bluuebunny/crossref_metadata_2025 huggingface dataset:
Health Impact of Climate Change in Older People: An Integrative Review and Implications for Nursing
Authors: Leyva Erwin William A. , Beaman Adam , Davidson Patricia M.
Published: October 2017

Purpose

Older people account for the highest proportion of mortality from extreme weather events associated with climate change. This article aims to describe the health impacts of climate change on older people.

Type of Study

An integrative review was conducted with 30 studies retrieved from PubMed, EBSCO, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) on climate stressors, determinants of resilient capacity, risk factors, and health outcomes.

Findings

Heat, temperature variability, and air pollution increase mortality risk in older people, especially from cardiovascular and respiratory diseases. Floods are linked with increasing incidence of post‐traumatic stress disorder, depression, and anxiety. Facing these adversities, older people exhibit both vulnerability and resilience.

Conclusions

Research gaps exist in understanding the full spectrum of the resilience experience of older people, and appreciating areas wherein nursing can play a pivotal role.

Clinical Relevance

Recognizing the vulnerabilities of older people in the context of climate change is important. Identifying opportunities to promote resilience is an important focus for nurses to develop tailored and targeted nursing interventions.
The Leverage Ratchet Effect
Authors: ADMATI ANAT R. , DEMARZO PETER M. , HELLWIG MARTIN F. , PFLEIDERER PAUL
Published: October 2017

Firms’ inability to commit to future funding choices has profound consequences for capital structure dynamics. With debt in place, shareholders pervasively resist leverage reductions no matter how much such reductions may enhance firm value. Shareholders would instead choose to increase leverage even if the new debt is junior and would reduce firm value. These asymmetric forces in leverage adjustments, which we call the leverage ratchet effect, cause equilibrium leverage outcomes to be history‐dependent. If forced to reduce leverage, shareholders are biased toward selling assets relative to potentially more efficient alternatives such as pure recapitalizations.
Iraq, Afghanistan, and rethinking the post‐heroic turn: Military decorations as indicators of change in warfare
Authors: Powel Brieg
Published: October 2017

This article compares the awarding patterns of the two senior Anglophone military decorations, the British/Commonwealth Victoria Cross and the American Medal of Honor, to challenge arguments that a shift to ‘post‐heroic’ warfare has been in progress in Western societies since 1990. Despite the two decorations being independent of each other, each born of a particular military, political, and social context in their respective parent societies, the article reveals strong consistencies across the two. These include common understandings of military heroism centred on infantry‐ rather than machine‐intensive combat, and a shared neglect of armoured, aerial, and naval combatants. Crucially, the medal data suggests that, despite academic suggestions to the contrary, there was no discernible shift towards ‘post‐heroism’ in the post‐Cold War era. Such a shift, however, is observable between 1916 and 1920, suggesting that the ‘new Western way of war’ began far earlier than is often suggested.
Motive–goal congruence moderates the use of automatic self‐regulation
Authors: Müller Florian , Rothermund Klaus
Published: October 2017

Objective

We tested whether the fit between individuals' motives and goal properties predicts efficiency of implicit self‐regulation.

Method

Participants' (German university students; Mage = 22; 64% female) implicit motives measurement (Multi‐Motive Grid) was followed by assessment of implicit self‐regulation in differently framed tasks. In Study 1 (N = 45), positive implicit evaluations of stimuli relating to an achievement goal (studying) were used as an indicator of implicit self‐regulation. Study 2 (N = 70) framed a laboratory task as either achievement or power related, thus experimentally controlling the goal's properties, and assessed implicit evaluations for task‐related stimuli with an evaluative priming paradigm. Study 3 (N = 67) contrasted playing a game framed as agency related (achievement, power) with a control condition. Implicit evaluations of task‐related stimuli were assessed as an indicator of self‐regulation with an approach/avoidance task.

Results

In Study 1, implicit positive evaluations of an achievement goal were positively related to participants' achievement motive. Because of similarities between achievement and power, implicit positive evaluations of task‐related stimuli were positively related to the achievement motive in both conditions of Study 2. In Study 3, positive implicit evaluations of the task were positively related to the agency motives only in the agency condition.

Conclusions

Congruence between individuals' implicit motives and goal properties boosts implicit self‐regulation, thus identifying a promising predictor for success and failure in self‐regulation that potentially mediates effects of goal–motive fit on goal pursuit.
The effect of dietary supplementation with Aurantiochytrium limacinum on lactating dairy cows in terms of animal health, productivity and milk composition
Authors: Moran C. A. , Morlacchini M. , Keegan J. D. , Fusconi G.
Published: October 2017

The aim of this study was to investigate the effect of dietary supplementation with the docosahexaenoic acid (DHA)‐rich microalgae, Aurantiochytrium limacinum (AURA), on a variety of health and productivity parameters in lactating cows. Twenty‐four cows were blocked by parity and number of days in milk and then randomly assigned to a control (CON; n = 12) group with no algal supplementation, or a treatment group (AURA; n = 12) provided with 100 g AURA cow−1 day−1 or 16 g DHA cow−1 day−1. A variety of health and productivity measurements were taken, and results indicated that supplementation had no negative effects on animal health in terms of somatic cell count, haematological and biochemical blood parameters, while body condition was marginally improved by algal supplementation. No differences were found for the various production parameters measured; however, a tendency towards increased milk production was observed for the AURA group during the final stage of the study (+4.5 kg cow−1 day−1, day 78–84). The fatty acid profile of milk was improved by supplementation, with significantly lower saturated fatty acids, significantly higher omega‐3 fatty acids and an improved omega‐3/omega‐6 ratio observed when compared to the control group. The amount of DHA in the milk of cows provided 105 g AURA head−1 day−1 was 4.7 mg/100 g milk with a peak transfer efficiency from feed to milk at day 49 of 8.3%. These results indicate that supplementation with 105 g AURA head−1 day−1 resulted in the successful enrichment of milk with DHA without negatively impacting the health or productivity of the animals.
Relationships of family conflict, cohesion, and chaos in the home environment on maternal and child food‐related behaviours
Authors: Martin‐Biggers Jennifer , Quick Virginia , Zhang Man , Jin Yanhong , Byrd‐Bredbenner Carol
Published: October 2017

This study examined how food‐related behaviours differed in mothers and their preschool children by levels of family functioning (cohesion and conflict) and household disorganization (chaos). A nationally representative sample of mothers of preschoolers completed an online survey assessing food‐related behaviours of themselves and their children. Maternal and child diet, eating behaviours, and health status; household availability of fruits/vegetables, salty/fatty snacks, and sugar‐sweetened beverages; family mealtime atmosphere; and family conflict, cohesion, and household chaos were assessed with valid, reliable scales. Cluster analyses assigned families into low, middle, and high conflict, cohesion, and chaos groups. Participants (n = 550) were 72% White, and 82% had some post‐secondary education. Regression analysis examining the association of cluster grouping levels on diet‐related behaviour measures revealed that positive home environments (i.e., low family conflict, high family cohesion, and low household chaos) were associated with healthier food‐related behaviours (e.g., increased fruits/vegetables intake), whereas negative home environments (i.e., high family conflict, low family cohesion, and high household chaos) were associated with unhealthy food‐related behaviours (e.g., greater % total calories from fat) even after controlling for sociodemographic and related behavioural factors. Findings suggest family functioning and household chaos are associated with food‐related behaviours. This frequently overlooked component of family interaction may affect intervention outcomes and objectives of educational and interventional initiatives.
Male partner involvement on initiation and sustainment of exclusive breastfeeding among HIV‐infected post‐partum women: Study protocol for a randomized controlled trial
Authors: Ihekuna Dorothy , Rosenburg Neal , Menson William Nii Ayitey , Gbadamosi Semiu Olatunde , Olawepo John Olajide , Chike‐Okoli Adaeze , Cross Chad , Onoka Chima , Ezeanolue Echezona E.
Published: October 2017

Exclusive Breastfeeding (EBF) among human immunodeficiency virus (HIV)‐infected mothers is known to be associated with a sustained and significant reduction in HIV transmission and has the potential to reduce infant and under‐five mortality. Research shows that EBF is not common in many HIV‐endemic, resource‐limited settings despite recommendations by the World Health Organization. Although evidence abounds that male partner involvement increases HIV testing and uptake and retention of prevention of mother‐to‐child transmission interventions, few studies have evaluated the impact of male partners' involvement and decision‐making on initiation, maintenance, and sustainment of EBF. We propose a comparative effectiveness trial of Men's Club as intervention group compared to the control group on initiation and sustainment of EBF. Men's Club will provide male partners of HIV‐infected pregnant women one 5‐hr interactive educational intervention to increase knowledge on EBF and explore barriers and facilitators of EBF and support. Additionally, participating male partners in the Men's Club as intervention group will receive weekly text message reminders during the first 6‐week post‐natal period to improve initiation and sustainment of EBF. Participants in the Men's Club as control group will receive only educational pamphlets. Primary outcomes are the differences in the rates of initiation and sustainment of EBF at 6 months between the two groups. Secondary outcomes are differences in male partner knowledge of infant feeding options and the intent to support EBF in the two groups. Understanding the role and impact of male partners on the EBF decision‐making process will inform the development of effective and sustainable evidence‐based interventions to support the initiation and sustainment of EBF.
Lonely Arts: The Status of Aesthetics as A Sub‐Discipline
Authors: Wiltsher Nick
Published: October 2017

This article offers five things: first, a description of the current status of aesthetics as a sub‐discipline of philosophy, showing that it's currently not regarded as part of the field's core; second, a case history asserting that the particular interests and approaches of aestheticians active in the twenty years or so after 1945 started trends that have defined the sub‐discipline ever since; third, a diagnosis arguing that this definition, which involves a narrow focus on certain questions about art, is responsible for the marginal status of aesthetics, leading as it does to the estrangement of curious students and the devaluation of expertise in aesthetics; fourth, a prescription suggesting that we can reverse those trends, and so bring aesthetics toward the core of philosophy; and fifth, a prognosis demonstrating that, happily, just the approach prescribed is already starting to take hold in aesthetics.
Publish or Perish
Authors: Davies Benjamin , Felappi Giulia
Published: October 2017

Funds and positions in philosophy should be awarded through systems that are reliable, objective, and efficient. One question usually taken to be relevant is how many publications people have in a group of well‐respected journals. In the context of significant competition for jobs and funding, however, relying on quantity of publications creates a serious downside: the oft‐lamented demand that we publish or perish. This article offers a systematic review of the problems involved in contemporary academic philosophy, and argues that the resulting situation is bad not just for individual philosophers but also for philosophy itself: we are not working as a discipline to as high a standard as we might. The article then suggests some potential solutions, including some more detailed considerations around what seems a particularly promising option: a professional code of conduct for philosophers.
Blockchain, The Greater Good, and Human and Civil Rights
Authors: Hughes Kobina
Published: October 2017

The central theme of this paper is that the development of a technology that is predicted to have a major impact on the way we transact with each other should be a matter where the needs of society at large are taken into account. Where the technology is one that emerges from the domain of the Internet, inclusivity becomes even more acute in order to avoid widening the already existing gap in reaping the “digital dividend.” With blockchain, the obligation could even be seen as a moral one, as blockchain is said to have the potential to negate the scope for the abuse of trust by states and institutions. This could be a game changer in areas such as public procurement and the conduct of elections where abuse can lead to the denial of essential resources and a concomitant loss of life, or to conflict and mass killings. Blockchain presents an opportunity for the Internet development community to claim a degree of recognition in the human rights realm by aiding civil intervention in areas where military intervention has been deemed inappropriate.
Fifty shades of SUMO: its role in immunity and at the fulcrum of the growth–defence balance
Authors: Verma Vivek , Croley Fenella , Sadanandom Ari
Published: October 2017

The sessile nature of plants requires them to cope with an ever‐changing environment. Effective adaptive responses require sophisticated cellular mechanisms at the post‐transcriptional and post‐translational levels. Post‐translational modification by small ubiquitin‐like modifier (SUMO) proteins is emerging as a key player in these adaptive responses. SUMO conjugation can rapidly change the overall fate of target proteins by altering their stability or interaction with partner proteins or DNA. SUMOylation entails an enzyme cascade that leads to the activation, conjugation and ligation of SUMO to lysine residues of target proteins. In addition to their SUMO processing activities, SUMO proteases also possess de‐conjugative activity capable of cleaving SUMO from target proteins, providing reversibility and buffering to the pathway. These proteases play critical roles in the maintenance of the SUMO machinery in equilibrium. We hypothesize that SUMO proteases provide the all‐important substrate specificity within the SUMO system. Furthermore, we provide an overview of the role of SUMO in plant innate immunity. SUMOylation also overlaps with multiple growth‐promoting and defence‐related hormone signalling pathways, and hence is pivotal for the maintenance of the growth–defence balance. This review aims to highlight the intricate molecular mechanisms utilized by SUMO to regulate plant defence and to stabilize the growth–defence equilibrium.
Clinical implications of gastrointestinal symptoms in systemic amyloidosis
Authors: Yen T. , Chen F. W. , Witteles R. M. , Liedtke M. , Nguyen L. A.
Published: October 2017

Background

Gastrointestinal (GI) symptoms in systemic amyloidosis patients are poorly characterized. This purpose of this study is to define the epidemiology and clinical implications of such symptoms.

Methods

This was a retrospective cohort study of 583 amyloid patients seen at a tertiary referral center. Of 96 symptomatic patients, 82 received endoscopic biopsies, subsequently grouped into those with histologic evidence of GI amyloid (biopsy proven) vs without (biopsy absent).

Key Results

16.8% of patients had GI symptoms, and had more abnormal NT‐proBNP, cardiac ejection fraction, serum albumin, and alkaline phosphatase (P < .01). Of those who received endoscopy, the sites of highest diagnostic yield were stomach, duodenum and colon. The most common symptom was abdominal pain, nausea, or vomiting (50.0%). Of the symptomatic patients, only 37 (45%) had biopsy proven GI amyloid. Biopsy proven patients more often had cardiac involvement (P < .005), and more often received hematologic therapy or transplant (P = .01). Biopsy absent patients had more frequent neurologic involvement (P = .17). Biopsy status had no significant correlation with other indicators of amyloid burden, GI symptoms or management.

Conclusions & Inferences

Nearly one in six amyloid patients have GI symptoms, and half do not have GI amyloid. The type of symptom does not predict endoscopic findings. Most biopsy absent patients are not managed as a functional disorder despite no alternative etiology. Gastroenterologists may have an increased role to play in the care of systemic amyloidosis beyond performing endoscopies, such as evaluating cardiac amyloid patients for concurrent GI amyloid.
Comparative efficacy of five long‐term weight loss drugs: quantitative information for medication guidelines
Authors: Dong Z. , Xu L. , Liu H. , Lv Y. , Zheng Q. , Li L.
Published: October 2017

Quantitative information is scarce in current obesity medication guidelines, and they do not clearly reflect the differences in the efficacy characteristics among various drugs. This study quantitatively assessed the efficacy characteristics of five FDA‐approved long‐term weight loss drugs. Potentially eligible studies were obtained from public databases. Using the differences in the weight change from baseline between the drug group and the corresponding placebo group as the major indicator of efficacy, a time‐effect model was established, and crucial pharmacodynamic parameters, such as the maximal efficacy, drug onset time and rate of body weight regain after the maximal efficacy point, were used to reflect the differences in efficacy among the five drugs. Finally, 50 reports (involving 43,443 participants) were included. After deducting the placebo effects, the maximal efficacies (95% CI) of orlistat (120 mg), lorcaserin, naltrexone–bupropion, phentermine–topiramate (PT, 7.5/46 mg) and liraglutide were −2.94 (−5.82, −1.27), −3.06 (−4.39, −1.71), −6.15 (−9.78, −3.25), −7.45 (−9.76, −3.88) and −5.50 (−10.62, −2.97) kg at weeks 60, 54, 67, 59 and 65 respectively, and their rates of body weight regain were 0.51, 0.48, 0.91, 1.27and 0.43 kg per year respectively. The 1‐year dropout rates of orlistat, lorcaserin, naltrexone‐bupropion, PT and liraglutide were 29.0, 40.9, 49.1, 34.9 and 24.3% respectively. In addition, a significant dose–effect correlation was observed for orlistat and PT. This study provides valid quantitative information for medication guidelines.
Recent developments in genome editing and applications in plant breeding
Authors: Jung Christian , Capistrano‐Gossmann Gina , Braatz Janina , Sashidhar Niharika , Melzer Siegbert
Published: October 2017

Increasing genetic variation beyond natural variation is an important aim in plant breeding. In the past 70 years, random mutagenesis by irradiation or by chemicals has created numerous mutants which have been frequently used in breeding. However, their application is hampered by the mutational load due to many background mutations. In the past 10 years, new techniques for site‐directed mutagenesis have been introduced to plant breeding which are commonly referred to as “genome editing.” Among these, the CRISPR/Cas9 system turned out to be the most efficient and easy to apply. DNA is cleaved by a nuclease precisely at a target site where a mutation is likely to be beneficial. The DNA is healed by the cellular repair system either by error‐prone non‐homologous end joining or by homologous recombination, by which small DNA fragments can be inserted at the target site. In this review, we describe the application of targeted mutagenesis to crop plants and the modification of agronomically important traits, which could have direct impacts on plant breeding.
Proteinuria in pediatric renal transplant recipients
Authors: Yılmaz Songül , Özçakar Z. Birsin , Taktak Aysel , Kurt‐Şükür Eda Didem , Çakar Nilgün , Yalçınkaya Fatoş
Published: October 2017

Proteinuria has been shown to be an important and potentially treatable risk factor for graft loss. The aim of this study was to evaluate prevalence, etiology, and outcome of proteinuria during the follow‐up of children with renal transplantation. We retrospectively reviewed the files of renal transplanted children between 2006 and 2016 in our center. All patients were interpreted with respect to the demographic data and clinical and laboratory features including information about proteinuria. Chi‐square test and Mann‐Whitney U test were used for analysis. Fifty‐two children were eligible for the study. Proteinuria was observed in 34 (65%) and nephrotic range proteinuria was detected in 5 (9.6%) patients. Etiology of proteinuria could be identified in 21 patients. Acute rejection and uncontrolled hypertension were the most frequent causes of proteinuria. Proteinuria had resolved during the follow‐up in 59% of the patients. We found that children with and without proteinuria had similar glomerular filtration rate at the end of 50 months of follow‐up period. Proteinuria seems to be a common complication in renal transplant recipients. Graft functions can be preserved by immediate evaluation of increasing proteinuria, and by fixing treatable causes rapidly and efficiently during the follow‐up in majority of the patients.
The pursuit of original equipment manufacturer strategy: insights from an Asian country
Authors: Wonglimpiyarat Jarunee
Published: October 2017

The automotive sector is the major industry of Thailand's economy. This paper discusses the national strategy of Thailand toward the Detroit of Asia. In particular, the study analyses the pursuit of original equipment manufacturer (OEM) strategy in the Thai automotive industry, based on Porter's Diamond Model. A qualitative approach was adopted, using semi‐structured interviews to understand the reasons behind Thailand's adoption of OEM strategy and its decisions in not following other strategic approaches. The findings provide important lessons to other developing economies in terms of adopting the right strategies to improve the national performance and competitiveness. The case of Thailand is clearly evident that the Thai government chooses not to develop its own brand (OBM strategy) but pursue the OEM path to strengthen its automotive industry.
Trust in Numbers
Authors: Spiegelhalter David
Published: October 2017

Those who value quantitative and scientific evidence are faced with claims both of a reproducibility crisis in scientific publication and of a post-truth society abounding in fake news and alternative facts. Both issues are of vital importance to statisticians, and both are deeply concerned with trust in expertise. By considering the ‘pipelines’ through which scientific and political evidence is propagated, I consider possible ways of improving both the trustworthiness of the statistical evidence being communicated, and the ability of audiences to assess the quality and reliability of what they are being told.
Ethical considerations when conducting joint interviews with close relatives or family: an integrative review
Authors: Voltelen Barbara , Konradsen Hanne , Østergaard Birte
Published: October 2017

Background

Researchers are obligated to do no harm to participants of research. Conflicts in relationships can cause negative well‐being; therefore, insight is needed into the particular ethical considerations that arise when conducting joint interviews with close relatives or family members simultaneously in the healthcare setting.

Aim

To collect and share knowledge related to ethical considerations conducting joint interviews.

Design and methods

A literature review inspired by the integrative review method was performed. Data were retrieved through a structured search in PubMed, CINAHL and the Philosopher's Index and Academic Search Premier for articles published in English from 1980 to 2016 and included 18 articles, of a possible 2153. Article content was assessed line‐by‐line, and ethical considerations were extracted and organized in three subgroups regarding: Planning joint interviews; Conduction joint interviews and Reporting on joint interviews Findings: Participants should be offered the best terms for a constructive, on‐going relationship after the joint interview has ended. This obligates the researcher to ensure a safe environment during the joint interview and create a delicate balance between the needs of the participants, using nonconfrontational techniques that foster equal and neutral but dedicated attention to all parties, before, during and after the joint interviews.

Conclusion

Specific ethical considerations should be taken into account before, during and after joint interviewing. Further research is needed before a final conclusion can be drawn.
Healthcare professionals’ work engagement in Finnish university hospitals
Authors: Lepistö Sari , Alanen Seija , Aalto Pirjo , Järvinen Päivi , Leino Kaija , Mattila Elina , Kaunonen Marja
Published: October 2017

Background

Concerns about the sufficiency and dedication of the healthcare workforce have arisen as the baby boomer generation is retiring and the generation Y might have different working environment demands.

Aims and objective

To describe the association between work engagement of healthcare professionals’ and its background factors at five Finnish university hospitals.

Methods

Survey data were collected from nurses, physicians and administrative staff (n = 561) at all five university hospitals in Finland. Data were collected using an electronic questionnaire that comprised the Utrecht Work Engagement Scale (9 items) and 13 questions regarding the respondents’ backgrounds. Descriptive and correlational analyses were used to examine the data.

Results

Most respondents were female (85%) and nursing staff (72%). Baby boomers (49%) were the largest generational cohort. The work engagement composite mean for the total sample was 5.0, indicating high work engagement. Significant differences in work engagement existed only among sex and age groups. The highest work engagement scores were among administrative staff.

Conclusions

Work engagement among healthcare professionals in Finnish university hospitals is high. High work engagement might be explained by suitable job resources and challenges, as well as opportunities provided by a frontline care environment. Attention should especially be paid to meeting the needs of young people entering the workforce to strengthen their dedication and absorption.
Natural (Non‐)Informative Priors for Skew‐symmetric Distributions
Authors: Dette Holger , Ley Christophe , Rubio Francisco
Published: October 2017

In this paper, we present an innovative method for constructing proper priors for the skewness (shape) parameter in the skew‐symmetric family of distributions. The proposed method is based on assigning a prior distribution on the perturbation effect of the shape parameter, which is quantified in terms of the total variation distance. We discuss strategies to translate prior beliefs about the asymmetry of the data into an informative prior distribution of this class. We show via a Monte Carlo simulation study that our non‐informative priors induce posterior distributions with good frequentist properties, similar to those of the Jeffreys prior. Our informative priors yield better results than their competitors from the literature. We also propose a scale‐invariant and location‐invariant prior structure for models with unknown location and scale parameters and provide sufficient conditions for the propriety of the corresponding posterior distribution. Illustrative examples are presented using simulated and real data.
Out of the shadows: Shedding light on intimate partner homicide amongLatinawomen
Authors: Harper Shannon B.
Published: October 2017

Intimate partner homicide (IPH) victimization is typically associated with prior domestic violence. Latina women are disproportionately vulnerable to domestic violence and intimate partner femicide. Latino cultural values related to devotion to family and gender role conformance may shape Latinas' experiences of domestic violence and IPH. Display/endorsement of these values, as well as intersections of race/ethnicity, class, gender, and immigration status may exacerbate Latinas' IPH risk. A small and outdated body of IPH literature exists that examines IPH among Latinas but, fails to bridge the gap between factors influencing Latinas' experiences of domestic violence (e.g., cultural values, intersectionality, and immigration status) and IPH. This paper reviews literature that examines IPH among Latinas and provides suggestions for future research, including utilization of an intersectional approach to studying IPH among this understudied ethnic group.
Discovery of HLA‐C*14:87, a novel HLA‐C*14 variant, in a Taiwanese individual
Authors: Yang K. L. , Lin P. Y.
Published: October 2017

One nucleotide substitution at residue 526 of the HLA‐C*14:15 results in a novel allele, HLA‐C*14:87.
Role of pelvic ultrasound simulation
Authors: Arya Sushila , Mulla Zuber D , Kupesic Plavsic Sanja
Published: October 2017

Background

Pelvic ultrasound is a critical diagnostic imaging tool in obstetrics and gynaecology. Training opportunities in transvaginal ultrasound have not kept pace with the demand among learners because of the increased complexity of modern ultrasound technology and duty‐hour restrictions. Ultrasound simulation training has the potential to overcome this gap.

Training opportunities in transvaginal ultrasound have not kept pace with the demand

Objective

Our study aimed to determine the usefulness, applicability and attitudes toward pelvic ultrasound simulation training among residents, sonographers and practising doctors.

Methods

Pelvic ultrasound simulation activity using high‐fidelity virtual reality ultrasound simulators lasted 4 hours and consisted of three modules: abnormal uterine bleeding, adnexal masses and bleeding in pregnancy. All learners completed a pre‐ and post‐encounter quiz, and an anonymous post‐simulation survey on the relevance of ultrasound simulation to clinical learning, and its usefulness to improve scanning performance and interpretation skills.

Results

Thirty‐one participants attended the workshop, and 28 (90.3%) of them responded to the survey. Five respondents agreed and 23 strongly agreed that pelvic ultrasound simulation applies to their clinical ultrasound practice, and seven of them agreed and 21 strongly agreed that their performance of ultrasound and interpretation skills will be improved following their simulation training. The average post‐activity knowledge score for all three topics significantly increased (paired Student's t‐test, p < 0.0001).

Conclusions

All 28 respondents believe that ultrasound simulation is a useful complement to learning with real patients, with the potential to improve their pelvic ultrasound performance, interpretation skills and clinical reasoning.
Negative hepatic computed tomographic attenuation pattern in a dog with vacuolar hepatopathy and hepatic fat accumulation secondary to cushing's syndrome
Authors: Carloni Andrea , Paninarova Michaela , Cavina Damiano , Romanucci Mariarita , Salda Leonardo Della , Teodori Simone , Vignoli Massimo
Published: October 2017

This report describes an unusual computed tomographic (CT) hepatic pattern, characterized by negative attenuation values (from –19.59 to –28.85 Hounsfield Units, HU) in a canine patient with severe Cushing's syndrome. Attenuation values of the splenic parenchyma (63.26 HU) and abdominal fat (–118.34 HU) were within normal limits. The negative hepatic attenuation values allowed a CT diagnosis of severe hepatic fatty infiltration that was subsequently confirmed by tissue‐core biopsy and histopathological examination.
Reducing Readmissions: Nurse‐Driven Interventions in the Transition of Care From the Hospital
Authors: Dizon Mae L. , Reinking Cheryl
Published: October 2017

Background

Transitions of care (TOC) from hospitals is a continuing focus for quality improvement to reduce readmissions. Sufficient resources to offer interventions remain an issue for hospitals, leading to efforts to target high‐risk patients and identify effective interventions.

Objectives

Describe and measure effects, hospital‐wide and among high‐risk patients, of a multifaceted TOC program on 30‐day readmissions in a 441‐bed acute care community hospital.

Methods

Pre‐post TOC intervention examining 30‐day readmission rates during planning, implementation, and intervention years compared to baseline. Patient characteristics and services received by patients targeted for TOC individualized interventions during hospitalization and after discharge were retrieved from medical records and compared over 4 years during which the intervention was planned and implemented.

Results

Summary hospital‐wide readmission rates reduced from 11.8% during planning (2011), 12.0% during implementation (2012), to 11.4% during intervention (2013) compared to 13.7% at prestudy baseline (2010; p < .001). TOC program patients were mostly identified by clinician referral (66.7%) rather than computer‐generated risk at admission (32.3%), and nearly one‐third (30.6%) were readmitted within 30 days of release.

Linking Evidence to Action

Reductions in readmissions were achieved using a multifaceted approach with efforts at admission, predischarge, and postdischarge in a community hospital. Having clinical staff involved in TOC program is important in both patient identification and interventions to reduce readmissions.
A hybrid approach for the regularized long wave-Burgers equation
Authors: Zeytinoglu Asuman , Sari Murat , Allahverdiev Bilender P.
Published: October 2017

In this paper, a new hybrid approach based on sixth-order finite difference and seventh-order weighted essentially non-oscillatory finite difference scheme is proposed to capture numerical simulation of the regularized long wave-Burgers equation which represents a balance relation among dissipation, dispersion and nonlinearity. The corresponding approach is implemented to the spatial derivatives and then MacCormack method is used for the resulting system. Some test problems discussed by different researchers are considered to apply the suggested method. The produced results are compared with some earlier studies, and to validate the accuracy and efficiency of the method, some error norms are computed. The obtained solutions are in good agreement with the literature. Furthermore, the accuracy of the method is higher than some previous works when some error norms are taken into consideration.
Articulatory characteristics of preboundary lengthening in interaction with prominence on tri-syllabic words in American English
Authors: Kim Sahyang , Jang Jiyoung , Cho Taehong
Published: October 2017

This study investigated articulation of preboundary lengthening (PBL) in tri-syllabic pseudo words (bábaba, babába, bababá) in American English. Results from 10 speakers showed that PBL was modulated by the degree of prominence, i.e., the less prominent, the more PBL. PBL was attracted to the penultimate stressed syllable but only when the word received no pitch accent whereas the antepenultimate syllable showed no PBL. Kinematically, PBL was accompanied by a larger movement along with an increase in peak velocity, showing a kind of boundary-related articulatory strengthening, although there was some evidence of temporal expansion possibly due to lowered stiffness.
Modeling of reverberant room responses for two-dimensional spatial sound field analysis and synthesis
Authors: Bai Mingsian R. , Li Yi , Chiang Yi-Hao
Published: October 2017

A unified framework is proposed for analysis and synthesis of two-dimensional spatial sound field in reverberant environments. In the sound field analysis (SFA) phase, an unbaffled 24-element circular microphone array is utilized to encode the sound field based on the plane-wave decomposition. Depending on the sparsity of the sound sources, the SFA stage can be implemented in two manners. For sparse-source scenarios, a one-stage algorithm based on compressive sensing algorithm is utilized. Alternatively, a two-stage algorithm can be used, where the minimum power distortionless response beamformer is used to localize the sources and Tikhonov regularization algorithm is used to extract the source amplitudes. In the sound field synthesis (SFS), a 32-element rectangular loudspeaker array is employed to decode the target sound field using pressure matching technique. To establish the room response model, as required in the pressure matching step of the SFS phase, an SFA technique for nonsparse-source scenarios is utilized. Choice of regularization parameters is vital to the reproduced sound field. In the SFS phase, three SFS approaches are compared in terms of localization performance and voice reproduction quality. Experimental results obtained in a reverberant room are presented and reveal that an accurate room response model is vital to immersive rendering of the reproduced sound field.
Institutional Adaptation to Technological Innovation: Lessons From the NCAA’s Regulation of Football Television Broadcasts (1938–1984)
Authors: Nite Calvin , Washington Marvin
Published: October 2017

The effective management of innovation is important for sport organizations seeking to maintain dominance within their respective fields. However, innovation can be problematic as it threatens to alter institutional arrangements. This study examined how technological innovation impacted institutional arrangements within U.S. intercollegiate athletics. Adopting the institutional work framework, we studied the emergence of television and the National Collegiate Athletic Association’s (NCAA) struggle to maintain centralized control of television regulations. We drew from historical data that discussed the NCAA’s regulation of television from the 1940s until the mid-1980s. We found that disparate perceptions of the impact of live televising of college football games and the NCAA’s protracted regulations resulted in tensions among its members. This led to large universities forming strategic alliances and openly defying NCAA regulations. The tensions culminated when universities sued the NCAA in a case that was ultimately ruled upon by the U.S. Supreme Court. This resulted in substantial institutional change that saw the NCAA losing regulative authority of college football television contracts. The findings of this study have implications beyond the context of U.S. intercollegiate athletics.
Foxo1 and Foxp1 play opposing roles in regulating the differentiation and antitumor activity of T
H
9 cells programmed by IL-7
Authors: Bi Enguang , Ma Xingzhe , Lu Yong , Yang Maojie , Wang Qiang , Xue Gang , Qian Jianfei , Wang Siqing , Yi Qing
Published: October 2017

The cytokine IL-7 enhances the generation and antitumor activity of a T cell subset that may be used in cancer immunotherapy.
Temperature-activated ion channels in neural crest cells confer maternal fever–associated birth defects
Authors: Hutson Mary R. , Keyte Anna L. , Hernández-Morales Miriam , Gibbs Eric , Kupchinsky Zachary A. , Argyridis Ioannis , Erwin Kyle N. , Pegram Kelly , Kneifel Margaret , Rosenberg Paul B. , Matak Pavle , Xie Luke , Grandl Jörg , Davis Erica E. , Katsanis Nicholas , Liu Chunlei , Benner Eric J.
Published: October 2017

Fever during the first trimester may induce birth defects by activating TRPV ion channels in neural crest cells.
Highlight: Antitumor strategies
Authors: Foley John F.
Published: October 2017

Two papers highlight potential ways to boost the antitumor immune response.
Evaluation of Pharmacokinetic/Pharmacodynamic Model-Based Optimized Combination Regimens against Multidrug-Resistant Pseudomonas aeruginosa in a Murine Thigh Infection Model by Using Humanized Dosing Schemes
Authors: Yadav Rajbharan , Bulitta Jürgen B. , Wang Jiping , Nation Roger L. , Landersdorfer Cornelia B.
Published: October 2017

We previously optimized imipenem and tobramycin combination regimens against a double-resistant clinical
Pseudomonas aeruginosa
isolate by using
in vitro
infection models, mechanism-based pharmacokinetic/pharmacodynamic modeling (MBM), and Monte Carlo simulations. The current study aimed to evaluate these regimens in a neutropenic murine thigh infection model and to characterize the time course of bacterial killing and regrowth via MBM. We studied monotherapies and combinations of imipenem with tobramycin
in vivo
against the double-resistant clinical
P. aeruginosa
isolate by using humanized dosing schemes. Viable count profiles of total and resistant populations were quantified over 24 h. Tobramycin monotherapy (7 mg/kg every 24 h [q24h] as a 0.5-h infusion) was ineffective. Imipenem monotherapies (continuous infusion of 4 or 5 g/day with a 1-g loading dose) yielded 2.47 or 2.57 log
10
CFU/thigh killing at 6 h. At 24 h, imipenem at 4 g/day led to regrowth up to the initial inoculum (4.79 ± 0.26 log
10
CFU/thigh), whereas imipenem at 5 g/day displayed 1.75 log
10
killing versus the initial inoculum. The combinations (i.e., imipenem at 4 or 5 g/day plus tobramycin) provided a clear benefit, with bacterial killing of ≥2.51 or ≥1.50 log
10
CFU/thigh compared to the respective most active monotherapy at 24 h. No colonies were detected on 3×MIC agar plates for combinations, whereas increased resistance (at 3×MIC) emerged for monotherapies (except imipenem at 5 g/day). MBM suggested that tobramycin considerably enhanced the imipenem target site concentration up to 2.6-fold. The combination regimens, rationally optimized via a translational modeling approach, demonstrated substantially enhanced bacterial killing and suppression of regrowth
in vivo
against a double-resistant isolate and are therefore promising for future clinical evaluation.
Antibiotics Promote Escherichia coli-Pseudomonas aeruginosa Conjugation through Inhibiting Quorum Sensing
Authors: Lu Yang , Zeng Jianming , Wang Linjing , Lan Kai , E Shunmei , Wang Lina , Xiao Qian , Luo Qiang , Huang Xianzhang , Huang Bin , Chen Cha
Published: October 2017

The effect of antibiotics on horizontal gene transfer (HGT) is controversial, and the underlying mechanism remains poorly understood. Here, using
Escherichia coli
SM10λπ as the donor strain, which carries a chromosomally integrated RP4 plasmid, we investigated the effect of antibiotics on conjugational transfer of a mobilizable gentamicin (Gm) resistance plasmid. The results showed that an exposure to gentamicin that restricted the survival of recipient cells significantly enhanced SM10λπ-
Pseudomonas aeruginosa
PAO1 conjugation, which was attenuated by a deficiency of
lasI-rhlI
, genes associated with the generation of the quorum sensing signals
N
-acyl homoserine lactones (AHLs) in PAO1, or the deletion of the AHL receptor SdiA in SM10λπ. Subsequent mechanistic investigations revealed that a treatment with Gm repressed the mRNA expression of
lasI
and
rhlI
in PAO1 and upregulated
traI
expression in SM10λπ. Moreover, PAO1 treated with other quorum sensing (QS)-inhibiting antibiotics such as azithromycin or chloramphenicol also showed a conjugation-promoting ability. On the other hand, when using non-AHL-producing
E. coli
strain EC600 as the recipient cells, the promoting effect of Gm on conjugation could not be observed. These data suggest that AHL-SdiA contributes to the effectiveness of antibiotics on plasmid conjugation. Collectively, our findings highlight the HGT-promoting effect of antibiotics and suggest quorum sensing as a promising target for controlling antibiotic resistance dissemination. These findings have implications for assessing the risks of antibiotic use and developing advisable antibiotic treatment protocols.
Inhibition of Fosfomycin Resistance Protein FosA by Phosphonoformate (Foscarnet) in Multidrug-Resistant Gram-Negative Pathogens
Authors: Ito Ryota , Tomich Adam D. , McElheny Christi L. , Mettus Roberta T. , Sluis-Cremer Nicolas , Doi Yohei
Published: October 2017

FosA proteins confer fosfomycin resistance to Gram-negative pathogens via glutathione-mediated modification of the antibiotic. In this study, we assessed whether inhibition of FosA by sodium phosphonoformate (PPF) (foscarnet), a clinically approved antiviral agent, would reverse fosfomycin resistance in representative Gram-negative pathogens. The inhibitory activity of PPF against purified recombinant FosA from
Escherichia coli
(FosA3),
Klebsiella pneumoniae
(FosA
KP
),
Enterobacter cloacae
(FosA
EC
), and
Pseudomonas aeruginosa
(FosA
PA
) was determined by steady-state kinetic measurements. The antibacterial activity of PPF against FosA in clinical strains of these species was evaluated by susceptibility testing and time-kill assays. PPF increased the Michaelis constant (

K
m

) for fosfomycin in a dose-dependent manner, without affecting the maximum rate (
V
max
) of the reaction, for all four FosA enzymes tested, indicating a competitive mechanism of inhibition. Inhibitory constant (

K
i

) values were 22.6, 35.8, 24.4, and 56.3 μM for FosA
KP
, FosA
EC
, FosA
PA
, and FosA3, respectively. Addition of clinically achievable concentrations of PPF (∼667 μM) reduced the fosfomycin MICs by ≥4-fold among 52% of the
K. pneumoniae
,
E. cloacae
, and
P. aeruginosa
clinical strains tested and led to a bacteriostatic or bactericidal effect in time-kill assays among representative strains. PPF inhibits FosA activity across Gram-negative species and can potentiate fosfomycin activity against the majority of strains with chromosomally encoded
fosA
. These data suggest that PPF may be repurposed as an adjuvant for fosfomycin to treat infections caused by some FosA-producing, multidrug-resistant, Gram-negative pathogens.