectively (all P < 0.01).

Conclusions

A higher degree of physical activity was associated with lower blood glucose regardless of sex, menopause status and first‐degree family history of diabetes. MVPA is a negative factor associated with blood glucose independently. Physical activity of adequate duration and intensity is strongly recommended to individuals with susceptibility to diabetes as a result of sex and family history, but without overweight/obesity.
Negative effect of fatty liver on visualization of pancreatic cystic lesions at screening transabdominal ultrasonography
Authors: Kashiwagi Kazuhiro , Seino Takashi , Makino Kanako , Shimizu‐Hirota Ryoko , Takayama Michiyo , Yoshida Toshifumi , Iwasaki Eisuke , Sugino Yoshinori , Inoue Nagamu , Iwao Yasushi , Kanai Takanori
Published: April 2019

Rationale, aims, and objectives

The aim of this observational study is to identify factors by which some pancreatic cystic lesions (PCLs) were undetectable at transabdominal ultrasonography (TAUS), using magnetic resonance imaging (MRI) as reference standard.

Methods

The database for 781 consecutive subjects who underwent a health checkup including fat computed tomography and upper abdominal MRI as option was searched. The presence of fatty liver and fatty pancreas was diagnosed by TAUS, and atrophic pancreas was determined by reevaluating the image of the pancreas in the chest computed tomography for screening. Subjects with PCL detected and those undetected at TAUS were statistically compared in clinical characteristics.

Results

The prevalence of PCL detected at MRI was 17.8% in the general population. Multivariate logistic regression analysis showed that fatty liver, body mass index, and the size of PCL were significantly associated with the factors influencing the visualization of PCL at TAUS (odds ratio [OR]: 0.337, 95% confidence interval [CI]: 0.154‐0.734, P = 0.006; OR: 0.852, 95% CI: 0.737‐0.985, P = 0.030; OR:1.120, 95% CI: 1.045‐1.200, P = .001). Thirty‐six PCLs (64.3%) in a total of 56 PCLs were undermeasured by TAUS. Additionally, nine (56%) out of 16 PCLs (≥ 15 mm) were undermeasured by 5 mm or more by TAUS, although a significantly higher detection rate was observed for PCLs (≥ 15 mm) in comparison with that for PCLs (< 15 mm) (80% vs 33.6%, P = .000).

Conclusions

It should be noted that coexisting fatty liver may lower the detection of PCL, and its size may be underestimated by TAUS.
Effects of Interval Training on Visceral Adipose Tissue in Centrally Obese 70‐Year‐Old Individuals: A Randomized Controlled Trial
Authors: Ballin Marcel , Lundberg Emmy , Sörlén Niklas , Nordström Peter , Hult Andreas , Nordström Anna
Published: April 2019

OBJECTIVE

To investigate the effects of 10 weeks of progressive vigorous‐intensity interval training as a single intervention on body composition among 70‐year‐old individuals with central obesity.

DESIGN

Randomized controlled trial (ClinicalTrials.gov registration No. NCT03450655).

SETTING

Community‐dwelling 70‐year‐old men and women living in the Umeå municipality in Sweden.

PARTICIPANTS

Seventy‐seven 70‐year‐old men and women with central obesity (greater than 1 kg visceral adipose tissue [VAT] for women and greater than 2 kg VAT for men).

INTERVENTION

Participants allocated to the intervention group were offered a 10‐week progressive concurrent exercise program performed three times per week. All participants in both groups had received tailored lifestyle recommendations focused on diet and physical activity at one occasion within 12 months prior to trial initiation.

MEASUREMENTS

The primary outcome was changes in VAT, and secondary outcomes included changes in total fat mass (FM), total lean body mass (LBM), and body mass index.

RESULTS

Comparing the groups, there were no significant differences in decrease of VAT mass (P = .10), although the intervention group significantly decreased FM by 716 g (P = .01) and gained LBM by 508 g (P = .03), compared to the control group. Furthermore, the effects of the training were significantly greater in the male subcohort (P < .05 for interaction), with positive effects also on VAT and FM, where men in the intervention group decreased VAT by 175 g (P < .05) and FM by 1364 g (P = .004), compared to the male controls.

CONCLUSIONS

The present trial demonstrates that 10 weeks of progressive vigorous interval training is sufficient to significantly decrease FM in older adults with central obesity, with positive effects also on LBM. J Am Geriatr Soc 67:1625–1631, 2019
A comparative study on the effectiveness of herbal extracts vs 2.5% benzoyl peroxide in the treatment of mild to moderate acne vulgaris
Authors: Lubtikulthum Patrida , Kamanamool Nanticha , Udompataikul Montree
Published: April 2019

Background

Although there is a standard guideline for the treatment of acne, it is still a common skin disease, and suboptimal medication adherence is a major reason for treatment failure. Herbal extracts are an interesting alternative medicine because they consist of a variety of active ingredients. Moreover, herbal extracts may have improved therapeutic efficacy because of the combination of various herbs.

Objectives

To evaluate the effectiveness of herbal extracts for the treatment of mild to moderate acne vulgaris.

Methods

A total of 77 patients were randomized to receive either an herbal extract or 2.5% benzoyl peroxide, which were applied for a period of 12 weeks. Acne lesion counts, adherence, porphyrin counts, the Dermatology Life Quality Index, satisfaction and side effects were assessed.

Result

At the 12‐week point, the acne lesion counts decreased, with statistically significant differences from the baseline values in both groups and for all types of acne (P‐value < 0.001). The adherence rate was significantly higher in the patients using the herbal extract than in the patients using 2.5% benzoyl peroxide (P‐value = 0.002). There was no statistically significant difference in terms of porphyrin counts, spot scores, the Dermatology Life Quality Index or satisfaction with efficacy between the groups; however, satisfaction with drug administration was significantly higher in the patients using the herbal extract (P‐value = 0.001).

Conclusion

Herbal extracts could be beneficial for anti‐acne pharmaceutical preparations and may be used as an alternative medicine for patients with mild to moderate acne vulgaris who do not adhere to benzoyl peroxide treatment.
Nurse practitioner primary care organizational climate questionnaire: Item response theory and differential item functioning
Authors: Poghosyan Lusine , Ghaffari Affan , Shaffer Jonathan
Published: April 2019

Aims and objectives

To validate Nurse Practitioner Primary Care Organizational Climate Questionnaire (NP‐PCOCQ) items using item response theory (IRT) models and conduct differential item functioning (DIF) analysis to test the item functioning among nurse practitioners (NPs) practicing in different U.S. states with variable regulations governing NP practice.

Background

Nurse Practitioner Primary Care Organizational Climate Questionnaire is the only NP‐specific tool measuring NP work environment and is being used in different U.S. states with variable NP scope of practice regulations and internationally to produce evidence about NP work environments within their organisations.

Design

Cross‐sectional survey design was used to collect data from 278 primary care NPs in New York (NY) and 314 NPs in Massachusetts (MA).

Methods

NPs completed the 29‐item NP‐PCOCQ. Data collection involved an online survey in NY and a mail survey in MA in 2012. We used Samejima's graded response model for IRT and ordinal logistic regression for DIF analysis. A STROBE checklist was completed.

Results

IRT models yielded discrimination parameters ranging from 0.98–4.65 in NY and 1.25–6.94 in MA. Item difficulty parameters were within −3 to +3 range, suggesting a fair range of item difficulties exist in the scale. Only five of the 29 items on NP‐PCOCQ exhibited DIF, suggesting some other state‐related factor besides the measured construct influenced item responses; thus, the items were removed.

Conclusion

Our findings indicate that a shortened, 24‐item NP‐PCOCQ is capable of measuring organisational climate of NPs practicing in different U.S. states. NP‐PCOCQ can be used in future research to measure NP work environment.

Relevance to clinical practice

The tool can also be used by practice administrators to assess NP work environment and identify deficiencies to address them. This evidence about NP work environment can be used by practice administrators to promote favourable work environments for NPs to deliver high‐quality care.
Gastric‐type endocervical adenocarcinoma with uterine corpus involvement mimicking primary endometrial carcinoma
Authors: Kamiya Akio , Ikura Yoshihiro , Iizuka Noriaki , Yokokawa Toru , Kato Hiroki , Oishi Tetsuya
Published: April 2019

Differentiation of endocervical adenocarcinomas involving the uterine corpus from primary endometrial (EM) carcinomas involving the cervix is, not only clinically but also pathologically, often difficult. We report a case of gastric‐type endocervical adenocarcinoma involving the corpus that could be correctly diagnosed because it was a unique endocervical adenocarcinoma subtype. A 69‐year‐old woman who presented with abnormal genital bleeding was diagnosed as having a uterine adenocarcinoma on pathological examination of EM biopsy. Preoperative imaging findings and a surgical specimen showed that the tumor was mainly located in the corpus and involved the cervix. We considered at first that the tumor was an EM adenocarcinoma invading into the cervix. However, results of an immunohistochemical examination indicated that it was a gastric‐type mucinous adenocarcinoma derived from the endocervix. Our final pathological diagnosis was a gastric‐type endocervical adenocarcinoma spreading to the uterine corpus.
Breeding and selection of Buxus for resistance to Calonectria pseudonaviculata
Authors: Van Laere Katrijn , Heungens Kurt , Gehesquière Bjorn , Leus Leen , Hermans Didier , Van Huylenbroeck Johan
Published: April 2019

Box blight is a widespread disease of Buxus caused by the pathogen Calonectria pseudonaviculata. It is responsible for significant losses in nurseries, gardens and wild boxwood populations. Our goal was to maximize the efficiency of a breeding programme towards increased disease resistance. The use of artificial inoculation of young F1 seedlings with C. pseudonaviculata spores under greenhouse conditions appeared to be a reliable tool for early selection of interesting prebreeding material. Overall, the four hybrid populations screened showed a segregating behaviour between their parents when determining the percentage of diseased leaves and lesion diameter. Genotypes were also found with an increased tolerance as compared to the parental species. Approximately 50% of the seedlings had the same score for both parameters after artificial inoculation in the greenhouse and in the field. Of the seedlings that showed severe symptoms in the greenhouse, <15% showed no disease symptoms in the field. Therefore, for larger breeding programmes, we propose a two‐step selection procedure: first artificial inoculation at seedling level to eliminate all genotypes with severe symptoms and then evaluation of the remaining seedlings in the field. Using this strategy, we were able to select several genotypes in our four hybrid populations with improved resistance to C. pseudonaviculata.
A storytelling intervention reduces childhood caries risk behaviors among American Indian and Alaska Native mothers in Northern California
Authors: Heaton Brenda , Crawford Andrew J. , Wimsatt Maureen A. , Henshaw Michelle , Riedy Christine A. , Barker Judith C. , Garcia Raul I.
Published: April 2019

Objectives

To evaluate a storytelling intervention targeting the oral health beliefs, knowledge, and behaviors of AIAN pregnant women and mothers.

Methods

Fifty‐three adult AIAN women from three tribal communities in Northern California participated. The intervention story delivered oral health messaging using a traditional storytelling format. The effect of the intervention on self‐reported oral health behaviors, dental knowledge, and beliefs was assessed using a pretest‐posttest design, with an additional six‐month follow‐up. Tests of repeated measures using Generalized Linear Models were conducted to assess changes in oral health knowledge, beliefs, and behaviors.

Results

Knowledge and beliefs significantly increased as a result of the intervention and persisted after six months. A consistent, significant increase in positive oral health behaviors from baseline to six‐months was also observed.

Conclusions

The results of this intervention study suggest promise for traditional storytelling to increase oral health‐related knowledge, beliefs, and behaviors among self‐identified AIAN pregnant women and mothers.
Contrast enhancement ultrasound of renal perfusion in dogs with acute kidney injury
Authors: Mannucci T. , Lippi I. , Rota A. , Citi S.
Published: April 2019

Objective

To evaluate the efficacy of contrast‐enhanced ultrasound to assess changes in renal perfusion in dogs with acute kidney injury.

Materials and Methods

The left kidney of each dog in two groups was examined using contrast‐enhanced ultrasound: Group A consisted of 16 healthy dogs and Group B consisted of 12 dogs with acute kidney injury.

Results

All dogs in Group A showed the same sequence of wash‐in and wash‐out. In Group B the distribution of contrast media showed a similar cortical phase to healthy dogs, but a faster time to maximal medullary enhancement. Group B showed increased medullary peak intensity and medullary area under the curve compared to Group A. Both qualitative and quantitative analyses showed vascular changes especially in the medulla, with more rapid medullary vascularisation and increased medullary perfusion. These results were interpreted as medullary congestion in dogs with acute kidney injury.

Clinical Significance

Contrast‐enhanced ultrasound represents an easy to perform, safe, and non‐invasive method to detect changes in renal perfusion in dogs with acute kidney injury.
Staying young and fit? Ontogenetic and phylogenetic consequences of animal anhydrobiosis
Authors: Kaczmarek Ł. , Roszkowska M. , Fontaneto D. , Jezierska M. , Pietrzak B. , Wieczorek R. , Poprawa I. , Kosicki J. Z. , Karachitos A. , Kmita H.
Published: April 2019

Although gradual deterioration of life functions with age is not a fundamental rule, it is pervasive among living organisms, regardless of their mode of reproduction and the number of constituent cells. However, deterioration can be temporarily arrested or slowed down due to the process of anhydrobiosis. Two modes of anhydrobiosis can be distinguished for the developmental and adult stages of animals. Developmental resting stages are reported for different animals, including sponges (Porifera), stingers (Cnidaria), flatworms (Platyhelminthes), insects (Insecta), copepods (Copepoda) and branchiopods (Branchiopoda). However, anhydrobiosis occurring at any stage of animal life, including adults, is found only in a few invertebrate phyla, namely roundworms (Nematoda), wheel animals (Rotifera) and water bears (Tardigrada). Notably, in the second group anhydrobiosis has been proposed to eliminate or slow‐down aging symptoms. This, in turn, may correlate with higher fitness and fecundity, and increased offspring longevity. We present available data concerning anhydrobiosis of tardigrades, bdelloid rotifers and nematodes, the only animals known to be capable of anhydrobiosis as adult individuals. The impact of anhydrobiosis on animal aging is illustrated by two models based on experimental data, namely the “Sleeping Beauty” and “Picture of Dorian Grey” models. According to the “Sleeping Beauty” model, anhydrobiotic organisms do not age during anhydrobiosis, whereas the “Picture of Dorian Grey” model predicts that the anhydrobiotic organism ages, at least during the initial stage of anhydrobiosis. Finally, we discuss possible implications of these models for individual longevity and survival as well as phenotypic diversity of taxa and their evolution. A better understanding of life strategies of anhydrobiotic animals both at the ontogenetic and phylogenetic levels can provide answers to many fundamental questions and useful practical outputs in branches of applied sciences.
Intraluminal prucalopride increases propulsive motor activities via luminal 5‐HT4 receptors in the rabbit colon
Authors: Shokrollahi Mitra , Chen Ji‐Hong , Huizinga Jan D.
Published: April 2019

Background

Activating luminal 5‐HT4 receptors results in the release of 5‐HT from enterochromaffin cells into the lamina propria to modulate colonic motility. Our aim was to evaluate characteristics of colonic motor patterns involved in the prokinetic effects of intraluminal prucalopride in the rabbit colon.

Methods

Colonic motor patterns were studied ex vivo using simultaneous spatiotemporal diameter mapping and pressure sensing.

Key Results

Intraluminal prucalopride and intraluminal exogenous 5‐HT strongly evoked or enhanced the colonic motor complex at all levels of excitation beginning with generation of clusters of fast propagating contractions (FPCs), then development of long‐distance contractions (LDCs) within the clusters, and finally forceful LDCs as the highest level of excitation. Intraluminal prucalopride and intraluminal exogenous 5‐HT stimulated propulsive motor activity in a dose‐dependent and antagonist‐sensitive manner by increasing the contraction amplitude, intraluminal pressure, frequency, velocity, and degree of propagation of the colonic motor complex.

Conclusions and Inferences

Activating mucosal 5‐HT4 receptors via intraluminal prucalopride or 5‐HT increases propulsive motor activity in a graded manner; that is, depending on starting conditions, amplitudes or frequencies of an activity may increase or a new pattern may be initiated. Our data support further studies into delivering 5‐HT4 receptor agonists via colon‐targeted drug delivery systems and studies into the role of luminal 5‐HT as an essential requirement for normal colon motor pattern generation.