bluuebunny/crossref_metadata_2025 huggingface dataset:
Drill‐related root injury caused by intraoperative intermaxillary fixation: an analysis of 1067 screw applications
Authors: Hartwig Stefan , Boettner Andreas , Doll Christian , Voss Jan O. , Hertel Moritz , Preissner Saskia , Raguse Jan D.
Published: September 2016

Background/Aims

Intermaxillary fixation is a standard procedure for the treatment of mandibular fractures or in orthognathic surgery. Predrilling for screws poses the risk of accidental tooth root injury, potentially leading to further pathological processes. Limited evidence about accidental tooth injury during intermaxillary fixation is available due to heterogenous study designs. The aim of this study was to evaluate the risk of root trauma using predrilled transgingival fixation screws and the clinical consequences for the affected teeth.

Materials and Methods

In this retrospective study, the data of open reduction and internal fixation surgery files with intraoperative application of predrilled intermaxillary fixation screws were analysed. The postoperative radiographic images were evaluated for the occurrence of tooth root injury. Patients diagnosed with root injury were clinically followed up with respect to the dental health for the affected teeth.

Results

A total of 133 radiologically diagnosed tooth root injuries were recorded (12.5% of screws). The median follow‐up interval was 16 months (range: 3–77 months). The return rate was 49.5% for all patients. Of these, four of the injured teeth (3%) needed endodontic treatment. No toothache was reported, no tooth was lost, and no negative impact on periodontal health was clinically evident.

Conclusion

Intermaxillary fixation with predrilled transgingival screws is a safe way to manage mandibular fractures. The incidence of tooth root injury is not uncommon, but the adverse side effects are rare and the health of the affected teeth is mostly not compromised.
Diagnostic utility of invasiveEEGfor epilepsy surgery: Indications, modalities, and techniques
Authors: Jayakar Prasanna , Gotman Jean , Harvey A. Simon , Palmini André , Tassi Laura , Schomer Donald , Dubeau Francois , Bartolomei Fabrice , Yu Alice , Kršek Pavel , Velis Demetrios , Kahane Philippe
Published: September 2016

Many patients with medically refractory epilepsy now undergo successful surgery based on noninvasive diagnostic information, but intracranial electroencephalography (IEEG) continues to be used as increasingly complex cases are considered surgical candidates. The indications forIEEGand the modalities employed vary across epilepsy surgical centers; each modality has its advantages and limitations.IEEGcan be performed in the same intraoperative setting, that is, intraoperative electrocorticography, or through an independent implantation procedure with chronic extraoperative recordings; the latter are not only resource intensive but also carry risk. A lack of understanding ofIEEGlimitations predisposes to data misinterpretation that can lead to denying surgery when indicated or, worse yet, incorrect resection with adverse outcomes. Given the lack of class 1 or 2 evidence onIEEG, a consensus‐based expert recommendation on the diagnostic utility ofIEEGis presented, with emphasis on the application of various modalities in specific substrates or locations, taking into account their relative efficacy, safety, ease, and incremental cost‐benefit. These recommendations aim to curtail outlying indications that risk the over‐ or underutilization ofIEEG, while retaining substantial flexibility in keeping with most standard practices at epilepsy centers and addressing some of the needs of resource‐poor regions around the world.
Neuropsychological performance and seizure control after subsequent anteromesial temporal lobe resection following selective amygdalohippocampectomy
Authors: Sauvigny Thomas , Brückner Katja , Dührsen Lasse , Heese Oliver , Westphal Manfred , Stodieck Stefan R. G. , Martens Tobias
Published: September 2016

Objective

Selective amygdalohippocampectomy (sAHE) is a well‐established treatment for temporal lobe epilepsy, commonly with favorable neuropsychological outcome. Yet, it is still unknown if subsequent resection of the anteromesial temporal lobe (AMTLR), when necessary, deteriorates neuropsychological performance in this selected group of patients. Thus, we evaluated the clinical and neuropsychological data of patients who, due to insufficient seizure control after sAHE, received a subsequent ipsilateral AMTLR and compared these findings with patients who did not receive a second resection (control group).

Methods

Patients’ characteristics and neuropsychological data were assessed and analyzed in the reoperated as well as in the control group at each step of treatment. Experienced neuropsychologists conducted the standardized examination focusing on verbal, figural and working memory, speech fluency and attention. Preoperative diagnostics included further continuous video‐electroencephalography monitoring, high‐resolution magnetic resonance imaging and functional transcranial Doppler sonography.

Results

Eighty patients having received sAHE in our center from 11/2007 to 02/2013 were included in this study. Seventeen of these patients underwent subsequent AMTLR. Thirteen of these were available for follow‐up after the second surgery and twelve had a comprehensive neuropsychological testing at all three steps. Analyzing the neuropsychological data revealed no significant differences compared with controls. On the individual level, the data demonstrated that improvement in a subdomain was more frequent than decline, if the performance had already deteriorated after the first procedure. Seizure control improved significantly (p < 0.001) in all patients after subsequent AMTLR resulting in seven patients being seizure‐free at follow‐up.

Significance

Subsequent AMTLR following sAHE can be a safe procedure to improve seizure outcome in selected patients. In our series the risk for further neuropsychological deterioration after the second procedure was low. The neuropsychological performance after the sAHE can be a valuable criterion to advise patients who are eligible for a second surgery on their risk of further cognitive decline.
Complexity of hydrogeologic regime around an ancient low‐angle thrust fault revealed by multidisciplinary field study
Authors: Mundy E. M. , Dascher‐Cousineau K. , Gleeson T. , Rowe C. D. , Allen D. M.
Published: September 2016

Co‐located and integrated observation of the surface and subsurface is necessary to characterize fault zone hydrogeology. The spectacular cliff‐face exposure of the Champlain Thrust fault at Lone Rock Point, Vermont, and a nearby well‐field site provides the opportunity for co‐located structural and hydrogeologic field observations. We mapped the prominent structural features of the Champlain Thrust fault and discrete groundwater seeps in outcrop, and also drilled through the fault near the outcrop and determined aquifer parameters from aquifer pumping tests. In outcrop, the fault core thickness varies on the meter scale, splays out into multiple strands, and is offset by a minor normal fault. Groundwater seeps are prevalent in the heavily fractured footwall, but limited in the fault core and hanging wall, suggesting that at the cliff face the water table is generally near the fault core and groundwater flow in the hanging wall is limited. Enrichment of more soluble minerals in cemented fault rock associated with older strands of the fault system may play an important role in localizing karst features in the hanging wall. At the well‐field site, the Champlain Thrust fault is offset significantly by a high‐angle normal fault, the water table is near the surface, and aquifer pumping tests reveal a complex hydrogeologic system, with karst and steep fractures as strong hydraulic conduits in the hanging wall and fault core. The most salient features of the fault zone hydrogeology in the surface and subsurface data are different, but can be integrated into a preliminary conceptual model. Together, the surface and subsurface methods underscore and emphasize the complexity and heterogeneity of the hydrogeology of this low‐angle sedimentary fault.
Effects of seasonality and a daily photo‐protection upon some facial signs of Chinese women
Authors: Flament F. , Qiu H.
Published: September 2016

Objectives

These were two‐fold: (i) to record through standardized pictures, the possible changes in 31 facial signs induced, in a 6‐month period, by the periodical shift from winter to summer in a group of 43 Chinese women and (ii) to appraise the preventive effects of a strong photo‐protective product, daily applied to the faces of an additional group (N = 40) of women of same age‐range and presenting same severities of facial signs in winter.

Methods

Facial signs (structural and pigmentation‐related) were scored in blind by a panel of 12 experts from photographs taken under standard conditions. Scorings were performed under specific scales as established by a previously published referential Skin Aging Atlas, Volume 2, Asian Type.

Results

A significant seasonal impact was found for more than 60% of facial signs, that is presenting a higher severity in summer in the unprotected group. Some changes are of a low or subtle extent, whereas some others show significant amplitudes. The latter comprise eight signs, among the 31, that became, far above scoring threshold, indeed affected during this 6‐month period. The observed changes in six of these eight signs, in majority related to pigmentation, appeared efficiently alleviated in the photo‐protected group.

Conclusion

The shift from winter to summer exposure is confirmed in altering some facial pigmented signs among Chinese women. Such changes appear much alleviated by a daily strong photo‐protective regimen.
Stress Relaxation and Refractive Index Change of As2S3 in Compression Molding
Authors: Zhou Jian , Yu Jianfeng , Lee L. James , Shen Lianguan , Yi Allen
Published: September 2016

As2S3 is one of the chalcogenide glasses that have attracted increasing interests for compression molding applications. This article aimed to evaluate the stress relaxation behavior of As2S3 above its glass transition temperature and calculate its refractive index change during cooling. First, creep tests were conducted with cylinder glass specimens at three different temperatures, in order to deduce the shear stress relaxation function by using the relationship with creep compliance function. In addition, the shift factor for thermo‐rheological simplicity using Williams–Landel–Ferry equation was obtained. Then, finite element simulation was implemented to verify the calculated shear stress relaxation function. The acquired shear stress relaxation function needs to be modified to compensate the influence of friction on the thickness change in the experiments, so that the simulation results using the modified shear stress relaxation would match the experiments better. Finally, the refractive index changes of As2S3 at different cooling rates were modeled by using the Tool–Narayanaswamy–Moynihan (TNM) model for structural relaxation behavior. It is confirmed that the slower the cooling rate is, the less the refractive index drop will be. It was also demonstrated that the refractive index drop is strictly dependent on the cooling rate logarithmically by using TNM model. In summary, the results presented in this article can provide reliable references for viscoelastic characterization of As2S3 glass, crucial for compression molding or similar applications.
Clinical pharmacists' opportunities to reduce inappropriate prescription of QT-prolonging medications: calls to action
Authors: Dhanani Trusha C , Mantovani Emily H , Turner J Rick
Published: September 2016

All biologically active agents carry the potential to lead to adverse reactions in certain individuals, including serious cardiac adverse reactions. Since 2005, there has been an international regulatory landscape governing the investigation of a new drug's propensity to lead to the polymorphic ventricular tachycardia Torsades de Pointes (Torsades), a rare but potentially fatal occurrence. When a regulatory agency considers it appropriate, warning information is placed in a medicine's patient information leaflet (label) concerning drug-induced QT interval prolongation, a phenomenon associated with Torsades. In busy hospital settings, however, prescribers, including cardiologists, make injudicious prescribing decisions that put patients at risk. The science of cardiac safety, including the clinical trials that generate the information about QT prolongation in patient information leaflets, is frequently not part of the curriculum at Schools of Pharmacy. Given that medication-induced cardiotoxicity is extremely serious, we advocate that schools integrate the science of cardiac safety into existing therapeutics/therapeutic medication monitoring courses. Given their expert knowledge of pharmacology, pharmacists working as part of a hospital's clinical team would then be even better placed to review prescribing decisions concerning medications that prolong the QT interval, and alert prescribers in cases where reassessing their decisions seems prudent. National pharmacy societies or other pertinent professional societies could create practice guidelines to support graduates once employed as clinical pharmacists. Clinical pharmacists are well placed to be influential arbiters of safer prescribing decisions. Cardiac safety education during their pharmacy training and practice guideline support from professional societies during their careers can optimize this role.
It’s not what you do it’s the way that it’s measured: quality assessment of minor ailment management in community pharmacies
Authors: Inch Jackie , Porteous Terry , Maskrey Vivienne , Blyth Annie , Burr Jackie , Cleland Jennifer , Wright David J , Holland Richard , Bond Christine M , Watson Margaret C
Published: September 2016

Background

Effective management of minor ailments in community pharmacies could reduce the burden on alternative high-cost services (general practices, Emergency Departments). Evidence is needed regarding the appropriateness of management of these conditions in community pharmacies.

Objective

To explore the appropriateness of minor ailment management in community pharmacies.

Setting

Prospective, observational study of simulated patient (SP) visits to community pharmacies in Grampian (Scotland) and East Anglia (England).

Method

Eighteen pharmacies (nine per centre) were recruited within a 25-mile radius of Aberdeen or Norwich. Consultations for four minor ailments were evaluated: back pain; vomiting/diarrhoea; sore throat; and eye discomfort. Each pharmacy received one SP visit per ailment (four visits/pharmacy; 72 visits total). Visits were audio-recorded and SPs completed a data collection form immediately after each visit.

Primary Outcome Measure

Each SP consultation was assessed for appropriateness against product licence, practice guidelines and study-specific consensus standards developed by a multi-disciplinary consensus panel.

Results

Evaluable data were available for 68/72 (94.4%) visits. Most (96%) visits resulted in the sale of a product; advice alone was the outcome of three visits. All product sales complied with the product licence, 52 (76%) visits complied with practice guidelines and seven visits achieved a ‘basic’ standard according to the consensus standard.

Conclusion

Appropriateness of care varied according to the standard used. Pharmacy-specific quality standards are needed which are realistic and relevant to the pharmacy context and which reflect legal and clinical guidelines to promote the safe and effective management of minor ailments in this setting.
Evaluation of brand names of medicines: linguistic and format issues
Authors: Pires Carla , Cavaco Afonso , Vigário Marina
Published: September 2016

Objectives

Focusing on the shape of brand names of medicines in the Portuguese market, the aims of this study were: to evaluate the number of words, syllables and letters, to identify the combinations of letters that are not found in Portuguese words and to characterize the use of capital letters in these names.

Methods

A descriptive study was conducted using 474 randomized brand names of medicines, approximately 25% of all over-the-counter and prescribed medicines available in Portugal. The number of words, syllables and letters was automatically determined with a dedicated software. The combinations of letters that are not found in Portuguese and the use of capital letters were quantified through visual inspection.

Key Findings

The 474 names were formed by 615 words. 74.5% of the words comprised three or less syllables, the most common number of syllables in the Portuguese words (91%). As recommended, 81% (n = 385) names were formed by just one word, 59.2% (n = 281) of the names were composed of 5–8 letters, and 83.1% (n = 394) presented the first letter in capitals or all letters in upper case. Contrary to recommendations, 22% of the names comprised combinations of letters that are not commonly found in Portuguese words.

Conclusions

Given the current readability requirements, some of the Portuguese brand names of medicines should be reduced in length, adapted to the native language or capitalized. Equivalent studies are recommended in other European countries, because many brands of medicines are internationally marketed, while their development and approval should be beyond general marketing rules.
The relationship between employer‐provided training and the retention of older workers: Evidence from Germany
Authors: BERG Peter B. , HAMMAN Mary K. , PISZCZEK Matthew M. , RUHM Christopher J.
Published: September 2016

A substantial portion of Germany's workforce will soon retire, making it difficult for businesses to meet their human capital needs; training older workers may help to manage this demographic transition. The authors therefore examine the relationships between employer‐provided training programmes, wages and retirement among older workers. They find that when establishments offer special training programmes targeted at these workers, women – especially low‐paid women – are less likely to retire, possibly because of consequent wage growth. Their results suggest that such targeted training can indeed play an important role in retaining low‐wage older women and advancing their careers.
Psychological responses, coping and supporting needs of healthcare professionals as second victims
Authors: Chan S.T. , Khong P.C.B. , Wang W.
Published: September 2016

Aim

To provide an overview of healthcare professionals' psychological responses, coping strategies and supporting needs in the aftermath of an adverse event, thus informing health policy implications and future research in this aspect.

Background

Trauma experienced by healthcare professionals as second victims potentially provokes intense emotional distress, detrimental professional outcomes and imposes harsh long‐term effects.

Methods

A systematic literature review was performed to synthesize the experiences and needs of second victims who are healthcare professionals being traumatized by an unanticipated adverse event, medical error or patient‐related injury. CINAHL, Embase, PsycINFO, PubMed and Scopus databases were searched for relevant articles published in English from January 2000 to October 2015.

Results

Data extraction was performed for the 30 studies selected. Second victims experienced enduring intense negative psychological responses. They adopted multiple coping mechanisms and desired emotional and informational support.

Conclusion

Second victims experience substantial psychological impact which can be mitigated with supportive environments. It is imperative that subsequent research consider the potential factors affecting second victims' emotional experience, efficacy of coping strategies in facilitating recovery and obtain a comprehensive understanding of second victims' experience.

Implications for nursing and health policy

Nursing and health management's role in establishing organizational support structures is necessary to meet second victims' needs. This existing knowledge is significant to guide policy makers in developing a holistic and effective second victim support programme.
Minimizing the total waiting time of intermediate products in a manufacturing process
Authors: de Matta Renato
Published: September 2016

A mixed model production plan may use a schedule that will consecutively produce a small batch of each product model on a production line. However, it may be necessary to deviate from this schedule and produce the models in larger batches at a manufacturing cell in the production line if the manufacturing cell cannot support many setups. A potential problem with large batches is that products that are produced early must wait for its turn at the next step of the production process. When additional operations are performed on products that wait in order to restore its quality, it is imperative to schedule production such that the total time products wait is minimized. We model the problem as scheduling jobs on a single machine with setups and deadlines such that the total waiting time is minimized. We develop a tabu search based heuristic and branch‐and‐bound algorithm to solve the model. Results show that the heuristic solution to 30‐product–3‐product model problems is within 3% of its optimal solution.
Theory‐based self‐management educational interventions on patients with type 2 diabetes: a systematic review and meta‐analysis of randomized controlled trials
Authors: Zhao Fang‐Fang , Suhonen Riitta , Koskinen Sanna , Leino‐Kilpi Helena
Published: September 2016

Aim

To synthesize the effects of theory‐based self‐management educational interventions on patients with type 2 diabetes (T2DM) in randomized controlled trials.

Background

Type 2 diabetes is a common chronic disease causing complications that put a heavy burden on society and reduce the quality of life of patients. Good self‐management of diabetes can prevent complications and improve the quality of life of T2DM patients.

Design

Systematic review with meta‐analysis of randomized controlled trials following Cochrane methods.

Data resources

A literature search was carried out in the MEDLINE, EMBASE, CINAHL, PSYCINFO, and Web of Science databases (1980–April 2015).

Review methods

The risk of bias of these eligible studies was assessed independently by two authors using the Cochrane Collaboration's tool. The Publication bias of the main outcomes was examined. Statistical heterogeneity and random‐effects model were used for meta‐analysis.

Results

Twenty studies with 5802 participants met the inclusion criteria. The interventions in the studies were based on one or more theories which mostly belong to mid‐range theories. The pooled main outcomes by random‐effects model showed significant improvements in HbA1c, self‐efficacy, and diabetes knowledge, but not in BMI. As for quality of life, no conclusions can be drawn as the pooled outcome became the opposite with reduced heterogeneity after one study was excluded. No significant publication bias was found in the main outcomes.

Conclusion

To get theory‐based interventions to produce more effects, the role of patients should be more involved and stronger and the education team should be trained beyond the primary preparation for the self‐management education program.
The potential for nurses to contribute to and lead improvement science in health care
Authors: Flynn Rachel , Scott Shannon D. , Rotter Thomas , Hartfield Dawn
Published: September 2016

Aim

A discussion of how nurses can contribute to and lead improvement science activities in health care.

Background

Quality failures in health care have led to the urgent need for healthcare quality improvement. However, commonly quality improvement interventions proceed to practice implementation without rigorous methods or sufficient empirical evidence. This lack of evidence for quality improvement has led to the development of improvement science, which embodies quality improvement research and quality improvement practice. This paper discusses how the discipline of nursing and the nursing profession possesses many strengths that enable nurses to lead and to play an integral role in improvement science activities. However, we also discuss that there are insufficiencies in nursing education that require attention for nurses to truly contribute to and lead improvement science in health care.

Design

Discussion paper.

Data sources

This paper builds on a collection of our previous work, a 12‐month scoping review (March 2013–March 2014), baseline study on a quality improvement management system (Lean), interviews with nurses on quality improvement implementation and supporting literature.

Implications for nursing

This paper highlights how nurses have the philosophical, theoretical, political and ethical positioning to contribute to and lead improvement science activities. However up to now, the potential for nurses to lead improvement science activities has not been fully used.

Conclusion

We suggest that one starting point is to include improvement science in nursing education curricula. Specifically, there needs to be increased focus on the nursing roles and skills needed to contribute to and lead healthcare improvement science activities.
Biological embedding: evaluation and analysis of an emerging concept for nursing scholarship
Authors: Nist Marliese Dion
Published: September 2016

Aim

The purpose of this paper was to report the analysis of the concept of biological embedding.

Background

Research that incorporates a life course perspective is becoming increasingly prominent in the health sciences. Biological embedding is a central concept in life course theory and may be important for nursing theories to enhance our understanding of health states in individuals and populations. Before the concept of biological embedding can be used in nursing theory and research, an analysis of the concept is required to advance it towards full maturity.

Design

Concept analysis.

Data sources

PubMed, CINAHL and PsycINFO were searched for publications using the term ‘biological embedding’ or ‘biological programming’ and published through 2015.

Methods

An evaluation of the concept was first conducted to determine the concept's level of maturity and was followed by a concept comparison, using the methods for concept evaluation and comparison described by Morse.

Results

A consistent definition of biological embedding – the process by which early life experience alters biological processes to affect adult health outcomes – was found throughout the literature. The concept has been used in several theories that describe the mechanisms through which biological embedding might occur and highlight its role in the development of health trajectories. Biological embedding is a partially mature concept, requiring concept comparison with an overlapping concept – biological programming – to more clearly establish the boundaries of biological embedding.

Conclusions

Biological embedding has significant potential for theory development and application in multiple academic disciplines, including nursing.
Urinary incontinence and mortality among older adults residing in care homes
Authors: Damián Javier , Pastor‐Barriuso Roberto , García López Fernando J. , de Pedro‐Cuesta Jesús
Published: September 2016

Aim

To assess the association between baseline urinary incontinence and long‐term, all‐cause mortality.

Background

Urinary incontinence is a common disorder among older institutionalised adults, with important consequences for morbidity and quality of life. Moreover, while it is a consistent mortality marker, the extent to which this association might be causal remains controversial.

Design

A cohort study.

Methods

We conducted a mortality follow‐up study on a cohort of 675 nursing‐home residents in the city of Madrid (Spain), from their 1998–1999 baseline interviews to September 2013. Study subjects or their caregivers were asked whether the resident had experienced any involuntary leakage of urine in the preceding 14 days, with subjects being subsequently defined as continent, mildly incontinent, or severely incontinent. Hazard ratios for all‐cause mortality were estimated using Cox proportional hazards models.

Results

After a 4061 person‐year follow‐up (median/maximum of 4·6/15·2 years), 576 participants had died. In fully‐adjusted models, urinary incontinence was associated with a 24 per cent increased risk of all‐cause mortality. There was a graded relationship across severity levels, with hazard ratios 7% higher for mild and 44% higher for severe incontinence as compared with the continent group. The adjusted mortality fraction attributable to urinary incontinence was 11 per cent.

Conclusion

It would appear that urinary incontinence is not only a marker but also a real determinant of survival in the institutionalized population. This finding, which seems plausible in a population of frail older adults, warrants further research into mechanisms that could help to elucidate this hypothesis.
Genetic correlations between dressage, show jumping and studbook‐entry inspection traits in a process of specialization in Dutch Warmblood horses
Authors: Rovere G. , Ducro B.J. , van Arendonk J.A.M. , Norberg E. , Madsen P.
Published: September 2016

Sport performance in dressage and show jumping are two important traits in the breeding goals of many studbooks. To determine the optimum selection scheme for jumping and dressage, knowledge is needed on the genetic correlation between both disciplines and between traits measured early in life and performance in competition in each discipline. This study aimed to estimate genetic parameters to support decision‐making on specialization of breeding horses for dressage and show jumping in Dutch warmblood horses. Genetic correlations between performance of horses in dressage and show jumping were estimated as well as the genetic correlation between traits recorded during studbook‐entry inspections and performance in dressage and show jumping competitions. The information on competition comprised the performance of 82 694 horses in dressage and 62 072 horses in show jumping, recorded in the period 1993–2012. For 26 056 horses, information was available for both disciplines. The information on traits recorded at studbook‐entry inspections comprised 62 628 horses, recorded in the period 1992–2013. Genetic parameters were estimated from the whole dataset and from a subset without horses recorded in both disciplines. Additionally, the genetic parameters were estimated in three different time periods defined by horses' birth year. The genetic correlation between dressage and show jumping in the whole dataset was −0.23, and it was −0.03 when it was estimated from horses recorded in only one discipline. The genetic correlation between dressage and show jumping was more negative in the most recent time period in all the cases. The more negative correlation between disciplines in more recent time periods was not reflected in changes in the correlations between competitions traits and the traits recorded in the studbook‐first inspection. These results suggest that a breeding programme under specialization might be most effective defining two separate aggregate breeding goals for each of the disciplines.
Survey of Emergency Physician Approaches to Management of Asymptomatic Hypertension
Authors: Brody Aaron , Twiner Michael , Kumar Arun , Goldberg Elizabeth , McNaughton Candace , Souffront Kimberly , Millis Scott , Levy Phillip D.
Published: September 2016

Uncontrolled hypertension (HTN) is commonly encountered in emergency medicine practice, but the optimal approach to management has not been delineated. The objective of this study was to define emergency physician (EP) approaches to management of asymptomatic HTN in various clinical scenarios and assess adherence to the American College of Emergency Physician clinical policies, utilizing an online survey of EPs. A total of 1200 surveys were distributed by e‐mail with completion by 199 participants. The variables associated with a decision to prescribe oral antihypertensive medications were a history of HTN and referral from primary care. Acute blood pressure (BP) reduction using intravenous antihypertensive medications was also more likely with the latter and BP >180/120 mm Hg. Logistic regression revealed association of EP female sex, fewer years in practice, and a high‐volume practice setting with guideline‐concordant therapy. Wide variability exists in EP approaches to patients with asymptomatic HTN. Treatment decisions were impacted by patient history of chronic HTN, referral from primary care providers, and magnitude of BP elevation.
Genistein suppresses leptin‐induced proliferation and migration of vascular smooth muscle cells and neointima formation
Authors: Tsai Yung‐Chieh , Leu Sy‐Ying , Peng Yi‐Jen , Lee Yen‐Mei , Hsu Chih‐Hsiung , Chou Shen‐Chieh , Yen Mao‐Hsiung , Cheng Pao‐Yun
Published: September 2016

Obesity is a strong risk factor for the development of cardiovascular diseases and is associated with a marked increase in circulating leptin concentration. Leptin is a peptide hormone mainly produced by adipose tissue and is regulated by energy level, hormones and various inflammatory mediators. Genistein is an isoflavone that exhibits diverse health‐promoting effects. Here, we investigated whether genistein suppressed the atherogenic effect induced by leptin. The A10 cells were treated with leptin and/or genistein, and then the cell proliferation and migration were analysed. The reactive oxygen species (ROS) and proteins levels were also measured, such as p44/42MAPK, cell cycle‐related protein (cyclin D1 and p21) and matrix metalloproteinase‐2 (MMP‐2). Immunohistochemistry and morphometric analysis were used for the neointima formation in a rat carotid artery injury model. Genistein (5 μM) significantly inhibited both the proliferation and migration of leptin (10 ng/ml)‐stimulated A10 cells. In accordance with these finding, genistein decreased the leptin‐stimulated ROS production and phosphorylation of the p44/42MAPK signal transduction pathway. Meanwhile, genistein reversed the leptin‐induced expression of cyclin D1, and cyclin‐dependent kinase inhibitor, p21. Genistein attenuated leptin‐induced A10 cell migration by inhibiting MMP‐2 activity. Furthermore, the leptin (0.25 mg/kg)‐augmented neointima formation in a rat carotid artery injury model was attenuated in the genistein (5 mg/kg body weight)‐treated group when compared with the balloon injury plus leptin group. Genistein was capable of suppressing the atherogenic effects of leptin in vitro and in vivo, and may be a promising candidate drug in the clinical setting.
Inhibition of cytokine response to TLR stimulation and alleviation of collagen‐induced arthritis in mice by Schistosoma japonicum peptide SJMHE1
Authors: Wang Xuefeng , Li Li , Wang Jun , Dong Liyang , Shu Yang , Liang Yong , Shi Liang , Xu Chengcheng , Zhou Yuepeng , Wang Yi , Chen Deyu , Mao Chaoming
Published: September 2016

Helminth‐derived products have recently been shown to prevent the development of inflammatory diseases in mouse models. However, most identified immunomodulators from helminthes are mixtures or macromolecules with potentially immunogenic side effects. We previously identified an immunomodulatory peptide called SJMHE1 from the HSP60 protein of Schistosoma japonicum. In this study, we assessed the ability of SJMHE1 to affect murine splenocytes and human peripheral blood mononuclear cells (PBMCs) stimulated by toll‐like receptor (TLR) ligands in vitro and its treatment effect on mice with collagen‐induced arthritis (CIA). We show that SJMHE1 not only modulates the cytokine production of murine macrophage (MΦ) and dendritic cell but also affects cytokine production upon coculturing with allogeneic CD4+ T cell. SJMHE1 potently inhibits the cytokine response to TLR ligands lipopolysaccharide (LPS), CpG oligodeoxynucleotides (CpG) or resiquimod (R848) from mouse splenocytes, and human PBMCs stimulated by LPS. Furthermore, SJMHE1 suppressed clinical signs of CIA in mice and blocked joint erosion progression. This effect was mediated by downregulation of key cytokines involved in the pathogenesis of CIA, such as interferon‐γ (IFN‐γ), tumour necrosis factor‐α (TNF‐α), interleukin (IL)‐6, IL‐17, and IL‐22 and up‐regulation of the inhibitory cytokine IL‐10, Tgf‐β1 mRNA, and CD4+CD25+Foxp3+ Tregs. This study provides new evidence that the peptide from S. japonicum, which is the ‘safe’ selective generation of small molecule peptide that has evolved during host–parasite interactions, is of great value in the search for novel anti‐inflammatory agents and therapeutic targets for autoimmune diseases.
Trojan Horses in EU Foreign Policy
Authors: Orenstein Mitchell A. , Kelemen R. Daniel
Published: September 2016

Why has the European Union been able to craft a unified sanctions policy against Russia but failed to rein in Russia's ‘Trojan horses’ within the EU that pursue pro‐Putin foreign policies? We argue that the EU suffers from a specific type of disaggregation in its foreign and security policy. While the EU's Common Foreign and Security Policy has increased its capacities over time, the EU still lacks the power to prevent Member States from pursuing their own independent policies. In the face of the Ukraine crisis, for instance, the EU marshaled a surprisingly strong sanctions regime, but could not prevent Member States from pursuing divergent pro‐Russia policies, such as signing new energy deals or granting port access for Russian naval forces. As EU foreign and security powers grow, foreign powers face increasing incentives to cultivate Trojan horses among the EU Member States.
Reduced tract integrity of the model for social communication is a neural substrate of social communication deficits in autism spectrum disorder
Authors: Lo Yu‐Chun , Chen Yu‐Jen , Hsu Yung‐Chin , Tseng Wen‐Yih Isaac , Gau Susan Shur‐Fen
Published: September 2016

Background

Autism spectrum disorder (ASD) is a neurodevelopmental disorder with social communication deficits as one of the core symptoms. Recently, a five‐level model for the social communication has been proposed in which white matter tracts corresponding to each level of the model are identified. Given that the model for social communication subserves social language functions, we hypothesized that the tract integrity of the model for social communication may be reduced in ASD, and the reduction may be related to social communication deficits.

Methods

Sixty‐two right‐handed boys with ASD and 55 typically developing (TD) boys received clinical evaluations, intelligence tests, the Social Communication Questionnaire (SCQ), and MRI scans. Generalized fractional anisotropy (GFA) was measured by diffusion spectrum imaging to indicate the microstructural integrity of the tracts for each level of the social communication model. Group difference in the tract integrity and its relationship with the SCQ subscales of social communication and social interaction were investigated.

Results

We found that the GFA values of the superior longitudinal fasciculus III (SLF III, level 1) and the frontal aslant tracts (FAT, level 2) were decreased in ASD compared to TD. Moreover, the GFA values of the SLF III and the FAT were associated with the social interaction subscale in ASD.

Conclusions

The tract integrity of the model for social communication is reduced in ASD, and the reduction is associated with impaired social interaction. Our results support that reduced tract integrity of the model for social communication might be a neural substrate of social communication deficits in ASD.
Parenting and cognitive and psychomotor delay due to small‐for‐gestational‐age birth
Authors: Li Xiuhong , Eiden Rina D. , Epstein Leonard H. , Shenassa Edmond D. , Xie Chuanbo , Wen Xiaozhong
Published: September 2016

Background

To examine whether different dimensions of parenting at different ages help small‐for‐gestational‐age (SGA) children ‘catch‐up’ the normal children in cognition and psychomotor.

Methods

We analyzed data of 800 children born SGA and 3,000 children born appropriate‐for‐gestational‐age (AGA) from the Early Childhood Longitudinal Study‐Birth cohort. The Two Bag Task was used to measure 2‐year or 4‐year parenting dimensions. Children's reading, math, gross motor, and fine motor scores were assessed at 5 years. Multivariable linear regression models were fitted to test the interactions between SGA and 2‐year or 4‐year parenting dimensions on 5‐year cognitive and psychomotor outcomes (dependent variables).

Results

There were significant interactions between SGA and early parenting on 5‐year reading, math, and fine motor scores. The gap between SGA and AGA children in 5‐year fine motor score was attenuated to null [−0.25 (95% confidence interval, −0.41, −0.09) vs. 0.03 (−0.13, 0.20)] when 2‐year parental sensitivity score increased from 1 standard deviation (SD) below mean (Mean − SD) to 1 SD above mean (Mean + SD). The gap between SGA and AGA children in 5‐year fine motor [−0.28 (−0.44, −0.13) vs. 0.06 (−0.09, 0.22)] and math [−1.32 (−2.27, −0.37) vs. 0.20 (−0.77, 1.17)] scores was also attenuated to null when 4‐year parental emotional support score increased from Mean − SD to Mean + SD. In contrast, the gap between SGA and AGA children in 5‐year reading score increased from 0.49 (−0.90, 1.88) to −1.31 (−2.55, −0.07) when 4‐year parental intrusiveness score increased from Mean − SD to Mean + SD. Similarly, the gap between SGA and AGA children in fine motor score increased with 4‐year parental negative regard from 0.02 (−0.14, 0.18) to −0.23 (−0.38, −0.08).

Conclusions

Early high‐quality parenting may buffer some adversity in long‐term reading, math, and fine motor skills related to SGA birth, whereas low‐quality parenting can amplify the adversity.
Reduction of Escherichia coli O157:H7 population on baby spinach leaves by liquid sanitizers
Authors: Pyatkovskyy Taras , Shynkaryk Mykola , Yousef Ahmed , Sastry Sudhir K.
Published: September 2016

The effectiveness of various liquid sanitizers and methods of application against Escherichia coli on baby spinach was investigated. Inoculated spinach was treated with (i) Pro‐San L (commercially prepared solution containing 0.66% citric acid, 0.036% sodium dodecyl sulfate (SDS); (ii) chlorine solution (200 ppm), alone or with addition of 0.036% SDS; and (iii) aqueous solution of 0.66% levulinic acid with 0.036% SDS. Population reduction in response to these treatments ranged between 2.1 and 2.8 log CFU/g. No significant difference (p > .05) was found among tested sanitizers in microbial count reduction. Spraying, dipping, and “dry” vacuum impregnation methods of Pro‐San L application were compared. Dipping was the most effective in reducing E. coli O157:H7 population (4.4 log CFU/g reduction). Dry vacuum impregnation was less effective (3.3 log CFU/g reduction) and caused damage to the produce. The effectiveness of spray Pro‐San L application and holding for prolonged time (up to 3 days) was also evaluated. However, increasing time of exposure to organic acid sanitizer did not increase sanitizing effectiveness and led to progressive damage of spinach leaves.
Application of multicriteria decision technique to determine optimum sodium alginate concentration for microencapsulation of Lactobacillus casei Shirota by extrusion and emulsification
Authors: Gul Osman , Dervisoglu Muhammet
Published: September 2016

The aim of this study was to evaluate the effect of sodium alginate concentration on microencapsulation of probiotic Lactobacillus casei Shirota (LCS) by extrusion and emulsification methods and determine the optimum alginate concentration using Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) approach. Determined morphology and size of the capsules, encapsulation efficiency, release of entrapped cells, and survivability of entrapped cell exposed heat treatment, simulated gastric and intestinal juice conditions were significantly varied depending on encapsulation method and alginate concentrations (p < .05). The beads obtained with extrusion more protected the probiotic cells than beads obtained with emulsification. TOPSIS was performed to determine optimum alginate concentration regarding capsule size, encapsulation efficiency, release rate of entrapped cells, and survivability of entrapped cell exposed heat treatment, simulated gastric and intestinal juice conditions. According to TOPSIS, 2% and 2.5% of alginate may be effectively used to microencapsulation of LCS for extrusion and emulsification methods, respectively.

Practical applications

Microencapsulation is a technology that is widely used for enclosed valuable core material in very small capsules with coating materials. The stability of microencapsulated probiotic bacteria is affected by several factors such as coating material and its concentration, microencapsulation methods, etc. The results of this work present the optimum sodium alginate concentration using TOPSIS for microencapsulation of Lactobacillus casei Shirota by extrusion and emulsification methods and present the ideal microencapsulation method.
Implementing a Dynamic Life Cycle Assessment Methodology with a Case Study on Domestic Hot Water Production
Authors: Beloin‐Saint‐Pierre Didier , Levasseur Annie , Margni Manuele , Blanc Isabelle
Published: September 2016

This work contributes to the development of a dynamic life cycle assessment (DLCA) methodology by providing a methodological framework to link a dynamic system modeling method with a time‐dependent impact assessment method. This three‐step methodology starts by modeling systems where flows are described by temporal distributions. Then, a temporally differentiated life cycle inventory (TDLCI) is calculated to present the environmental exchanges through time. Finally, time‐dependent characterization factors are applied to the TDLCI to evaluate climate‐change impacts through time. The implementation of this new framework is illustrated by comparing systems producing domestic hot water (DHW) over an 80‐year period. Electricity is used to heat water in the first system, whereas the second system uses a combination of solar energy and gas to heat an equivalent amount of DHW at the same temperature. This comparison shows that using a different temporal precision (i.e., monthly vs. annual) to describe process flows can reverse conclusions regarding which case has the best environmental performance. Results also show that considering the timing of greenhouse gas (GHG) emissions reduces the absolute values of carbon footprint in the short‐term when compared with results from the static life cycle assessment. This pragmatic framework for the implementation of time in DLCA studies is proposed to help in the development of the methodology. It is not yet a fully operational scheme, and efforts are still required before DLCA can become state of practice.