bluuebunny/crossref_metadata_2025 huggingface dataset:
Sarah Siddons and the Romantic Hamlet
Authors: Boatner-Doane Charlotte
Published: April 2018

This paper considers Sarah Siddons’s cross-gender performances as Hamlet in relation to critical fascination with the character’s interiority in the early Romantic era. An examination of the responses to Siddons’s Hamlet in the context of late eighteenth- and early nineteenth-century studies of the play reveals that Siddons’s contemporaries saw the actress’s femininity and acting methods as particularly effective for conveying the sensibility and irresolution that became increasingly associated with Hamlet in literary criticism of the period. In particular, the responses to Siddons’s performances emphasise Hamlet’s first encounter with his father’s Ghost, a scene often considered the focal point of definitive performances by actors like Thomas Betterton, David Garrick, and Siddons’s brother, John Philip Kemble. The fact that these commentators describe Siddons’s Hamlet as superior to her brother’s and praise her reactions in the Ghost scene suggests that Siddons succeeded in creating a dramatic interpretation of the character that aligned with the Romantic focus on Hamlet’s inner life.
Plasma microRNA-21, microRNA-146a and IL-13 expression in asthmatic children
Authors: Hammad Mahmoud Hammad Reham , Hamed Dina Hossam El Dine , Eldosoky Mona Abd EL Rahman , Ahmad Ashraf Abd Elmonem Sayed , Osman Hanan Mohsen , Abd Elgalil Heba Mohamed , Mahmoud Hassan Mahmoud Mohsen
Published: April 2018

Childhood asthma represents a worldwide problem, involving genetic, immune defense and environmental components. MicroRNAs (miRs) are non-coding, single-stranded RNAs involved in immune regulation. The aim was to evaluate clinical potential of plasma miR-21 and miR-146a involved in T helper differentiation in childhood asthma and non-asthmatic controls. Group 1 consisted of 27 asthmatic children receiving inhaled corticosteroids (ICSs), which was compared to group 2 with 21 healthy control children. All patients were assessed by pulmonary function tests. miR-21 and miR-146a expression levels were determined by real-time quantitative PCR, and IL-13 was measured using ELISA. Group 1 showed significant up-regulation of plasma miR-21 and miR-146a levels with mean values 42.6-fold and 4.7-fold higher than average expression, respectively, in group 2. miR-21 levels positively correlated with IL-13 levels and eosinophil percentage, while miR-146a only correlated to eosinophil percentage. There was a linear association between each of miR-21 and miR-146a expression and FEV1 (forced expiratory volume in the first second), miR-21 and miR-146a are up-regulated in asthmatic children. miR-21 served as a better asthma biomarker. Association between both markers and FEV1 points to their role in determining asthma outcome following ICS treatment. miR-21 and miR-146a play a role in eosinophilic endotypic classification of asthma.
Design enhancement of overall Paralympics wheelchair for para table tennis competition
Authors: Tang Shao Qiang , Li King Ho Holden , Lim See Leng Davy
Published: April 2018

This study focused on enhancing the performance of the para table tennis player by implementing design modifications to the wheelchair to increase the sweep area of the player. In this article, a detailed study of pressure distribution on the player’s seat during play was performed to facilitate potential enhancements to the wheelchair that would alleviate issues that could arise from long hours of training and actual competition. Some of these issues include the discomfort and fatigue that could develop from an imbalanced posture resulting in imbalanced seat pressure distribution exerted on the gluteus maximus, as well as pressure sores that could develop during training and competition. Such issues impact the immediate and long-term development of competitiveness in the player. Through a systematic and quantitative understanding of the situation, further structural enhancements to the wheelchair as well as modifications to the training methodologies, strategies and techniques of gameplay could be implemented.
Preliminary evaluation of an adolescent positive health measurement scale: a salutogenic health promotion approach
Authors: Lake Donna M. , Rhynders Patricia
Published: April 2018

Health measurement tools typically assess indicators of poor health by identifying the absence, or presence, of disease and risk factors. This article describes development and validation of the first instrument for measurement of adolescent engagement in positive health promoting actions from a salutogenic approach. This cross-sectional study of 406 youths 14–16 years old tested the validity and reliability of the Salutogenic Wellness Promotion Scale for Adolescents (SWPS-Adol) and examined the extent to which SWPS-Adol positively correlated with and was able to predict perceived health among this population. Findings indicated that SWPS-Adol had good internal consistency ( α = 0.84, subscales α = 0.70), a multi-dimensional structure (physical, emotional, social, vocational and spiritual), and was positively correlated with perceived health ( r = 0.37, p < 0.001). The SWPS-Adol total score also showed significant positive correlations with the physical ( p ≤ 0.001), emotional ( p < 0.001), social ( p < 0.001) and vocational ( p < 0.039) dimensions. The more adolescents engaged in positive behaviors, the better their perceived health. The SWPS-Adol tool provides positive health data to guide adolescent health programs and health curricula, to inform health professionals and policy makers about how positive health actions enhance health and community wellness.
Health Sensors, Smart Home Devices, and the Internet of Medical Things: An Opportunity for Dramatic Improvement in Care for the Lower Extremity Complications of Diabetes
Authors: Basatneh Rami , Najafi Bijan , Armstrong David G.
Published: April 2018

Objective:

The prevalent and long-neglected diabetic foot ulcer (DFU) and its related complications rank among the most debilitating and costly sequelae of diabetes. With the rise of the Internet of medical things (IoMT), along with smart devices, the med-tech industry is on the cusp of a home-care revolution, which could also create opportunity for developing effective solutions with significant potential to reduce DFU-associated costs and saving limbs. This article discusses potential applications of IoMT to the DFU patient population and beyond.

Methods:

To better understand potential opportunities and challenges associated with implementing IoMT for management of DFU, the authors reviewed recent relevant literatures and included their own expert opinions from a multidisciplinary point of view including podiatry, engineering, and data security.

Results:

The IoMT has opened digital transformation of home-based diabetic foot care, as it enables promoting patient engagement, personalized care and smart management of chronic and noncommunicable diseases through individual data-driven treatment regimens, telecommunication, data mining, and comprehensive feedback tailored to individual requirements. In particular, with recent advances in voice-activated commands technology and its integration as a part of IoMT, new opportunities have emerged to improve the patient’s central role and responsibility in enabling an optimized health care ecosystem.

Conclusions:

The IoMT has opened new opportunities in health care from remote monitoring to smart sensors and medical device integration. While it is at its early stage of development, ultimately we envisage a connected home that, using voice-controlled technology and Bluetooth-radio-connected add-ons, may augment much of what home health does today.
Partisan Barriers to Bipartisanship
Authors: Ehret Phillip J. , Van Boven Leaf , Sherman David K.
Published: April 2018

Everyday partisans evaluate policies partly by following partisan cues, fomenting polarization. However, there is debate over the influence of partisan cues in “real-world,” nonlaboratory contexts. An experiment with a real climate change initiative in the 2016 Washington State election tested whether partisan cues influenced climate policy polarization. In a primary study, 504 prospective voters were randomly assigned to view veridical policy endorsements by partisan elites; this study was followed by a preregistered conceptual replication ( N = 1,178). Democrats supported the climate policy more than Republicans. But this difference was greater when Democrats endorsed the policy (with Republican opposition) than when Republicans endorsed the policy (with Democratic opposition). Neither knowledge nor belief in climate change reduced these polarizing effects, and greater policy knowledge was associated with increased polarization. Further, the effect of partisan cues on normative perceptions mediated the effect of partisan cues on policy support.
Potential and limitations of health policy to improve coronary heart disease prevention and to reduce the burden of disease: A Russian experience
Authors: Pogosova Nana , Oganov Rafael , Saner Hugo , Suvorov Sergey , Sokolova Olga
Published: April 2018

Background

Mortality from cardiovascular diseases is particularly high in Russia compared with the European average. The National Priority Project ‘Health’, launched in 2005, aimed to promote prevention of non-communicable diseases, particularly cardiovascular diseases, in primary care and to increase availability of state-of-art cardiovascular disease management.

Methods

This is a multiregional population based study with analysis of indicators for cardiovascular health and coronary heart disease in Moscow, St Petersburg, the Moscow region and across Russia, including a total population of 143.7 million inhabitants between 2005 and 2013. Data were collected using conventional methodology and originate from open statistical sources.

Results

The overall age-standardized coronary heart disease mortality decreased in 2005–2013 by 24.7% from 383.6 to 289.0 per 100000 population, but with substantial interregional differences: it declined from 306.1 to 196.9 per 100,000 in Moscow (–35.7%), from 362.1 to 258.9 per 100,000 in St Petersburg (–28.5%) and from 433.8 to 374.3 per 100,000 in the Moscow region (–13.7%). Income in Moscow exceeded the national average 2–3-fold, and Moscow had the highest availability of modern treatments and interventions. Although vegetables, fruits and fish consumption increased overall in Russia, this trend was most prominent in Moscow. Indicators for psychosocial well-being also were best in Moscow. Life expectancy in Moscow is almost six years higher than the Russian average.

Conclusion

Health policy interventions turned out to be successful but with substantial interregional differences. Lower coronary heart disease mortality and higher life expectancy in Moscow may be due to a more favourable socioeconomic and psychological environment, more healthy eating and greater availability of medical care.
Patient-reported outcomes are independent predictors of one-year mortality and cardiac events across cardiac diagnoses: Findings from the national DenHeart survey
Authors: Berg Selina K , Thorup Charlotte B , Borregaard Britt , Christensen Anne V , Thrysoee Lars , Rasmussen Trine B , Ekholm Ola , Juel Knud , Vamosi Marianne
Published: April 2018

Aims

Patient-reported quality of life and anxiety/depression scores provide important prognostic information independently of traditional clinical data. The aims of this study were to describe: (a) mortality and cardiac events one year after hospital discharge across cardiac diagnoses; (b) patient-reported outcomes at hospital discharge as a predictor of mortality and cardiac events.

Design

A cross-sectional survey with register follow-up.

Methods

Participants: All patients discharged from April 2013 to April 2014 from five national heart centres in Denmark.

Main outcomes

Patient-reported outcomes: anxiety and depression (Hospital Anxiety and Depression Scale); perceived health (Short Form-12); quality of life (HeartQoL and EQ-5D); symptom burden (Edmonton Symptom Assessment Scale). Register data: mortality and cardiac events within one year following discharge.

Results

There were 471 deaths among the 16,689 respondents in the first year after discharge. Across diagnostic groups, patients reporting symptoms of anxiety had a two-fold greater mortality risk when adjusted for age, sex, marital status, educational level, comorbidity, smoking, body mass index and alcohol intake (hazard ratio (HR) 1.92, 95% confidence interval (CI) 1.52–2.42). Similar increased mortality risks were found for patients reporting symptoms of depression (HR 2.29, 95% CI 1.81–2.90), poor quality of life (HR 0.46, 95% CI 0.39–0.54) and severe symptom distress (HR 2.47, 95% CI 1.92–3.19). Cardiac events were predicted by poor quality of life (HR 0.71, 95% CI 0.65–0.77) and severe symptom distress (HR 1.58, 95% CI 1.35–1.85).

Conclusions

Patient-reported mental and physical health outcomes are independent predictors of one-year mortality and cardiac events across cardiac diagnoses.
Anterior versus posterior approach to treat cervical spondylotic myelopathy, clinical and radiological results with long period of follow-up
Authors: Audat Ziad A , Fawareh Mohammad D , Radydeh Ahmad M , Obeidat Moutasem M , Odat Mohannad A , Bashaireh Khaldoon M , Barbarawi Mohammad M , Nusairat Murad T , Ibraheem Amna B , Audat Mohammad Z
Published: April 2018

Background:

Cervical spondylotic myelopathy increases with age, but not all cases are symptomatic. It is usually diagnosed clinically and radiologically (X-ray and magnetic resonance imaging). Surgical treatment is indicated in severe symptomatic cases, while treatment controversy exists in the presence of less severe cases. Anterior and posterior approaches are generally used for decompression with no significant differences in the results of both.

Methods:

A total of 287 patients of cervical spondylotic myelopathy were treated at our hospital between January 2004 and December 2015. Only 140 patients were eligible for our study. They had at least 5 years of follow-up using full clinical scores and radiological evaluation. They were divided into two groups: group I with 73 patients (aged 23–79 years) underwent posterior decompression, lateral mass instrumentation, and fusion, while group II with 67 patients (aged 33–70 years) underwent anterior decompression, instrumentation, and fusion. Neck Disability Index, local score, and X-ray were used in the evaluation of the patients.

Results:

Preoperative mean ± standard deviation of Neck Disability Index of both the groups was 32.06 ± 6.33 and 29.88 ± 5.48, which improved in the last visit (>5 years) to 5.81 ± 7.39 and 2.94 ± 5.48 for groups I and II, respectively (p value <0.05). The local score of groups I and II was (P = 1, F = 21, G = 31, E = 19) and (P = 1, F = 12, G = 36, E = 18), which on discharge day improved to (P = 1, F = 4, G = 12, E = 55) and (P = 0, F = 3, G = 6, E = 58) at last follow-up, respectively. Fusion rate was nearly equal for both the groups during all the follow-up intervals and it was 91.1% and 91.7% in the last follow-up.

Conclusion:

There were no significant differences in the clinical and radiological results between the anterior and posterior approaches used in the surgical treatment of spondylotic cervical myelopathy. However, statistically significant results of Neck Disability Index of anterior approach were not clinically important and may be due to changes in the size and shape of the neck in group II.
Efficacy of percutaneous transhepatic portal vein embolization using gelatin sponge particles and metal coils
Authors: Komada Tomohiro , Suzuki Kojiro , Mizuno Takashi , Ebata Tomoki , Matsushima Masaya , Naganawa Shinji , Nagino Masato
Published: April 2018

Background

Percutaneous transhepatic portal vein embolization (PTPE) can increase the future liver remnant (FLR) volume before extended liver resection; however, there is no current consensus regarding the best embolic material for PTPE.

Purpose

To evaluate the efficacy of PTPE using gelatin sponge particles and coils.

Material and Methods

The medical records of 136 patients who underwent PTPE using gelatin sponge particles and metal coils were retrospectively reviewed. We evaluated the procedural details, liver volume on CT, and clinical status before and after PTPE.

Results

The mean FLR volume increased significantly from 390 ± 147 cm3 to 508 ± 141 cm3 ( P < 0.001). A mean of 22.1 ± 9.4 days after PTPE, the mean increase in the ratio of FLR volume to total liver volume was 9.4 ± 6.5%. Complications related to PTPE occurred in five patients, including arterial damage (n = 4) and biloma (n = 1). The white blood cell count and C-reactive protein level increased significantly and then returned to baseline within seven days. Aspartate aminotransferase and alanine aminotransferase showed no significant changes. Fever (defined by the Common Terminology Criteria for Adverse Events v4.0) was reported in 74 patients (54%), but it was generally mild (Grade 1/2; n = 72). None of the patients experienced severe complications that required cancellation of surgery.

Conclusion

PTPE with gelatin sponge particles and coils may impose low physical stress on patients and is a safe method of inducing a significant increase of FLR.
Osteoarthritis progression of the shoulder: A long-term follow-up after mini-open rotator cuff repair
Authors: Matsuba Tomoyuki , Hata Yukihiko , Ishigaki Norio , Nakamura Koichi , Kato Hiroyuki
Published: April 2018

Objective:

This study aimed to investigate whether (1) the primary repair of rotator cuff tears can prevent the progression of osteoarthritis (OA) and (2) the quality of postoperative cuff integrity affects the incidence of osteoarthritic changes.

Methods:

A total of 86 patients treated with mini-open repair for rotator cuff tears over a minimum of 10 years of follow-up (mean ± standard deviation 11.1 ± 1.0 years) were retrospectively analyzed. Preoperative and postoperative radiographs of the affected and unaffected sides were compared, and the degree of OA was evaluated using the Samilson and Prieto classification. Magnetic resonance imaging was used to evaluate cuff integrity, classify patients into good and poor cuff integrity groups, and compare the degree of OA between the two groups.

Results:

OA deteriorated either significantly or to a similar degree on both sides postoperatively. However, OA progressed in significantly more cases on the affected side. A comparison between the aforementioned cuff integrity groups showed that the postoperative OA of the poor cuff integrity group was significantly worse than that of the good cuff integrity group on the affected side.

Conclusion:

Our study showed that even if rotator cuff tears are repaired, the progression of osteoarthritic changes cannot be halted. The progression of OA was affected by cuff integrity. Rotator cuff dysfunction due to poor cuff integrity was a risk factor for shoulder arthritis.
Clinical implementation of rapid CYP2C19 genotyping to guide antiplatelet therapy after percutaneous coronary intervention
Authors: Cavallari Larisa H. , Franchi Francesco , Rollini Fabiana , Been Latonya , Rivas Andrea , Agarwal Malhar , Smith D. Max , Newsom Kimberly , Gong Yan , Elsey Amanda R. , Starostik Petr , Johnson Julie A. , Angiolillo Dominick J.
Published: April 2018

Background

The CYP2C19 nonfunctional genotype reduces clopidogrel effectiveness after percutaneous coronary intervention (PCI). Following clinical implementation of CYP2C19 genotyping at University Florida (UF) Health Shands Hospital in 2012, where genotype results are available approximately 3 days after PCI, testing was expanded to UF Health Jacksonville in 2016 utilizing a rapid genotyping approach. We describe metrics with this latter implementation.

Methods

Patients at UF Health Jacksonville undergoing left heart catheterization with intent to undergo PCI were targeted for genotyping using the Spartan RX™ system. Testing metrics and provider acceptance of testing and response to genotype results were examined, as was antiplatelet therapy over the 6 months following genotyping.

Results

In the first year, 931 patients, including 392/505 (78%) total patients undergoing PCI, were genotyped. The median genotype test turnaround time was 96 min. Genotype results were available for 388 (99%) PCI patients prior to discharge. Of 336 genotyped PCI patients alive at discharge and not enrolled in an antiplatelet therapy trial, 1/6 (17%) poor metabolizers (PMs, with two nonfunctional alleles), 38/93 (41%) intermediate metabolizers (IMs, with one nonfunctional allele), and 119/237 (50%) patients without a nonfunctional allele were prescribed clopidogrel (p = 0.110). Clopidogrel use was higher among non-ACS versus ACS patients (78.6% vs. 42.2%, p < 0.001). Six months later, among patients with follow-up data, clopidogrel was prescribed in 0/4 (0%) PMs, 33/65 (51%) IMs, and 115/182 (63%) patients without a nonfunctional allele (p = 0.008 across groups; p = 0.020 for PMs versus those without a nonfunctional allele).

Conclusion

These data demonstrate that rapid genotyping is clinically feasible at a high volume cardiac catheterization facility and allows informed chronic antiplatelet prescribing, with lower clopidogrel use in PMs at 6 months.

Trial registration ClinicalTrials.gov Identifier: NCT02724319; registered March 31, 2016; https://www.clinicaltrials.gov/ct2/show/NCT02724319?term=angiolillo&rank=7
Lessons in Integrating Shared Decision-Making Into Cancer Care
Authors: Steffensen Karina Dahl , Vinter Mette , Crüger Dorthe , Dankl Kathrina , Coulter Angela , Stuart Brad , Berry Leonard L.
Published: April 2018

The benefits of shared decision-making (SDM) in health care delivery are well documented, but implementing SDM at the institutional level is challenging, particularly when patients have complex illnesses and care needs, as in cancer. Denmark’s Lillebaelt Hospital, in creating The Patient’s Cancer Hospital in Vejle, has learned key lessons in implementing SDM so that the organization’s culture is actually being transformed. In short, SDM is becoming part of the fabric of care, not a mere add-on to it. Specifically, the hospital chose and structured its leadership to ensure that SDM is constantly championed. It organized multiple demonstration projects focused on use of decision aids, patient-reported outcome measures, and better communication tools and practices. It designed programs to train clinicians in the art of doctor-patient communication. It used research evidence to inform development of the decision aids that its clinicians use with their patients. And it rigorously measured SDM performance in an ongoing fashion so that progress could be tracked and refined to ensure continuous improvement. Initial data on the institution’s SDM initiatives from the Danish national annual survey of patients’ experiences show substantial progress, thereby motivating Lillebaelt to reassert its commitment to the effort, to share what it has learned, and to invite dialogue among all cancer care organizations as they seek to fully integrate SDM in daily clinical practice.
Cisgenderism and Certitude
Authors: Riggs Damien W. , Bartholomaeus Clare
Published: April 2018

In accounting for their experiences of having a transgender child, cisgender parents often make recourse to a trope of loss to account for their journeys. A focus on loss is also evident in guides for parents and academic writing. In this article, the authors seek to produce an alternative account of loss, one that shifts the focus away from transgender children themselves and onto the broader context in which parents and their transgender children live, with a particular focus on schools. Specifically, the authors consider how cisgenderism produces a loss of certitude for parents, in that parents lose the invisible privileges that accrue to those who occupy an unmarked place within the cisgender norm. To do this, the authors draw on survey data from sixty Australian cisgender parents of transgender children, exploring specifically how they spoke about experiences with schools, both negative and positive.
TFIIH localization is highly dynamic during zygotic genome activation in Drosophila, and its depletion causes catastrophic mitosis
Authors: Cruz-Becerra Grisel , Valerio-Cabrera Sarai , Juárez Mandy , Bucio-Mendez Alyeri , Zurita Mario
Published: April 2018

In Drosophila, zygotic genome activation occurs in pre-blastoderm embryos during rapid mitotic divisions. How the transcription machinery is coordinated to achieve this goal in a very brief time span is still poorly understood. Transcription factor II H (TFIIH) is fundamental for transcription initiation by RNA polymerase II (RNAPII). Herein, we show the in vivo dynamics of TFIIH at the onset of transcription in Drosophila embryos. TFIIH shows an oscillatory behaviour between the nucleus and cytoplasm. TFIIH foci are observed from interphase to metaphase, and colocalize with those for RNAPII phosphorylated at serine 5 (RNAPIIS5P) at prophase, suggesting that transcription occurs during the first mitotic phases. Furthermore, embryos with defects in subunits of either the CAK or the core subcomplexes of TFIIH show catastrophic mitosis. Although, transcriptome analyses show altered expression of several maternal genes that participate in mitosis, the global level of RNAPIIS5P in TFIIH mutant embryos is similar to that in the wild type, therefore, a direct role for TFIIH in mitosis cannot be ruled out. These results provide important insights regarding the role of a basal transcription machinery component when the zygotic genome is activated.
Functional Literacy of Younger Schoolchild: Problem Statement
Authors: Виноградова Наталья , Vinogradova Natalya
Published: April 2018

The article considers approaches to the formation of functional literacy of younger schoolchildren as a planned result of learning. The importance and necessity of the development of general cultural literacy in younger schoolchildren as a central component of social functional literacy is discussed. By the examples of the contents of different lessons on different subject courses methods, techniques and forms of organization of training of younger schoolchildren are described, contributing to the development of their ability to show emotional attitude to culture and its various spheres.
The Importance of Educational Institutions in the Preservation and Development of the Culture of the Indigenous Peoples of the Arctic
Authors: Марфусалова В. , Marfusalova V.
Published: April 2018

The article considers the directions of the Russian educational policy in the sphere of the development of culture and education of the indigenous low-numbered peoples of the North. The role of higher pedagogical educational organizations in the preservation and strengthening of the culture of the low-numbered peoples of the Russian Federation residing in the Arctic and subarctic territories is described. The curriculum of future teachers is being revealed.
Formation of Regulatory Universal Educational Activities byChildren in Physical Education Lessons
Authors: Лаврентичева М. , Lavrenticheva M.
Published: April 2018

The article reveals the nomenclature of regulatory universal educational activities, which is advisable to form in younger schoolchildren at physical education classes and in classes during extracurricular activities. The examples of exercises that contribute to the formation of the ability of a younger schoolchild to plan, monitor and assess his physical condition are given.
Some questions of forming the professional structure of the police at the present stage of the development of the bodies of the internal affairs
Authors: Сумина Екатерина , Sumina Ekaterina , Мыльников Михаил , Myl'nikov Mihail
Published: April 2018

In the article the authors consider the main directions of the formation of a professional core in the bodies of internal affairs, the concept of cadres, the profession, and specialization. An emphasis is placed on the personnel policy of the bodies of internal affairs of the Russian Federation. Important role in the provision of high-quality personnel is allocated to education and upbringing. The authors note that in order to successfully create the necessary professional skills for employees, it is also necessary to create conditions that allow staff to meet pressing needs.
The effectiveness of alcohol-based gel for hand sanitising in infection control
Authors: Munoz-Figueroa Gloria Patricia , Ojo Omorogieva
Published: April 2018

This article aims to evaluate the evidence relating to the effectiveness of alcohol-based gel for hand sanitising, or ‘handrub’, in infection control in healthcare settings with particular reference to renal nursing, as this has become pertinent due to the increasing reliance on evidence-based practice. There is a need to implement better infection control strategies and education, to reinforce knowledge among the public, health professionals and those at high risk of infection not only in renal nursing, but also in other areas of practice. Healthcare-associated infections (HCAIs) put patients' safety at risk, increase morbidity and mortality, extend the length of hospital admission and increase the cost to the NHS. There is evidence that the prevalence of HCAIs in England can be minimised through the use of different infection control measures. For example, alcohol-based handrub has been found to be associated with minimising the spread of gastrointestinal infections not only in hospital settings, but also in childcare centres. In addition, the UK national guidelines recommend regular handwashing (implementing the right technique) when hands are visibly dirty and hand disinfection with alcohol-based handrub when they are not visibly dirty. This should be before, in between and after different healthcare activities are performed.
– and still comply with the CQC!
Authors: Miteva Aleksandra
Published: April 2018

Dental nurse and compliance lead, Aleksandra MIteva, reveals how to pass a CQC inspection with flying colours – and remain environmetally friendly
Biological wound matrices with native dermis-like collagen efficiently modulate protease activity
Authors: Tati Ramesh , Nordin Sara , Abdillahi Suado M , Mörgelin Matthias
Published: April 2018

Objective:

When the delicate balance between catabolic and anabolic processes is disturbed for any reason, the healing process can stall, resulting in chronic wounds. In chronic wound pathophysiology, proteolytic imbalance is implicated due to elevated protease levels mediating tissue damage. Hence, it is important to design appropriate wound treatments able to control and modulate protease activity directly at the host/biomaterial interface. Here, we investigate collagen-based wound dressings with the focus on their potential to adsorb and inactivate tissue proteases.

Method:

We examined the effect of six collagen-based dressings on their ability to adsorb and inactivate different granulocyte proteases, plasmin, human neutrophil elastase (HLE), and matrix metalloproteases (MMP)-1, -2, -8, and -9, by an integrated approach including immunoelectron microscopy.

Results:

We observed a reduction of the proteolytic activities of plasmin, HLE, and MMP-1, -2, -8, and -9, both on the biomaterial surface and in human chronic wound fluid. The most pronounced effect was observed in collagen-based dressings, with the highest content of native collagen networks resembling dermis structures.

Conclusion:

Our data suggest that this treatment strategy might be beneficial for the chronic wound environment, with the potential to promote improved wound healing.
Distraction osteogenesis part 2: technical aspects
Authors: Barber Sophy , Carter Lachlan , Mannion Christopher , Bates Claire
Published: April 2018

Abstract: The history and uses of Distraction Osteogenesis (DO) in the craniofacial region have previously been discussed. In this second part of the review the technical aspects of DO and the role of the different team members in the multidisciplinary care are described. The orthodontist is a key member of the team, assisting with treatment planning, pre-surgical orthodontics and the post-distraction phase.

CPD/Clinical Relevance: This report provides a description of the technical aspects of distraction osteogenesis to enable orthodontists to understand the process and their role in the multidisciplinary team.
The Spring Statement: A missed opportunity
Authors: Dodhia Hitesh
Published: April 2018

Hitesh Dodhia analyses the Chancellor's Spring Statement, what it means for the NHS and the steps the government needs to take to secure its future
Family support for alcohol misuse
Authors: Al-Anon
Published: April 2018

Much is written about the effects of heavy alcohol consumption on the drinker, but how it affects those closest is equally as devastating. As Fiona's story shows, there is a place to help sufferers and their families through the journey to recovery
24-hour retirement advice for GPs
Authors: Gransby James
Published: April 2018

Specialist medical accountant James Gransby offers facts and figures on 24-hour retirement for practice managers to share with their doctors
Feet in orthogonal-Buekenhout–Metz unitals
Authors: Abarzúa N. , Pomareda R. , Vega O.
Published: April 2018

Given an orthogonal-Buekenhout–Metz unitalUα,β, embedded in PG(2,q2), and a pointP∉Uα,β, we study the setτP(Uα,β) of feet ofPinUα,β. We characterize geometrically each of these sets as eitherq+ 1 collinear points or asq+ 1 points partitioned into two arcs. Other results about the geometry of these sets are also given.
Renefouqueosis peruviensis, a new genus and species of Stenosini (Coleoptera: Tenebrionidae) from Peru with a key to the Stenosini of the World and notes on the genera Anchomma and Fitzsimonsium
Authors: Aalbu Rolf L. , Smith Aaron D. , Kanda Kojun , Bouchard Patrice
Published: April 2018

Renefouqueosis peruviensis gen. et sp. nov., a new tenebrionid genus and species of the tribe Stenosini (subtribe Stenosina) is described from the arid mountains of Northern Peru. Including the new genus Renefouqueosis gen. nov., the tribe Stenosini now includes 40 valid genera of which nine are from the New World. The genera are placed in six subtribes (two worldwide, two New World and two Old World). Type species and subtribal assignment for each genus is presented. Notes on the placement of the genera Anchomma LeConte, 1858 and Fitzsimonsium Koch, 1962 are given. The proper placement of these genera is uncertain. Because of numerous morphological similarities to the Stenosini, we have decided to place these in a key to the world genera of Stenosini, which we provide.
A review of the Asian species of the Cercyon unipunctatus group (Coleoptera: Hydrophilidae: Sphaeridiinae)
Authors: Ryndevich Sergey K. , Jia Fenglong , Fikáček Martin
Published: April 2018

Asian species of the Cercyon unipunctatus species group are reviewed. Nine species are recognized in Asia, three of which are described as new: C. flavimarginatus sp. nov. and C. kubani sp. nov. from Yunnan province of China, and C. undulipennis sp. nov. from Sichuan and Yunnan provinces in China. Besides these, the species group contains the following Asian species: C. divisus Hebauer, 2002 (newly recorded from northern India and China), C. quisquilius (Linnaeus, 1761) (newly recorded from Kyrgyzstan, Turkmenistan, Syria and Iran), C. unipunctatus (Linnaeus, 1758), C. unipustulatus Nakane, 1982 and C. verus Shatrovskiy, 1989. All species are (re)described, illustrated and a summary of the known distribution is provided. An identification key to the Asian species of C. unipunctatus group is provided, and the species are also briefly diagnosed from similar Palaearctic and Oriental Cercyon species.
Macrocera rohaceki sp. nov. and other interesting records of Keroplatidae (Diptera) from southern and central Europe, with DNA sequence data
Authors: Mantič Michal , Ševčík Jan
Published: April 2018

A new species of Keroplatidae (Diptera: Sciaroidea), Macrocera rohaceki sp. nov., is described from the island of Mallorca (Spain). A further remarkable species, Paleoplatyura johnsoni Johannsen, 1910, hitherto only known from the Nearctic Region, is recorded from Sicily (Italy). New records of Isoneuromyia czernyi (Strobl, 1909) and I. pseudochracea (Landrock, 1925) from Slovakia are provided, including figures of the male terminalia. Their relationships to the widely distributed European species, I. semirufa (Meigen, 1818), are reconstructed using three mitochondrial DNA markers (12S, COI, cytb). A key to the European species of Isoneuromyia Brunetti, 1912 is also provided.
Neural Mechanism and Representation of English and Chinese Metaphors of Bilinguals with Different Second Language Proficiency: An ERP Study
Authors: Wang Qian
Published: April 2018

Brain mechanism of metaphor processing has always been a focus in Neurolinguistics. This study approaches bilinguals’ metaphor semantic representation mechanism with Chinese bilinguals with different levels of second language proficiency by means of ERP (Event-related Potentials) technology. The experiment results showed that: 1) Both hemispheres collaborate in metaphor processing with the left hemisphere serving a leading semantic recognition role. The left hemisphere is more sensitive to first language input, while the right hemisphere is more active to second language input. 2) Compared with Chinese learners of higher proficiency in L2, learners of lower proficiency tend to adopt more Chinese neural mechanism in processing English metaphors. 3) When learners process metaphors, the neural mechanism difference of learners of higher proficiency is smaller than that of those of lower proficiency. The higher the second language proficiency, the higher the degree of common representation of Chinese and English metaphor.
Arithmetical rings and Krull dimension
Authors: Tuganbaev Askar A.
Published: April 2018

Let A be a commutative arithmetical ring. It is proved that the ring A has Krull dimension if and only if every factor ring of A is finite-dimensional and does not have idempotent proper essential ideals.
“They Heard from a Distance”: The šemû-rūqu Paradigm in the Late Neo-Assyrian Empire
Authors: Richardson Seth
Published: April 2018

In its first 500 years, Assyrian imperial ideology was based on the idea that the empire was a monopole, a unique and ever-expanding core of order and right that continuously pushed back the borders of a disordered periphery, bringing new lands within the Assyrian state. Across these centuries, this precept resulted in virtually every encounter with other polities and peoples being described in terms of visuality and frontality: the enemy submitted on seeing the king, overwhelmed by his brilliant melammu, and bowed before him. By the late 9th century BC, however, the illusion of a monopolar world could no longer be sustained. Assyria began to come into (often second-hand) contact with numerous rival polities and peer states such as Phrygia, Kush, Dilmun, and Cyprus—places it did not, could not, and would never control. This new geopolitical paradigm formed a problem for Assyrian ideology, both conceptually and rhetorically, one that royal inscriptions attempted to solve through two new narrative tropes, often explicitly linked, about “distant” (rūqu) lands which were apprehensible through hearing (šemû) rather than seeing. As a historical matter, the hermeneutics of this rhetoric form a clear and demonstrable shift in literary style and topos in the last two centuries of the empire; but they further mark a change in mentalité, insofar as “the distant” emerged as a new ontological category of space which could not be integrated into the earlier imperial paradigm.
Impact of childhood type 1 diabetes on maternal work-family relations
Authors: Shalitin Shlomit , Hershtik Efrat , Phillip Moshe , Gavan Michal-Yackobovitz , Cinamon Rachel Gali
Published: April 2018

Background:

The aim of the study was to evaluate work-family conflict (WFC) and work-family facilitation (WFF) of working mothers of children with type 1 diabetes (T1D) compared with those of working mothers of children under follow-up not requiring treatment and of healthy children, and to explore the impact of organizational resources and the characteristics of the child and his disease on this interface.

Methods:

The study included 157 working mothers: 50 mothers of children with T1D, 50 mothers of children on medical follow-up without chronic illness and 57 mothers of healthy children. The participants completed validated questionnaires including the WFC scale, WFF scale, organizational resources support scale, life and work satisfaction questionnaire, a background demographic questionnaire and a child health questionnaire. Mothers of children with T1D also completed a questionnaire relating to diabetes management.

Results:

Almost half of the mothers of children with T1D found it necessary to reduce their working hours or to change their workplace. This group also reported a significantly higher level of colleague support. There were no significant differences in WFC and WFF between mothers of children with T1D and controls.

Conclusions:

This study demonstrates the effect of raising a T1D child on the mother’s vocational behavior. Despite the additional burden, work is a source of enrichment for these mothers.
Evaluation and implementation of the STA R Max® hemostaseology analyzer in the central laboratory of a major hospital
Authors: Hofmann Babette , Schröder Cathleen , Geisler Niels , Stamminger Gudrun
Published: April 2018

Due to a change of provider at Zentrum für Diagnostik at Klinikum Chemnitz a comprehensive validation of the STA R Max® analyser from Stago was undertaken. Alongside intra-assay and inter-assay determinations, a broad range of comparative measurements using pooled patient plasma were also carried out against the previous routine method (BCS XP from Siemens). Results obtained from routine and emergency sample testing are presented in this publication. Good to very good results were observed which allowed for a swift switchover in systems. Furthermore, user friendliness, reagents, turnaround times (TAT) and general susceptibilities of the new system were evaluated. After various adaptations to the diagnostic process, the transition to routine operation successfully took place.
Infections after renal transplantation
Authors: Dasdelen Süha , Grebe Scott-Oliver
Published: April 2018

Renal transplantation is the treatment-of-choice for a significant number of patients with end-stage renal disease. Prophylaxis, diagnosis and treatment of infections are cornerstones in the management of transplant patients. There are a number of opportunistic and rare pathogens in the immunosuppressed transplant patient population, whose early detection is essential for an optimized and targeted treatment. As the immunosuppressive regimen is adopted after transplantation and due to a potentially delayed reactivation of latent diseases, certain infections can occur in defined time intervals following transplantation. The present review summarizes the common and some of the rare diseases caused by the broad microbiological spectrum in kidney transplant recipients and the respective therapeutic options.
Slow Oscillation in Non-Lemniscal Auditory Thalamus
Authors: He Jufang
Published: April 2018

In the present study, we investigated the oscillatory behavior of the auditory thalamic neurons throughin vivointracellular and extracellular recordings in anesthetized guinea pigs. Repeated acoustic stimulus and cortical electrical stimulation were applied to examine their modulatory effects on the thalamic oscillation. The time course of the spike frequency over each trial was obtained by summing all spikes in the onset period and/or the last time period of 100 or 200 msec in the raster display. Spectral analysis was made on the time course of the spike frequency. A slow-frequency oscillation ranging from 0.03 to 0.25 Hz (mean ± SD, 0.11 ± 0.05 Hz) was found in the medial geniculate body (MGB) together with a second rhythm of 5-10 Hz. The oscillation neurons had a mean auditory response latency of 17.3 ± 0.3 msec, which was significantly longer than that of the non-oscillation neurons in lemniscal MGB (9.0 ± 1.5 msec,p< 0.001, ANOVA) and similar to the non-oscillation neurons in the non-lemniscal MGB (17.6 ± 5.4 msec,p= 0.811). They were located in the non-lemniscal nuclei of the auditory thalamus. Cortical stimulation altered the thalamic oscillation, leading to termination of the oscillation or to acceleration of the rhythm of the oscillation (the average rhythm changed from 0.07 ± 0.03 to 0.11 ± 0.04 Hz,n= 8,p= 0.066,ttest). Acoustic stimulation triggered a more regular rhythm in the oscillation neurons. The present results suggest that only the non-lemniscal auditory thalamus is involved in the slow thalamocortical oscillation. The auditory cortex may control the oscillation of the auditory thalamic neurons.
Context-Dependent Neuronal Activity in the Lateral Amygdala Represents Fear Memories after Extinction
Authors: Hobin Jennifer A. , Goosens Ki A. , Maren Stephen
Published: April 2018

The context in which fear memories are extinguished has important implications for treating human fear and anxiety disorders. Extinction of Pavlovian fear conditioning is context specific; after extinction, fear responses are reduced only in the extinction context and remain elevated in every other context. Contextual modulation of spike firing in the amygdala is a putative mechanism for the context-specific expression of extinguished fear. To test this possibility, we conditioned rats to fear two auditory conditional stimuli (CSs) and then extinguished each CS in separate and distinct contexts. Thereafter, single-unit activity in the lateral nucleus of the amygdala (LA) and freezing behavior were recorded during tests in which each CS was presented in each extinction context. Hence, each CS was tested in its own extinction context and in the context of the other CS. Conditional freezing was context dependent; fear to an extinguished CS was low in its own extinction context and high in the other test context. Similarly, the majority of LA neurons exhibited context-dependent spike firing; short-latency spike firing was greater to both CSs when they were presented outside of their own extinction context. In contrast, behavioral and neuronal responses to either non-extinguished CSs or habituated auditory stimuli were not contextually modulated. Context-dependent neuronal activity in the LA may be an important mechanism for disambiguating the meaning of fear signals, thereby enabling appropriate behavioral responses to such stimuli.
40 years of bovine IVF in the new genomic selection context
Authors: Sirard Marc-André
Published: April 2018

The development of a complex technology such as in vitro fertilization (IVF) requires years of experimentation, sometimes comparing several species to learn how to create the right in vitro environment for oocytes, spermatozoa and early embryos. At the same time, individual species characteristics such as gamete physiology and gamete interaction are recently evolved traits and must be analysed within the context of each species. In the last 40 years since the birth of Louise Brown, IVF techniques progressed and are now used in multiple domestic and non-domestic animal species around the world. This does not mean that the technology is completely matured or satisfactory; a number of problems remain to be solved and several procedures still need to be optimized. The development of IVF in cattle is particularly interesting since agriculture practices permitted the commercial development of the procedure and it is now used at a scale comparable to human IVF (millions of newborns). The genomic selection of young animals or even embryos combined with sexing and freezing technologies is driving a new era of IVF in the dairy sector. The time has come for a retrospective analysis of the success and pitfalls of the last 40 years of bovine IVF and for the description of the challenges to overcome in the years to come.