bluuebunny/crossref_metadata_2025 huggingface dataset:
A sequential TPM-based scheme for improving production effectiveness presented with a case study
Authors: Bataineh Omar , Al-Hawari Tarek , Alshraideh Hussam , Dalalah Dorid
Published: January 2019

Purpose

The purpose of this paper is to improve production effectiveness of equipment by facilitating the implementation of the key principles of total productive maintenance (TPM).

Design/methodology/approach

A sequential TPM-based scheme consisting of 13 procedural steps is proposed. The steps cover the basic aspects of a generic improvement system, i.e. planning, implementation, checking, corrective action and control.

Findings

The proposed scheme was effective in increasing the overall equipment effectiveness by 62.6 percent over a nine-month period only. This was a direct reflection of improvements in equipment availability, efficiency and product quality. A positive feedback regarding the smooth implementation of the scheme was also received from the responsible maintenance staff.

Research limitations/implications

The proposed scheme is intended mainly to the manufacturing industrial sector, which utilizes failure-prone equipment in running operations.

Originality/value

This study presents an original scheme that tries to avoid the many barriers of success frequently encountered during the implementation of TPM schemes, as reported in the literature. This scheme is unique in integrating between 5S and safety, health and environment initiatives, by capitalizing on the close relation between the two initiatives, and simplifying procedures for measuring how well the two initiatives are implemented in an organization in one score card. Different from previous studies, the scheme treats both “education and training” and 6S as a foundation to the core TPM principles.
Measuring life cycle costs for complex B2B products
Authors: Schlipf Matthias , Keller Carlos , Lutzenberger Fabian , Pfosser Stefan , Rathgeber Andreas
Published: January 2019

Purpose

The purpose of this paper is to develop a new interdisciplinary methodology to estimate the life cycle cost (LCC) of complex business-to-business products in order to price different types of maintenance contracts and show the applicability of the method in a case study. LCC comprise of initial capital costs as well of operation costs including probabilistic costs (such as the costs of repairs and spare parts), which are directly linked to the maintenance characteristics of the product.

Design/methodology/approach

The paper proposes an integrated and practical methodology that applies different approaches from different disciplines. Therefore, exponential distributions for failure rates in subsystems, World Bank logistics factors for logistics costs of spare part handling, as well implied credit default probabilities for the counterpart risk in full service leasing contracts are applied. In order to validate the applicability of the proposed methodology to practical problems, the tool is applied in three case studies.

Findings

The results of the case studies show that this methodology can be applied to analyze LCC structures of engines operating in various regions with regard to different types of engine maintenance contracts. The results also highlight the interplay of technical as well as financial risks.

Originality/value

Because the literature in maintenance engineering so far either proposes general frameworks to calculate LCC or concentrates on specific aspects of LCC, the paper contributes to the literature in presenting a new interdisciplinary methodology to estimate the LCC.
Potential effect of selective pressure with different β‐lactam molecules on the emergence of reduced susceptibility to β‐lactams in group B Streptococci
Authors: Koide Shota , Hayashi Wataru , Taniguchi Yui , Tanaka Hayato , Kimura Kouji , Nagano Yukiko , Arakawa Yoshichika , Nagano Noriyuki
Published: January 2019

In this study, the selective potential of group B Streptococcus isolates with reduced penicillin susceptibility (PRGBS) in a neonate‐hypervirulent sequence type (ST)17 lineage was investigated by in vitro exposure to β‐lactams. After 19 passages of stepwise penicillin exposure, PRGBS with a high penicillin minimum inhibitory concentration MIC (0.5 mg/L), greatly augmented ceftibuten MIC (>512 mg/L), and acquisition of G406D predicted to provide destabilizing effect (ΔΔG 0.099 kcal/mol) on PBP2X structure were identified. In early passages of stepwise cefotaxime exposure, PRGBS possessing G398E predicted to stabilize PBP2X (ΔΔG −0.038 kcal/mol) emerged with high MICs for cefotaxime (0.5 mg/L), ceftibuten (>512 mg/L) and penicillin (0.25 mg/L). Additionally, G398E + G329V + H438Y predicted to provide more stabilizing effect (ΔΔG −0.415 kcal/mol) were detected in mutants with higher MICs to cefotaxime (1 mg/L) and penicillin (0.5 mg/L). PRGBS mutants selected by penicillin and cefotaxime had a marked growth disadvantage compared with the parent strain. After two passages of stepwise ceftibuten exposure, the mutants exhibited increased MICs toward ceftibuten and acquisition of T555S predicted to provide stabilizing effect (ΔΔG −0.111 kcal/mol) in PBP 2X. In subsequent passages, gradual increases in ceftibuten MICs from 128 mg/L to 512 mg/L were found among selected mutants with accompanying stabilizing T555S+A354V (ΔΔG −0.257 kcal/mol) followed by stabilizing T555S + A354V + A536V (ΔΔG −0.322 kcal/mol), resulting in selection of a penicillin‐susceptible group B Streptococcus lineage with reduced ceftibuten susceptibility (CTBrPSGBS). Notably, growth ability of CTBrPSGBS mutants was comparable to that of the parent strain. These findings may predict future failure of treatment for neonatal invasive infections caused by the neonate‐hypervirulent PRGBS ST17 lineage.
Species–habitat networks: A tool to improve landscape management for conservation
Authors: Marini Lorenzo , Bartomeus Ignasi , Rader Romina , Lami Francesco
Published: January 2019

Land‐use change is reshaping terrestrial ecosystems world‐wide and is recognized as a key driver of biodiversity loss with negative consequences on ecosystem functioning. Understanding how species use resources across landscapes is essential for the design of effective management strategies.

Despite recent advances in network ecology, there is still a gap between theory and applied ecological science, and we lack the information to manage entire landscapes to maximize biodiversity conservation and ecosystem service delivery. While several pioneering approaches have tried to link ecological networks and conservation science, applied ecologists still struggle to incorporate these models into research due to their inherent complexity.

We propose the application of bipartite networks principles to create species–habitat networks. This approach explicitly links multiple species and habitat resources, provides tools to estimate the importance of particular species or specific habitat in a given landscape, and quantifies emerging properties of entire habitat networks. Most existing metrics used to study properties of bipartite ecological networks can easily be adapted to investigate species–habitat relationships. The tool use is relatively simple and does not require advanced computational expertise.

Synthesis and applications. One of the biggest challenges in applied ecology is managing multiple habitats for the effective conservation of multiple species. One key advantage of this proposed approach is that the scale of the derived ecological information could match the scale of landscape management interventions. The versatility, visualization power and ease of interpretation of these networks will enable application of the species–habitat network concept to a wide array of real‐world problems, such as multispecies conservation, habitat restoration, ecosystem services management or invasion ecology. In particular, species–habitat networks could be applied to identify optimal landscape compositions and configurations to design effective interventions at the landscape scale. This approach also enables the detection of emerging network properties that could also be used to test the effects of large‐scale drivers of global change upon ecosystem structure and stability.
Effect of a cluster randomised team training intervention on adverse perinatal and maternal outcomes: a stepped wedge study
Authors: Romijn A , Ravelli ACJ , de Bruijne MC , Twisk JWR , Wagner C , de Groot CJM , Teunissen PW
Published: January 2019

Objective

To study the effect of an intervention based on Crew Resource Management team training, including a tool for structured communication, on adverse perinatal and maternal outcomes.

Design

Stepped wedge.

Setting

The Netherlands.

Population or sample

Registry data of 8123 women referred from primary care to a hospital during childbirth, at ≥ 32.0 weeks of singleton gestation and with no congenital abnormalities, in the period 2012–15.

Methods

Obstetric teams of five hospitals and their surrounding primary‐care midwifery practices participated in the intervention. In total, 49 team training sessions were organised for 465 care professionals (75.5% participated). Adverse perinatal and maternal outcomes before, during and after the intervention were analysed using multivariate logistic regression analyses.

Main Outcome Measures

Adverse Outcome Index (AOI‐5), a composite measure involving; intrapartum or neonatal death, admission to neonatal intensive care unit, Apgar < 7 at 5 minutes, postpartum haemorrhage and/or perineal tear.

Results

In total, an AOI‐5 score was reported in 11.3% of the study population. No significant difference was found in the incidence of the AOI‐5 score after the intervention compared with before the intervention (OR 1.07: 95% CI 0.92–1.24).

Conclusions

We found no effect of the intervention on adverse perinatal and maternal outcomes for women who were referred during childbirth. Team training is appreciated in practice, but evidence on the long‐term impact is still limited. Upcoming studies should build on previous research and consider more sensitive outcome measures.

Tweetable abstract

A cluster randomised team training intervention showed no effect on adverse perinatal and maternal outcomes for women referred during childbirth.
A practical dialogue protocol for sustainability science to contribute to regional resources management: its implementation in Réunion
Authors: Queste Jérôme , Wassenaar Tom
Published: January 2019

Over the last decade, adaptive co‐management has been recommended as a policy framework to address complex and uncertain resources management issues. Implementing this theoretical management concept requires the integration of multidisciplinary research and local knowledge. Yet practical protocols to link science, policymaking and societies have yet to be developed. We designed a protocol to produce legitimate, credible and relevant solutions to a regional resources management issue. This is a two‐component protocol. A stakeholder grid categorizes stakeholder representatives in three distinct specialized dialogue arenas: institution representatives, technical experts and local end‐users. An iterative co‐design process then builds on these arenas to assess the institutional legitimacy, technical credibility and empirical relevance dimensions of a common solution initiated by an initial plausible promise. We tested this framework in Réunion to address organic waste management issues at the regional level. The plausible solution explored was the introduction of a recycling industry involved in collecting organic waste and producing and selling organic fertilizers tailored for local crop systems. The protocol application outcomes were consolidated and documented scenarios accepted by all, with knowledge exchange and the broad spread of a stabilized expectation contributing to private initiatives and public policy change.
Understanding the Large‐Scale Influence of Levees on Floodplain Connectivity Using a Hydrogeomorphic Approach
Authors: Scheel Kara , Morrison Ryan R. , Annis Antonio , Nardi Fernando
Published: January 2019

The widespread construction of levees has reduced river–floodplain connectivity and altered associated fluvial processes in many river systems. Despite the recognition that levees can alter floodplain connectivity, few studies have examined the role of levees in reducing floodplain areas at large watershed scales. This paper explores the application of a hydrogeomorphic floodplain inundation model in the Wabash Basin, located in the Midwestern United States, to assess changes in floodplain area in levee‐protected areas. We evaluate 10‐ and 30‐m topographic resolutions and spatially examine the influence of levees on floodplain area in relation to river network attributes. Generally, floodplains in levee‐protected areas were influenced by topographic resolution, stream order, and elevation details of levees found in topography datasets. We show, when compared to Federal Emergency Management Agency maps, our approach underpredicts floodplain area when using 10‐m resolution topography data but only slightly overpredicts when using 30‐m resolution data. After removing details of levees from topography data, we found changes in floodplain area varied spatially, but basin‐aggregate results changed little compared to topography datasets that contain levees, though larger floodplain areas were produced in some regions where levees were removed. This work contributes to a growing research emphasis on using hydrogeomorphic floodplain models to understand floodplain disconnectivity.
Governing alongside:
Authors: FENT ASHLEY
Published: January 2019

Since 2014, local and regional state administrators in Senegal have negotiated a controversial zircon and titanium sands mining venture in villages of the Casamance region. Positioning themselves “alongside” the population, they enacted a lateral spatiality of the state by organizing opportunities for dialogue, drawing on fictive kinship relations, and articulating a governmental approach of “accompaniment,” which focused on collaborating with local people. Yet residents of Niafarang and nearby villages wanted an idealized version of the state that would deliver benefits and protection from the top down, and they were frustrated by the Senegalese state's self‐interest. As the debate continued, administrators used vertical authority to secure local acceptance of the mining project. Lateral relations therefore both challenged and bolstered vertical state power over localities, illustrating the multiple, conflicting spatialities of state practice. [mining,development,state spatiality,expectations of the state,Casamance,Senegal]
Five‐year results of small incision lenticule extraction (SMILE) and femtosecond laser LASIK (FS‐LASIK) for myopia
Authors: Li Meiyan , Li Meng , Chen Yingjun , Miao Huamao , Yang Dong , Ni Katherine , Zhou Xingtao
Published: January 2019

Purpose

To compare visual outcomes and aberration outcomes in small incision lenticule extraction (SMILE) versus femtosecond laser LASIK (FS‐LASIK).

Methods

This prospective, comparative, nonrandomized clinical study included 68 eyes of 37 patients receiving SMILE and 55 eyes of 30 patients receiving FS‐LASIK between December 2011 and January 2013 at the Fudan University Eye and ENT Hospital (Shanghai, People's Republic of China). Patients were followed up at 3, 6 months and 5 years after surgery. Main outcome measurements included uncorrected (UDVA) and corrected (CDVA) distance visual acuity, manifest refraction, central corneal thickness (CCT), total corneal refractive power (TCRP) and wavefront aberrations.

Results

About 98% (49/50) of treated eyes in the SMILE group and 95% (39/41) in the FS‐LASIK group had a postoperative logMAR UDVA of 0 or better. Spherical equivalent (SE) after 5 years was −0.01 ± 0.35 D in the SMILE group and −0.23 ± 0.41 D in the FS‐LASIK group. A regression of −0.02 ± 0.39 D in the SMILE group and −0.12 ± 0.32 D in the FS‐LASIK group was observed between 6 months and 5 years postoperative time‐points. TCRP increased by 0.39 ± 0.38 D in the SMILE group and 0.45 ± 0.49 D in the FS‐LASIK group between 6‐month and 5‐year time‐points. However, no statistically significant difference was found between the SMILE and FS‐LASIK groups in terms of ∆SE, ∆CCT and ∆TCRP between 6 months and 5 years postoperative time‐points.

Conclusion

Myopic regression was observed in terms of TCRP but not in subjective refraction. No statistically significant difference in stability was found between SMILE and FS‐LASIK.
Which outcomes have been measured in hand eczema trials? A systematic review
Authors: Rönsch Henriette , Apfelbacher Christian , Brans Richard , Matterne Uwe , Molin Sonja , Ofenloch Robert , Oosterhaven Jart A. F. , Schuttelaar Marie L. A. , Weisshaar Elke , Yew Yik Weng , Bauer Andrea
Published: January 2019

The considerable heterogeneity of outcomes and measurement instruments in hand eczema trials substantially limits the evidence synthesis concerning therapeutic and preventive interventions. Therefore, the Hand Eczema Core Outcome Set (HECOS) initiative is developing a core outcome set for future trials. The first objective was to identify outcomes that were measured in previous trials, to group them in domains, and to identify their measurement instruments. We conducted a systematic review of controlled and randomized controlled hand eczema trials published since 2000. Sixty‐one eligible studies were identified. Each assessed one or more of 47 outcomes in the “skin” domain. Eighteen trials (30%) additionally focused on preventive behaviour in risk occupations. Quality of life was measured in 13 studies (21%). Thirty‐two distinct named instruments were applied, but 223 measurements (62%) were conducted with unnamed instruments. Only 32 studies (52%) defined a primary outcome. Twenty‐nine trials (48%) provided some information on adverse events, but none gave any references concerning relevant methods. Our review confirms the need to harmonize outcome measurements in hand eczema trials. The findings form the basis for a consensus process to generate a core outcome set to improve the explanatory power and comparability of future hand eczema studies.
AID, POLICIES, AND GROWTH: WHY SO MUCH CONFUSION?
Authors: Jia Shaomeng , Williamson Claudia R.
Published: January 2019

We revisit the highly debated aid‐policy‐growth association. Our results overturn Burnside and Dollar's original findings by simply using new data over the same countries and years. Marginal effects from the extended sample (1962–2013) provide weak evidence that aid can promote growth in the presence of good policies. Post‐Cold War (1990–2013) analysis, however, reveals that aid can decrease growth at any level of policy. The overwhelming majority of the results suggest aid conditional on policy is ineffective. This debate continues because the results are highly sensitive to country‐year selection, choice of methodology, measurement of institutional quality, and growth rate measurement. (JEL F35, O23, O40)
Diagnostic utility of dual 5‐hydroxymethylcytosine/Melan‐A immunohistochemistry in differentiating nodal nevus from metastatic melanoma: An effective first‐line test for the workup of sentinel lymph node specimen
Authors: Siref Andrew B. , Huynh Carissa A.T. , Balzer Bonnie L. , Frishberg David P. , Essner Richard , Shon Wonwoo
Published: January 2019

Background

Distinguishing benign nodal nevus from metastatic melanoma can be diagnostically challenging, with important clinical consequences. Recently, the loss of epigenetic marker, 5‐hydroxymethylcytosine (5‐hmC) expression by immunohistochemistry has been found in melanomas and atypical melanocytic neoplasms.

Methods

About 41 metastatic melanomas and 20 nodal nevi were retrieved. Nuclear 5‐hmC (brown) and cytoplasmic Melan‐A Red (red) double immunohistochemical staining was performed.

Results

Total or partial loss of nuclear expression of 5‐hmC was noted in 40/41 metastatic melanomas; these tumor cells were strongly positive for Melan‐A Red, except in one case of desmoplastic melanoma. All cases of nodal nevus showed uniformly retained nuclear expression of 5‐hmC accompanied by strong Melan‐A Red cytoplasmic staining. In two cases containing both nodal nevus and metastatic melanoma, all tumor cells were positive for Melan‐A Red, but a nuclear expression of 5‐hmC was selectively absent only in the melanoma tumor cells.

Conclusion

Dual 5‐hmC/Melan‐A Red immunohistochemistry is highly specific in distinguishing nodal nevus from metastatic melanoma. Our protocol for brown and red chromogens used in this study provides excellent color contrast and is easy to interpret. Furthermore, this dual staining method allows the preservation of limited tumor tissue, which could be used for potential molecular studies.
Cutaneous ganglioneuroma: A case report and discussion of the literature
Authors: Segars Kelly A. , Baltazar David , Baribault Keith , Miller Richard A.
Published: January 2019

Ganglioneuromas (GNs) are benign tumors composed of ganglion cells in a Schwannian stroma. They are derived from neural crest cells that give rise to the sympathetic nervous system. Hence, GNs can be found anywhere a sympathetic ganglion is present. Most commonly, GNs are found in the posterior mediastinum and abdominal cavity. Within the abdominal cavity, they are most likely to be found in the retroperitoneal space or adrenal glands. Cutaneous involvement is uncommon and rarely reported in literature. We report an interesting case of a cutaneous ganglioneuroma on the abdomen of an 83‐year‐old male.
Interventions to improve upper limb function for children with bilateral cerebral palsy: a systematic review
Authors: Plasschaert Véronique F P , Vriezekolk Johanna E , Aarts Pauline B M , Geurts Alexander C H , Van den Ende Cornelia H M
Published: January 2019

Aim

To systematically review the efficacy of interventions on upper limb function in children 0 to 19 years of age with bilateral cerebral palsy on the basis of outcome measures of upper limb function and measures of activities and/or participation according to the International Classification of Functioning, Disability and Health.

Method

Cochrane, PubMed, Embase, CINAHL, and Web of Science were searched from inception to September 2017. Methodological quality and strength of evidence were analysed by two independent raters using Sackett's level of evidence and the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) guidelines.

Results

Fifteen studies with a large variety of interventions and heterogeneity in outcome measures met the inclusion criteria. Twelve studies provided level IV evidence according to AACPDM guidelines. For three small randomized controlled trials the level of evidence was II. Only one of these trials showed strong methodological quality: a study on hand–arm bimanual intensive therapy including lower extremities.

Interpretation

We identified a large variety of interventions, heterogeneity in outcome measures, and generally weak to moderate methodological quality for most studies. We recommend further research specifically aimed at bimanual‐intensive, goal‐directed, and task‐specific training programmes for the upper limb in children with bilateral cerebral palsy, using either high‐quality (multicentre) trials or well‐designed single‐case trials.

What this paper adds

There is a large variety of interventions on upper limb function in children with bilateral cerebral palsy.

Heterogeneity of outcome measures and interventions impeded firm conclusions about intervention efficacy.

Most studies had low‐level evidence and weak to moderate methodological quality.

The strongest evidence from a small randomized controlled trial was for hand–arm bimanual intensive therapy including lower extremities.
Religion and development in post‐Famine Ireland
Authors: Henderson Stuart
Published: January 2019

Over a century ago, Horace Plunkett began a debate about the role of religion in Irish development, pointing to what he saw as the economic shortcomings of Roman Catholicism. Thereafter, however, the debate waned, and only limited scholarship has subsequently investigated the significance of religion in Irish development, especially in statistical terms. In this article that lacuna is addressed, using a quantitative approach to examine the relationship between Roman Catholicism and economic and financial development in the post‐Famine era. Attention is directed to a variety of development indicators, namely, education, occupations, and commerce. By focusing on a selection of measures over time, it is possible to determine more precisely where differences, if any, occurred between the denominations and whether such differences changed over the period. The analysis reveals that Roman Catholicism tends to be initially negatively associated with more advanced development outcomes, but that this association weakens over time. As such, the results point to an economic convergence between Roman Catholics and Protestants, complementing historical evidence on an upward Catholic socioeconomic transition—a ‘Catholic embourgeoisement’—in the post‐Famine era.
Medical reliability of a video‐sharing website: The gingival recession model
Authors: Hamdan Ahmad A. , Shaqman Murad , Abu Karaky Ashraf , Hassona Yazan , Bouchard Philippe
Published: January 2019

Objectives

To evaluate the quality of the scientific/clinical information in dentistry delivered by videos hosted by a popular video‐sharing website.

Methods

The gingival recession condition was used as a model and YouTube™ as the video hosting service. A systematic observation of videos containing information on gingival recession was conducted. Videos were analysed to evaluate (i) the scientific reliability and quality of the information using Global Quality Scale (GQS) and DISCREN criteria; and (ii) the understandability of this information using a tailor‐made custom comprehensiveness index (CI).

Results

One hundred and eighty videos were identified. Videos dealing with surgical procedures were not included in the present review. After selection, 41 videos were analysed. The mean GQS was 2.34 on a 0‐5 scale, and 25 (61%) videos showed clear aims according to DISCREN criteria. Misleading content was observed in eight videos (19.5%). The scientific sources of information were unclear in 26 (63.4%) videos. All videos failed to give additional references for supplemental information. Only three videos (7%) provided basic information on aetiology, clinical presentations and management of gingival recession. Based on 0‐2 CI scores, three, nine and 29 videos had a score of 2, 1 and 0, respectively.

Conclusion

The present model indicates that social media websites aiming to provide health information should be carefully accounted, especially when dealing with dentistry. It also suggests professional involvement to improve the quality of the delivered information.
‘Higher education’ – substance use among Berlin college students
Authors: Viohl Leonard , Ernst Felicitas , Gabrysch Julian , Petzold Moritz B. , Köhler Stephan , Ströhle Andreas , Betzler Felix
Published: January 2019

Berlin is internationally known for its intense nightlife associated with high rates of psychoactive substance use. Previous studies conducted in other cities indicated college students as a group at high risk for substance (mis‐)use that was associated with individual psychological and cognitive impairments as well as lower academic performance. The aim of this study was to provide detailed data about the substance use patterns of Berlin college students. In addition, major protective and risk factors were analysed. An online questionnaire assessing sociodemographic data and various relevant aspects of both legal and illegal substance use such as consumption pattern and frequency as well as risk‐taking behaviour was developed and distributed among colleges in Berlin. A sample of 9351 participants from 17 different colleges in Berlin completed the questionnaire. The study revealed high lifetime (69.3%), past year (45.9%) and past month (28.3%) prevalence of illicit substance use in the sample. Daily tobacco‐smoking, a mental disorder diagnosis, a positive screening for problematic consumption (Cage‐AID), bisexual orientation and living in open relationship were main factors positively associated with the prevalence and the extent of illicit substance use. Students in Berlin appear to show higher rates of illicit substance use than was previously reported for age‐matched individuals in the general German population and college students in other cities. Thus, they are a relevant target group for early prevention and intervention concerning substance use and abuse.
Synchronized activation of striatal direct and indirect pathways underlies the behavior in unilateral dopamine‐depleted mice
Authors: Jáidar Omar , Carrillo‐Reid Luis , Nakano Yoko , Lopez‐Huerta Violeta Gisselle , Hernandez‐Cruz Arturo , Bargas José , Garcia‐Munoz Marianela , Arbuthnott Gordon William
Published: January 2019

For more than three decades it has been known, that striatal neurons become hyperactive after the loss of dopamine input, but the involvement of dopamine (DA) D1‐ or D2‐receptor‐expressing neurons has only been demonstrated indirectly. By recording neuronal activity using fluorescent calcium indicators in D1 or D2 eGFP‐expressing mice, we showed that following dopamine depletion, both types of striatal output neurons are involved in the large increase in neuronal activity generating a characteristic cell assembly of particular neurons that dominate the pattern. When we expressed channelrhodopsin in all the output neurons, light activation in freely moving animals, caused turning like that following dopamine loss. However, if the light stimulation was patterned in pulses the animals circled in the other direction. To explore the neuronal participation during this stimulation we infected normal mice with channelrhodopsin and calcium indicator in striatal output neurons. In slices made from these animals, continuous light stimulation for 15 s induced many cells to be active together and a particular dominant group of neurons, whereas light in patterned pulses activated fewer cells in more variable groups. These results suggest that the simultaneous activity of a large dominant group of striatal output neurons is intimately associated with parkinsonian symptoms.
Nitrogen addition does not reduce the role of spatial asynchrony in stabilising grassland communities
Authors: Zhang Yunhai , Feng Jinchao , Loreau Michel , He Nianpeng , Han Xingguo , Jiang Lin
Published: January 2019

While nitrogen (N) amendment is known to affect the stability of ecological communities, whether this effect is scale‐dependent remains an open question. By conducting a field experiment in a temperate grassland, we found that both plant richness and temporal stability of community biomass increased with spatial scale, but N enrichment reduced richness and stability at the two scales considered. Reduced local‐scale stability under N enrichment arose from N‐induced reduction in population stability, which was partly attributable to the decline in local species richness, as well as reduction in asynchronous local population dynamics across species. Importantly, N enrichment did not alter spatial asynchrony among local communities, which provided similar spatial insurance effects at the larger scale, regardless of N enrichment levels. These results suggest that spatial variability among local communities, in addition to local diversity, may help stabilise ecosystems at larger spatial scales even in the face of anthropogenic environmental changes.
Patterns of risk behaviors in Brazilian older adults: A latent class analysis
Authors: de Mello Gabrielli T , da Silva Kelly S , da Costa Bruno GG , Borgatto Adriano F
Published: January 2019

Aim

The aim of the present study was to describe the clustering of diet, physical activity, television viewing, and tobacco and alcohol use among Brazilian older adults (aged ≥60 years).

Methods

We carried out a secondary analysis of the Brazilian National Health Survey of 2013. Brazilian older adults (n = 11 177) reported their consumption of fruit and vegetables, leisure physical activity, television viewing, tobacco smoking, and alcohol intake. Latent class analysis was used to identify behavior patterns.

Results

Three classes of behaviors were identified. The “Healthy” class (34.8%) had the highest probability of meeting recommendations for physical activity, and fruit and vegetable consumption; the “Poor diet and PA” class (46.5%) presented low probabilities of meeting recommendations for physical activity and alcohol consumption; and the “Smoking and binge drinking” class (18.7%) had the highest probability of smoking and binge drinking.

Conclusions

Three behavioral patterns were identified in the Brazilian older population. Even in the “Healthy” class, less than half of the older adults were considered physically active, suggesting that there is no completely healthy profile. Nevertheless, physical activity and fruit and vegetable consumption behaviors clustered, as did smoking and binge drinking. Geriatr Gerontol Int 2019; 19: 245–248.
Favorable outcomes of culture‐based Helicobacter pylori eradication therapy in a region with high antimicrobial resistance
Authors: Lee Jung W. , Kim Nayoung , Nam Ryoung H. , Lee Sun M. , Kwon Yong H. , Sohn So D. , Kim Jung M. , Lee Dong H. , Jung Hyun C.
Published: January 2019

Background

The eradication rate of Helicobacter pylori has declined, mainly due to antimicrobial resistance. To overcome resistance‐associated treatment failure, the efficacy of culture‐based, susceptibility‐guided therapy was demonstrated as the first‐line eradication therapy for H pylori infection.

Aims

To evaluate the efficacy of culture‐based therapy as the first‐line eradication therapy in regions with high levels of antimicrobial resistance.

Methods

Helicobacter pylori‐positive patients without previous eradication treatment history were recommended to undergo culture to determine the minimal inhibitory concentration (MIC). If they consented, 7‐day clarithromycin‐containing PPI triple; 7‐day esomeprazole, moxifloxacin, and amoxicillin (MEA) therapy; or 7‐ or 14‐day esomeprazole, bismuth, metronidazole, and tetracycline (quadruple) therapy were administered based on the agar dilution‐determined MIC. Eradication, treatment compliance, and adverse events were examined.

Results

In total, 74 patients were enrolled, and 69 patients completed the protocols. The overall resistance rates to amoxicillin, clarithromycin, metronidazole, and moxifloxacin were 6.7%, 31.0%, 41.8%, and 39.2%, respectively. The patients were allocated to the PPI triple (n = 50), MEA (n = 8) or quadruple (n = 16) therapy. The eradication rate in the intention‐to‐treat analysis was 93.1% (69 of 74 patients). The eradication rates in the per‐protocol analysis were 100.0% (69 of 69 patients). Epigastric pain, nausea, and vomiting were less common than those of other empirical therapies.

Conclusions

Culture‐based, susceptibility‐guided therapy is effective first‐line eradication therapy, especially in regions with high levels of antimicrobial resistance.
Hope, disappointment and perseverance: Reflections of people with Myalgic encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Multiple Sclerosis participating in biomedical research. A qualitative focus group study
Authors: Lacerda Eliana M. , McDermott Clare , Kingdon Caroline C. , Butterworth Jack , Cliff Jacqueline M. , Nacul Luis
Published: January 2019

Background

The Clinical Understanding and Research Excellence in ME/CFS group (CureME) at the London School of Hygiene & Tropical Medicine has supported and undertaken studies in immunology, genetics, virology, clinical medicine, epidemiology and disability. It established the UK ME/CFS Biobank (UKMEB), which stores data and samples from three groups: participants with ME/CFS, Multiple Sclerosis (MS) and healthy controls. Patient and public involvement have played a central role from its inception.

Aim

To explore the views of participants with ME/CFS and MS on CureME research findings, dissemination and future biomedical research priorities.

Method

Five ME/CFS and MS focus groups were conducted at two UK sites. Discussions were transcribed and analysed thematically.

Results

A total of 28 UKMEB participants took part: 16 with ME/CFS and 12 with MS. Five themes emerged: (a) Seeking coherence: participants’ reactions to initial research findings; (b) Seeking acceptance: participants explore issues of stigma and validation; (c) Seeking a diagnosis: participants explore issues around diagnosis in their lives; (d) Seeking a better future: participants’ ideas on future research; and (e) Seeking to share understanding: participants’ views on dissemination. Focus groups perceived progress in ME/CFS and MS research in terms of “putting together a jigsaw” of evidence through perseverance and collaboration.

Conclusion

This study provides insight into the emotional, social and practical importance of research to people with MS and ME/CFS, suggesting a range of research topics for the future. Findings should inform biomedical research directions in ME/CFS and MS, adding patients’ voices to a call for a more collaborative research culture.
Rehabilitation environments: Service users’ perspective
Authors: Killington Maggie , Fyfe Dean , Patching Allan , Habib Paul , McNamara Annabel , Kay Rachael , Kochiyil Venugopal , Crotty Maria
Published: January 2019

Background

Design of rehabilitation environments is usually “expert” driven with little consideration given to the perceptions of service users, especially patients and informal carers. There is a need to engage with consumers of services to gain their insights into what design aspects are required to facilitate optimum physical activity, social interaction and psychological responses when they are attempting to overcome their limitations and regain function.

Research design

Qualitative exploratory study.

Method

Interviews were conducted with patients (n = 54) and informal carers (n = 23), and focus groups with rehabilitation staff (n = 90), from the three metropolitan South Australia rehabilitation health services, comprising different building and environmental configurations. Thematic analysis was assisted by the use of NVivo 11 qualitative software, with pooled data from all interviews and focus groups undergoing open, axial and finally selective coding.

Results

Four major themes were identified as follows: (a) choice can be an Illusion in a rehabilitation ward; (b) access to outside areas is a priority and affects well‐being; (c) socialization can be facilitated by the environment; and (d) ward configuration should align with the model of care.

Discussion and Conclusion

Participants who encountered the most restrictive environments accepted their situation until probed to consider alternatives; those who enjoyed the most choice and access to facilities showed the greatest enthusiasm for these affordances. Future architectural designers should therefore consider the perceptions of a wide range of consumers with varying experiences to ensure they understand the complex requirements of patients and that the ward design facilitates the optimum rehabilitation model of care.
De‐simplifying single‐tablet antiretroviral treatments: uptake, risks and cost savings
Authors: Krentz HB , Campbell S , Lahl M , Gill MJ
Published: January 2019

Objectives

As more HIV‐positive individuals receive antiretroviral therapy (ART), payers are seeking options for covering these increased and sustained drug costs. Strategic use of available generic antiretroviral (ARV) formulations may be feasible. De‐simplifying a single‐tablet co‐formulation (STF) into two or more tablets using both brand and generic drugs has been proposed. We determine if voluntary de‐simplification of one STF could be utilized as a cost‐saving strategy. We report on the challenges, uptake, outcomes and cost savings of this initiative.

Methods

Patients stable on the most commonly used STF (Triumeq®) were offered the option of remaining on Triumeq® or switching to generic abacavir/lamivudine and Tivicay® between 1 January 2015 and 1 January 2018; those starting ART consisting of abacavir/lamivudine/doulutegravir in the same period were offered the option of starting Triumeq® or generic abacavir/laminvudine and Tivicay®. No incentives were provided. We examined the acceptance/decline rates, patient satisfaction, health care outcomes and annual cost savings.

Results

Of 626 patients receiving Triumeq®, 321 were approached; 177 (55.1%) agreed to de‐simplify. Of patients initiating ART, 62.7% chose the generic co‐formulation. Patients switching to or starting on the generic co‐formulation were more likely to be male, > 45 years old, Caucasian, men who have sex with men (MSM) and more HIV‐experienced, and to have more comorbidities (all P < 0.05). Preference for STF was cited for declining de‐simplification. No concern about generic ARVs was expressed. The rate of viral load > 500 HIV‐1 RNA copies/mL after baseline was 2.7% in switched patients compared with 7.0% in those declining to switch. No de novo resistance occurred. A saving of Cdn$1 319 686 was achieved in the first year.

Conclusions

Reliance on altruism, while respecting patient autonomy, achieved de‐simplification in > 50% of patients approached, and generated immediate cost savings with no increased risk of adverse events, viral breakthrough or resistance.
Evaluation of weight‐based prescription of antiretroviral therapy in children
Authors: Dakshina S , Olaru ID , Khan P , Raman L , McHugh G , Bwakura–Dangarembizi M , Nathoo K , Munyati S , Mujuru H , Ferrand RA
Published: January 2019

Objectives

The aim of the study was to investigate the extent of and factors associated with incorrect dosing of antiretroviral therapy (ART) in HIV‐infected children in Harare, Zimbabwe.

Methods

All children aged 0–10 years and children aged 11–17 years who weighed < 35 kg and taking ART were recruited from the paediatric HIV clinic at Harare Hospital. Their current doses of ART drugs were compared against doses recommended by the national guidelines.

Results

Among 309 children recruited [55% male; median age 7 years (interquartile range (IQR) 5–10 years)], the median CD4 count was 899 cells/μL and the median duration of their current ART regimen was 11.2 months (IQR 4.9–17.1 months). Overall, 110 (35.6%) children were prescribed incorrect doses of at least one drug component within their ART regimen; 64 (20.7%) under‐dosed and 49 (15.9%) over‐dosed on at least one drug. Children receiving a higher than recommended dose of at least one drug were younger compared with correctly dosed children (median 6 versus 7 years, respectively; P = 0.001), had been on their current ART regimen for a shorter time (median 7.2 versus 13 months, respectively; P = 0.003) and were less likely to be receiving a three‐drug fixed‐dose combination (FDC; 42.9 versus 63.3%, respectively; P = 0.009). Those who were under‐dosed were also less likely to be on a three‐drug FDC (25 versus 63.3%, respectively; P < 0.001).

Conclusions

Over a third of children were prescribed incorrect doses of ART. Children taking triple‐drug FDCs were likely to be correctly dosed. Our study highlights the importance of weight monitoring at each clinical contact, training of health care providers on paediatric drug dosing and the need for wider availability of FDCs for children.
Patterns of change in fairness perceptions during the hiring process: A conceptual replication in a controlled context
Authors: Butucescu Andreea , Iliescu Dragoș
Published: January 2019

The present paper tackles a problem in the candidate reactions literature: the replicability of results that emerge when using in vivo and in vitro designs. The current study was designed to provide a conceptual replication of a dynamic model of change in fairness perceptions during the hiring process, using a different research design, different measures, and a different sample than the original paper. A sample of 209 participants in a simulated selection process reported their level of perceived fairness three times: before the testing, after the testing, and after the results were communicated. These results support the results of the original that the construction of fairness perceptions declines in a nonlinear way over time, with high initial levels of fairness perception corresponding to a lower rate of decline, and vice versa. Further analysis revealed no change in the individuals’ conceptualization of perceived fairness nor any shift in the respondents’ use of the measurement scale (i.e., no beta and gamma change were detected).
Isoform specific roles of Broad‐Complex in larval development in Leptinotarsa decemlineata
Authors: Xu Q.‐Y. , Meng Q.‐W. , Deng P. , Fu K.‐Y. , Guo W.‐C. , Li G.‐Q.
Published: January 2019

Broad‐Complex (BrC) is a downstream target of both 20‐hydroxyecdysone and juvenile hormone signalling. BrC regulates morphogenetic changes between nymphal instars in hemimetabolans, whereas it controls pupal commitment, pupal morphogenesis and inhibits adult differentiation in holometabolans. Among five BrC cDNAs (Z1–Z4 and Z6) identified in the Colorado potato beetle, we found in this work that Z1, Z2 and Z6 were mainly expressed at the last (fourth) instar and prepupal stages, whereas the levels of Z3 and Z4 increased during the penultimate (third) instar stage, peaked at the last instar larval phase and gradually decreased at the prepupal and pupal periods. When knocking down all BrC isoforms by RNA interference (RNAi) at the penultimate instar stage, around 20% of the resultant larvae remained as moribund beetles. These moribund BrC RNAi larvae were completely or partially wrapped in old cuticle. Likewise, a portion of larvae treated for a single double‐stranded RNA of Z3, Z4 or Z6 displayed a degree of similar aberrancies, increasing in the order of isoforms Z6 < Z3 < Z4. When silencing all BrC isoforms at the last instar period, most of the RNAi larvae did not normally pupate or emerge as adults. Separately silencing each of the five zinc finger domains revealed that approximately 70% of the Z1 RNAi larvae remained as prepupae, around 60% of the Z6 RNAi specimens formed aberrant prepupae or pupae and about 60% of the Z2 RNAi beetles became deformed pupae. After removal of the old exuviae, these deformed larvae in which either Z1, Z2 or Z6 was depleted possessed adult prothorax and mesothorax, developing antenna, mouthparts and wing discs. Moreover, less than 50% of the resultant pupae finally emerged as adults when either of Z1, Z2 or Z6 was knocked down. Therefore, our findings reveal, for the first time, that the two roles of BrC in insect groups (ie directing morphogenetic changes during juvenile development and regulating larval–pupal–adult metamorphosis) are played by different BrC isoforms in Leptinotarsa decemlineata.