bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of clinical and magnetic resonance imaging features of de novo hypervascular hepatocellular carcinoma using gadoxetic acid‐enhanced magnetic resonance imaging
Authors: Tamada Tsutomu , Korenaga Masaaki , Yamamoto Akira , Higaki Atsushi , Kanki Akihiko , Nishina Sohji , Hino Keisuke , Ito Katsuyoshi
Published: May 2016

Aim

To clarify the clinical and magnetic resonance imaging (MRI) features of de novo hypervascular hepatocellular carcinoma (HCC) using serial gadoxetic acid‐enhanced MRI.

Methods

The institutional review board approved this retrospective study. After review of 1007 MRI examinations in 240 patients with chronic liver disease, 17 newly developed hypervascular HCCs in 16 patients detected by follow‐up from initial MRI examination without hepatocellular nodules were evaluated. The clinical and MRI findings such as previous treatment history for HCC, period to hypervascular HCC onset, presence or absence of hypovascular hypointense nodules on hepatobiliary phase before hypervascularization, and intralesional fat component were recorded or evaluated. Statistical evaluations included Fisher's exact test, χ2‐test, and Mann–Whitney U‐test.

Results

In 17 HCCs, 12 (71%) were de novo hypervascular HCC without showing hypovascular hypointense nodule on hepatobiliary phase before hypervascularization (de novo group) and 5 (29%) were hypervascularized HCC developed during multistep hepatocarcinogenesis (multistep group). The incidence of previous treatment history for HCC in the de novo group (91%) was significantly higher than that in the multistep group (20%) (P = 0.013). The duration to hypervascular HCC onset from initial examination was shorter in the de novo group (mean, 291 days) than in the multistep group (mean, 509 days) (P = 0.035). The incidence of fat‐containing lesion in the de novo group (0%) was lower than that in the multistep group (40%) (P = 0.074).

Conclusion

De novo hypervascular HCC is characterized by rapid growth, patients with previous treatment history for HCC, and lack of intralesional fat, compared to hypervascular HCC with multistep progression.
Family history of periodontal disease and prevalence of smoking status among adult periodontitis patients: a cross‐sectional study
Authors: Ziukaite L , Slot DE , Loos BG , Coucke W , Van der Weijden GA
Published: May 2016

Objectives

What is the family history of periodontal disease and the prevalence of smoking status among patients with professionally diagnosed periodontitis? Are these factors related to extent and severity of periodontitis?

Methods

Over a 10‐year period, referred patients from a clinic for periodontology in the Netherlands were examined in a cross‐sectional study. Patients received at the intake appointment a full‐mouth periodontal examination. Data regarding family history of periodontitis and smoking status were recorded.

Results

A total of 5375 adult periodontitis patients were included in this study sample with a mean age of 50 years. The prevalence of smoking was 34% and 37% of the subjects had at least one parent or sibling with periodontitis. The chance to have severe periodontitis was higher if the patient was male, smoker or had a brother with periodontitis. Being male, smoker and having a parent with periodontitis were significantly associated with a larger extent of periodontitis.

Conclusions

Within the investigated population familial aggregation, smoking status, age and gender are factors that were related to extent and severity of adult periodontitis.
Report on the International Society for Laboratory Hematology Survey on guidelines to support clinical hematology laboratory practice
Authors: Hayward C. P. M. , Moffat K. A. , George T. I. , Proytcheva M. , Iorio A.
Published: May 2016

Introduction

Given the importance of evidence‐based guidelines in health care, we surveyed the laboratory hematology community to determine their opinions on guideline development and their experience and interest in developing clinical hematology laboratory practice guidelines.

Methods

The study was conducted using an online survey, distributed to members of the International Society for Laboratory Hematology (ISLH) in 2015, with analysis of collected, anonymized responses.

Results

A total of 245 individuals participated. Most worked in clinical and/or research laboratories (83%) or industry (11%). 42% felt there were gaps in current guidelines. The majority (58%) recommended that ISLH engages its membership in guideline development. Participants differed in their familiarity with, and use of, different organizations’ guidelines. Participants felt it was important to follow best practice recommendations on guideline development, including engagement of experts, statement about conflict of interests and how they were managed, systematic review and grading evidence for recommendations, identifying recommendations lacking evidence or consensus, and public input and peer review of the guideline. Moreover, it was considered important to provide guidelines free of charge. Industry involvement in guidelines was considered less important.

Conclusions

The clinical laboratory hematology community has high expectations of laboratory practice guidelines that are consistent with recent recommendations on evidence‐based guideline development.
Congenital erythrocytosis
Authors: McMullin M. F.
Published: May 2016

Introduction

Congenital erythrocytosis is by definition present from birth. Patients frequently present in childhood or as young adults and a family history may be present. The erythrocytosis can be primary where there is a defect in the erythroid compartment of secondary where increased erythropoietin production produced due to the defect leads to an erythrocytosis.

Material and methods

Primary causes include erythropoietin receptor mutations. Congenital secondary causes include mutations in the genes involved in the oxygen‐sensing pathway and haemoglobins with abnormal oxygen affinity. Investigations for the cause include an erythropoietin level, oxygen dissociation curve, haemoglobin electrophoresis and sequencing for known gene variants.

Results

The finding of a known or new molecular variant confirms a diagnosis of congenital erythrocytosis. A congenital erythrocytosis may be an incidental finding but nonspecific symptoms are described. Major thromboembolic events have been noted in some cases. Low‐dose aspirin and venesection are therapeutic manoeuvres which should be considered in managing these patients.

Conclusions

Rare individuals presenting often at a young age may have a congenital erythrocytosis. Molecular investigation may reveal a lesion. However, in the majority, currently no defect is identified.
Connections and Tensions Between Nationalist and Sustainability Discourses in the Scottish Legislative Process
Authors: Ross Andrea , Jones Rhys
Published: May 2016

This article illustrates how sustainability and nationalist discourses have operated together in practice in Scotland. Potential connections and tensions between nationalist and sustainability discourses are identified and used to analyse the events leading up to the passage of the Climate Change (Scotland) Act 2009 and the Regulatory Reform (Scotland) Act 2014. The analysis reveals how in certain contexts, the tensions and connections between sustainability and nationalist discourses can align to reinforce transformative initiatives while in other contexts, the tensions can lead to initiatives being watered down or set aside. The article concludes that more could be done to emphasize the connections between the two discourses. Engagement at the level of ‘nation’ can lead to sustainability discourses that are more attuned to nationalist values, increased public understanding, and acceptance of sustainable development, as well as additional opportunities for debate, public participation, and education.
Specific types of alcoholic beverage consumption and risk of type 2 diabetes: A systematic review and meta‐analysis
Authors: Huang Jin , Wang Xiuling , Zhang Yadong
Published: May 2016

Aims/Introduction

Previous meta‐analyses identified an inverse association of total alcohol consumption with the risk of type 2 diabetes. The current study further explored the relationship between specific types of alcoholic beverage and the incidence of type 2 diabetes.

Materials and Methods

A search of PubMed, Embase and Cochrane Library databases from January 1966 to February 2016 was carried out for prospective cohort studies that assessed the effects of specific types of alcoholic beverage on the risk of type 2 diabetes. The pooled relative risks with 95% confidence interval were calculated using random‐ or fixed‐effect models when appropriate.

Results

A total of 13 prospective studies were included in this meta‐analysis, with 397,296 study participants and 20,641 cases of type 2 diabetes. Relative to no or rare alcohol consumption, wine consumption was associated with a significant reduction of the risk of type 2 diabetes, with the pooled relative risks of 0.85, whereas beer or spirits consumption led to a slight trend of decreasing risk of type 2 diabetes (relative risk 0.96, 0.95, respectively). Further dose–response analysis showed a U‐shaped relationship between all three alcohol types and type 2 diabetes. Additionally, the peak risk reduction emerged at 20–30 g/day for wine and beer, and at 7–15 g/day for spirits, with a decrease of 20, 9 and 5%, respectively.

Conclusions

Compared with beer or spirits, wine was associated with a more significant decreased risk of type 2 diabetes. The present study showed that wine might be more helpful for protection against type 2 diabetes than beer or spirits.
Attractants for management of the pine sawyer beetle Monochamus sutor, a potential vector of Bursaphelenchus xylophilus
Authors: Pajares J. A. , Álvarez G. , Hall D. R. , Ibarra N. , Hoch G. , Halbig P. , Cocoş D. , Johansson H. , Schroeder M.
Published: May 2016

Monochamus sutor (Linnaeus) (Coleoptera: Cerambycidae) is a secondary wood borer that has been hypothesized as capable of transmitting Bursaphelenchus xylophilus, the causal agent of pine wilt disease (PWD). This fact supposes a risk of spread of PWD over Europe and has created an urgent need for effective tools to detect and monitor both the nematode and the insect species that vectors it. Recent reporting of 2‐undecyloxy‐1‐ethanol as the M. sutor male‐produced aggregation pheromone has opened the possibility of developing an efficient lure for this species. It is known that some European bark beetle pheromone compounds and host volatiles kairomonally attract this species. Besides, smoke volatiles from burnt trees might play a role in M. sutor host location. In this work, field trapping experiments during 3 years in three countries (Spain, Sweden and Austria), aimed to develop an efficient pheromone‐kairomone lure operative for M. sutor management were carried out. Electroantennographic responses by M. sutor to Ips pheromones and to the Pityogenes chalcographus pheromone chalcogran were also studied. GC‐EAG recording showed that M. sutor males and females clearly responded to ipsenol and ipsdienol, and females also responded to 2‐methyl‐3‐buten‐2‐ol. Chalcogran elicited a response to M. sutor female antennae. In field tests, ipsenol was the most attractive kairomone to both sexes of M. sutor, whereas ipsdienol, cis‐verbenol and 2‐methyl‐3‐buten‐2‐ol were attractive and chalcogran was unattractive. When combined with the pheromone, most bark beetle kairomones increased catches of both sexes although chalcogran was completely ineffective. Thus, ipsenol was the strongest individual kairomone for M. sutor and the best single kairomone to be combined with the pheromone. Smoke volatile blends tested in Spain and Austria did not elicit responses, suggesting that these compounds are likely not involved in host finding by this species.
Associations Between Asthma Control and Airway Obstruction and Performance of Activities of Daily Living in Older Adults with Asthma
Authors: Woods Eric C. , O'Conor Rachel , Martynenko Melissa , Wolf Michael S. , Wisnivesky Juan P. , Federman Alex D.
Published: May 2016

Objectives

To determine the effect of asthma on functional limitations of older adults in the United States.

Design

Analyses were conducted with data from the Asthma Beliefs and Literacy in the Elderly study, a prospective cohort study of people aged 60 and older with asthma.

Setting

Participants were recruited from urban primary care and pulmonary specialty practices in New York City and Chicago between 2010 and 2012.

Participants

Individuals aged 60 and older with asthma (380 women, 72 men, mean age 67.5 ± 6.8 (range 60–98), 40% Latino, 30% black).

Measurements

Characteristics of participants with and without activity of daily living (ADL) limitations were compared using the chi‐square test. Generalized estimating equations were used to model the relationships between poor asthma control (Asthma Control Questionnaire (ACQ) score >1.5) and severity of airway obstruction (forced expiratory volume in 1‐second (FEV1)) and number of ADL limitations.

Results

Participants with one or more ADL limitations were more likely to be female (90% vs 81%, P = .02) and Latino (58% vs 32%, P < .001), have less than a high school education (53% vs 27%, P < .001) and an income of $1,350 per month or less (79% vs 46%, P < .001), and be unmarried (78% vs 64%, P = .003). In the adjusted analysis, poorer ACQ scores (odds ratio (OR) = 1.6, 95% confidence interval (CI) = 1.0–2.4; P = .05) but not severity of airway obstruction (OR = 1.1, 95% CI = 0.6–1.9) was associated with greater ADL limitations.

Conclusion

Older adults reporting poor asthma control are more likely to have ADL limitations than those with controlled asthma, although one‐time spirometry may not adequately identify those at risk of physical impairment from asthma.
Behavioral Interventions in Six Dimensions of Wellness That Protect the Cognitive Health of Community‐Dwelling Older Adults: A Systematic Review
Authors: Strout Kelley A. , David Daniel J. , Dyer Elizabeth J. , Gray Roberta C. , Robnett Regula H. , Howard Elizabeth P.
Published: May 2016

Objectives

To systematically identify, appraise, and summarize research on the effects of behavioral interventions to prevent cognitive decline in community‐dwelling older adults using a holistic wellness framework.

Design

Systematic review of randomized controlled trials that tested the effectiveness of behavioral interventions within each of the six dimensions of wellness: occupational, social, intellectual, physical, emotional and spiritual. Databases searched included PubMed MEDLINE, EMBASE, CENTRAL, PsycINFO, CINAHL, ALOIS, and The Grey Literature Report through July 1, 2014.

Setting

Community.

Participants

Individuals aged 60 and older (N = 6,254).

Measurements

Consolidated Standards of Reporting Trials Checklist.

Results

Eighteen studies met the inclusion criteria. Interventions in the physical dimension of wellness were most common (11 studies); interventions in the spiritual dimension were least common (0 studies). Fifty‐nine different measures were used to measure multiple cognitive domains, with memory being the most commonly measured (17 studies) and language being the least commonly measured (5 studies). Fifty percent of the interventions examined in the 18 studies demonstrated statistically significant outcomes on at least one cognitive measure. Interventions in the intellectual dimension that examined cognitively stimulating activities using pen and paper or a computer represented the greatest percentage of statistically significant outcomes.

Conclusion

Intellectual and physical interventions were most studied, with varied results. Future research is needed using more‐consistent methods to measure cognition. Researchers should include the National Institutes of Health Toolbox Cognition Battery among measurement tools to facilitate effective data harmonization, pooling, and comparison.
The image of nursing: A glimpse of the Internet
Authors: Koo Malcolm , Lin Shih‐Chun
Published: May 2016

Aim

An inaccurate image of the nursing profession can negatively affect staff recruitment, resource allocation, and the perception of nursing professionalism. Previous research has investigated how nurses were portrayed in the traditional media but relatively little is known from the perspective of the Internet. Therefore, the present study aimed to explore how the nursing profession is portrayed on the Internet by using two popular sources of photographic images.

Methods

The first 100 images that were obtained using the search term “nurse” on Google Images and Shutterstock were analyzed. The distribution of the image attributes between the two websites was compared with Fisher's exact test. The text description of the images that were obtained from Shutterstock also was analyzed.

Results

In the 171 images with at least one nurse in them, the nurses were predominately female (91%). The facial expression of the nurses was mostly smiling (85%) and 68% of the nurses had a stethoscope. For those with their hands visible in the images, 39% were holding documents, writing boards, or tablet computers and 29% were shown touching patients. Only 7% were depicted as using medical devices.

Conclusions

While most of the nursing images were relatively professional‐looking, the nurses were portrayed only as engaging in comforting patients and recording data. Nurses who were engaged in clinical tasks or scientific activities, such as research, were absent in the portrayals. A plan needs to be developed to accurately and comprehensively represent the nursing profession on the Internet.
Effect of Brassica Biofumigant Amendments on Different Stages of the Life Cycle of Phytophthora cinnamomi
Authors: Ríos Pedro , Obregón Sara , de Haro Antonio , Fernández‐Rebollo Pilar , Serrano María‐Socorro , Sánchez María‐Esperanza
Published: May 2016

The oomycete plant pathogen Phytophthora cinnamomi causes a highly destructive root rot that affects numerous hosts. Integrated management strategies are needed to control P. cinnamomi in seminatural oak rangelands. We tested how biofumigation affects crucial stages of the pathogen's life cycle in vitro, in infested soils under laboratory conditions and in planta. Different genotypes of three potential biofumigant plant species (Brassica carinata, Brassica juncea, Brassica napus) were collected at different phenological stages, analysed for their glucosinolate contents, and subsequently tested. The most effective genotypes against mycelial growth and sporangial production were further tested on the viability of chlamydospores in artificially infested natural soils and in planta on Lupinus luteus, a host highly susceptible to P.cinnamomi. Brassica carinata and B. juncea genotypes inhibited mycelial growth, decreased sporangial production, and effectively inhibited the viability of chlamydospores in soil, but only B. carinata decreased disease symptoms in plants. Effective genotypes of Brassica had high levels of the glucosinolate sinigrin. Biofumigation with Brassica plants rich in sinigrin has potential to be a suitable tool for control of oak root disease caused by P. cinnamomi in Spanish oak rangeland ecosystems.
Influence of Milk and Milk‐Born Active Peptide Addition on Textural and Sensory Characteristics of Noodle
Authors: Li Zhicheng , Li Wenhao , Gao Peipei , Hu Yayun , Zan Linsen
Published: May 2016

The effects of milk and milk protein‐derived active peptide at various concentration additions on textural, cutting firmness and tensile strength properties, and sensory quality of wheat flour based noodles were investigated. Two types of additive were added to the flour at a mixture ratio of milk 4, 8, 12, 16 and 20% (w/w), and active peptide 5.44, 6.80, 8.16, 9.52 and 10.92 mg/100 g. Each treatment was analyzed and compared with a 100% flour noodle as a control. With increasing milk and active peptide ratios, the hardness, adhesiveness, chewiness, gumminess and resilience of uncooked noodles decreased. The noodle hardness, gumminess, chewiness and resilience of the cooked noodles increased with increasing milk and peptide ratios, from that in the control. Addition of milk and peptide greatly increased the tensile strength during stretching and firmness during compressing of cooked and uncooked noodles. Sensory evaluation indicated that addition of milk and milk active peptide could enhance the overall acceptability of cooked noodles, and 12% (w/w) milk and 6.80 mg/100 g peptide, respectively, could be recommended to add during the noodles producing. This study may stimulate further interest in using milk and milk‐born active peptide ingredients in developing healthy staple foods.

Practical Applications

This research showed a novel way to incorporate nutritional and functional components in noodle formulation, and the fresh type of noodle can meet the consumers demand as a functional staple food. In addition, the addition of milk and active peptides into noodles could improve the quality of noodles, increase its nutrition value and function, which is important for people who dislike direct consumption of milk and dairy products in undeveloped countries and regions.
Determinants of stunting reduction in Ethiopia 2000 – 2011
Authors: Woodruff Bradley A. , Wirth James P. , Bailes Adam , Matji Joan , Timmer Arnold , Rohner Fabian
Published: May 2016

The prevalence of stunting in Ethiopia declined from 57% in 2000 to 44% in 2011, yet the factors producing this change are not fully understood. Data on 23,999 children 0–59 months of age from three Demographic and Health Surveys (DHS) from 2000, 2005, and 2011 were analyzed to assess the trends in stunting prevalence, mean height‐for‐age z‐scores (HAZ) and the associations between potential factors and HAZ. Associations were determined separately using three separate generalized linear models for children age less than 6 months, 6–23 months, and 24–59 months of age. Significant variables were then analyzed to determine if they showed an overall trend between the 2000 and 2011 surveys. In children < 6 months of age, only mother's height was both a significant predictor of HAZ and showed a progressive, albeit non‐significant, increase from 2000 to 2011. In children 6–23 months of age, only mother's use of modern contraception showed substantial changes in a direction consistent with improving HAZ, but improvements in maternal nutrition status were observed from 2000 to 2005. For children 24–59 months of age a consistent and progressive change is seen in child's diarrhea, fever, mother's education, and the occurrence of open defecation. Our analysis demonstrated that factors associated with HAZ vary by child's age and the dominant livelihood practice in the community. Variables that could have contributed to the decline of stunting in Ethiopia in children less than 5 years of age include markers of child health, mother's nutritional status, mother's educational level, and environmental hygiene.
Genomic signatures of rapid adaptive evolution in the bluespotted cornetfish, a Mediterranean Lessepsian invader
Authors: Bernardi Giacomo , Azzurro Ernesto , Golani Daniel , Miller Michael Ryan
Published: May 2016

Biological invasions are increasingly creating ecological and economical problems both on land and in aquatic environments. For over a century, the Mediterranean Sea has steadily been invaded by Indian Ocean/Red Sea species (called Lessepsian invaders) via the Suez Canal, with a current estimate of ~450 species. The bluespotted cornetfish,Fistularia commersonii, considered a ‘Lessepsian sprinter’, entered the Mediterranean in 2000 and by 2007 had spread through the entire basin from Israel to Spain. The situation is unique and interesting both because of its unprecedented rapidity and by the fact that it took this speciesc. 130 years to immigrate into the Mediterranean. Using genome scans, with restriction site‐associatedDNA(RAD) sequencing, we evaluated neutral and selected genomic regions for Mediterranean vs. Red Sea cornetfish individuals. We found that few fixed neutral changes were detectable among populations. However, almost half of the genes associated with the 47 outlier loci (potentially under selection) were related to disease resistance and osmoregulation. Due to the short time elapsed from the beginning of the invasion to our sampling, we interpret these changes as signatures of rapid adaptation that may be explained by several mechanisms including preadaptation and strong local selection. Such genomic regions are therefore good candidates to further study their role in invasion success.
Challenges and opportunities for measuring the impact of a nutrition programme amongst young people at risk of food insecurity: A pilot study
Authors: Barbour L. R. , Ho M. Y. L. , Davidson Z. E. , Palermo C. E.
Published: May 2016

Food insecurity in Australia is increasing. Organisations within the charitable food sector aim to manage, and in some cases are implementing strategies to prevent, food insecurity, such as food literacy programmes. This pilot study describes the challenges and opportunities for evaluating the impact of a food literacy programme, FoodMate by SecondBite™, which aims to reduce food insecurity amongst ‘at risk’ young people. Three community agencies working with ‘at risk’ young people delivered an 8‐week food literacy programme in Melbourne, Australia. A pre‐test/post‐test design was used and outcome measures included: (i) food intake, (ii) diet quality, (iii) cooking confidence and (iv) food independence. These were assessed via questionnaires and 24‐hour recalls at three time points: pre‐programme (T1), post‐programme (T2) and at 4 to 6‐week follow‐up (T3). Twenty‐one young people aged 16–25 years participated in this pilot study. The response rate for the questionnaire and 24‐hour recalls declined across the study: T1 (n = 21), T2 (n = 11) and T3 (n = 9). Some positive effects were associated with the programme but attrition rates were high and the majority of participants did not complete all measures. Although results were inconclusive, this study describes some common challenges of conducting a food literacy intervention with vulnerable young people and highlights the benefit of nutrition researchers and practitioners working together to conduct evaluation of such programmes.
Good Nutrition for Cancer Recovery – a nutritional resource for the treatment of cancer‐induced weight loss
Authors: Ní Bhuachalla É. , O’ Connor A. , Healy J. , Dwyer F. , Ryan A. M.
Published: May 2016

Cancer‐induced weight loss is a debilitating condition which affects 31–87% of patients with cancer and is recognised to be a negative prognostic indicator for a range of malignancies. Although intensive nutritional intervention has been shown to play a beneficial role in weight stabilisation, one‐to‐one dietetic counselling is not available for all patients. The aim of the ‘Good Nutrition for Cancer Recovery’ initiative was to produce an Irish resource that translates clinical nutrition recommendations into simple information and nutritious recipes appropriate for patients with cancer‐induced weight loss. High‐protein, high‐energy recipe guidelines, based on recommendations for nutritionally vulnerable patients, were developed and distributed to all members of the Irish Nutrition and Dietetic Institute, specialist oncology dietitians and nurses, patients and carers, as well as professional chefs from across Ireland. The resulting recipes were analysed and professional chefs consulted in order to optimise the nutritional composition of these meals. This process resulted in a 120‐page resource for patients with cancer‐induced weight loss, containing nutrition information, advice and a bank of nourishing recipes. Recipes were enriched and portion sizes adjusted to ensure that meals were nutrient dense and appropriate in size for patients with small appetites. Nineteen thousand copies of the resource were printed and distributed to >74 locations and made available to patients free of charge. An extensive outreach campaign was launched in order to disseminate the information to all relevant stakeholders. This extensive resource is now widely available to facilitate patients in achieving the energy and protein levels required to attenuate cancer‐induced weight loss.
Physician and Patient Survey of Taper Schedule and Family Physician Letters Following Discharged from the Acute Pain Service
Authors: Friedman Zeev , Arzola Cristian , Postonogova Tetyana , Malavade Archana , Siddiqui Naveed T.
Published: May 2016

Purpose

Following discharge, patients requiring high opioid doses may be at risk for both under‐ and overdosing, posing a major challenge to community physicians. The aim of this study was to examine the effectiveness and degree of satisfaction with a personalized taper schedule and physician letter through interviews of patients and physicians.

Methods

This was a 1‐year prospective study. Following ethics approval and informed written consent, patients admitted for elective surgery, 18 to 60 years of age, receiving opioid analgesics, were recruited. Prior to discharge, the acute pain service team provided patients with a taper schedule explained in detail. Individualized physician letters were faxed to treating family physicians. Patients were contacted by phone 2, 4, and 6 weeks after discharge. Physicians were contacted once, a month after discharge. Patients and physicians were asked to grade the taper schedule on a 1‐ to 5‐point Likert scale. Questions pertained to clarity, usefulness, ability to follow the instructions, and general satisfaction.

Results

Twenty‐six patients and 21 physicians completed the study. Physicians were generally satisfied with both the taper schedule and letter and rated all aspects between 3.76 and 4.38 of 5. Similarly, patients were satisfied with the taper schedule and rated all aspects between 4.08 and 4.5.

Conclusions

Both physicians and patients generally found the taper schedule and letter helpful in assisting them to taper off their opioid use. This is one way of bridging the gap in continuity of care between the acute and primary care providers while reducing the risk to patients during the transition period.
The Effect of Forest Management Strategy on Carbon Storage and Revenue in Western Washington: A Probabilistic Simulation of Tradeoffs
Authors: Fischer Paul W. , Cullen Alison C. , Ettl Gregory J.
Published: May 2016

The objectives of this study are to understand tradeoffs between forest carbon and timber values, and evaluate the impact of uncertainty in improved forest management (IFM) carbon offset projects to improve forest management decisions. The study uses probabilistic simulation of uncertainty in financial risk for three management scenarios (clearcutting in 45‐ and 65‐year rotations and no harvest) under three carbon price schemes (historic voluntary market prices, cap and trade, and carbon prices set to equal net present value (NPV) from timber‐oriented management). Uncertainty is modeled for value and amount of carbon credits and wood products, the accuracy of forest growth model forecasts, and four other variables relevant to American Carbon Registry methodology. Calculations use forest inventory data from a 1,740 ha forest in western Washington State, using the Forest Vegetation Simulator (FVS) growth model. Sensitivity analysis shows that FVS model uncertainty contributes more than 70% to overall NPV variance, followed in importance by variability in inventory sample (3–14%), and short‐term prices for timber products (8%), while variability in carbon credit price has little influence (1.1%). At regional average land‐holding costs, a no‐harvest management scenario would become revenue‐positive at a carbon credit break‐point price of $14.17/Mg carbon dioxide equivalent (CO2e). IFM carbon projects are associated with a greater chance of both large payouts and large losses to landowners. These results inform policymakers and forest owners of the carbon credit price necessary for IFM approaches to equal or better the business‐as‐usual strategy, while highlighting the magnitude of financial risk and reward through probabilistic simulation.
The Effects of Precautionary Messages about Electromagnetic Fields from Mobile Phones and Base Stations Revisited: The Role of Recipient Characteristics
Authors: Boehmert Christoph , Wiedemann Peter , Pye Jonathon , Croft Rodney
Published: May 2016

Precautionary messages have been shown to increase recipients’ threat perceptions about radio‐frequency electromagnetic fields (RF‐EMFs) emitted by mobile phones and mobile phone base stations. The current study explored the interplay of variables on the side of message recipients with this effect. The individual difference variables of interest were gender, trait anxiety, personal need for structure, and personal fear of invalidity. Furthermore, the study determined whether the increased threat perception is accompanied by emotional distress. A total of 298 university students answered a survey after reading either a basic text about RF‐EMFs or a text including precautionary information. Linear multiple regression with interactions analyses showed that the effect of precautionary messages differed for people with different levels of trait anxiety. How trait anxiety was related to the effect of precautionary messages in turn depended on participants’ gender. Personal need for structure and personal fear of invalidity were mostly unrelated to the effect of precautionary messages. Regarding participants’ emotional distress, we found no difference in state anxiety scores between those participants who received precautionary information and those who did not. The findings show that the effects of precautionary messages on threat perception depend on individual difference variables such as recipients’ trait anxiety and gender. Also, the fact that precautionary communication did not result in heightened state anxiety challenges the assumption that precautionary messages induce fear or anxiety.
Regionalization of Multiscale Spatial Processes by Using a Criterion for Spatial Aggregation Error
Authors: Bradley Jonathan R. , Wikle Christopher K. , Holan Scott H.
Published: May 2016

The modifiable areal unit problem and the ecological fallacy are known problems that occur when modelling multiscale spatial processes. We investigate how these forms of spatial aggregation error can guide a regionalization over a spatial domain of interest. By ‘regionalization’ we mean a specification of geographies that define the spatial support for areal data. This topic has been studied vigorously by geographers but has been given less attention by spatial statisticians. Thus, we propose a criterion for spatial aggregation error, which we minimize to obtain an optimal regionalization. To define the criterion we draw a connection between spatial aggregation error and a new multiscale representation of the Karhunen–Loève expansion. This relationship between the criterion for spatial aggregation error and the multiscale Karhunen–Loève expansion leads to illuminating theoretical developments including connections between spatial aggregation error, squared prediction error, spatial variance and a novel extension of Obled–Creutin eigenfunctions. The effectiveness of our approach is demonstrated through an analysis of two data sets: one using the American Community Survey and one related to environmental ocean winds.
Unmet needs in young adults with a parent with a chronic condition: a mixed‐method investigation and measure development study
Authors: Nicholls Wendy , Patterson Pandora , McDonald Fiona E.J. , Hulbert‐Williams Nicholas J.
Published: May 2016

Rationale

Given the high number of young adults caring for a family member, and the potential for adverse psychosocial outcomes, there is a need for a screening tool, with clinical utility, to identify those most vulnerable to poor outcomes and to aid targeted interventions.

Objectives

(i) To determine whether current knowledge from cancer literature regarding young carers is generalisable to chronic conditions and, therefore, whether an existing screening tool could be adapted for this population. (ii) To develop a measure of unmet needs in this population and conduct initial psychometric analysis.

Design

This was mixed method; interviews in study one informed measure development in study two. Inclusion criteria were as follows: having a parent with a chronic condition and being aged 16–24 years. In study 1, an interpretative phenomenological analysis was conducted on interviews from seven young adults (age range 17–19 years). Study 2 explored factor structure, reliability and validity of the Offspring Chronic Illness Needs Inventory (OCINI). Participants were 73 females and 34 males (mean ages 18.22, SD = 1.16; 18.65, SD = 1.25).

Main outcome measures

OCINI, Depression Anxiety and Stress Scale, and the Adult Carers Quality of Life Scale.

Results

Interviews communicated that the impact of their parent's condition went unacknowledged and resulted in psychosocial, support and informational needs. An exploratory principal axis analysis of the OCINI yielded five factors. Significant and positive correlations were found between unmet needs and stress, anxiety, and depression, and inversely with quality of life.

Conclusions

The scale has applications in clinical settings where these young people, who are at risk of negative psychological outcomes, may be assessed and unmet needs targeted appropriately.
Factors affecting in‐hospital informal caregiving as decided by families: findings from a longitudinal study conducted in acute medical units
Authors: Ambrosi Elisa , Biavati Catia , Guarnier Annamaria , Barelli Paolo , Zambiasi Paola , Allegrini Elisabetta , Bazoli Letizia , Casson Paola , Marin Meri , Padovan Marisa , Picogna Michele , Taddia Patrizia , Salmaso Daniele , Chiari Paolo , Frison Tiziana , Marognolli Oliva , Benaglio Carla , Canzan Federica , Saiani Luisa , Palese Alvisa ,   ESAMED Group
Published: May 2016

Background

Informal caregiving offered by family members has been widely studied in the community setting, but little attention to date has been dedicated to that offered at the hospital level.

Aims

To describe the proportion of patients admitted to acute medical units receiving care from informal caregivers as decided by the family and to identify the factors affecting the numbers of care shifts performed by informal caregivers.

Design and methods

A longitudinal study was performed involving 12 acute medical units located in 12 northern Italian hospitals.

Results

All patients (N = 1464) admitted to medical units were included, and 77.1% of them received at least one shift of informal care during their in‐hospital stay, especially during the mornings and afternoons. At the patient level, those at higher risk of prolonged hospitalisation and difficult discharge at admission, and those reporting higher occurrence of adverse events, such as pressure sores, confusion events and use of physical restraints during hospitalisation, were more likely receiving informal care. At the nursing care level, a higher amount of missed nursing care was associated with an increased number of care shifts offered by informal caregivers during patient hospitalisation, whereas the amount of care offered by staff was a protective factor.

Conclusions

Families play a care role in the care of older patients admitted to acute medical units. They contribute substantially to the care of patients, especially during morning and afternoon shifts.
Perceived Anti‐Germanism in Austria
Authors: Greth Julia , Köllen Thomas
Published: May 2016

Germans working in Austria are confronted with several subliminal resentments. Research on nationalism, racism, and diversity has overlooked this topic up to now, as Germans, as well as other Northern American or Western European citizens, are very rarely analysed as marginalized groups. Furthermore, the situation of migrants from geographically, linguistically, and culturally close countries, has received scant attention and been deemed of little importance up to now. The anti‐German sentiments in Austria are primarily based on the Austrian self‐perception of being non‐German as a constitutive element of ‘Austrian‐ness’. Related to that, negative attributions ascribed to Germans simultaneously mean a positive attribution of ‘Being Austrian’. Based on a content analysis of ten narrative interviews, conducted with Germans working in Austria, it appears that they permanently experience being categorized as ‘the Germans’, which leads to several types of exclusion, demotion, and also discrimination in the workplace. Differences in hierarchy level and perceived competition seem to moderate this effect. It appears that workplace superiors of Germans tend also to put an emphasis on positive stereotypes related with Germans, whereas Austrian colleagues on the same hierarchy level tend to performatively construct and reproduce ‘Being German’ as a deficit that they associate with negative stereotypes.
Endless Escape: From Syria to Turkey, Then to Europe
Authors: Kutlu‐Tonak Zümray
Published: May 2016

This article provides a critical analysis of the state of services that refugees – specifically Syrians – encounter in Turkey after they have fled their home countries but before they set out for Western Europe. Highlighting both the legislation passed by the state and the work conducted by non‐governmental organizations (NGOs) on the issues of accommodation, health care, education, and employment of refugees in Turkey, this article depicts the legal and actual situation in Turkey, which exacerbates the desire to get to Western Europe.
Predictors of Children's Rights Attitudes and Psychological Well‐being Among Rural and Urban Mainland Chinese Adolescents
Authors: To Sharon , Helwig Charles C. , Yang Shaogang
Published: May 2016

This study examined rural and urban Chinese adolescents’ (13–19 years, N = 395) attitudes toward children's self‐determination and nurturance rights, and how these attitudes relate to various dimensions of socialization in their family and school environments, including perceptions of parental and teacher autonomy support and responsiveness and family and school democratic climate. Relations between these variables and psychological well‐being also were examined. Hierarchical regression analyses revealed that maternal responsiveness and teacher autonomy support predicted higher levels of endorsement of nurturance rights. Maternal autonomy support and tolerance of dissent at home predicted greater endorsement of self‐determination rights. Democratic climate in the home predicted higher life‐satisfaction and fewer depressive symptoms, even when parent and teacher autonomy support and responsiveness were controlled. Our findings suggest that environments that are structured more democratically and that are more responsive to children's autonomy needs are associated with higher levels of endorsement of children's rights and contribute to adolescents’ psychological health and well‐being in a non‐Western culture.
‘2A‐Like’ Signal Sequences Mediating Translational Recoding: A Novel Form of Dual Protein Targeting
Authors: Roulston Claire , Luke Garry A. , de Felipe Pablo , Ruan Lin , Cope Jonathan , Nicholson John , Sukhodub Andriy , Tilsner Jens , Ryan Martin D.
Published: May 2016

We report the initial characterization of an N‐terminal oligopeptide ‘2A‐like’ sequence that is able to function both as a signal sequence and as a translational recoding element. Owing to this translational recoding activity, two forms of nascent polypeptide are synthesized: (i) when 2A‐mediated translational recoding has not occurred: the nascent polypeptide is fused to the 2A‐like N‐terminal signal sequence and the fusion translation product is targeted to the exocytic pathway, and, (ii) a translation product where 2A‐mediated translational recoding has occurred: the 2A‐like signal sequence is synthesized as a separate translation product and, therefore, the nascent (downstream) polypeptide lacks the 2A‐like signal sequence and is localized to the cytoplasm. This type of dual‐functional signal sequence results, therefore, in the partitioning of the translation products between the two sub‐cellular sites and represents a newly described form of dual protein targeting.
Comparison of microbial populations and foaming dynamics in conventional versus membrane enhanced biological phosphorous removal systems
Authors: Winkler M. ‐K. H. , Kröber Eileen , Mohn William W. , Koch Frederic , Frigon Dominic
Published: May 2016

In this study, molecular community analysis and analytical measurements were combined to assess and compare the identity, functionality, structure, and temporal changes of membrane and conventional enhanced biological phosphorous removal systems (which ran stable over 300 days) and to identify the dynamics of the foam forming population. Magnesium was added to the system with the goal to enhance phosphate removal. Both systems behaved similarly with respect to phosphate and nitrogen removal efficiency and had similar community evenness, but they differed in community composition. A principle component analysis indicated that, the community of the membrane system changed permanently whereas the conventional system returned to approximately its initial composition. The relative intensity of DGGE bands were transformed in a numerical matrix and based on this matrix a model was constructed, which predicted some bands as foam forming bands, which were identified as foam‐forming filamentous bacteria by sequencing.
Planar regions of GaAs (001) prepared by Ga droplet motion
Authors: Zheng Changxi , Tang Wen-Xin , Jesson David E.
Published: May 2016

The authors describe a simple method for obtaining planar regions of GaAs (001) suitable for surface science studies. The technique, which requires no buffer layer growth, atomic hydrogen source, or the introduction of As flux, employs controllable Ga droplet motion to create planar trail regions during Langmuir evaporation. Low-energy electron microscopy/diffraction techniques are applied to monitor the droplet motion and characterize the morphology and the surface reconstruction. It is found that the planar regions exhibit atomic flatness at the level of a high-quality buffer layer.
The microscale evolution of the erosion front of blood clots exposed to ultrasound stimulated microbubbles
Authors: Acconcia Christopher N. , Leung Ben Y. C. , Goertz David E.
Published: May 2016

Serial two-photon microscopy of blood clots with fluorescently tagged fibrin networks was conducted during microbubble-mediated sonothrombolysis to examine the microscale evolution of the resulting erosion front. The development of a complex zonal erosion pattern was observed, comprised of a cell depleted layer of fibrin network overlying intact clot which then underwent progressive recession. The fibrin zone architecture was dependent on exposure conditions with 0.1 MPa causing no erosion, 0.39 MPa resulting in homogenous structure, and combination 0.39/0.96 MPa pulses forming large-scale tunnels. High speed imaging and Coulter counter data indicated the fibrin zone formation process involves the ejection of intact erythrocytes.
An all-in-one bacterial ubiquitylation machine
Authors: VanHook Annalisa M.
Published: May 2016

A single bacterial enzyme uses NAD, rather than E1 and E2 enzymes and ATP, to ubiquitylate a host protein.
Distribution of Staphylococcal Cassette Chromosome (SCC)
mec
Element Types in Fusidic Acid-Resistant Staphylococcus epidermidis and Identification of a Novel SCC
7684
Element
Authors: Chen Hsiao-Jan , Lin Yu-Tzu , Hung Wei-Chun , Tsai Jui-Chang , Hsueh Po-Ren , Teng Lee-Jene
Published: May 2016

We analyzed the staphylococcal cassette chromosome
mec
(SCC
mec
) types of 143 fusidic acid- and methicillin-resistant
Staphylococcus epidermidis
isolates. The most frequent SCC
mec
type was SCC
mec
III/SCC
Hg
(53%), followed by SCC
mec
IV (29%). Clonal spreading of SCC
mec
III/SCC
Hg
strains contributed to the increased prevalence of SCC
mec
III. A novel non-
mec
SCC structure, SCC
7684
, adjacent to SCC
mec
III, which carries a new
ccrC
allotype (
ccrC3
allele 1) and contains heavy metal resistance genes, was identified in 14 isolates.