bluuebunny/crossref_metadata_2025 huggingface dataset:
Hyperplastic sensory corpuscles in nevus sebaceus of labia minora pudendi. A case report
Authors: Feito Jorge , Cebrián‐Muiños Carmen , Alonso‐Morrondo Elena Julia , García‐Mesa Yolanda , García‐Piqueras Jorge , Cobo Ramón , García‐Suárez Olivia , Vega José Antonio
Published: July 2018

A vulvar case of nevus sebaceus is presented. During the routine histopatological examination, attention was drawn by several corpuscular structures. Immunohistochemistry demonstrated that they were sensory corpuscles, identified respectively as Meissner‐like and glomerular corpuscles. Nevertheless, compared with typical Meissner corpuscles from digital glabrous skin, Meissner‐like corpuscles identified here were bigger, the axon showed an irregular course, and the lamellar cells were smaller. Regarding the glomerular corpuscles they were bigger but with a normal arrangement of the corpuscular constituents. These findings suggest that these cutaneous sensory corpuscles are part of the nevus sebaceus hamartoma.
Stroke in childhood neurofibromatosis type 2
Authors: Kirkham Fenella J , Keylock Annette , Saunders Dawn E
Published: July 2018

This commentary is on the case series by Lascelles et al. on pages 1285–1288 of this issue.
Empagliflozin compared with glimepiride in metformin‐treated patients with type 2 diabetes: 208‐week data from a masked randomized controlled trial
Authors: Ridderstråle Martin , Rosenstock Julio , Andersen Knut R. , Woerle Hans J. , Salsali Afshin ,   on behalf of the EMPA‐REG H2H‐SU trial investigators
Published: July 2018

Aim

To report results at week 208, including a 104‐week masked extension, of the EMPA‐REG H2H‐SU trial in patients with type 2 diabetes with inadequate glycaemic control on metformin, in which empagliflozin 25 mg given for 104 weeks provided a sustained reduction in glycated haemoglobin (HbA1c) with a small but statistically significant benefit vs glimepiride, sustained reductions in weight and blood pressure, and low risk of hypoglycaemia.

Research Design and Methods

Patients with type 2 diabetes and HbA1c 53‐86 mmol/mol (7% to 10%) were randomized to empagliflozin 25 mg or glimepiride 1 to 4 mg for 104 weeks as add‐on to metformin. Patients who completed the randomized treatment period could participate in a 104‐week extension in which they continued the double‐blind treatment allocated at randomization.

Results

Of 765 and 780 patients treated with empagliflozin and glimepiride, 576 and 549 patients, respectively, entered the extension period of the study. At week 208, the adjusted mean difference in change from baseline in HbA1c with empagliflozin vs glimepiride was −1.96 mmol/mol, 95% CI −3.57, −0.35 (−0.18%, 95% CI −0.33, −0.03); P = 0.0172. Rescue therapy was given to 23% of patients on empagliflozin and 34% on glimepiride (odds ratio 0.56 [95% CI 0.45, 0.71]; P < 0.0001). Confirmed hypoglycaemic adverse events (plasma glucose ≤3.9 mmol/L and/or requiring assistance) occurred in 3% of patients on empagliflozin and 28% on glimepiride (odds ratio 0.08 [95% CI 0.05, 0.13]; P < 0.0001).

Conclusions

In patients with type 2 diabetes, empagliflozin 25 mg as add‐on to metformin for 208 weeks reduced HbA1c with a significantly lower risk of hypoglycaemia and a significantly smaller proportion of patients receiving rescue therapy compared with glimepiride.
Cardiac shock wave therapy improves myocardial perfusion and preserves left ventricular mechanics in patients with refractory angina: A study with speckle tracking echocardiography
Authors: Duque Anderson S. , Ceccon Conrado L. , Mathias Wilson , Majesky Joana Diniz , Gowdak Luis H. , Sbano João C. N. , Cesar Luis Antonio Machado , Abduch Maria Cristina , Lima Márcio S. M. , Dourado Paulo M. M. , Cruz Cecilia B. B. V. , Tsutsui Jeane M.
Published: July 2018

Background

Cardiac shockwave therapy (CSWT) is a new potential option for the treatment of patients with chronic coronary disease and refractory angina (RA). We aimed to study the effects of CSWT on left ventricular myocardial perfusion and mechanics in patients with RA.

Method

We prospectively studied 19 patients who underwent CSWT. Left ventricular mechanics were evaluated by speckle tracking echocardiography (STE), and myocardial perfusion by single‐photon emission computed tomography, using stress/rest–Technetium‐99 m Sestamibi, for determination of summed stress score (SSS). Canadian Cardiac Society (CCS), New York Heart Association (NYHA), and quality of life by Seattle Angina Questionnaire (SAQ) were assessed at baseline and 6 months after therapy.

Results

CSWT therapy was applied without major side effects. At baseline, 18 patients (94.7%) had CCS class III or IV, and after CSWT there was reduction to 3 (15.8%), P = .0001, associated with improvement in SAQ (38.5%; P < .001). Thirteen (68.4%) had class NYHA III or IV before treatment, with significant reduction to 7 (36.8%); P = .014. No change was observed in the global SSS from baseline to 6‐month follow‐up (15.33 ± 8.60 vs 16.60 ± 8.06; P = .157). However, there was a significant reduction in the average SSS of the treated ischemic segments (2.1 ± 0.87 pre vs 1.6 ± 1.19 post CSWT; P = .024). Global longitudinal strain by STE remained unaltered (‐13.03 ± 8.96 pre vs ‐15.88 ± 3.43 6‐month post CSWT; P = .256).

Conclusion

CSWT is a safe procedure for the treatment of patients with RA that results in better quality of life, improvement in myocardial perfusion of the treated segments with preservation of left ventricular mechanics.
Normative reference data, determinants, and clinical implications of right atrial reservoir function in women assessed by 2D speckle‐tracking echocardiography
Authors: Brand Anna , Bathe Marny , Hübscher Anne , Baldenhofer Gerd , Hättasch Robert , Seeland Ute , Oertelt‐Prigione Sabine , Rücke Mirjam , Regitz‐Zagrosek Vera , Stangl Karl , Dreger Henryk , Stangl Verena , Knebel Fabian
Published: July 2018

Aim

We aim to determine normative reference data of phasic right atrial (RA) strain and to investigate determinants, possible clinical implications as well as feasibility and reproducibility of RA strain analysis.

Methods and Results

Right atrial strain was analyzed in 266 participants of the cross‐sectional Berlin Female Risk Evaluation (BEFRI) study using 2D speckle‐tracking echocardiography (2D STE). To determine reference values, phasic RA strain was determined in a subgroup of 123 individuals without known cardiovascular diseases or risk factors. Mean RA reservoir strain (RAS), RA conduit, and contraction strain in this reference group were 44.9 ± 11.6%, 27.1 ± 9.5%, and 17.0 ± 5.9%, respectively. Regarding possible clinical implications, RAS was significantly reduced in women with a BMI ≥ 25, compared with women with a BMI < 25 (35.5 ± 11.1% vs 43.4 ± 11.6%, P < 0.0001). RA strain analysis showed a good feasibility (92.7%); intra‐ and inter‐observer variability was low (<5%). BMI, global longitudinal peak systolic LV strain (LVGLS%), RA area, TAPSE, and early diastolic myocardial relaxation velocity of the RV (RV‐e′) were significantly associated with RA mechanics in a multivariate logistic regression analysis.

Conclusion

In this cross‐sectional trial, we determined reference values, feasibility and reproducibility, clinical and echocardiographic determinants, and possible clinical implications of RA strain analysis. Our data may help to introduce the analysis of RA mechanics into future echocardiographic routine use.
Reproduction as a bottleneck to treeline advance across the circumarctic forest tundra ecotone
Authors: Brown Carissa D. , Dufour‐Tremblay Geneviève , Jameson Ryan G. , Mamet Steven D. , Trant Andrew J. , Walker Xanthe J. , Boudreau Stéphane , Harper Karen A. , Henry Gregory H. R. , Hermanutz Luise , Hofgaard Annika , Isaeva Ludmila , Kershaw G. Peter , Johnstone Jill F.
Published: July 2018

The fundamental niche of many species is shifting with climate change, especially in sub‐arctic ecosystems with pronounced recent warming. Ongoing warming in sub‐arctic regions should lessen environmental constraints on tree growth and reproduction, leading to increased success of trees colonising tundra. Nevertheless, variable responses of treeline ecotones have been documented in association with warming temperatures. One explanation for time lags between increasingly favourable environmental conditions and treeline ecotone movement is reproductive limitations caused by low seed availability. Our objective was to assess the reproductive constraints of the dominant tree species at the treeline ecotone in the circumpolar north. We sampled reproductive structures of trees (cones and catkins) and stand attributes across circumarctic treeline ecotones. We used generalized linear mixed models to estimate the sensitivity of seed production and the availability of viable seed to regional climate, stand structure, and species‐specific characteristics. Both seed production and viability of available seed were strongly driven by specific, sequential seasonal climatic conditions, but in different ways. Seed production was greatest when growing seasons with more growing degree days coincided with years with high precipitation. Two consecutive years with more growing degree days and low precipitation resulted in low seed production. Seasonal climate effects on the viability of available seed depended on the physical characteristics of the reproductive structures. Large‐coned and ‐seeded species take more time to develop mature embryos and were therefore more sensitive to increases in growing degree days in the year of flowering and embryo development. Our findings suggest that both moisture stress and abbreviated growing seasons can have a notable negative influence on the production and viability of available seed at treeline. Our synthesis revealed that constraints on predispersal reproduction within the treeline ecotone might create a considerable time lag for range expansion of tree populations into tundra ecosystems.
Anthropogenic threats can have cascading homogenizing effects on the phylogenetic and functional diversity of tropical ecosystems
Authors: Park Daniel S. , Razafindratsima Onja H.
Published: July 2018

Determining the mechanisms that underlie species distributions and assemblages is necessary to effectively preserve biodiversity. This cannot be accomplished by examining a single taxonomic group, as communities comprise a plethora of interactions across species and trophic levels. Here, we examine the patterns and relationships among plant, mammal, and bird diversity in Madagascar, a hotspot of biodiversity and endemism, across taxonomic, phylogenetic, and functional axes. We found that plant community diversity and structure are shaped by geography and climate, and have significant influences on the taxonomic, phylogenetic and functional diversity of mammals and birds. Patterns of primate diversity, in particular, were strongly correlated with patterns of plant diversity. Furthermore, our findings suggest that plant and animal communities could become more phylogenetically and functionally clustered in the future, leading to homogenization of the flora and fauna. These results underscore the importance and need of multi‐taxon approaches to conservation, given that even small threats to plant diversity can have significant cascading effects on mammalian and avian community diversity, structure, and function.
High intraspecific variability in morphology and diet in tropical stream fish communities
Authors: Manna Luisa Resende , Villéger Sébastien , Rezende Carla Ferreira , Mazzoni Rosana
Published: July 2018

Functional diversity of fish communities has been measured according to (a) interspecific variability, assuming that intraspecific variability is negligible, or (b) morphological differences, as good descriptors of complex functions, such as diet. These two assumptions have been scarcely tested on the individual level, especially in species‐rich tropical ecosystems. Here, we adapted intraspecific specialisation (ISpe) and intraspecific originality indices (IOri) to assess complementary components of intraspecific variability. Next, we applied these indices to evaluate the intra‐ and interspecific variability of morphological and diet traits in two contrasting Brazilian stream‐dwelling fish assemblages (rainforest and savannah). We also compared correlations between morphology and diet at the individual and species level to test whether accounting for intraspecific variability increases the predictability of diet due to morphological differences. Significant contributions of intraspecific variability to differences between fish were revealed for morphology and diet. Intraspecific variability in the diet was higher than that in morphology in both assemblages. The ISpe was positively correlated to IOri in the diet of both ecosystems. The morphological–dietary relationships were significant but weak at both individual and species levels. Our findings highlight the importance of measuring individual variability and accounting for complementary components of the intraspecific variability (ISpe and IOri). Importantly, we showed that the variability in morphology does not predict diet variability at both intra‐ and interspecific levels. Thus, high intraspecific variability in morphology and diet challenges the use of functional traits measured at the species level to describe the functional diversity of different fish assemblages.
First reported implementation of a German‐language progress test in an undergraduate dental curriculum: A prospective study
Authors: Kirnbauer B. , Avian A. , Jakse N. , Rugani P. , Ithaler D. , Egger R.
Published: July 2018

Introduction

Progress testing is a special form of longitudinal and feedback‐oriented assessment. Even though well established in human medical curricula, this is not the case in dental education. The aim was the prospective development and implementation of the first reported German‐language Dental Progress Test (DPT) for the undergraduate dental curriculum at the Medical University of Graz, Austria.

Material and methods

Participation in DPT was compulsory for all dental students in terms 7‐12 (years 4‐6). Three tests, each consisting of 100 items out of a pool of 375, were administered within 3 consecutive terms in 2016 and 2017. Rasch analyses were used to evaluate the questionnaire and identify misfitting items.

Results

In the item responses, 59.7% were “correct,” 27.0% were “false” and 13.3% were answered with “don't know,” with similar results at all 3 time points. The assumption of parallel ICC was met (T1: χ2 = 51.071, df = 74, P = .981; T2: χ2 = 57.044, df = 67, P = .802; T3: χ2 = 58.443, df = 72, P = .876) and item difficulties for the thematic fields were similarly distributed across the latent dimensions.

Conclusion

The newly introduced DPT is appropriate for testing dental students and is well balanced for the tested target group.
In vivo biocompatibility and biomineralization of calcium silicate cements
Authors: Benetti Francine , Gomes‐Filho João E. , de Araújo Lopes Juliana M. , Barbosa Jéssica G. , Jacinto Rogério C. , Cintra Luciano T. A.
Published: July 2018

A new mineral trioxide aggregate (MTA) material has been developed with a modified composition that requires investigations to support its clinical use. This study evaluated the biocompatibility and biomineralization of this new MTA material and compared it with that of two other MTA cements over time. Tubes containing materials (or empty tubes as controls) were inserted into the subcutaneous tissues of 40 rats. On days 7, 15, 30, 60, and 90, the tubes were removed with the surrounding tissues, which were either stained with haematoxylin and eosin or von Kossa for further analyses or unstained for observation under polarized light. On days 7 and 15, moderate inflammation was observed in most specimens, and the fibrous capsule was thick. On day 30, there was mild inflammation in all groups, and the fibrous capsule was thin. On days 60 and 90, there was mild inflammation in the material groups, while the control group showed no inflammation, although no statistically significant difference between the groups was observed and the fibrous capsule was thin. All material groups showed structures that stained with von Kossa and could be observed under polarized light; this was not found for the control. In conclusion, the new MTA material had biocompatibility and biomineralization properties similar to those of the two existing MTA materials.
Investment Decisions, Debt Renegotiation Friction, and Agency Conflicts
Authors: Kim Hwa‐Sung
Published: July 2018

This paper investigates how investment decisions are influenced by the possibility of debt renegotiation failure and shareholder–debtholder conflicts by extending the Sundaresan and Wang (2007) model. We find that the difference in investment thresholds due to agency conflicts decreases as shareholders’ bargaining power increases. We also show that as the probability of renegotiation friction is lower, the investment threshold is lower, which is consistent with the empirical result of Favara et al. (2017).
Reduction in glucose fluctuations in elderly patients with type 2 diabetes using repaglinide: A randomized controlled trial of repaglinide vs sulfonylurea
Authors: Omori Kazuno , Nomoto Hiroshi , Nakamura Akinobu , Takase Takahiro , Cho Kyu Yong , Ono Kota , Manda Naoki , Kurihara Yoshio , Aoki Shin , Atsumi Tatsuya , Miyoshi Hideaki
Published: July 2018

Aims/Introduction

Glinides are antidiabetic drugs that enhance the early phase of insulin secretion, but have been considered to be less effective at lowering blood glucose than sulfonylureas. However, glinides show a lower risk of hypoglycemia and a greater effect on postprandial hyperglycemia, and are particularly recommended for use in elderly patients with type 2 diabetes. We investigated the efficacy and safety of repaglinide compared with sulfonylurea for the treatment of elderly patients.

Materials and Methods

In the present multicenter, prospective, randomized, open‐label, controlled trial, 57 elderly lean patients with type 2 diabetes who were being treated with sulfonylureas were studied. They were either switched to repaglinide (Repa group) or continued a sulfonylurea (SU group) for 12 weeks. The primary outcome comprised the change in glycemic control, and among the secondary outcomes was the presence of hypoglycemia and drug compliance.

Results

Although glycated hemoglobin (HbA1c) was not significantly different between the two groups (SU +0.02% vs Repa −0.07%), greater improvements in the glycated albumin (GA) and GA to HbA1c ratio (GA/HbA1c) were observed in the Repa group (ΔGA, SU +0.12% vs Repa −1.15%; ΔGA/HbA1c, SU +0.01 vs Repa −0.13; each P < 0.01) without increasing hypoglycemia. When the Repa group was subdivided according to whether GA improved, the SU dose before switching to repaglinide was significantly smaller and the homeostatic model assessment of β‐cell function was significantly higher in the GA improvement subgroup.

Conclusions

Switching from SU to Repa improved GA and GA/HbA1c, and had favorable effects on glucose fluctuation in elderly patients with type 2 diabetes.
Major histocompatibility complex variation and blood parasites in resident and migratory populations of the common yellowthroat
Authors: Whittingham Linda A. , Dunn Peter O. , Freeman‐Gallant Corey R. , Taff Conor C. , Johnson Jeff A.
Published: July 2018

Genes of the major histocompatibility complex (MHC) are a critical part of the adaptive immune response, and the most polymorphic genes in the vertebrate genome, especially in passerine birds. This diversity is thought to be influenced by exposure to pathogens which can vary in relation to numerous factors. Migratory behaviour may be a particularly important trait to consider because migratory birds are exposed to a greater number of different pathogens and parasites at both breeding (i.e. temperate) and overwintering (i.e. tropical and subtropical) areas, as well as at stopover sites during migration. Thus, migrants are predicted to have greater MHC diversity than residents. We compared MHC variation, at both class I and II, and levels of haemosporidian infection between one resident and two migratory populations of the common yellowthroat (Geothlypis trichas). We found that residents were less likely to be infected with haemosporidian parasites and had lower MHC diversity at class I; however, variation at MHC class II was greater in residents than migrants, contrary to our prediction. These patterns were not likely to be caused by differences in population demography as genomewide heterozygosity (based on 9225 single nucleotide polymorphisms) was high in all three populations and not correlated with MHC variation. Our different results for MHC class I and II suggest that studies of immune gene variation in relation to life history need to consider that there could be different selection pressures arising from intracellular (class I) and extracellular (class II) pathogens in different populations.
Media market concentration and pluralism
Authors: Stühmeier Torben
Published: July 2018

We study the relationship between market concentration and market variety, and thereby focus on two dimensions of variety, namely on internal variety and on external variety. In our setup, firms can expand their internal variety continuously around their focus point on a Salop‐circle. External variety then refers to the market supply of variety offered by all firms on the circle. We believe that this setting is particularly applicable to media. It turns out that in more concentrated markets, there is an incentive to provide more internal variety in order to compete for consumers. Then, the relationship between market concentration and external variety turns out to be ambiguous. There also exists no clear free market bias with respect to socially optimal internal and external variety.
Millipedes vs. pathogens: Defensive secretions of some julids (Diplopoda: Julida) as potential antimicrobial agents
Authors: Ilić Bojan , Dimkić Ivica , Unković Nikola , Grbić Milica Ljaljević , Vukojević Jelena , Vujisić Ljubodrag , Tešević Vele , Stanković Slaviša , Makarov Slobodan , Lučić Luka
Published: July 2018

In the light of growing interest in discovering new sources of natural antimicrobial agents, we extracted and tested the efficiency of julid defensive secretions in comparison with commercially used antibiotic and antimycotics. This work involved chemical characterization of the defensive secretions of Cylindroiulus boleti (C. L. Koch, 1847), Megaphyllum bosniense (Verhoeff, 1897) and M. unilineatum (C. L. Koch, 1838), as well as in vitro evaluation of their antimicrobial activity against 11 bacteria, one yeast and eight filamentous fungi. Compounds of the analysed defensive secretions included p‐benzoquinones, alkyl esters of fatty acids and ketones. Ketones were recorded for the first time in the order Julida, and they were detected in secretions of both Megaphyllum species. All three analysed defensive secretions showed antibacterial and antifungal potential against all of the tested pathogens. Staphylococcus aureus proved to be the most sensitive bacterial strain to all analysed secretions. Also, defensive secretion of M. unilineatum showed significant antibacterial potential against Bacillus subtilis. The most resistant bacterial strains in this study were Escherichia coli, Erwinia persicina and Pseudomonas syringae pv. tomato. Analysed defensive secretions achieved the strongest antifungal activity against Aspergillus parasiticus (secretions of all three millipede species), Penicillium griseofulvum (secretions of C. boleti and M. bosniense) and Cladosporium oxysporum (secretion of M. unilineatum). The most resistant mycromycetes were A. niger (to all tested defensive secretions), A. flavus (to secretion of M. unilineatum) and P. lanosum (to secretions of C. boleti and M. bosniense). Our results showed a generally lower level of activity compared to antibiotic and a significantly higher level compared to antimycotics. The results of this study elucidate and open opportunities for further research in the field of millipede chemical ecology.
Egg cannibalism in capelin Mallotus villosus at beach and deep‐water spawning habitats in the north‐west Atlantic Ocean
Authors: Bone Bryden , Davoren Gail K.
Published: July 2018

We investigated egg cannibalism in spawning capelin Mallotus villosus on the north‐east Newfoundland coast during July 2012–2014, specifically whether sex, spawning condition (i.e., spawning or spent) and spawning habitat influenced egg cannibalism. Capelin spawning in deep‐water were 4.5–14 times more likely to be cannibals than those at the beach, probably due to the higher spatial overlap of spawners and conspecific eggs within this habitat relative to beaches. Males were 2.1–3.7 times more likely to be cannibals than females, but female cannibals had more eggs per stomach. Spawning fish were 1.6–1.9 times more likely to be cannibals than spent fish, but spent female cannibals had more eggs per stomach relative to spawning males and females in either habitat. Findings suggest that cannibalism may be an important foraging strategy, especially at deep‐water spawning habitat, possibly extending the spawning season for males or increasing the probability of post‐spawning survival for females. Although 44% of sampled females and 50% of males were cannibals, the estimated mortality due to egg cannibalism was low (0.49–2.97% of eggs produced annually), suggesting that egg cannibalism does not influence recruitment to a great extent in Newfoundland capelin.
Preferential incorporation of dark, coloured materials into nests by a mound‐nesting stream cyprinid
Authors: Bramburger Andrew J. , Moir Katherine E. , Hickey M. Brian C.
Published: July 2018

We compared size and colour characteristics of rocks used by male cutlip minnowsExoglossum maxillinguato build nests to those of streambed background materials. We found that materials used to construct conspicuous, mound‐shaped nests were uniform in size and darker and more colour‐saturated than background materials of the same size. To our knowledge, this phenomenon is the first reported example of fish selecting nest materials based on colour and has important implications for the conservation of mound‐nesting stream cyprinid species.
Engaging the patient: improving dietary intake and meal experience through bedside terminal meal ordering for oncology patients
Authors: Barrington V. , Maunder K. , Kelaart A.
Published: July 2018

Background

The present study aimed to determine changes in patient dietary intake, plate waste and meal experience associated with the implementation of a patient‐directed bedside electronic meal ordering system (BMOS) compared to traditional paper menus (PMs).

Methods

The study evaluated the effect of a BMOS compared to PM at an oncology hospital between 2015 and 2016. Patient dietary intake, plate waste and patient meal experience were the key outcomes measured. Plate waste was determined using a validated seven‐point visual wastage scale. The weight eaten estimates were converted into nutrients consumed in each food item to estimate dietary intake. Patient meal experience was measured via written surveys.

Results

There was an increase in patient dietary intake and patient meal experience, with BMOS compared to PM. Comparison between BMOS (n = 105) and PM (n = 96) showed statistically significant increases in ordering sufficient energy (8683 kJ day−1 versus 6773 kJ day−1, P = 0.004) and protein (97 g day−1 versus 82 g day−1, P = 0.023), as well as average energy intake (6457 kJ day−1 versus 4805 kJ day−1, P < 0.001) and protein intake (73 g day−1 versus 58 g day−1, P < 0.001). Average plate waste remained the same for both cohorts. Patient meal experience showed that 60% of patients accessed the BMOS independently. The BMOS cohort had significant increases in receiving the food that they ordered (P < 0.001) and in choosing food that they liked (P = 0.006).

Conclusions

The results of the present study demonstrate that a patient‐directed electronic meal ordering system improved patient dietary intake and meal experience. These results are most likely a result of empowering patients to make decisions about their meal selections and nutritional care through accessible meal ordering and improved menu communication.
Tai chi and yoga in residential aged care: Perspectives of participants: A qualitative study
Authors: Saravanakumar Padmapriya , Higgins Isabel J , Van Der Riet Pamela J , Sibbritt David
Published: July 2018

Aims and objectives

This qualitative study examined the appropriateness and acceptability of 14‐week modified tai chi and yoga programmes in an Australian residential aged care (RAC) setting by exploring experiences and perspectives of frail older residents and staff participants.

Background

Older persons in RAC have limited opportunities for physical activity. Tai chi and yoga are mindfulness‐based exercise interventions that have been used to promote physical and psychological health of older adults in community settings. While research on tai chi and yoga interventions in community settings is promising, there is limited research regarding the interventions’ appropriateness and acceptability for frail older residents in residential care settings in Australia.

Design

Descriptive and qualitative component of a mixed‐methods study.

Methods

All residents who participated in the modified yoga and tai chi interventions and staff who supported them were invited. A total of 19 individuals comprising 16 residents and three staff members participated in three focus group interviews. The interviews were audio‐recorded, transcribed and analysed thematically using a qualitative descriptive approach.

Results

Nine themes that reflected the uniqueness of the programmes' mind–body approach are presented: (a) novel, new and exciting; (b) smoothness, rhythm and flow; (c) slow and mindful; (d) gentle but rewarding; (e) moving whole body; (f) perceived benefits; (g) worthwhile; (h) feeling alive; and (i) calming and relaxing.

Conclusions

The modified programmes of tai chi and yoga was acceptable, appropriate, enjoyable and helpful. Both tai chi and yoga appear to provide appropriate physical exercise and opportunities for older persons to enhance their quality of life through interaction of physical, emotional and intellectual wellness domains.

Relevance to clinical practice

The 14‐week modified programmes of tai chi and yoga could be applied to frail older RAC population to promote health and active ageing.
eHealth versus equity: Using a feminist poststructural framework to explore the influence of perinatal eHealth resources on health equity
Authors: Richardson Brianna , Goldberg Lisa , Aston Megan , Campbell‐Yeo Marsha
Published: July 2018

Aims and objectives

To explore whether and how eHealth resources targeted to families during the perinatal period effectively reach a diverse population or further oppress marginalised groups.

Background

eHealth is often intended to reach a broad population, thus health content must be relatively generalised which limits the ability to tailor health education and interventions to individual needs. Generalisation of health information has historically represented a hegemonic depiction of the health consumer, especially within the perinatal period, often disregarding the diversity that exists in the world and perpetuating heteronormative constructs within healthcare systems as a result.

Design

A critical review of the literature regarding perinatal eHealth resources was conducted using a feminist poststructuralist approach for analysis. Included literature addresses the development, implementation and/or evaluation of perinatal eHealth resources.

Discussion

This approach uncovered hegemonic discourses related to the current state of perinatal eHealth resources. Nurses and midwives have the unique advantage of interacting and understanding diverse populations. Thus, nurses and midwives are integral to the development, implementation and evaluation of eHealth resources to reduce social health inequity.

Relevance to clinical practice

This paper acts as an exemplar on how to apply feminist poststructuralism to highlight inequities that exist and identifies strategies for nurses and midwives to become involved in the development of eHealth resources or advocate for greater visibility within current resources.
The effectiveness of aromatherapy and massage on stress management in nurses: A systematic review
Authors: Li Huanhuan , Zhao Minghui , Shi Ying , Xing Zhuangjie , Li Yuan , Wang Shouqi , Ying Jie , Zhang Meiling , Sun Jiao
Published: July 2018

Aims and objectives

To assess the effectiveness of aromatherapy and massage on relieving stress in nurses.

Background

Nurses face uncommon levels of stress in medical settings. Stress has a negative impact on nurses’ well‐being and the organisation where they work. Aromatherapy and massage are important strategies for stress reduction. However, the effectiveness of aromatherapy and massage on relieving stress in nurses currently lacks understanding.

Design

Systematic review.

Method

We performed a quantitative systematic review using Cochrane methods. We searched existing literature in the following databases: PubMed, PsycINFO, Embase, Web of Science and Cochrane Library, to examine any experimental design studies published from the earliest date available to August 2017 in English. Risk of bias per outcome was assessed.

Results

A total of 10 articles met the inclusion criteria, including aromatherapy (n = 4), massage (n = 4) and aromatherapy massage (n = 2). Most studies reported that aromatherapy and massage exert a beneficial effect on the stress of nurses. One study showed that the aromatherapy massage with music interventions has no effect on the stress of nurses. However, the number of the studies is limited and has high or unclear risk of bias.

Conclusion

This review revealed that the evidence does not sufficiently prove that aromatherapy, massage and aromatherapy massage are effective for reducing job‐related stress of nurses. We need to conduct high‐quality studies to verify the effects of these interventions on nurses’ stress levels in the future. Moreover, we need to integrate outcome measures of stress levels for developing more appropriate tools than the ones used as present.

Relevance to clinical practice

Nurses’ stress has a negative impact on their own and organisation where they work. All available opportunities should be taken to reduce nurses’ stress. It will be beneficial for nurse shortage.
Factor analysis and validity of the Polish version of the Peritraumatic Distress Inventory in mothers of seriously ill children
Authors: Rybojad Beata , Aftyka Anna , Samardakiewicz Marzena
Published: July 2018

Aims and objectives

The purpose of this study was to evaluate and validate the Peritraumatic Distress Inventory (PDI) in mothers of severely ill children hospitalised currently or in the past within a paediatric hospital setting.

Background

Serious illness in a child causes a sense of fear in her parents, which may occur in variously manifested stress.

Methods/Setting/Participants

The participants were 135 mothers of children treated in the Intensive Care Unit (ICU), Hematology & Oncology Department, and with perinatal history, who filled out Authors’ Questionnaire and the Polish version of the Peritraumatic Distress Inventory. Mothers of all children except those hospitalised in the Intensive Care Unit, additionally filled out the Hospital Anxiety and Depression Scale‐Modified (HADS‐M) and Impact of Event Scale‐Revised (IES‐R).

Results

Statistical analyses demonstrated a bifactor structure explaining 49.28% of the total variance. The first factor refers to the distress associated with the feeling of threat and somatic reactions, explaining 34.99% of the variance. The second factor, describing negative emotions, explains 14.99% of the variance. Cronbach's α coefficient for the whole scale, eventually consisting of 11 items, is 0.80; for the subscale Feeling of Threat and Somatic Reactions is 0.75, and Negative Emotions is 0.72. The general severity of peritraumatic distress correlates positively with the level of anxiety (ρ = 0.50; p < 0.01) and depression (ρ = 0.49; p < 0.01).

Conclusions

Polish adaptation of the PDI appears to be a valuable tool for studying distress in parents of seriously ill children.

Relevance to clinical practice

All parents of hospitalised children are at risk of distress so personnel should pay attention to that and report to a clinical psychologist.
Asynchronous rhythms of circulating conjugated and unconjugated bile acids in the modulation of human metabolism
Authors: Al‐Khaifi A. , Straniero S. , Voronova V. , Chernikova D. , Sokolov V. , Kumar C. , Angelin B. , Rudling M.
Published: July 2018

Background and Objectives

Bile acids (BAs) traversing the enterohepatic circulation (EHC) influence important metabolic pathways. By determining individual serum BAs in relation to markers of metabolic activity, we explored how diurnal variations in their EHC relate to hepatic metabolism in normal humans.

Methods

Serum BAs, fibroblast growth factor 19 (FGF19), lipoproteins, glucose/insulin and markers of cholesterol and BA syntheses were monitored for 32 h in 8 healthy males. Studies were conducted at basal state and during initiation of cholestyramine treatment, with and without atorvastatin pretreatment. Time series cross‐correlation analysis, Bayesian structural model and Granger causality test were applied.

Results

Bile acids synthesis dominated daytime, and cholesterol production at night. Conjugated BAs peaked after food intake, with subsequent FGF19 elevations. BA synthesis was reduced following conjugated BA and FGF19 peaks. Cholestyramine reduced conjugated BAs and FGF19, and increased BA and cholesterol production; the latter effects attenuated by atorvastatin. The relative importance of FGF19 vs. conjugated BAs in this feedback inhibition could not be discriminated. Unconjugated BAs displayed one major peak late at night/early morning that was unrelated to FGF19 and BA synthesis, and abolished by cholestyramine. The normal suppression of serum triglycerides, glucose and insulin observed at night was attenuated by cholestyramine.

Conclusions

Conjugated and unconjugated BAs have asynchronous rhythms of EHC in humans. Postprandial transintestinal flux of conjugated BAs increases circulating FGF19 levels and suppresses BA synthesis. Unconjugated BAs peak late at night, indicating a non‐postprandial diurnal change in human gut microflora, the physiological implications of which warrants further study.
Investigating the Effect of Different Surface Treatments on Vickers Hardness and Flexural Strength of Zirconium and Lithium Disilicate Ceramics
Authors: Ozdogan Alper , Yesil Duymus Zeynep
Published: July 2018

Purpose

To investigate the effect of different surface treatments on Vickers hardness and flexural strength of zirconia and lithium disilicate ceramics.

Materials and Methods

50 zirconia and 50 lithium disilicate ceramic specimens were used. After identifying one group as the control, grinding, sandblasting, CoJet, and Er:YAG laser were applied on the surface of specimens (n = 10). After applying Vickers hardness test to specimens, flexural strength test was performed. The data were analyzed with two‐way ANOVA and Duncan's multiple comparisons tests.

Results

There were statistically significant differences found between surface treatment groups in terms of Vickers hardness of zirconia and lithium disilicate ceramics (p < 0.001), but there were no statistically significant differences found between surface treatment groups in terms of flexural strength (p > 0.05).

Conclusions

Surface treatments could affect the hardness of ceramics. Therefore, was zirconia found to be harder and more durable than lithium disilicate ceramics.
Mildly Explosive Autoregression Under Stationary Conditional Heteroskedasticity
Authors: Arvanitis Stelios , Magdalinos Tassos
Published: July 2018

A limit theory is developed for mildly explosive autoregressions under stationary (weakly or strongly dependent) conditionally heteroskedastic errors. The conditional variance process is allowed to be stationary, integrable and mixingale, thus encompassing general classes of generalized autoregressive conditional heteroskedasticity‐type or stochastic volatility models. No mixing conditions or moments of higher order than 2 are assumed for the innovation process. As in Magdalinos (), we find that the asymptotic behaviour of the sample moments is affected by the memory of the innovation process both in the form of the limiting distribution and, in the case of long range dependence, the rate of convergence, while conditional heteroskedasticity affects only the asymptotic variance. These effects are cancelled out in least squares regression theory, and thereby, the Cauchy limit theory of Phillips and Magdalinos () remains invariant to a wide class of stationary conditionally heteroskedastic innovations processes.
On the Role of Input in Second Language Acquisition: The Case of French Strong Pronouns
Authors: Shimanskaya Elena
Published: July 2018

This study examined the acquisition of a linguistic property that is underrepresented in the input available to second language (L2) learners, namely, interpretation of French strong pronouns as [–animate]. To understand how pronouns are used and interpreted and how this topic is treated in pedagogical grammars, three types of analyses were conducted: corpus analysis, review of pedagogical materials, and experimental study with native and L2 speakers of French. Corpus data suggested that French strong pronouns were not inherently specified as [+animate] and that native speakers used these forms to refer to inanimate objects, at least when strong pronouns were used as objects of prepositions. Additionally, experimental data revealed that advanced L2 speakers also accepted inanimate interpretations. Taken together, the findings suggested that targetlike interpretation of pronouns can be acquired despite the scarcity of input, negative transfer from learners’ first language, and lack of explicit instruction of the target property.
Generalization of Syntactic Knowledge in Semiartificial Language Learning
Authors: Tao Yan , Williams John N.
Published: July 2018

A hallmark of grammatical knowledge is the ability to parse novel syntactic structures. Previous artificial language studies have examined learning hierarchical structures, but few have involved meaningful language and shown generalization to novel structures. This study addressed this issue using the semiartificial language paradigm. The experimental group of monolingual English speakers was exposed to singly embedded sentences combining Chinese syntax with English lexis. A novel testing procedure was used where participants made plausibility judgments on grammatical sentences featuring two‐level embedding. Only correct application of the rules underlying the training sentences permitted correct discrimination of plausible and implausible sentences. The experimental group performed above chance, an untrained control group performed at chance, and an untrained and unaware Chinese control group showed above‐chance performance. Confidence judgments and rule recognition analysis suggested that learning was implicit. We concluded that the experimental group demonstrated structural generalization and might have acquired the syntactic rule system.
When I say … understand
Authors: Kelly Martina , Dornan Tim , Ruparell Tinu
Published: July 2018

Do you understand what it means to understand? In this article, Kelly et al. use hermeneutics to clarify what it means to develop understanding between medical professionals and patients.
Lectotypification of Calamus nambariensis (Arecaceae)
Authors: Deka Kishor , Borthakur S. K. , Nepi Chiara , Tanti Bhaben
Published: July 2018

Calamus nambariensis Becc. (Arecaceae) has been recollected after a century from its original locality. As there is no holotype for the species name, a lectotype is designated from FI‐BP. Further, an epitype is designated to overcome the ambiguity of the incomplete material available at FI‐BP and a detailed description of the female flower from live material is provided.
Cholesterol Peroxidation as a Special Type of Lipid Oxidation in Photodynamic Systems
Authors: Girotti Albert W. , Korytowski Witold
Published: July 2018

Like other unsaturated lipids in cell membranes and lipoproteins, cholesterol (Ch) is susceptible to oxidative modification, including photodynamic oxidation. There is a sustained interest in the pathogenic properties of Ch oxides such as those generated by photooxidation. Singlet oxygen (1O2)‐mediated Ch photooxidation (Type II mechanism) gives rise to three hydroperoxide (ChOOH) isomers: 5α‐OOH, 6α‐OOH and 6β‐OOH, the 5α‐OOH yield far exceeding that of the others. 5α‐OOH detection is relatively straightforward and serves as a definitive indicator of 1O2 involvement in a reaction, photochemical or otherwise. Like all lipid hydroperoxides (LOOHs), ChOOHs can disrupt membrane or lipoprotein structure/function on their own, but subsequent light‐independent reactions may either intensify or attenuate such effects. Such reactions include (1) one‐electron reduction to redox‐active free radical intermediates, (2) two‐electron reduction to redox‐silent alcohols and (3) translocation to other lipid compartments, where (1) or (2) may take place. In addition to these effects, ChOOHs may act as signaling molecules in reactions that affect cell fates. Although processes a‐c have been well studied for ChOOHs, signaling activity is still poorly understood compared with that of hydrogen peroxide. This review focuses on these various aspects Ch photoperoxidation and its biological consequences.
Intense White Molecular Fluorescence from Naphthoxazole‐Quinoline Derivatives
Authors: Zanocco Renzo P. , Valdebenito Silvana , Gidi Yasser , Zapata‐Torres Gerald , Lemp Else , Nonell Santi , Zanocco Antonio L.
Published: July 2018

Naphthoxazole derivatives are small heterocyclic compounds endowed with outstanding fluorescence properties. In this work, we report a detailed study of the intense white light fluorescence observed in naphthoxazole‐quinoline dyads in solvent mixtures including at least a strong hydrogen bonding solvent. The same phenomenon was also studied in inclusion complexes naphthoxazole derivatives—sulfonated‐βCD either in aqueous solution as well as in solid phase. A novel mechanism of white molecular fluorescence generation based on solvent‐to‐fluorophore proton transfer facilitated by ground state hydrogen bonding was characterized. The emission combines both, a blue charge transfer fluorescence emitted by the locally excited singlet state along with a red‐shifted emission from a proton transfer complex.