bluuebunny/crossref_metadata_2025 huggingface dataset:
Contextual Breathing
Authors: JEFFRIES APRIL
Published: January 2019

Title: Contextual Breathing – The importance of opening in an increasingly closed world. Context cannot be ignored. The ability to pull back, observe and listen deeply balanced with internal analysis and reflection has significant impact on our individual and societal health. Myopic views that ignore or distort what is happening around us have resulted in a social, cultural and political bipolar effect that occurs within a narrow spectrum of isolation. Extreme swings from close‐minded tribes to secluded self dialogue, wreak havoc on our broader needs for transcendence and compassion.

A study of middle‐class moms in America, found a pull toward insular communities in unexpected places. Hostile or challenging political arguments were increasingly infiltrating conversations in venues ranging from Facebook to book club. Emotional eruptions in previously “safe spaces” caused retreats to like‐minded groups. Women who may have otherwise enjoyed open curiosity or stimulating debate, in these situations, were ill‐equipped to handle feelings of rejection and separation. Tribal political behavior was a result of stress and a deep sense of loss.

The rhythmic balance of convergence and divergence is as necessary as breathing, to fairly assess external realities and form rational individual opinions. Ethnography is a prime opportunity to build this context. Revealing non‐judgmental stories of those unlike ourselves, we draw back from the myopic focus, which initiates a return to the center with deeper understanding and empathy.
Helping People Heal
Authors: PARK REBEKAH , PRESTON EMILY
Published: January 2019

A documentary‐style short film exploring how people in the United States heal themselves once they leave the doctor's office. This film is based on in‐depth field research and illustrates how healing depends on the alignment between what doctors expect from patients, and what people actually do in their everyday lives. Exploring and entering the lives of three individuals, Helping People Heal reveals the ways that people put their recommended treatments into practice—and why these personalized applications achieve better health outcomes beyond simply doing what the doctor ordered.
Seeing Double
Authors: MENDONCA KARL
Published: January 2019

Dekho, Purani Dilli (Seeing Double) is an essayistic film that illustrates the experiential and contextual nature of ethnography, while reflecting on cultural predispositions that often frame ways of seeing and knowing. The film was produced as part of a design conference in Delhi, where conversations centered on ‘modernizing’ traditional modes of production, distribution and the object itself. My goal was to question a peculiar narrative of modernity and development that positioned design and digital technology as an answer to longstanding social, cultural and political relations. Working in the tradition of structuralist film making, the film is composed as a series of encounters in Old Delhi, where object and people play the role of interlocutors that prompt a turn to history and a deeper engagement with place. As an evidentiary form, the film is an inversion of the typical ‘deliverable’ serving as a critique of accelerated design culture and a meditation on the critical lens ethnography can provide.
Multiple Factors Including Infections and Antibiotics Affecting New‐Onset Epilepsy in Hemodialysis Patients
Authors: Zhang Peipei , Lu Keda , Xia Hong
Published: January 2019

This study investigates some clinical characteristics of maintenance hemodialysis patients with new‐onset epilepsy. Thirty‐five patients with new‐onset epilepsy who underwent maintenance hemodialysis were selected for study. Sixty patients undergoing routine hemodialysis were selected as the control group. We evaluated and compared the general characteristics, clinical features, and prognosis of patients in both groups. Investigation of the etiology of the 35 cases of new‐onset epilepsy identified 17 cases of metabolic encephalopathy, six cases of viral encephalitis, five cases of cerebral infarction, five cases of cerebral hemorrhage, and two cases of purulent meningitis. Among the 35 patients, 19 experienced improvement in their condition and 16 patients died. The overall mortality rate was 45.71%. There were statistically significant differences between the epilepsy group and control group in gender, incidence of fever, application of antibiotic treatment, levels of serum albumin, and the clinical course of hypertension (P < 0.05). Maintenance hemodialysis patients who experience new‐onset epilepsy are often critically ill with rapid progression of disease and a high mortality rate. Female dialysis patients complicated with infections, antibiotics use and hypoalbuminemia are more likely to develop epilepsy.
From Economics to Political Economy: Contradictions, Challenge, and Change
Authors: Stilwell Frank
Published: January 2019

The nature of the challenge to mainstream economics needs to be carefully considered. This article presents an overview of the challenge, emphasizing that it is not just a matter of heterodox economists developing non‐neoclassical economic theories. The embrace of a pluralist method and pedagogy is equally significant. The development of a transdisciplinary approach adds further to the breadth of the challenge. Weaving these elements together as political economy provides an alternative paradigm to mainstream economics. Extending its influence requires focus on adult education, the media, and public policy, as well as sustained efforts within universities.
Coincidence of Andersen–Tawil syndrome and Marfan syndrome: A case report
Authors: Krych Michalina , Ponińska Joanna , Bilińska Zofia T. , Płoski Rafał , Biernacka Elżbieta K.
Published: January 2019

We report on a 44‐year‐old woman with coincidence of two genetic disorders: Andersen–Tawil syndrome and Marfan syndrome. In both, life‐threatening arrhythmias could occur. A 44‐year‐old woman presented acute ascending aortic dissection with aortic arch involvement and chronic thoracic descending and abdominal aortic dissection. Clinical and genetic examination confirmed Marfan syndrome (MFS) diagnosis. Due to repolarization disorder in ECG and premature ventricular contractions in Holter ECG, the sequencing data were analyzed again and mutation in KCNJ2 gene was identified. The case showed that coincidence of Andersen–Tawil syndrome (ATS) and MFS did not provoke life‐threatening arrhythmias. Complication was rather caused by expression of FBN1 mutation.
Controlling axillary intra‐aortic balloon pump inflation is a viable option for turning an acute heart failure patient into a chronic one
Authors: Barac Yaron D. , Schroder Jacob N. , Bishawi Muath , Patel Chetan B. , Milano Carmelo A. , Daneshmand Mani A.
Published: January 2019

Intra‐aortic balloon pump (IABP) is often used to support patients in decompensated heart failure. Placement of the IABP via the axillary artery facilitates long‐term support with the device and may allow for the conversion of an acute heart failure (HF) patient into a chronic HF patient using a modified weaning protocol; allowing for medical symptom management and removal of mechanical support. We will discuss strategies for supporting these complicated patients.
Mitochondrial dysfunction in Alzheimer's disease: Role in pathogenesis and novel therapeutic opportunities
Authors: Perez Ortiz Judit M. , Swerdlow Russell H.
Published: January 2019

Dysfunction of cell bioenergetics is a common feature of neurodegenerative diseases, the most common of which is Alzheimer's disease (AD). Disrupted energy utilization implicates mitochondria at its nexus. This review summarizes some of the evidence that points to faulty mitochondrial function in AD and highlights past and current therapeutic development efforts. Classical neuropathological hallmarks of disease (β‐amyloid and τ) and sporadic AD risk genes (APOE) may trigger mitochondrial disturbance, yet mitochondrial dysfunction may incite pathology. Preclinical and clinical efforts have overwhelmingly centred on the amyloid pathway, but clinical trials have yet to reveal clear‐cut benefits. AD therapies aimed at mitochondrial dysfunction are few and concentrate on reversing oxidative stress and cell death pathways. Novel research efforts aimed at boosting mitochondrial and bioenergetic function offer an alternative treatment strategy. Enhancing cell bioenergetics in preclinical models may yield widespread favourable effects that could benefit persons with AD.

Linked Articles

This article is part of a themed section on Therapeutics for Dementia and Alzheimer's Disease: New Directions for Precision Medicine. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v176.18/issuetoc
Depressive symptom‐associated IL‐1β and TNF‐α release correlates with impaired bronchodilator response and neutrophilic airway inflammation in asthma
Authors: Zhang Li , Zhang Xin , Zheng Jing , Liu Ying , Wang Ji , Wang Gang , Zhang Hong Ping , Kang De Ying , Peng Zu Gui , Ji Yu Lin , Wang Lei , Gibson Peter Gerard , Wang Gang
Published: January 2019

Background

Depressive symptoms worsen asthma outcomes; however, the mechanism remains largely unexplored.

Objective

This study aimed to determine whether depressive symptom‐associated immune inflammation correlates with impaired bronchodilator response (BDR) and airway inflammatory phenotypes.

Methods

Eligible adults with asthma (n = 198) underwent clinical assessment, sputum induction and blood sampling. Depressive symptoms were defined by scores on the depression subscale of the Hospital Anxiety and Depression Scale (HADS‐D). Pre‐ and post‐bronchodilator spirometry was performed for BDR. Airway inflammatory phenotypes were defined by sputum cell counts. CRP, IL‐1β, IL‐5, IL‐6, IL‐8, TNF‐α, IFN‐γ, CCL17 and CCL22 in serum and sputum were detected.

Results

Compared with the non‐depressive group (n = 174), the depressive group (n = 24) exhibited impaired BDR (P = 0.032) and increased sputum neutrophils (P = 0.023), which correlated with the HADS‐D scores (P = 0.027 and P = 0.029). Levels of IL‐1β, TNF‐α and IFN‐γ in the serum and those of IL‐1β and IFN‐γ in the sputum were elevated in the depressive group compared to those in the non‐depressive group (all P < 0.05). Multiple regression models indicated that TNF‐α in the sputum and IL‐1β, IL‐6 and IFN‐γ in both the serum and sputum were inversely associated with BDR; TNF‐α in the sputum and IL‐1β in both the serum and sputum were positively correlated with sputum neutrophils. Mediation analyses revealed that IL‐1β and TNF‐α in the sputum and IL‐1β in both the serum and sputum mediate the correlations of the HADS‐D scores with BDR and sputum neutrophils, respectively.

Conclusions and Clinical Relevance

Asthma patients with depressive symptoms present worse asthma control, which is most likely explained by impaired BDR and neutrophilic airway inflammation. IL‐1β and TNF‐α, which are two key pro‐inflammatory cytokines that mediate the correlation of depressive symptoms with impaired BDR and neutrophilic airway inflammation, may serve as targeted biomarkers in the neuropsychological phenotype of asthma; however, this result needs to be further validated.
Endoplasmic reticulum stress induces apoptosis of arginine vasopressin neurons in central diabetes insipidus via PI3K/Akt pathway
Authors: Zhou Ming‐Feng , Feng Zhan‐Peng , Ou Yi‐Chao , Peng Jun‐Jie , Li Kai , Gong Hao‐Dong , Qiu Bing‐Hui , Liu Ya‐Wei , Wang Yong‐Jia , Qi Song‐Tao
Published: January 2019

Aims

Central diabetes insipidus (CDI), a typical complication caused by pituitary stalk injury, often occurs after surgery, trauma, or tumor compression around hypothalamic structures such as the pituitary stalk and optic chiasma. CDI is linked to decreased arginine vasopressin (AVP) neurons in the hypothalamic supraoptic nucleus and paraventricular nucleus, along with a deficit in circulating AVP and oxytocin. However, little has been elucidated about the changes in AVP neurons in CDI. Hence, our study was designed to understand the role of several pathophysiologic changes such as endoplasmic reticulum (ER) stress and apoptosis of AVP neurons in CDI.

Methods

In a novel pituitary stalk electric lesion (PEL) model to mimic CDI, immunofluorescence and immunoblotting were used to understand the underlying regulatory mechanisms.

Results

We reported that in CDI condition, generated by PEL, ER stress induced apoptosis of AVP neurons via activation of the PI3K/Akt and ERK pathways. Furthermore, application of N‐acetylcysteine protected hypothalamic AVP neurons from ER stress‐induced apoptosis through blocking the PI3K/Akt and ERK pathways.

Conclusion

Our findings showed that AVP neurons underwent apoptosis induced by ER stress, and ER stress might play a vital role in CDI condition through the PI3K/Akt and ERK pathways.
Recurrent Bell's palsy
Authors: Dong Sung Hwa , Jung Ah Ra , Jung Junyang , Jung Su Young , Byun Jae Yong , Park Moon Suh , Kim Sang Hoon , Yeo Seung Geun
Published: January 2019

Objective

Although recurrent facial palsy was first reported in 1871, the aetiology, definitions, classifications, pathogenesis, treatment options and prognosis have not been clearly determined. There have been no systematic reviews and meta‐analyses of recurrent Bell's palsy. The purpose of this study was to evaluate the clinical manifestations of recurrent Bell's palsy through a systematic review and meta‐analysis.

Design

The SCOPUS, PubMed, Cochrane Library and EBSCO databases were searched through 1 May 2018, using the search terms “recurrent Bell's palsy” and “recurrent facial palsy,” for studies involving patients with recurrent Bell's palsy. Reference lists of eligible studies were also reviewed.

Results

A search of titles and abstracts in these four databases identified 222 studies; of these, 27 studies, involving 1041 patients from 13 countries, were analysed. The mean percentage of patients who experienced recurrence of Bell's palsy ranged from 0.8% to 19.4%. Five studies that included 191 patients were included in the meta‐analysis.

Conclusions

Among patients previously affected by Bell's palsy, the mean incidence of recurrent Bell's palsy was 6.5%. Sidedness of recurrent disease, relative to the side of the original disease, had no effect on patient prognosis. Of all patients with Bell's palsy, 66.0% recovered completely, with the recovery rate lower in patients with recurrent than with primary Bell's palsy.
Incremental cost‐effectiveness of evidence‐based non‐surgical weight loss strategies
Authors: Finkelstein Eric A. , Verghese Naina R.
Published: January 2019

Recent medical advancements have led to new modes of treatment for non‐surgical weight loss, including several new medications. Our aim was to conduct an incremental cost‐effectiveness analysis for all commercially available, evidence‐based non‐surgical weight loss interventions for people with excess weight. We identified interventions through a systematic review of randomized controlled trials that reported weight loss 12 months from baseline. We then meta‐analysed the results, sourced costs and performed an incremental cost‐effectiveness analysis from the payer perspective. Cost‐effectiveness was presented in terms of cost per kilogram lost and quality‐adjusted life years (QALY) gained. We further performed sensitivity analyses on costs and duration of benefits, and a probabilistic sensitivity analysis. Ten interventions were identified for inclusion: six pharmaceutical products (Alli, Xenical, Qsymia, Contrave, Belviq and Saxenda), two lifestyle modification programmes (Weight Watchers Meetings and Online), one food replacement and lifestyle programme (Jenny Craig) and one intragastric balloon system (Orbera). At an incremental cost‐effectiveness ratio of $30 071 per additional QALY gained, only Weight Watchers Meetings was cost‐effective. Sensitivity analyses revealed that for the medications to become incrementally cost‐effective, costs would have to decrease by as much as 91%. Results are highly dependent on duration that benefits are maintained. Despite several newly available interventions, Weight Watchers Meetings is currently the only evidence‐based, commercially available, cost‐effective option for non‐surgical weight loss. Other interventions, specifically medications, are more effective but priced too high to be cost‐effective.
Involvement of selective epithelial cell death in the formation of feather buds on a bioengineered skin
Authors: Ishida Kentaro , Saito Tetsuichiro , Mitsui Toshiyuki
Published: January 2019

Selective cell death by apoptosis plays important roles in organogenesis. Apoptotic cells are observed in the developmental and homeostatic processes of several ectodermal organs, such as hairs, feathers, and mammary glands. In chick feather development, apoptotic events have been observed during feather morphogenesis, but have not been investigated during early feather bud formation. Previously, we have reported a method for generating feather buds on a bioengineered skin from dissociated skin epithelial and mesenchymal cells in three‐dimensional culture. During the development of the bioengineered skin, epithelial cavity formation by apoptosis was observed in the epithelial tissue. In this study, we examined the selective epithelial cell death during the bioengineered skin development. Histological analyses suggest that the selective epithelial cell death in the bioengineered skin was induced by caspase‐3‐related apoptosis. The formation of feather buds of the bioengineered skin was disturbed by the treatment with a pan‐caspase inhibitor. The pan‐caspase inhibitor treatment suppressed the rearrangement of the epithelial layer and the formation of dermal condensation, which are thought to be essential step to form feather buds. The suppression of the formation of feather buds on the pan‐caspase inhibitor‐treated skin was partially compensated by the addition of a GSK‐3β inhibitor, which activates Wnt/β‐catenin signaling. These results suggest that the epithelial cell death is involved in the formation of feather buds of the bioengineered skin. These observations also suggest that caspase activities and Wnt/β‐catenin signaling may contribute to the formation of epithelial and mesenchymal components in the bioengineered skin.
The Functional Communication Classification System for children with cerebral palsy: the potential of a new measure
Authors: McCartney Elspeth
Published: January 2019

This commentary is on the original article by Caynes et al. on pages 805–812 of this issue.
Assessing the severity of Type 2 diabetes using clinical data‐based measures: a systematic review
Authors: Zghebi S. S. , Panagioti M. , Rutter M. K. , Ashcroft D. M. , van Marwijk H. , Salisbury C. , Chew‐Graham C. A. , Buchan I. , Qureshi N. , Peek N. , Mallen C. , Mamas M. , Kontopantelis E.
Published: January 2019

Aims

To identify and critically appraise measures that use clinical data to grade the severity of Type 2 diabetes.

Methods

We searched MEDLINE, Embase and PubMed between inception and June 2018. Studies reporting on clinical data‐based diabetes‐specific severity measures in adults with Type 2 diabetes were included. We excluded studies conducted solely in participants with other types of diabetes. After independent screening, the characteristics of the eligible measures including design and severity domains, the clinical utility of developed measures, and the relationship between severity levels and health‐related outcomes were assessed.

Results

We identified 6798 studies, of which 17 studies reporting 18 different severity measures (32 314 participants in 17 countries) were included: a diabetes severity index (eight studies, 44%); severity categories (seven studies, 39%); complication count (two studies, 11%); and a severity checklist (one study, 6%). Nearly 89% of the measures included diabetes‐related complications and/or glycaemic control indicators. Two of the severity measures were validated in a separate study population. More severe diabetes was associated with increased healthcare costs, poorer cognitive function and significantly greater risks of hospitalization and mortality. The identified measures differed greatly in terms of the included domains. One study reported on the use of a severity measure prospectively.

Conclusions

Health records are suitable for assessment of diabetes severity; however, the clinical uptake of existing measures is limited. The need to advance this research area is fundamental as higher levels of diabetes severity are associated with greater risks of adverse outcomes. Diabetes severity assessment could help identify people requiring targeted and intensive therapies and provide a major benchmark for efficient healthcare services.
Does myocardial strain remain abnormal long after normalization of ejection fraction in patients with acute myocarditis?
Authors: Manalo Rachel , Bourget Laura , Garg Ashish , Swaminathan Sethuraman
Published: January 2019

Myocarditis is a common cause for acute heart failure in the pediatric population. Various imaging modalities have evolved over the past 3 decades in order to noninvasively image the myocardium in this patient population. These include standard 2‐dimensional echocardiographic imaging, tissue Doppler imaging, and magnetic resonance imaging of the heart. More recently, myocardial speckle tracking also known as strain imaging has been utilized to assess regional wall motion abnormalities with increasing accuracy. We report a case of acute myocarditis in a teenage female in whom progression of myocardial strain findings correlated with the rapidly evolving clinical course of the patient.
Sequential liver and haematopoietic stem cell transplantation in a case of fulminant hepatitis associated liver failure and aplastic anaemia
Authors: Al‐Shaibani Zeyad , Kotha Sreelakshmi , Lam Wilson , Galvin Zita , Lilly Leslie , Lipton Jeffrey H , Law Arjun Datt
Published: January 2019

The management of severe aplastic anaemia is particularly challenging when it occurs in the context of recent liver transplantation. Rapid identification of a suitable donor followed by allogeneic haematopoietic stem cell transplantation is the only curative option. This scenario is often complicated by potentially life‐threatening infections that develop as a consequence of immunosuppression. Alternative donor transplantation using suitably matched unrelated donors can be potentially life‐saving when suitably matched sibling donors are unavailable. Above all, a dedicated interdisciplinary approach with seamless communication between hepatology, transplant surgery, haematology, and stem cell transplant services is essential to achieving optimal outcomes. Herein, we describe a case of severe hepatitis leading to hepatic failure who was treated with liver transplantation from a deceased donor, and later received an allogeneic haematopoietic stem cell transplantation from a matched unrelated donor for hepatitis‐associated aplastic anaemia.
Effects of transcranial direct current stimulation over right posterior parietal cortex on attention function in healthy young adults
Authors: Lo On‐Yee , van Donkelaar Paul , Chou Li‐Shan
Published: January 2019

Attention involves three distinct networks for alerting, orienting, and executive control. Interventions targeting the specific attentional networks remain lacking. Transcranial direct current stimulation (tDCS) has been shown to modulate cortical excitability, which potentially serves as an interventional tool to treat individuals with attention impairment. The purpose of this study was to examine the effects of applying tDCS over the right posterior parietal cortex (PPC) on the performance of the three attentional networks. Twenty‐six healthy young adults performed the Attention Network Test before and after anodal or sham tDCS stimulation over the right PPC. The alerting, orienting, and executive effects were assessed before and after the stimulation. The results demonstrated that the orienting effect was significantly improved after real tDCS relative to sham, whereas the alerting and executive control effects remained unaffected. Consistent with previous clinical and functional imaging studies, this suggests that the right PPC is actively engaged with the spatial orienting of attention.
Capitularies in the Ottonian realm
Authors: Patzold Steffen
Published: January 2019

This essay is a study of the transmission and later use of Carolingian capitularies. Issued in the ninth century, in a number of cases these documents are known to us only through copies made in the tenth century, in the Ottonian empire. The goal of the study is to prompt a rethinking of the contrast often drawn between the text‐based legal culture of the Carolingian empire and the supposedly oral and ritual culture of Ottonian rule. A survey of seventeen capitulary manuscripts is offered, followed by two case studies. The first concerns a tenth‐century Metz manuscript; the second centres around a Mainz book. These appeal to the Carolingian past in order to shape legal claims in the present: as assemblages of legal texts, they bear important witness to the context of their production.
Low‐cost, green synthesis and adsorption properties for dyes of novel porous gangue/palygorskite composite microspheres
Authors: Yan Shu , Wang Qinggang , Zhang Fanyong , Zhang Xiaoyan , Lu Yuju , Gan Ke , Huo Wenlong , Zhang Shuhao , Liu Jingjing , Yang Jinlong
Published: January 2019

In this work, gangue/palygorskite composite microspheres were fabricated through spray drying process and activated by calcination treatment. Its microstructure and adsorption capacity for the removal of dye (MB) were also studied, systematically. Results showed that kaolinite, α‐quartz and palygorskite were the major phases in microspheres after proper calcination (lower than 900°C). BET‐specific surface area of the microspheres reached the maximum value of 62.23 m2/g at 700°C, and then decreased with further increasing the heating temperature. In general, composite microspheres showed the largest adsorption capacity of MB after heat‐treated at 700°C. The qmax of MB onto microspheres was 29.9‐51.9 mg/g. The adsorption process of MB onto microspheres was well described by both the pseudo‐second‐order kinetic and Langmuir isotherm model. The composite microspheres also had extraordinary recyclability. This novel microsphere could be employed as a candidate for novel absorbent and filter medium in the practical application for dye treatment in industrial applications.
Adolescents’ experiences of distress on an acute mental health inpatient unit: A qualitative study
Authors: Spencer Stephen , Stone Teresa , Kable Ashley , McMillan Margaret
Published: January 2019

Adolescents admitted to acute mental health inpatient units can experience episodes of distress for numerous reasons. Little is known about how they attempt to cope with this distress. This paper explores adolescent experiences of distress in an acute mental health inpatient unit. Fifty hours of non‐participant observations were conducted and documented using a critical incident technique (CIT) framework. An interpretive descriptive approach was used to analyse the observation data collected. Nineteen episodes of adolescent distress were observed and five themes emerged, of which two will be explored in this paper: clinical contexts and triggers, and coping or help‐seeking actions. The findings of this study will help mental health nurses working on acute adolescent units understand how adolescents attempt to cope with, and seek help for, episodes of distress, and enhance early responses to prevent escalation of distress.
Successful sexual reproduction of the scleractinian coral Porites panamensis: Evidence of planktonic larvae and recruitment
Authors: Santiago‐Valentín Jeimy D. , Rodríguez‐Troncoso Alma P. , Bautista‐Guerrero Eric , López‐Pérez Andrés , Cupul‐Magaña Amilcar L.
Published: January 2019

Porites panamensis is a hermatypic brooder coral endemic to, and distributed along, the Eastern Tropical Pacific, and is considered a species vulnerable to local effects because it has limited capacity for long‐distance dispersal (and low genetic diversity). Although larvae of P. panamensis have been previously shown to recruit to artificial settlement platforms, they have never been observed in the water column. The present study describes the reproductive behavior of P. panamensis, with a focus on using molecular tools to document evidence for a larval planktonic stage and for successful recruitment. Larvae collected from the water column, and recruitment on natural and artificial substrata were documented. Phylogenetic analysis of two ribosomal markers, 18s rRNA and ITS (ITS1‐5.8‐ITS2), and one mitochondrial marker, cytochrome oxidase subunit 1 (cox1), confirmed the taxonomic identity of larvae, and showed that larvae and recruits have genotypes similar to adults of P. panamensis. Lipid vacuoles and Symbiodinium sp. were present in the gastrodermis of all larvae. A total of 12 and 371 recruits settled on artificial and natural substrates, respectively, and the recruitment rate differed significantly over time. By documenting the reproductive success of the species, we show the potential for existing individuals both to maintain the population in the study area and to contribute to maintenance of the coral reef community in the coming decades.
Effectiveness of vertical ridge augmentation interventions: A systematic review and meta‐analysis
Authors: Urban Istvan A. , Montero Eduardo , Monje Alberto , Sanz‐Sánchez Ignacio
Published: January 2019

Aim

The primary aim of this systematic review was to evaluate the effect of various techniques used for vertical ridge augmentation on clinical vertical bone gain.

Material and Methods

A protocol was developed to answer the following focused question: “In patients with vertical alveolar ridge deficiencies, how effective are different augmentation procedures for clinical alveolar ridge gain?” Randomized and controlled clinical trials and prospective and retrospective case series were included, and meta‐analyses were performed to evaluate vertical bone gain based on the type of procedure and to compare bone gains in controlled studies.

Results

Thirty‐six publications were included. Results demonstrated a significant vertical bone gain for all treatment approaches (n = 33; weighted mean effect = 4.16 mm; 95% CI 3.72–4.61; p < 0.001). Clinical vertical bone gain and complications rate varied among the different procedures, with a weighted mean gain of 8.04 mm and complications rate of 47.3% for distraction osteogenesis, 4.18 mm and 12.1% for guided bone regeneration (GBR), and 3.46 mm and 23.9% for bone blocks. In comparative studies, GBR achieved a significant greater bone gain when compared to bone blocks (n = 3; weighted mean difference = 1.34 mm; 95% CI 0.76–1.91; p < 0.001).

Conclusions

Vertical ridge augmentation is a feasible and effective therapy for the reconstruction of deficient alveolar ridges, although complications are common.
Association of accumulated advanced glycation end‐products with a high prevalence of sarcopenia and dynapenia in patients with type 2 diabetes
Authors: Mori Hiroyasu , Kuroda Akio , Ishizu Masashi , Ohishi Mami , Takashi Yuichi , Otsuka Yinhua , Taniguchi Satoshi , Tamaki Motoyuki , Kurahashi Kiyoe , Yoshida Sumiko , Endo Itsuro , Aihara Ken‐ichi , Funaki Makoto , Akehi Yuko , Matsuhisa Munehide
Published: January 2019

Aims/Introduction

Advanced glycation end‐products (AGEs), which are a major cause of diabetic vascular complications, accumulate in various tissues under chronic hyperglycemic conditions, as well as with aging in patients with diabetes. The loss of muscle mass and strength, so‐called sarcopenia and dynapenia, has recently been recognized as a diabetic complication. However, the influence of accumulated AGEs on muscle mass and strength remains unclear. The present study aimed to evaluate the association of sarcopenia and dynapenia with accumulated AGEs in patients with type 2 diabetes.

Materials and Methods

We recruited 166 patients with type 2 diabetes aged ≥30 years (mean age 63.2 ± 12.3 years; body mass index 26.3 ± 4.9 kg/m2; glycated hemoglobin 7.1 ± 1.1%). Skin autofluorescence as a marker of AGEs, limb skeletal muscle mass index, grip strength, knee extension strength and gait speed were assessed.

Results

Sarcopenia and dynapenia were observed in 7.2 and 13.9% of participants, respectively. Skin autofluorescence was significantly higher in patients with sarcopenia and dynapenia. Skin autofluorescence was the independent determinant for skeletal muscle mass index, grip strength, knee extension strength, sarcopenia and dynapenia.

Conclusions

Accumulated AGEs could contribute to reduced muscle mass and strength, leading to sarcopenia and dynapenia in patients with type 2 diabetes.
Does integration of Magee equations into routine clinical practice affect whether oncologists order the Oncotype DX test? A prospective randomized trial
Authors: Robertson Susan J. , Ibrahim Mohammed F.K. , Stober Carol , Hilton John , Kos Zuzana , Mazzarello Sasha , Ramsay Tim , Fergusson Dean , Vandermeer Lisa , Mallick Ranjeeta , Arnaout Angel , Dent Susan F. , Segal Roanne , Sehdev Sandeep , Gertler Stan , Hutton Brian , Clemons Mark
Published: January 2019

Objective

The three Magee Equations provide an estimate of the Oncotype DX recurrence score using commonly available clinicopathologic information (tumour size, grade, oestrogen receptor, progesterone receptor, HER2, and Ki67). We assessed whether integration of Magee Equations into routine clinical practice affected the frequency of Oncotype DX requests.

Methods

Patients with newly diagnosed, node negative, hormone receptor positive, and HER2 negative invasive breast cancer were randomized to undergo a Magee calculation or not. At the first clinic assessment, the oncologist was provided with all routinely available clinicopathologic information (including Ki67) either with or without the results of Magee Equations. Primary outcome was frequency of Oncotype DX ordering. Secondary outcomes included frequency of chemotherapy use, time to commencement of radiotherapy, or systemic therapy. Physician comfort with systemic therapy choices and the use of Ki67 and Magee Equations was also assessed.

Results

Data from 175 randomized patients was available, 84 patients (48%) with and 91 (52%) without calculated Magee Equations. Oncotype DX was ordered in 10 (12.05%) and 13 (14.44%) (RR 0.83, 0.39‐1.80; P = 0.64) in the Magee and no Magee groups, respectively. There were no statistically or clinically significant differences between the randomized groups for any of the secondary outcomes. Availability of both Ki67 and Magee Equations was associated with increased physician comfort around systemic treatment decisions.

Conclusions

In a practice where Ki67 is routinely available, addition of Magee Equations into routine clinic practice was not associated with a reduction in Oncotype DX use. Availability of both Ki67 and Magee Equations did however increase physician comfort with systemic therapy decisions.
Bycatch and discarding patterns of dogfish and sharks taken in English and Welsh commercial fisheries
Authors: Silva Joana F. , Ellis Jim R.
Published: January 2019

At‐sea observer programmes can provide spatio‐temporal data on the sizes and quantities of fish being either discarded or retained, including for species and size categories that may not be sampled effectively during scientific surveys. Such data were analysed for English and Welsh fisheries operating on the continental shelf of the North Sea ecoregion (ICES Divisions 4a–c and 7d) and Celtic Seas ecoregion (ICES Divisions 6a, 7a–c, e–k) for the period (2002–2016). These data were collated for four main gear types: beamtrawl, nephrops and otter trawls, and nets (including gillnets, tangle nets and trammel nets). Beamtrawlers caught proportionally more smaller individuals than otter trawlers, whilst nets were the most size‐selective gear for larger sharks. Size‐related discarding was observed, with smaller spurdog Squalus acanthias and starry smooth‐hound Mustelus asterias (< 60 cm total length, LT) usually being discarded. Such size‐based selection was not evident for lesser‐spotted dogfish Scyliorhinus canicula, which was generally landed as bait. Temporal changes in the discard–retention patterns were evident for S. acanthias and porbeagle Lamna nasus, with increased regulatory discarding as management measures became restrictive. A corresponding increase in the proportion of the non‐quota M. asterias retained was also observed over the study period. Knowledge of the size‐based discard–retention patterns by métier can also help inform on where future studies on discard survival could usefully be undertaken.
Association of low skeletal muscle mass with advanced liver fibrosis in patients with non‐alcoholic fatty liver disease
Authors: Kang Min Kyu , Park Jung Gil , Lee Heon Ju , Kim Min Cheol
Published: January 2019

Background and Aim

Although low skeletal muscle mass (LSMM) is known to increase the risk of non‐alcoholic fatty liver disease (NAFLD), limited reports have described the relationship between LSMM and advanced fibrosis. Here, we investigated the association between LSMM and advanced liver fibrosis in NAFLD patients.

Methods

Fatty liver was diagnosed using ultrasound, and appendicular skeletal muscle mass (ASM) was measured using bioelectrical impedance analysis. LSMM was defined in two ways: ASM/body weight percentage (LSMM‐BW) and ASM/body mass index. Liver fibrosis stage was assessed by two models, the NAFLD fibrosis score and the Fibrosis‐4 index, which determined low and high cutoff values (COVs).

Results

Of 10 711 NAFLD patients, 615 were diagnosed with LSMM‐BW. LSMM patients were older (47.6 vs 52.5 years, P = 0.001) and had higher body mass index values (23.6 vs 29.1 kg/m2, P < 0.001) and waist circumferences (80.1 vs 93.3 cm, P < 0.001) than non‐LSMM patients. LSMM was an independent risk factor for advanced fibrosis assessed by a low COV for the Fibrosis‐4 index regardless of its classification (adjusted for metabolic and lipid profiles and sex, odds ratio [OR], 1.27–2.01; all P < 0.05). LSMM was an independent risk factor for advanced fibrosis assessed by both COVs of NAFLD fibrosis score (adjusted for obesity, hypertension, lipid profile, and sex; OR, 1.64–2.01, P < 0.01 in the low COV group; OR, 2.68–3.12, P = 0.002 in the high COV group).

Conclusions

Low skeletal muscle mass is associated with advanced fibrosis in NAFLD patients independent of metabolic risk factors.
Dementia‐Capable Healthcare: One Step Closer
Authors: Borson Soo
Published: January 2019

This Editorial comments on the Clinical Investigation by Lee A. Jennings et al. in this issue.
Intention to leave among staff nurses in small‐ and medium‐sized hospitals
Authors: Park Jeong Hye , Park Min Jung , Hwang Hye Young
Published: January 2019

Aims and objectives

To explore the factors associated with the intention to leave among nurses in small‐ and medium‐sized hospitals and to determine the predictors about work environment and rewards.

Background

Compared with large hospitals, insight into the working conditions, rewards and turnover of nurses working for these hospitals is lacking internationally.

Design

Cross‐sectional study design.

Methods

Data were obtained from the Korean Nurses Association's 2016 Welfare Policy and System Improvement Survey. Of the participants, data from 951 staff nurses working three shifts were analysed using hierarchical multiple regression to explore the predictors of nurses’ turnover intention. This study complied with the Strengthening the Reporting of Observational studies in Epidemiology.

Results

The perceived pay level satisfaction was the most obvious and persistent predictor of the intention to leave. Living benefits were shown to be scarcely satisfied, rendering considerable influence on turnover intention. Concerning aspects related to the working environment, the implementation of contract‐abiding working hours and nurse‐friendly night shift schedules reduced the turnover intention of nurses.

Conclusions

Nurses in small‐ and medium‐sized hospitals are likely to have particular challenges in terms of professional growth. When fundamental rewards and basic working conditions are acceptable to nurses, their turnover can be reduced, and the professional growth can also be expected. Hospitals with a high nurse turnover rate need to preferentially verify these factors perceived by their nurses and to improve to increase nurses’ retention.

Relevance to clinical practice

Understanding the determinants of intention to leave can lead to the development of strategies that persuade nurses to remain employed. These findings inform policymakers, nurse managers and hospital managers of the causes of nurses’ intentions to leave in small‐ and medium‐sized hospitals. Our findings also provide empirical data on the working conditions and rewards of these nurses and suggest strategies for their retention.
Identifying selection criteria for non‐radical hysterectomy in FIGO stage IB cervical cancer
Authors: Kasamatsu Takahiro , Ishikawa Mitsuya , Murakami Naoya , Okada Satoshi , Ikeda Shun‐Ichi , Kato Tomoyasu , Itami Jun
Published: January 2019

Aim

This retrospective study sought to identify the selection criteria required for a non‐radical hysterectomy with minimal parametrectomy in patients with International Federation of Gynecology and Obstetrics (FIGO) stage IB invasive cervical cancer.

Methods

Overall, 461 patients with FIGO stage IB cervical cancer who underwent a radical hysterectomy were reviewed clinicopathologically according to pathological tumor size (≤2 cm, >2 – ≤4 cm, and > 4 cm).

Results

The pathological parametrial involvement rate in the less than equal to 2 cm group (2%) was significantly lower than in greater than 2–less than equal to 4 cm (13%) or greater than 4 cm (29%) groups (both P < 0.001). The 5‐year overall survival rate was significantly higher in the less than equal to 2 cm group (97%, 95% confidence interval [CI] 94–99%) compared with greater than 2–less than equal to 4 cm (90%, 95% CI 94–86%) and greater than 4 cm (70%, 95% CI 79–60%) groups (both P < 0.001). Cox model analysis identified tumor size to be an independent prognostic factor for survival (95% CI 1.33–5.78) and recurrence (95% CI 1.31–5.66) compared to other pathological factors. However, a significant difference between the three groups was not found in rates of Grade 3 or 4 adverse events following radical hysterectomy (P = 0.19).

Conclusions

Tumor size is an independent prognostic factor for survival in patients with FIGO stage IB invasive cervical cancer. This retrospective study suggests that FIGO stage IB patients with a less than equal to 2 cm tumor size are optimal candidates for non‐radical hysterectomy with minimal parametrectomy, and without resulting bladder dysfunction.
Japan Obstetric Compensation System for Cerebral Palsy: Strategic system of data aggregation, investigation, amelioration and no‐fault compensation
Authors: Ushiro Shin , Suzuki Hideaki , Ueda Shigeru
Published: January 2019

The Japan Obstetric Compensation System for Cerebral Palsy (JOCS‐CP), which investigates, develops preventive mechanisms and awards monetary compensation, to cases of cerebral palsy was urgently introduced in 2009 in response to growing concern about Japan's deteriorating perinatal care and low birthrate. Under the political leadership, the Japan Council for Quality Health Care launched the JOCS‐CP with support of various stakeholders. The JOCS‐CP features of no‐fault‐based compensation which was discussed decades ago in the Japan Medical Association aiming at financial aid to patient and family and early settlement of dispute. As of 2017, 2233 petitions had been approved by the Review Committee for compensation. All the approved cases were consecutively put on analysis in the Investigation Committee which has compiled more than 1000 Investigative Reports. The reports were delivered not only to the childbirth facility but to the guardians/families. Survey revealed that most of childbirth facility and the guardians/families responded in favor of the reports. With regard to amelioration of profound cerebral palsy, the Prevention Report has been published on annual basis through analysis of all the Investigative Reports. The Prevention Reports and other educational materials were produced and distributed not only among medical professionals but among pregnant women. It is notable that the number of lawsuit filing related to obstetrics demonstrated rapid decrease compared to that of other medical specialties. The JOCS‐CP could be described as a social experiment. It was overhauled in 2015 but deserves further discussion on reform for evolving into better system.
Water column dissolved silica concentration limits microphytobenthic primary production in intertidal sediments
Authors: Bohórquez Julio , Calenti Danielle , García‐Robledo Emilio , Papaspyrou Sokratis , Jimenez‐Arias Juan Luis , Gómez‐Ramírez Eddy Humberto , Corzo Alfonso
Published: January 2019

Primary production of microphytobenthos (MPB) contributes significantly to the total production in shallow coastal environments. MPB is a diverse community in which diatoms are usually the main microalgal group. Diatoms require N, P, and other nutrients as with other autotrophs, but in addition require silicate to create their outer cell wall. Therefore, dissolved silica (DSi) might be a potential limiting factor for benthic primary production in areas with reduced freshwater input. To test this hypothesis, a microcosm experiment was conducted using intact sediment cores collected from an intertidal mudflat in the Bay of Cádiz and supplied with increasing concentrations of DSi (0, 5, 10, 25, and 45 μmol · L−1). After 7 d of enrichment, we determined chlorophyll a and c (Chl a, c) contents, metabolic rates (Net [Pn] and Areal Gross [PgA] Production and Light [RL] and Dark [RD] Respiration), as well as fluxes of inorganic nutrients across the sediment‐water interface. Chl a and c contents increased significantly with respect to the initial conditions but no differences between treatments were found. Both Pn and PgA showed a saturating‐like pattern with silicate concentration, reaching maximum rates at a DSi concentration of 45 μmol · L−1. The addition of DSi also resulted in an increase of DSi and ammonium uptake by the sediment, which was significantly higher in light than in darkness. Our results clearly show that water column DSi concentrations have a direct impact on benthic primary production, also controlling other related processes such as inorganic nutrient fluxes.