bluuebunny/crossref_metadata_2025 huggingface dataset:
Roster process review: a case study on the implications of preliminary findings
Authors: Eather Bernadette , Malica Emma , Walton Cassandra , Hollmann Peter , Kwong Wyman
Published: April 2015

Rostering is an important process to enable efficient, effective and safe delivery of health care, and one which receives little attention. The work outlined in this case study demonstrates that the analysis of rostering processes from a range of perspectives including the organisation, staff and the roster manager can identify significant opportunities for improvement. Roster governance is not universally applied, nor understood, which can result in dissonant expectations between managers and staff and a lack of transparency in how and why decisions about rostering are made. Redesigning roster processes can promote more effective governance and improve organisational efficiency.
Factors that affect job satisfaction and intention to leave of allied health professionals in a metropolitan hospital
Authors: Wilson Natalie A.
Published: April 2015

Objective The purpose of the present study was to determine the aspects of the allied health professional’s job that contribute most to job satisfaction and intention to leave in a metropolitan hospital. Method Data were collected via a questionnaire that was emailed to all clinical allied health staff at Campbelltown and Camden Hospitals in New South Wales, Australia. The participants then rated their level of satisfaction with various job aspects. Results A significant correlation was found between several job satisfaction factors and intention to leave in this study group, including quality of supervision, level of competency to do the job, recognition for doing the job, advancement opportunities, autonomy, feelings of worthwhile accomplishment, communication and support from the manager. Conclusion In relation to Herzberg’s job satisfaction theory, both intrinsic and extrinsic work factors have been shown to have a significant correlation with intention to leave in this study group. This information can assist workforce planners to implement strategies to improve retention levels of allied health professionals in the work place. What is known about the topic? Job satisfaction is a significant predictor of retention in the workplace for allied health professionals in rural and remote areas; however, limited research has reviewed predictors of job satisfaction of allied health professionals in metropolitan hospitals. What does this paper add? This paper provides evidence that job satisfaction factors are important predictors of intention to leave for allied health in metropolitan hospitals, and that both intrinsic and extrinsic job satisfaction factors have a significant correlation with intention to leave. What are the implications for practice? Those involved in workforce management of allied health professionals can implement strategies to improve job satisfaction and assist with retention of the allied health workforce.
Practice Guidance for Buprenorphine for the Treatment of Opioid Use Disorders: Results of an Expert Panel Process
Authors: Farmer Carrie M. , Lindsay Dawn , Williams Jessica , Ayers Amanda , Schuster James , Cilia Alyssa , Flaherty Michael T. , Mandell Todd , Gordon Adam J. , Stein Bradley D.
Published: April 2015

Background

Although the number of physicians credentialed to prescribe buprenorphine has increased over time, many credentialed physicians may be reluctant to treat individuals with opioid use disorders due to discomfort with prescribing buprenorphine. Although prescribing physicians are required to complete a training course, many have questions about buprenorphine and treatment guidelines have not been updated to reflect clinical experience in recent years. We report on an expert panel process to update and expand buprenorphine guidelines.

Methods

We identified candidate guidelines through expert opinion and a review of the literature and used a modified RAND/UCLA Appropriateness Method to assess the validity of the candidate guidelines. An expert panel completed 2 rounds of rating, with a meeting to discuss the guidelines between the first and second ratings.

Results

Through the rating process, expert panel members rated 90 candidate guideline statements across 8 domains, including candidacy for buprenorphine treatment, dosing of buprenorphine, psychosocial counseling, and treatment of co-occurring depression and anxiety. A total of 65 guideline statements (72%) were rated as valid. Expert panel members had agreement in some areas, such as the treatment of co-occurring mental health problems, but disagreement in others, including the appropriate dosing of buprenorphine given patient complexities.

Conclusions

Through an expert panel process, we developed an updated and expanded set of buprenorphine treatment guidelines; this additional guidance may increase credentialed physicians’ comfort with prescribing buprenorphine to patients with opioid use disorders. Future efforts should focus on appropriate dosing guidance and ensuring that guidelines can be adapted to a variety of practice settings.
Functional and Nutritional Characteristics of Wheat Grown in Organic and Conventional Cropping Systems
Authors: Park Eun Young , Baik Byung‐Kee , Miller Perry R. , Burke Ian C. , Wegner Eric A. , Tautges Nicole E. , Morris Craig F. , Fuerst E. Patrick
Published: April 2015

The effects of organic versus conventional farming practices on wheat functional and nutritional characteristics were compared. Soft white winter wheat and hard red spring wheat were obtained from multiyear replicated field plots near Pullman, Washington, and Bozeman, Montana. Test weight, kernel weight, and kernel diameter tended to be greater in both soft and hard organic wheat than in conventional wheat in the Pullman studies. Phenolic content and total antioxidant capacity tended to be lower in organic than in conventional wheat. Flour ash, P, and Mg contents in whole wheat flour varied in parallel among cropping systems, but levels were not consistently associated with either organic or conventional cropping systems. Protein contents of whole wheat and refined flours were similar in organic and conventional wheat from Pullman when fertility levels were similar. Higher fertility was associated with higher protein content in both organic and conventional cropping systems. Soft wheat flour from a low‐fertility organic cropping system had lower sodium carbonate, lactic acid, and sucrose solvent retention capacities, lower protein content, and greater cookie diameter and cake volume than soft wheat flour from the higher fertility organic and conventional cropping systems; the change in end‐product quality was significant in one out of two crop years. In the Bozeman hard wheat studies, higher fertility in both organic and conventional cropping systems tended to increase protein content and bread loaf volume. Results indicated that neither organic nor conventional cropping systems were associated with substantially improved mineral and antioxidant nutritional properties, and end‐use quality of wheat was more strongly associated with fertility level than with organic versus conventional cropping systems.
Gluten Structural Evolution During Pasta Processing of Refined and Whole Wheat Pasta from Hard White Winter Wheat: The Influence of Mixing, Drying, and Cooking
Authors: Bock Jayne E. , West Ryan , Iametti Stefania , Bonomi Francesco , Marengo Mauro , Seetharaman Koushik
Published: April 2015

An attempt was made to evaluate gluten structural changes in refined and whole wheat pasta from hard white winter wheat to elucidate the impact of whole wheat components on the formation and structure of the gluten network in pasta. Attenuated total reflectance–FTIR spectroscopy was used to track gluten secondary structure through most of the major steps in pasta processing: raw material, mixing, drying, and cooking. Protein solubility, accessible thiols, and SDS‐PAGE data were also collected to provide additional information on the nature of protein interactions and network composition. Few secondary structural differences were observed between refined and whole wheat flours from hard white wheat. However, mixing induced a significant shift to β‐sheet structures in refined dough that was not equally matched by whole wheat dough. Drying under both high temperature, short time (HT) and low temperature, long time (LT) conditions resulted in a reversion to structural distributions similar to those for flour in both pastas. However, greater protein denaturation in HT samples was indicated by lower protein solubility also in the presence of denaturants and disulfide reducing agents. Cooking generated a substantial increase in β‐sheet structures for both pasta systems. This structure was greatest in refined and LT samples. Thiol accessibility data indicate the presence of a highly aggregated, compact gluten network in refined pasta, mostly driven by hydrophobic association. Conversely, the network in whole wheat pasta was more loosely associated and dependent on disulfide bonding, both of which fit well with the secondary structural data.
Transcriptomic Analysis ofSinorhizobium melilotiandMedicago truncatulaSymbiosis Using Nitrogen Fixation–Deficient Nodules
Authors: Lang Claus , Long Sharon R.
Published: April 2015

The bacterium Sinorhizobium meliloti interacts symbiotically with legume plant hosts such as Medicago truncatula to form nitrogen-fixing root nodules. During symbiosis, plant and bacterial cells differentiate in a coordinated manner, resulting in specialized plant cells that contain nitrogen-fixing bacteroids. Both plant and bacterial genes are required at each developmental stage of symbiosis. We analyzed gene expression in nodules formed by wild-type bacteria on six plant mutants with defects in nitrogen fixation. We observed differential expression of 482 S. meliloti genes with functions in cell envelope homeostasis, cell division, stress response, energy metabolism, and nitrogen fixation. We simultaneously analyzed gene expression in M. truncatula and observed differential regulation of host processes that may trigger bacteroid differentiation and control bacterial infection. Our analyses of developmentally arrested plant mutants indicate that plants use distinct means to control bacterial infection during early and late symbiotic stages.
Occurrence of QoI Fungicide Resistance in Cercospora sojina from Mississippi Soybean
Authors: Standish J. R. , Tomaso-Peterson M. , Allen T. W. , Sabanadzovic S. , Aboughanem-Sabanadzovic N.
Published: April 2015

Frogeye leaf spot, caused by Cercospora sojina Hara, is a foliar disease affecting soybean (Glycine max (L.) Merr.), often managed by applications of quinone outside inhibitor (QoI) fungicides. In 2013 and 2014, 634 C. sojina monoconidial isolates were collected from soybean fields throughout Mississippi. Initially, in vitro bioassays were performed to evaluate the sensitivity of 14 of 634 isolates plus a baseline. Resistant and sensitive isolates were characterized by determining the effective fungicide concentrations at which 50% of conidial germination was inhibited (EC50). The molecular mechanism of resistance was determined for all 634 isolates, using a PCR-RFLP method and comparing nucleotide sequences of the cytochrome b gene. The state of Mississippi was divided into five distinct geographical regions (the Hills, Delta, Pines, Capital, and Coast) based on estimates of total soybean hectares. The greatest proportion (16.7%) of QoI-sensitive isolates was collected in the Hills while the Coast had no QoI-sensitive isolates. QoI-sensitive isolates from the Pines, Capital, and Delta ranged from 1.6 to 7.0%. Results of this study determined that more than 93% of C. sojina isolates collected in Mississippi carried the G143A amino acid substitution, indicating a shift to a QoI-resistant population throughout Mississippi soybean fields.
Identification and Characterization of Three Monilinia Species from Plum in China
Authors: Yin Liang-Fen , Chen Shu-Ning , Chen Guo-Kang , Schnabel Guido , Du Sheng-Fang , Chen Chu , Li Guo-Qing , Luo Chao-Xi
Published: April 2015

In total, 112 Monilinia spp. single-spore isolates were collected from plum fruit (Prunus salicina) symptomatic for brown rot disease from Yunnan, Hubei, and Zhejiang provinces and Chongqing municipality, China between 2012 and 2014. Three distinct colony morphologies (phenotypes) were observed on potato dextrose agar and two isolates per phenotype were selected for further analysis. Colony color, colony shape, conidia size, number of germ tubes per conidia, and pathogenicity on plum were investigated. The ribosomal internal transcribed spacer regions 1 and 2 as well as a polymerase chain reaction-based method that amplified fragments of the glyceraldehyde-3-phosphate dehydrogenase (G3PDH) and β-tubulin (TUB2) genes were used to identify the isolates to the species level. The three phenotypes were identified to be three different species: Monilinia fructicola, Monilia mumecola, and Monilia yunnanensis. Phylogenetic analysis based on G3PDH and TUB2 nucleotide sequences revealed that isolates within species clustered together regardless of host or geographical origin, suggesting that these factors did not play an important role for the evolutionary separation of the described species.
Efficacy of Intravenous Mannitol in the Management of Orbital Compartment Syndrome: A Nonhuman Primate Model
Authors: Johnson Davin , Winterborn Andrew , Kratky Vladimir
Published: April 2015

Purpose:

To report the efficacy of intravenous mannitol in the treatment of orbital compartment syndrome.

Methods:

An experimental study was conducted on 4 nonhuman primates (8 orbits). Orbital compartment syndrome was simulated by injecting autologous blood into both orbits of each nonhuman primate until a pressure of 80 mm Hg was reached (time 0). After 10 minutes, nonhuman primates were randomized to receive an infusion of either mannitol or saline, given over 15 minutes. Five minutes after the infusion was complete, lateral canthotomy and cantholysis was performed on both orbits in isolated steps every 5 minutes. During the study protocol, orbital and intraocular pressures were recorded every 5 minutes, with a final set of measurements at 60 minutes. The primary outcome measures were the mean change in pressure from time 0 to 60 minutes, as well as the mean change in pressure during the infusion period.

Results:

There was no statistically significant difference in the mean changes in orbital or intraocular pressure from time 0 to 60 minutes of the protocol. However, during the infusion period there was significantly greater decrease in both orbital and intraocular pressure in the mannitol compared with saline group (-34.0 vs. -9.3 mm Hg for orbital pressure [p = 0.03]; -34.8 vs. -9.7 mm Hg for intraocular pressure [p = 0.04]).

Conclusions:

While the definitive treatment of orbital compartment syndrome is lateral canthotomy and cantholysis, mannitol results in a rapid and clinically meaningful drop in orbital and intraocular pressure. The authors believe that their data support the routine use of mannitol in orbital compartment syndrome, especially when there is a delay in timely surgical management.
Delineating structures controlling sandstone‐hosted base‐metal deposits using high‐resolution multicomponent seismic and radio‐magnetotelluric methods: a case study from Northern Sweden
Authors: Malehmir Alireza , Wang Shunguo , Lamminen Jarkko , Brodic Bojan , Bastani Mehrdad , Vaittinen Katri , Juhlin Christopher , Place Joachim
Published: April 2015

Over the past few decades seismic methods have increasingly been used for the exploration of mineral, geothermal, and groundwater resources. Nevertheless, there have only been a few cases demonstrating the advantages of multicomponent seismic data for these purposes. To illustrate some of the benefits of three‐component data, a test seismic survey, using 60 digital three‐component sensors spaced between 2 m and 4 m and assembled in a 160 m‐long prototype landstreamer, was carried out over shallow basement structures underlying mineralized horizons and over a magnetic lineament of unknown origin. Two different types of seismic sources, i.e., explosives and a sledgehammer, were used to survey an approximately 4 km‐long seismic profile. Radio‐magnetotelluric measurements were also carried out to provide constraints on the interpretation of the seismic data over a portion of the profile where explosive sources were used. Good quality seismic data were recorded on all three components, particularly when explosives were used as the seismic source. The vertical component data from the explosive sources image the top of the crystalline basement and its undulated/faulted surface at a depth of about 50 m–60 m. Supported by the radio‐magnetotelluric results, however, shallower reflections are observed in the horizontal component data, one of them steeply dipping and associated with the magnetic lineament. The vertical component sledgehammer data also clearly image the crystalline basement and its undulations, but significant shear‐wave signals are not present on the horizontal components. This study demonstrates that multicomponent seismic data can particularly be useful for providing information on shallow structures and in aiding mineral exploration where structural control on the mineralization is expected.
Dispersal mode mediates the effect of patch size and patch connectivity on metacommunity diversity
Authors: Jones Natalie T. , Germain Rachel M. , Grainger Tess N. , Hall Aaron M. , Baldwin Lyn , Gilbert Benjamin
Published: April 2015

Metacommunity theory predicts that increasing patch size and patch connectivity can alter local species diversity by affecting either colonization rates, extinction rates or both. Although species’ dispersal abilities or ‘dispersal mode’ (e.g. gravity‐, wind‐ or animal‐dispersed seeds) can mediate the effects of patch size and connectivity on diversity, these important factors are frequently overlooked in empirical metacommunity work.

We use a natural metacommunity of aspen stands within a grassland matrix to determine whether dispersal mode alters the influence of stand size and connectivity on understorey plant diversity. We sampled the same area in each patch, controlled for the presence of matrix species in aspen stands, and tested for the effects of size, connectivity and dispersal mode on metacommunity richness. Because dispersal groups responded differently to patch size and connectivity, we created a null model and assessed ungulate activity to explore whether competitive dynamics or herbivory were driving diversity patterns.

Animal‐dispersed species and species with no dispersal aid had higher diversity per unit area in larger stands, likely because large stands can both support larger populations that are less prone to extinction and may also attract seed‐dispersing animals such as birds and small mammals that are sensitive to edge effects. Consistent with other empirical work, we found a positive relationship between diversity and connectivity for wind‐dispersed species. However, we detected a negative effect of stand connectivity on the diversity of species with no dispersal aid, possibly due to the presence of other highly competitive species groups dominating well‐connected patches, as our null model results suggest. We found no evidence for higher ungulate activity in highly connected patches, suggesting that herbivory may not be driving the decline in diversity of plants with no dispersal aid.

Synthesis. Overall, we see a positive effect of stand area on diversity for most groups despite sampling equal area in all stands, which is a prediction of metacommunity theory that is normally overlooked. Our results demonstrate the importance of considering variation in the dispersal modes of focal species for explaining the diversity patterns of natural metacommunities.
Effects of pre‐eclampsia and fetal growth restriction on C‐type natriuretic peptide
Authors: Espiner EA , Prickett TCR , Taylor RS , Reid RA , McCowan LM
Published: April 2015

Objective

To determine changes in plasma C–type natriuretic peptide (CNP), a paracrine product of the vascular endothelium, in pregnancies with vascular disorders, and relate these to time of presentation and severity.

Design

Retrospective nested cases and controls.

Setting

Community study, Auckland New Zealand.

Population

Screening for Pregnancy Endpoints (SCOPE) data and bio‐bank of maternal plasma.

Methods

Maternal plasma amino terminal proCNP (NTproCNP) was measured by radioimmunoassay in early (14–16 weeks of gestation, and again at 19–21 weeks of gestation) and late (34–36 weeks of gestation) pregnancy in three groups of women (20 per group): pre‐eclampsia (pre‐eclampsia); gestational hypertension (GHT) with small for gestational age (SGA); and uncomplicated pregnancy.

Main outcome measures

Change in NTproCNP and associations with concurrent blood pressure, time of case presentation, severity, and infant birthweight.

Results

Plasma NTproCNP in early pregnancy in women with vascular disorders did not differ from those found in controls. In late pregnancy, levels in pre‐eclampsia (28.8 ± 2.3 pM) and in GHT with SGA (28.6 ± 4.8 pM) were significantly increased (P = 0.01 and 0.027, respectively) compared with controls (21.3 ± 1 pM). In pre‐eclampsia, levels were significantly higher (P < 0.03) at 14–16 weeks of gestation in women diagnosed prior to 34 weeks of gestation. Combining all three groups, associations of NTproCNP with concurrent diastolic and mean arterial pressure were found at 34–36 weeks of gestation (r = 0.46). No significant associations were identified with birthweight.

Conclusions

CNP secretion during gestation is responsive to vascular stress. Plasma NTproCNP measurements may have clinical application in late pregnancy in defining the different phenotypes associated with pre‐eclampsia.

Tweetable abstract

Plasma NTproCNP is raised in women diagnosed with PET in a case–controlled study using SCOPE data and biobank.
Dual‐System Use and Intermediate Health Outcomes among Veterans Enrolled in Medicare Advantage Plans
Authors: Cooper Alicia L. , Jiang Lan , Yoon Jean , Charlton Mary E. , Wilson Ira B. , Mor Vincent , Kizer Kenneth W. , Trivedi Amal N.
Published: April 2015

Objective

The concurrent use of multiple health care systems may duplicate or fragment care. We assessed the characteristics of veterans who were dually enrolled in both the Veterans Affairs (VA) health care system and a Medicare Advantage (MA) plan, and compared intermediate quality outcomes among those exclusively receiving care in the VA with those receiving care in both systems.

Data Sources/Study Setting

VA and MA quality and administrative data from 2008 to 2009.

Study Design

We used propensity score methods to test the association between dual use and five intermediate outcome quality measures. Outcomes included control of cholesterol, blood pressure, and glycosylated hemoglobin among persons with coronary heart disease (CHD), hypertension, and diabetes.

Data Collection/Extraction Methods

VA and MA data were merged to identify VA‐only users (n = 1,637) and dual‐system users (n = 5,006).

Principal Findings

We found no significant differences in intermediate outcomes between VA‐only and dual‐user populations. Differences ranged from a 3.2 percentage point (95 percent CI: −1.8 to 8.2) greater rate of controlled cholesterol among VA‐only users with CHD to a 2.2 percentage point (95 percent CI: −2.4 to 6.6) greater rate of controlled blood pressure among dual users with diabetes.

Conclusions

For the five measures studied, we did not find evidence that veterans with dual use of VA and MA care experienced improved or worsened outcomes as compared with veterans who exclusively used VA care.
Novel Antifungal Peptides Produced by Leuconostoc mesenteroides DU15 Effectively Inhibit Growth of Aspergillus niger
Authors: Muhialdin Belal J. , Hassan Zaiton , Abu Bakar Fatimah , Algboory Hussein L. , Saari Nazamid
Published: April 2015

The ability of Leuconostoc mesenteroides DU15 to produce antifungal peptides that inhibit growth of Aspergillus niger was evaluated under optimum growth conditions of 30 °C for 48 h. The cell‐free supernatant showed inhibitory activity against A. niger. Five novel peptides were isolated with the sequences GPFPL, YVPLF, LLHGVPLP, GPFPLEMTLGPT, and TVYPFPGPL as identified by de novo sequencing using PEAKS 6 software. Peptide LLHGVPLP was the only positively charged (cationic peptides) and peptide GPFPLEMTLGPT negatively charged (anionic), whereas the rest are neutral. The identified peptides had high hydrophobicity ratio and low molecular weights with amino acids sequences ranging from 5 to 12 residues. The mode of action of these peptides is observed under the scanning electron microscope and is due to cell lysis of fungi. This work reveals the potential of peptides from L. mesenteroides DU15 as natural antifungal preservatives in inhibiting the growth of A. niger that is implicated to the spoilage during storage.
Physical–Chemical Characterization of Fruit Purees and Relationship with Sensory Analysis Carried out by Infants (12 to 24 mo)
Authors: Inarejos‐García A.M. , Mancebo‐Campos V. , Cañizares P. , Llanos J.
Published: April 2015

Fruit purees are one of the foods earliest introduced foods in infants’ diet during the complementary period. The rheological characteristics together with the sensory analysis are decisive factors for the acceptance of the food product by the infant. The sensory analysis of three commercial fruit purees (mixed fruits, pear, and plum) was studied by employing a new objective sensory parameter named as SAIR (Sensory Acceptance by Infants Ratio), which is the quotient between the percentage of puree consumed (%) by the time (seconds) throughout the storage time. In parallel, the rheological characteristics of the purees were analyzed in order to obtain a relationship with the SAIR parameter. It was proved that the best acceptance of the product (higher SAIR) was observed for such purees showing a lower apparent viscosity (lower consistency index, “K”) and a less pseudoplastic behavior (higher flow behavior index, “n”). These results may help to obtain higher acceptance values based on easy obtainable and objective parameters.
A new permutation technique to explore and control for spatial autocorrelation
Authors: Radersma Reinder , Sheldon Ben C.
Published: April 2015

Permutation tests are important in ecology and evolution as they enable robust analysis of small sample sizes and control for various forms of dependencies among observations. A common source of dependence is spatial autocorrelation. Accounting for spatial autocorrelation is often crucial, because many ecological and evolutionary processes are spatially restricted, such as gene flow, dispersal, mate choice, inter‐ and intraspecific competition, mutualism and predation.

Here we discuss various ways of controlling for spatial autocorrelation in permutation tests; we highlight their particular properties and assumptions and introduce a new permutation technique which explores and controls for spatial autocorrelation: the floating grid permutation technique (FGPT).

The FGPT is a method to randomize observations with known geographical locations. Within the randomization process, the probability an observation is assigned to any of the spatial locations is a negative function of the distance between its original and assigned location. The slope of this function depends on a preset parameter, and by exploring its parameter space, non‐random ecological and evolutionary processes can be both assessed and controlled at multiple spatial scales.

We show that the FGPT has acceptable type‐I‐error rates. We applied the FGPT to simulated univariate and bivariate data sets in which both negative and positive spatial autocorrelation were present. In comparison with a method that uses eigenvector decomposition to separate negative from positive spatial autocorrelation, the FGPT performed better for negative spatial autocorrelation alone, equal for positive spatial autocorrelation alone and equal or slightly worse for simultaneous negative and positive spatial autocorrelation. For the bivariate data, it performed equally to a bootstrapping technique in which sampling probabilities were weighted by distance. The FGPT benefits from a large flexibility for application to bivariate (e.g. dyadic interactions) and multivariate observations (e.g. genetic marker‐based relatedness measures) and has a large freedom in the choice of test statistic. It also has the potential to identify two spatial autocorrelation patterns, even if both result in positive spatial autocorrelation, given that they operate at different spatial scales.

The Floating Grid Permutation Technique is available as the R‐packagefgptin CRAN.
Discrepant Trends in Income, Drinking, and Alcohol Problems in an Emergent Economy: Brazil 2006 to 2012
Authors: Caetano Raul , Mills Britain , Madruga Clarice , Pinsky Ilana , Laranjeira Ronaldo
Published: April 2015

Background

To examine the association between increases in income and self‐reported alcohol consumption, binge drinking, and alcohol problems in 2006 and 2012 in Brazil.

Methods

Participants were interviewed as part of 2 multistage representative cluster samples of the Brazilian household population between November 2005 and April 2006 and between November 2011 and March 2012. The number of current drinkers during these 2 intervals (n = 1,379 and n = 1,907, respectively) comprised the sample analyzed. Four past‐year outcome variables—standard drinks per week, binge drinking, presence of alcohol‐related social/health problems, and DSM‐5 alcohol use disorder (AUD)—were estimated across income, age, and gender groups. Regression models were estimated to evaluate these and other sociodemographic effects on drinking and problem outcomes and to test for possible wave by income interactions.

Results

Response rates were 66.4% in 2006 and 77% in 2012. Income increases were seen in virtually all age–gender subgroups and were particularly pronounced for younger age groups and older women. Both genders reported increased drinks per week (men: 12.82, 2006; 15.78, 2012; p < 0.01; women: 4.89, 2006; 7.66, 2012; p < 0.001) and proportion binge drinking (men: 57%, 2006; 66%, 2012; p < 0.05; women: 39%, 2006; 48%, 2012; p < 0.05), although this was not seen in all gender and age groups. Social/health problem prevalence decreased among men (37%, 2006; 26%, 2012; p < 0.001) and remained the same among women (13%, 2006; 14%, 2012). DSM‐5 AUD decreased among men (34%, 2006; 24%, 2012; p < 0.01) and remained stable among women (14%, 2006; 16%, 2012).

Conclusions

Brazilian economic development between 2006 and 2012 led to a rise in income in several gender and age groups. Although not always directly associated with an observed increase in alcohol consumption, the rise in income may have created a sense of optimism that inhibited a rise in alcohol‐related problems.
Altered Relation Between Lipopolysaccharide‐Induced Inflammatory Response and Excitotoxicity in Rat Organotypic Hippocampal Slice Cultures During Ethanol Withdrawal
Authors: Lutz Joseph A. , Carter Megan , Fields Logan , Barron Susan , Littleton John M.
Published: April 2015

Background

Ethanol (EtOH) causes neurotoxicity by several mechanisms including excitotoxicity and neuroinflammation, but little is known about the interaction between these mechanisms. Because neuroinflammation is known to enhance excitotoxicity, we hypothesized that neuroinflammation contributes to the enhanced excitotoxicity, which is associated with EtOH withdrawal (EWD). The aim of this study was to evaluate the lipopolysaccharide (LPS)‐induced inflammatory response of cultured hippocampal tissue during EWD and its effects on the enhanced N‐methyl‐d‐aspartate (NMDA) receptor‐mediated excitotoxicity, which occurs at this time.

Methods

Using a neonatal organotypic hippocampal slice culture (OHSC) model, we assessed the effects of NMDA and LPS (separately or combined) during EWD after 10 days of EtOH exposure. Neurotoxicity was assessed using propidium iodide uptake, and the inflammatory response was evaluated by measuring the release of tumor necrosis factor (TNF)‐alpha (quantified by enzyme‐linked immunosorbent assay) and nitric oxide (NO; quantified by the Griess reaction) into culture media. Furthermore, we explored the potential role of the microglial cell type using immortalized BV2 microglia treated with EtOH for 10 days and challenged with LPS during EWD.

Results

As predicted, NMDA‐induced toxicity was potentiated by LPS under control conditions. However, during EWD, the reverse was observed and LPS inhibited peak NMDA‐induced toxicity. Additionally, LPS‐induced release of TNF‐alpha and NO during EWD was reduced compared to control conditions. In BV2 microglia, following EtOH exposure, LPS‐induced release of NO was reduced, whereas TNF‐alpha release was potentiated.

Conclusions

During EWD following chronic EtOH exposure, OHSC exhibited a desensitized inflammatory response to LPS and the effects of LPS on NMDA toxicity were reversed. This might be explained by a change in microglia to an anti‐inflammatory and neuroprotective phenotype. In support, studies on BV2 microglia indicate that EtOH exposure and EWD do alter the response of these cells to LPS, but this cannot fully explain the changes observed in the OHSC. The data suggest that neuroinflammation and excitotoxicity do interact during EWD. However, the interaction is not as simple as we originally proposed. This in turn illustrates the need to assess the extent, importance, and relation of these mechanisms in models of EtOH exposure producing neurotoxicity.
Ethical issues raised by a ban on the sale of electronic nicotine devices
Authors: Hall Wayne , Gartner Coral , Forlini Cynthia
Published: April 2015

Background

Some countries have banned the sale of electronic nicotine delivery systems (ENDS).

Aims

We analyse the ethical issues raised by this ban and various ways in which the sale of ENDS could be permitted.

Method

We examine the ban and alternative policies in terms of the degree to which they respect ethical principles of autonomy, beneficence, non‐maleficence and justice, as follows.

Results

Respect for autonomy: prohibiting ENDS infringes on smokers’ autonomy to use a less harmful nicotine product while inconsistently allowing individuals to begin and continue smoking cigarettes. Non‐maleficence: prohibition is supposed to prevent ENDS recruiting new smokers and discouraging smokers from quitting, but it has not prevented uptake of ENDS. It also perpetuates harm by preventing addicted smokers from using a less harmful nicotine product. Beneficence: ENDS could benefit addicted smokers by reducing their health risks if they use them to quit and do not engage in dual use. Distributive justice: lack of access to ENDS disadvantages smokers who want to reduce their health risks. Different national policies create inequalities in the availability of products to smokers internationally.

Conclusions

We do not have to choose between a ban and an unregulated free market. We can ethically allow ENDS to be sold in ways that allow smokers to reduce the harms of smoking while minimizing the risks of deterring quitting and increasing smoking among youth.
Potential bias due to outcome‐related loss to follow‐up in cohort studies on incidence of drug injection: systematic review and meta‐analysis
Authors: Sordo Luis , Bravo Maria J. , Barrio Gregorio , Indave B. Iciar , Degenhardt Louisa , Pastor‐Barriuso Roberto
Published: April 2015

Aims

A systematic review and meta‐analysis were conducted to synthesize results from cohort studies on initiation into drug injection among vulnerable populations, to quantify heterogeneity in the estimated incidence rates of drug injection and to identify potential sources of heterogeneity and bias.

Methods

MEDLINE, EMBASE, PsycINFO and LILACS were searched for relevant studies published between 1980 and 2012. Investigators independently reviewed studies for inclusion, retrieved information on baseline population characteristics and follow‐up features and assessed study quality. Study‐specific incidence rates of drug injection were calculated as the number of new injectors divided by the person‐years at risk. The I2 statistic was used to quantify heterogeneity in incidence rates across studies, and random‐effects meta‐regression models were used to identify determinants of heterogeneity and bias.

Results

Nine cohorts totalling 1843 participants met the inclusion criteria, with individual sample sizes of 70–415 participants and follow‐up lengths of 6 months–3.4 years. The incidence of drug injection varied widely, from 2.1 to 24.2 cases per 100 person‐years. The strong between‐study heterogeneity (I2 = 90%, P<0.001) was reduced significantly after accounting for the different follow‐up lengths (I2 = 17%, P = 0.30), with a 57% (95% confidence interval 46–66%) decrease in the pooled incidence of drug injection per 1‐year increase in average follow‐up.

Conclusions

The incidence of drug injection decreases sharply with increasing follow‐up length in cohort studies on drug injection initiation. Low retention rates and potential for downward selection bias in cohort studies on drug injection initiation are caused primarily by greater loss to follow‐up among individuals at higher risk of starting injection, compared with other participants.
A randomized controlled trial of treatments for co‐occurring substance use disorders and post‐traumatic stress disorder
Authors: McGovern Mark P. , Lambert‐Harris Chantal , Xie Haiyi , Meier Andrea , McLeman Bethany , Saunders Elizabeth
Published: April 2015

Background and Aims

Post‐traumatic stress disorder (PTSD) is common among people with substance use disorders, and the comorbidity is associated with negative outcomes. We report on a randomized controlled trial comparing the effect of integrated cognitive–behavioral therapy (ICBT) plus standard care, individual addiction counseling plus standard care and standard care alone on substance use and PTSD symptoms.

Design

Three‐group, multi‐site randomized controlled trial.

Setting

Seven addiction treatment programs in Vermont and New Hampshire, USA.

Participants/Cases

Recruitment took place between December 2010 and January 2013. In this single‐blind study, 221 participants were randomized to one of three conditions: ICBT plus standard care (SC) (n = 73), individual addiction counseling (IAC) plus SC (n = 75) or SC only (n = 73). One hundred and seventy‐two patients were assessed at 6‐month follow‐up (58 ICBT; 61 IAC; 53 SC). Intervention and comparators: ICBT is a manual‐guided therapy focused on PTSD and substance use symptom reduction with three main components: patient education, mindful relaxation and flexible thinking. IAC is a manual‐guided therapy focused exclusively on substance use and recovery with modules organized in a stage‐based approach: treatment initiation, early abstinence, maintaining abstinence and recovery. SC are intensive out‐patient program services that include 9–12 hours of face‐to‐face contact per week over 2–4 days of group and individual therapies plus medication management.

Measurements

Primary outcomes were PTSD severity and substance use severity at 6 months. Secondary outcomes were therapy retention.

Findings

PTSD symptoms reduced in all conditions with no difference between them. In analyses of covariance, ICBT produced more favorable outcomes on toxicology than IAC or SC [comparison with IAC, parameter estimate: 1.10; confidence interval (CI) = 0.17–2.04; comparison with SC, parameter estimate: 1.13; CI = 0.18–2.08] and had a greater reduction in reported drug use than SC (parameter estimate: –9.92; CI = –18.14 to –1.70). ICBT patients had better therapy continuation versus IAC (P<0.001). There were no unexpected or study‐related adverse events.

Conclusions

Integrated cognitive behavioral therapy may improve drug‐related outcomes in post‐traumatic stress disorder sufferers with substance use disorder more than drug‐focused counseling, but probably not by reducing post‐traumatic stress disorder symptoms to a greater extent.
The effect of drug use disorder onset, remission or persistence on an individual's personal social network
Authors: Mowbray Orion , Scott Jessica A.
Published: April 2015

Background and Objectives

Drug use disorders (DUD) have strong associations with numerous social problems. However, little is known concerning differences between individuals who experience DUD onset, persistence or remission. While the literature is fairly clear on who is most likely to experience DUD onset and persistence, many correlates of DUD remission, including personal social networks, lack the empirical foundation to utilize them in evidence‐based intervention or prevention efforts. While small, community samples suggest DUD remission is associated with growth in personal social networks, this conclusion is in need of larger population studies to justify.

Methods

This study used Waves 1 and 2 of the National Epidemiologic Study on Alcohol and Related Conditions (NESARC) to examine whether DUD status is a correlate of personal social networks.

Results

Multivariate models showed DUD onset and DUD persistence were related to smaller personal social networks. However, individuals who experience DUD remission showed personal social networks similar to persons who never experienced a DUD.

Discussion and Conclusions

As one of the first empirical studies of personal social networks among individuals with different stages of DUD using nationally representative data, these findings suggest that by decreasing drug use, personal social networks may be increased, which is a strong trait associated with the social influence necessary with maintaining DUD recovery. (Am J Addict 2015;24:427 –434)
Intrapartum Referral from Primary to Secondary Care in The Netherlands: A Retrospective Cohort Study on Management of Labor and Outcomes
Authors: Perdok Hilde , Jans Suze , Verhoeven Corine , van Dillen Jeroen , Mol Ben Willem , de Jonge Ank
Published: April 2015

Background

In the Dutch maternity care system, primary care midwives provide care to low‐risk women and refer to obstetricians if risks or complications occur. We examined reasons for referral, management of labor, and maternal and neonatal outcomes among women who were referred during labor.

Methods

In a retrospective cohort study, descriptive analyses were performed on data obtained from patient records. Six purposively chosen hospitals in The Netherlands participated in the study from June 2011 to February 2012. The study population included 600 pregnant women who were referred during labor from primary to secondary care.

Main outcome measures

Reasons for referral, interventions after referral, mode of delivery, and maternal and neonatal outcomes.

Results

Of women who were referred during labor, three out of four women were referred for moderate risk indications: request for pain relief (30.5%), meconium‐stained liquor (25.3%), failure to progress during first stage of labor (14.0%), and prolonged ruptured membranes without contractions (12.5%). Of all women, 65.7 percent had a spontaneous vaginal delivery and 59.7 percent received some kind of pain relief. Acute referral, meaning fetal distress, occurred in 5.5 percent. Of the newborns, 2.7 percent had an Apgar score of 7 or less after 5 minutes and 1.2 percent had an umbilical cord pH < 7.05. Postpartum complications occurred among 11.0 percent of women.

Conclusion

Women who are referred during labor have a high probability of spontaneous vaginal delivery. To improve continuity of care and satisfaction for this group of women, management of labor could be continued by trained primary care midwives.
Adverse Perinatal Outcomes among Immigrant Women from Ethiopia in Israel
Authors: Calderon‐Margalit Ronit , Sherman Dan , Manor Orly , Kurzweil Yaffa
Published: April 2015

Background

Immigration from Ethiopia to Israel started about 30 years ago. We aimed to compare birth outcomes between Israeli women of Ethiopian origin and Israeli‐born, non‐Ethiopian women. We hypothesized a higher frequency of adverse birth outcomes among Ethiopian women and a trend of improvement among those who were raised in Israel since early childhood.

Methods

This is a descriptive study, comparing birth outcomes of Ethiopian (n = 1,319) and non‐Ethiopian women (n = 27,307) who gave birth in a medical center in Central Israel in 2002 to 2009. Ethiopian women were further categorized by age at immigration. Logistic regressions were constructed to compare the incidence of adverse birth outcomes between Ethiopian and non‐Ethiopian women, controlling for potential confounders.

Results

Ethiopian women had about twice the incidence of very and extremely preterm births, compared with non‐Ethiopians. Ethiopian women had twice the odds for neonates who were either small for gestational age or had low 5‐minute Apgar scores. Ethiopian women had about threefold increased risk of stillbirths (OR 2.9 [95% CI 1.87–4.49]). No trend of improvement was noted for women who were raised in Israel from early childhood.

Conclusion

Ethiopian women are at increased risk of adverse birth outcomes. Future research is needed to investigate the underlying causes for the increased risks and lack of improvement among those who were raised in Israel that will lead to effective interventions.
Tubulin Inhibitor Identification by Bioactive Conformation Alignment Pharmacophore‐Guided Virtual Screening
Authors: Nagarajan Shanthi , Choi Min Jeong , Cho Yong Seo , Min Sun‐Joon , Keum Gyochang , Kim Soo Jin , Lee Chang Sik , Pae Ae Nim
Published: April 2015

Microtubules are important cellular component that are critical for proper cellular function. Microtubules are synthesized by polymerization of αβ tubulin heterodimers called protofilaments. Microtubule dynamics facilitate proper cell division during mitosis. Disruption of microtubule dynamics by small‐molecule agents inhibits mitosis, resulting in apoptotic cell death and preventing cell cycle progression. To identify a novel small molecule that binds the αβ tubulin interface to affect microtubule dynamics, we developed a bioactive conformation alignment pharmacophore (BCAP) model to screen tubulin inhibitors from a huge database. The application of BCAP model generated based on the known αβ‐tubulin interface binders enabled us to identify several small‐molecules that cause apoptosis in human promyelocytic leukemia (HL‐60) cells. Virtual screening combined with an in vitro assay yielded 15 cytotoxic molecules. In particular, ethyl 2‐(4‐(5‐methyl‐3‐nitro‐1H‐pyrazol‐1‐yl)butanamido)‐4‐phenylthiophene‐3‐carboxylate (H05) inhibited tubulin polymerization with an IC50 of 17.6 μm concentration. The virtual screening results suggest that the application of an unbiased BCAP pharmacophore greatly eliminates unlikely compounds from a huge database and maximizes screening success. From the limited compounds tested in the tubulin polymerization inhibitor (TPI) assay, compound H05 was discovered as a tubulin inhibitor. This compound requires further structure activity optimization to identify additional potent inhibitors from the same class of molecules.