bluuebunny/crossref_metadata_2025 huggingface dataset:
The effects of an epithelial barrier protective cationic aerosol on allergen‐induced airway inflammation in asthma: a randomized, placebo‐controlled clinical trial
Authors: Nair P. , Denis S. , Cancelliere L. , Radford K. , Efthimiadis A. , Rosano M. , Hanrahan J.
Published: August 2014

Inhaled cationic airway lining modulator (iCALM) is a cationic aerosol therapy comprised of 1.29% calcium chloride dissolved in 0.9% isotonic saline that enhances the biophysical barrier function of the airway lining fluid and primes the host defense response. It's ability to attenuate bronchitis caused by inhaled particles was investigated using an allergen‐inhalation model in a proof‐of‐concept study. In a randomized, double‐blind, placebo‐controlled cross‐over trial of 6 mild atopic steroid‐naïve asthmatic subjects, 3 doses of iCALM were well tolerated and they attenuated allergen‐induced increase in sputum eosinophils, and levels of IL‐5, MCP‐1 and eotaxin. This study provides an opportunity to investigate the role of enhancing epithelial barrier to decrease airway inflammation provoked by inhaled particles in a variety of airway diseases.
Neutrophil–lymphocyte ratio is a reliable predictive marker for early‐stage diabetic nephropathy
Authors: Huang Wanjing , Huang Jinhua , Liu Qingxing , Lin Fuchuan , He Zhihao , Zeng Zhenhua , He Lei
Published: August 2014

Introduction

Diabetic nephropathy (DN) is a common complication in diabetics. Recent evidence suggests that neutrophil–lymphocyte ratio (NLR) affects the development and acceleration of some diabetic complications. Scholars have rarely investigated the relationship between DN and NLR. This study aims to evaluate the relationship between DN and NLR and estimate whether or not NLR is a reliable marker for early‐stage DN.

Patients and methods

The study included 253 patients with type 2 diabetes mellitus, 115 of whom have early‐stage DN. The control group was composed of 210 healthy age‐ and sex‐matched subjects.

Results

The NLR values of the patients with diabetes were significantly higher than those of the healthy controls (P < 0·001), and the NLR values of the patients with early‐stage DN were higher than those of the patients without DN (P < 0·001). Logistic regression analysis showed that the risk predictors of DN include NLR, creatinine, total cholesterol, systolic blood pressure, HbA1c and insulin resistance. NLR (P = 0·004, EXP(B) = 2·088, 95% CI = 1·271–3·429) levels positively correlated with DN. The DN odds ratio increased by a factor of 2·088 (95% CI, 1·271–3·429) for every one unit increase in NLR.

Conclusions

Increased NLR was significantly associated with DN, and high NLR values may be a reliable predictive marker of early‐stage DN.
Connecting Conscious and Unconscious Processing
Authors: Cleeremans Axel
Published: August 2014

Consciousness remains a mystery—“a phenomenon that people do not know how to think about—yet” (Dennett, , p. 21). Here, I consider how the connectionist perspective on information processing may help us progress toward the goal of understanding the computational principles through which conscious and unconscious processing differ. I begin by delineating the conceptual challenges associated with classical approaches to cognition insofar as understanding unconscious information processing is concerned, and to highlight several contrasting computational principles that are constitutive of the connectionist approach. This leads me to suggest that conscious and unconscious processing are fundamentally connected, that is, rooted in the very same computational principles. I further develop a perspective according to which the brain continuously and unconsciously learns to redescribe its own activity itself based on constant interaction with itself, with the world, and with other minds. The outcome of such interactions is the emergence of internal models that are metacognitive in nature and that function so as to make it possible for an agent to develop a (limited, implicit, practical) understanding of itself. In this light, plasticity and learning are constitutive of what makes us conscious, for it is in virtue of our own experiences with ourselves and with other people that our mental life acquires its subjective character. The connectionist framework continues to be uniquely positioned in the Cognitive Sciences to address the challenge of identifying what one could call the “computational correlates of consciousness” (Mathis & Mozer, ) because it makes it possible to focus on the mechanisms through which information processing takes place.
Skeptical Appeal: The Source‐Content Bias
Authors: Turri John
Published: August 2014

Radical skepticism is the view that we know nothing or at least next to nothing. Nearly no one actually believes that skepticism is true. Yet it has remained a serious topic of discussion for millennia and it looms large in popular culture. What explains its persistent and widespread appeal? How does the skeptic get us to doubt what we ordinarily take ourselves to know? I present evidence from two experiments that classic skeptical arguments gain potency from an interaction between two factors. First, people evaluate inferential belief more harshly than perceptual belief. Second, people evaluate inferential belief more harshly when its content is negative (i.e., that something is not the case) than when it is positive (i.e., that something is the case). It just so happens that potent skeptical arguments tend to focus our attention on negative inferential beliefs, and we are especially prone to doubt that such beliefs count as knowledge. That is, our cognitive evaluations are biased against this specific combination of source and content. The skeptic sows seeds of doubt by exploiting this feature of our psychology.
Primary cutaneous follicle center lymphoma with Hodgkin and Reed‐Sternberg‐like cells: a new histopathologic variant
Authors: Marie Dilly , Houda Ben‐Rejeb , Béatrice Vergier , Matthieu Feldis , Louis Toty , Olivier Nohra , Marie Beylot‐Barry , Audrey Gros , Jean‐Philippe Merlio , Marie Parrens
Published: August 2014

Primary cutaneous follicle center lymphoma (PCFCL) is the most frequent cutaneous B‐cell lymphoma. A 62‐year‐old man presented with a solitary indolent subcutaneous nodule for 3 years duration, without other abnormalities. Histological examination showed lymphoproliferation with a nodular growth pattern characterized by fibrous collagen bands surrounding nodules. The nodules were composed of medium‐sized centrocytes admixed with many large multilobulated and lacunar cells without eosinophils or granulomatous aspect. Hodgkin‐like cells were CD30+, CD15+, PAX5+, OCT2+, BOB1+, MUM1+, Ki67+, Bcl6+ and focally CD20+ and EMA−, CD79a−, Bcl2− and CD10−. The medium‐sized cells were CD20+, CD79a+, Bcl2+, Bcl6+ and CD10+, enmeshed in a network of CD21‐positive follicular dendritic cells. Epstein‐Barr virus detection was negative. Interphase fluorescence in situ hybridization showed the absence of BCL2 or BCL6 rearrangement. In such a case, the presence of Hodgkin‐like cells intermixed with the tumor population may result in a pitfall diagnosis of classical Hodgkin lymphoma (CHL). Differential diagnoses to be ruled out are secondary or primary skin localization of rather CHL, or systemic follicular lymphoma. Several clinical, radiological, histological, immunohistochemical and molecular arguments indicated the diagnosis of PCFCL. To our knowledge, this is the first report of PCFCL with Hodgkin‐like cells.
Caring for a child with severe psychomotor impairment: the impact on parental sleep and quality of life
Authors: Weiss S K
Published: August 2014

This commentary is on the original article by Tietze et al. on pages 1187–1193 of this issue.
Neurodevelopmental and mental health comorbidities in children and adolescents with epilepsy and migraine: a response to identified research gaps
Authors: Wagner Janelle L , Wilson Dulaney A , Smith Gigi , Malek Angela , Selassie Anbesaw W
Published: August 2014

Aim

To determine the distribution and risk characteristics of comorbid neurodevelopmental and mental health comorbidities among children and adolescents (6–18y) with epilepsy or migraine (i.e. a neurological condition with shared features and potential etiology) compared with lower extremity fracture (LEF).

Method

This case–control study involved a subset analysis of surveillance data in South Carolina, USA. Hospital admission, outpatient, and emergency department visits for individuals with an International Classification of Disease, 9th revision Clinical Modification diagnosis of epilepsy (n=6730; 54.5% females, 45.5% males; mean age [SD] 14y 2mo [4y 5mo]); migraine (n=10 495; 74.5% females, 25.5% males; 15y 6mo [2y 6mo]), or LEF (n=15 305; 40.3% females, 59.7% males; 13y 11mo [2y 11mo]) from January 1 2000 to December 31 2011 were identified. The association of epilepsy, migraine, or LEF with any mental health comorbidity was evaluated with univariate and multivariate polytomous logistic regression.

Results

Comorbidities were highly prevalent in children and adolescents, with epilepsy with a rate of 29.7% (95% confidence interval [CI]: 28.6–30.8) for mental health comorbidities and 30.8% (95% CI: 29.7–31.9) for neurodevelopmental comorbidities. The odds of mental health comorbidity was 2.20 (95% CI: 2.02–2.39) for children and adolescents with epilepsy and 1.60 (95% CI: 1.48–1.73) for migraine, in reference to children and adolescents with LEF after adjusting for potential confounders. Prevalence and risk for specific comorbidities are presented.

Interpretation

Neuropathophysiological and psychosocial factors specific to epilepsy may provide more risk for adolescents with epilepsy compared to migraine.
Unbalanced growth and health care expenditure
Authors: Ho Chun‐Yu , Li Xin , Zhou Weimin
Published: August 2014

Baumol's model of unbalanced growth implies that health care expenditure (HCE) is driven by wage increases in excess of productivity growth. However, it remains unclear whether the HCE in developing countries is affected by the same factor. This paper tests this hypothesis by using China provincial panel data. We show that HCE grows more rapidly if economy‐wide wage growth exceeds productivity growth in China. The results are robust to the use of housing price as an instrumental variable for the economy‐wide nominal wage and the inclusion of real GDP growth, demographic structure, government deficit, pollution emissions and health sector quality as control variables. Furthermore, our findings show that Baumol's cost disease plays a more important role in the less economically developed western regions in which the rural–urban migration is less pronounced.
Antibiotics in agriculture and the risk to human health: how worried should we be?
Authors: Chang Qiuzhi , Wang Weike , Regev‐Yochay Gili , Lipsitch Marc , Hanage William P.
Published: August 2014

The use of antibiotics in agriculture is routinely described as a major contributor to the clinical problem of resistant disease in human medicine. While a link is plausible, there are no data conclusively showing the magnitude of the threat emerging from agriculture. Here, we define the potential mechanisms by which agricultural antibiotic use could lead to human disease and use case studies to critically assess the potential risk from each. The three mechanisms considered are as follows 1: direct infection with resistant bacteria from an animal source, 2: breaches in the species barrier followed by sustained transmission in humans of resistant strains arising in livestock, and 3: transfer of resistance genes from agriculture into human pathogens. Of these, mechanism 1 is the most readily estimated, while significant is small in comparison with the overall burden of resistant disease. Several cases of mechanism 2 are known, and we discuss the likely livestock origins of resistant clones of Staphylococcus aureus and Enterococcus faecium, but while it is easy to show relatedness the direction of transmission is hard to assess in robust fashion. More difficult yet to study is the contribution of mechanism 3, which may be the most important of all.
Mass mortality events in atoll lagoons: environmental control and increased future vulnerability
Authors: Andréfouët Serge , Dutheil Cyril , Menkes Christophe E. , Bador Margot , Lengaigne Matthieu
Published: August 2014

Coral reefs and lagoons worldwide are vulnerable environments. However, specific geomorphological reef types (fringing, barrier, atoll, bank for the main ones) can be vulnerable to specific disturbances that will not affect most other reefs. This has implications for local management and science priorities. Several geomorphologically closed atolls of the Pacific Ocean have experienced in recent decades mass benthic and pelagic lagoonal life mortalities, likely triggered by unusually calm weather conditions lasting for several weeks. These events, although poorly known, reported, and characterized, pose a major threat for resource sustainability. Based on a sample of eleven events on eight atolls from the central South Pacific occurring between 1993 and 2012, the conservative environmental thresholds required to trigger such events are identified using sea surface temperature, significant wave height and wind stress satellite data. Using these thresholds, spatial maps of potential risk are produced for the central South Pacific region, with the highest risk zone lying north of Tuamotu Archipelago. A regional climate model, which risk map compares well with observations over the recent period (r = 0.97), is then used to downscale the projected future climate. This allows us to estimate the potential change in risk by the end of the 21st century and highlights a relative risk increase of up to 60% for the eastern Tuamotu atolls. However, the small sample size used to train the analysis led to the identification of conservative thresholds that overestimated the observed risk. The results of this study suggest that long‐term monitoring of the biophysical conditions of the lagoons at risk would enable more precise identification of the physical thresholds and better understanding of the biological processes involved in these rare, but consequential, mass mortality events.
Touring “Terrorism”: Landscapes of Memory in Post‐War Sri Lanka
Authors: Hyndman Jennifer , Amarasingam Amarnath
Published: August 2014

The Sri Lankan state's power to narrate the war and characterize the enemy is an expression of “triumphalist nationalism” and is a selective remembering of war. Based on photographs taken during several field visits to these sites by both authors between December 2012 and January 2014, we analyze the relationship of war and tourism and how a particular Sinhala nationalist remembering of the war and landscape of memory are being constructed in post‐war Sri Lanka.

Today, Sri Lanka is a former war zone where the Government's troops defeated the rebel Liberation Tigers of Tamil Eelam (LTTE or Tamil Tigers) and ended 26 years of violent conflict in May 2009. The end of the war came at a huge cost to civilian life in the northern part of the country; the UN estimates that over 40,000 people were killed, most of whom were Tamils who form the majority in Northern Sri Lanka. Despite the end of military conflict, war continues by other means, and its representation encapsulates a nationalist politics of victory that at once vilifies the defeated LTTE “terrorists” and excludes Northern Tamils from the Sri Lankan polis. The LTTE's former hideouts, training facilities, weapons, and vehicles are now tourist sites on display for public viewing.
Managing clients’ expectations at the outset of online Cognitive Behavioural Therapy (CBT) for depression
Authors: Ekberg Stuart , Barnes Rebecca K. , Kessler David S. , Malpass Alice , Shaw Alison R. G.
Published: August 2014

Background

Engaging clients in psychotherapy by managing their expectations is important for therapeutic success. Initial moments in first sessions of therapy are thought to afford an opportunity to establish a shared understanding of how therapy will proceed. However, there is little evidence from analysis of actual sessions of therapy to support this.

Objective

This study utilised recorded session logs to examine how therapists manage clients’ expectations during the first two sessions of online Cognitive Behavioural Therapy (CBT).

Methods

Expectation management was investigated through conversation analysis of sessions from 176 client‐therapist dyads involved in online CBT. The primary focus of analysis was expectation management during the initial moments of first sessions, with a secondary focus on expectations at subsequent points.

Analysis

Clients’ expectations for therapy were most commonly managed during the initial moments of first sessions of therapy. At this point, most therapists either produced a description outlining the tasks of the first and subsequent sessions (n = 36) or the first session only (n = 108). On other occasions (n = 32), no attempt was made to manage clients’ expectations by outlining what would happen in therapy. Observations of the interactional consequences of such an absence suggest clients may struggle to engage with the therapeutic process in the absence of appropriate expectation management by therapists.

Conclusion

Clients may more readily engage from the outset of therapy when provided with an explanation that manages their expectation of what is involved. Therapists can accomplish this by projecting how therapy will proceed, particularly beyond the initial session.
Influence of working length and apical preparation size on apical bacterial extrusion during reciprocating instrumentation
Authors: Teixeira J. M. S. , Cunha F. M. , Jesus R. O. , Silva E. J. N. L. , Fidel S. R. , Sassone L. M.
Published: August 2014

Aim

To evaluate the influence of reciprocating single‐file instrumentation with different working lengths (WL) and apical preparation sizes on apical bacterial extrusion.

Methodology

Sixty‐eight human single‐rooted pre‐molars were used. Conventional access cavities were prepared, and the root canals were contaminated with an Enterococcus faecalis suspension and incubated at 37°C for 30 days. Teeth were then divided into four groups of 15 specimens each (Reciproc size 25, .08 taper and Reciproc size 40, .06 taper instruments were used at the foramen; Reciproc size 25, .08 taper and Reciproc size 40, .06 taper instruments were used 1 mm short of the foramen). Positive and negative controls consisted of four infected and four uninfected pre‐molars that were instrumented according to each experimental group. Bacteria extruded from the apical foramen during instrumentation were collected into vials containing 0.9% NaCl. The microbiological samples were then incubated in a brain–heart agar medium for 24 h. The resulting bacterial titre, in colony‐forming units (CFU) per mL, was determined, and these data were analysed using a Wilcoxon matched‐pairs signed rank test and a Kruskal–Wallis H‐test. The level of significance was set at α = 0.05.

Results

No growth was observed in the negative control group. All positive controls demonstrated bacterial growth after the experimental time interval. No significant difference was found in the number of CFU amongst all experimental groups (P = 0.95).

Conclusions

This study showed that the WL and the apical preparation size did not have a significant effect on bacterial extrusion when performing reciprocating instrumentation.
Survey of root canal irrigating solutions used in dental practices within Germany
Authors: Willershausen I. , Wolf T. G. , Schmidtmann I. , Berger C. , Ehlers V. , Willershausen B. , Briseño B.
Published: August 2014

Aim

Irrigant usage information in relation to years of professional experience was collected from general dentists in different German federal states by means of a questionnaire.

Methodology

A short survey concerning endodontic treatment and use of irrigants was mailed to 4240 dentists or delivered to 3720 dental offices as an extra page in a journal in eight German states. Detailed information concerning the most frequently used irrigants, their concentrations, the spectrum of disinfectants used in root canal treatment concepts for vital and nonvital pulps, main topics of continuing education as well as years of professional experience was collected. The statistical analysis of differences found amongst the dentists in relation to professional experience or federal state was performed using the chi‐square test.

Results

Of a total of 7960 invitations, 1630 replies were evaluated (response rate 20.5%). The majority of the dentists (57.3%) had >20 years of professional experience, 23% had >30 years. Dentists with long‐standing professional experience (20–30 years) used H2O2 significantly more often than dentists with less experience (P < 0.001), and of the older colleagues (>30 years of professional experience), 14.6% never used NaOCl, whilst the younger colleagues almost always used it (P < 0.001). Differences were also found for the usage of irrigants amongst dentists from the various German states.

Conclusions

Whilst NaOCl was used in almost all states, regional differences were found regarding the choice of additional irrigants, which were mainly determined by the irrigation protocols taught at different universities.
Microbial community in persistent apical periodontitis: a 16S rRNA gene clone library analysis
Authors: Zakaria M. N. , Takeshita T. , Shibata Y. , Maeda H. , Wada N. , Akamine A. , Yamashita Y.
Published: August 2014

Aim

To characterize the microbial composition of persistent periapical lesions of root filled teeth using a molecular genetics approach.

Methodology

Apical lesion samples were collected from 12 patients (23–80 years old) who visited the Kyushu University Hospital for apicectomy with persistent periapical lesions associated with root filled teeth. DNA was directly extracted from each sample and the microbial composition was comprehensively analysed using clone library analysis of the 16S rRNA gene. Enterococcus faecalis, Candida albicans and specific fimA genotypes of Porphyromonas gingivalis were confirmed using polymerase chain reaction (PCR) analysis with specific primers.

Results

Bacteria were detected in all samples, and the dominant findings were P. gingivalis (19.9%), Fusobacterium nucleatum (11.2%) and Propionibacterium acnes (9%). Bacterial diversity was greater in symptomatic lesions than in asymptomatic ones. In addition, the following bacteria or bacterial combinations were characteristic to symptomatic lesions: Prevotella spp., Treponema spp., Peptostreptococcaceae sp. HOT‐113, Olsenella uli, Slackia exigua, Selemonas infelix, P. gingivalis with type IV fimA, and a combination of P. gingivalis, F. nucleatum, and Peptostreptococcaceae sp. HOT‐113 and predominance of Streptococcus spp. On the other hand, neither Enterococcus faecalis nor C. albicans were detected in any of the samples.

Conclusion

Whilst a diverse bacterial species were observed in the persistent apical lesions, some characteristic patterns of bacterial community were found in the symptomatic lesions. The diverse variation of community indicates that bacterial combinations as a community may cause persistent inflammation in periapical tissues rather than specific bacterial species.
Apical extrusion of debris from root canals using reciprocating files associated with two irrigation systems
Authors: Xavier F. , Nevares G. , Romeiro M. K. , Gonçalves K. , Gominho L. , Albuquerque D.
Published: August 2014

Aim

To compare apical extrusion of debris in canals prepared with two reciprocating file systems and two different irrigation systems.

Methodology

Forty single straight root canals in human mandibular pre‐molars were prepared using Reciproc R40 (REC) and WaveOne Large (WO) instruments. Before preparation, the dimensions of a size 40 instrument from each system were measured under scanning electron microscopy (SEM) at 80X. The teeth were randomly divided into four different groups of 10: REC and VPro EndoSafe (REC/VPro); WO/VPro; REC and conventional irrigation (REC/CI); and WO/CI Eppendorf tubes containing a single tooth were weighed on an analytical balance to the nearest 0.1 mg before instrumentation. Irrigation was performed with a total volume of 8 mL of 2.5% sodium hypochlorite. After instrumentation, the teeth were removed from the Eppendorf tube and incubated at 37 °C for 15 days to evaporate the liquid. The tubes were weighed again, and the difference between the initial and final debris weights was calculated and statistically evaluated using analysis of variance (two‐way anova) with a significance level of 0.05.

Results

No significant difference was observed between the VPro and CI irrigation systems (P > 0.05). Apical extrusion of debris was confirmed in all samples, and extrusion was greater in the REC groups than in the WO groups (P < 0.05). The WO file had a 20% smaller diameter at the tip (D0) than the measurement provided by the manufacturer.

Conclusions

All systems were associated with apical extrusion of debris. The WO system was associated with less extrusion than the REC system. The amount of extruded debris was independent of the irrigation system used and was related to the instrumentation technique. Morphological analysis of instruments using SEM revealed no correlation between the diameter provided by the manufacturer and the measured diameter for the WO Large file.
‘Screw‐in’ tendency of rotary nickel–titanium files due to design geometry
Authors: Ha J. H. , Cheung G. S. P. , Versluis A. , Lee C. J. , Kwak S. W. , Kim H. C.
Published: August 2014

Aim

To examine the effect of several standard geometric characteristics of rotary instruments on the ‘screw‐in’ forces and stresses generated on root dentine using 3D finite element analysis (FEA).

Methodology

Four cross‐sectional designs (triangular, slender‐rectangular, rectangular and square) were evaluated. The area of the triangular cross‐section and of the slender‐rectangular model were the same. Another rectangular model had the same centre‐core diameter as the triangular one. Each design was twisted into a file model with 5, 10 or 15 threads over its 16‐mm‐long working section. Three curved root canals were simulated as rigid surface models: θ = 15 degrees/R = 36 mm radius; θ = 30/R = 18; and θ = 45/R = 12. A commercial FEA package was used to simulate the file rotating in the canal to determine the ‘screw‐in’ force and reaction torque on the instrument.

Results

Instruments of a square cross‐section had the highest ‘screw‐in’ force and reaction torsional stresses followed by the rectangle, the triangle design and the slender‐rectangle design, respectively. The file with closer pitch generated lower stresses, compared with that with longer pitch. The greater the root canal curvature, the higher the ‘screw‐in’ force and reaction torque generated.

Conclusion

This study demonstrated that the ‘screw‐in’ tendency depends on both the instrument geometry and canal curvature. Clinicians should be aware that certain instrument designs are prone to develop high ‘screw‐in’ forces, requiring the operator to maintain control of the handpiece or to use a brushing action to prevent instruments being pulled into the canal.
Green spirit: consumer empathies for green apparel
Authors: Cowan Kirsten , Kinley Tammy
Published: August 2014

The fashion industry has not fully addressed the movement towards sustainability head‐on. The purpose of this study was to identify factors influencing environmentally friendly apparel purchase intentions using the theory of planned behaviour as a guide. In this case, environmental knowledge, environmental concern and attitudes towards environmentally friendly apparel purchase behaviour make up the attitude component. In addition to social pressure, we suggest environmental guilt also makes up the dimension of normative influence. Furthermore, the study extends the theory of planned behaviour's idea of perceived behavioural control beyond previous behaviour and convenience, also taking into account willingness to pay. Data were collected from 220 American adults via an online consumer panel. The results show that individual environmental attitudes, environmental concern and knowledge, social pressure to behave in an environmentally friendly manner, environmental guilt, perceived environmental impact, past environmentally friendly apparel purchases, accessibility and cost of environmentally friendly apparel all impact purchase intentions. Furthermore, previous purchases, attitudes towards purchasing environmentally friendly apparel and social pressure are the strongest indicators of future environmentally friendly purchase behaviour. Managerial implications are discussed.
Hospital nurses' individual priorities, internal psychological states and work motivation
Authors: Toode K. , Routasalo P. , Helminen M. , Suominen T.
Published: August 2014

Aim

This study looks to describe the relationships between hospital nurses' individual priorities, internal psychological states and their work motivation.

Background

Connections between hospital nurses' work‐related needs, values and work motivation are essential for providing safe and high quality health care. However, there is insufficient empirical knowledge concerning these connections for the practice development.

Methods

A cross‐sectional empirical research study was undertaken. A total of 201 registered nurses from all types of Estonian hospitals filled out an electronic self‐reported questionnaire. Descriptive statistics, Mann–Whitney, Kruskal–Wallis and Spearman's correlation were used for data analysis.

Results

In individual priorities, higher order needs strength were negatively correlated with age and duration of service. Regarding nurses' internal psychological states, central hospital nurses had less sense of meaningfulness of work. Nurses' individual priorities (i.e. their higher order needs strength and shared values with the organization) correlated with their work motivation. Their internal psychological states (i.e. their experienced meaningfulness of work, experienced responsibility for work outcomes and their knowledge of results) correlated with intrinsic work motivation.

Discussion

Nurses who prioritize their higher order needs are more motivated to work. The more their own values are compatible with those of the organization, the more intrinsically motivated they are likely to be.

Conclusion

Nurses' individual achievements, autonomy and training are key factors which influence their motivation to work.

Limitations

The small sample size and low response rate of the study limit the direct transferability of the findings to the wider nurse population, so further research is needed.

Implications for Nursing and Health Policy

This study highlights the need and importance to support nurses' professional development and self‐determination, in order to develop and retain motivated nurses. It also indicates a need to value both nurses and nursing in healthcare policy and management.
A promoter mutation in the haemagglutinin segment of influenza A virus generates an effective candidate live attenuated vaccine
Authors: Harvey Ruth , Johnson Rachel E. , MacLellan‐Gibson Kirsty , Robertson James S. , Engelhardt Othmar G.
Published: August 2014

Background

Annual seasonal and pandemic influenza vaccines need to be produced in a very tight time frame. Haemagglutinin (HA) is the major immunogenic component of influenza vaccines, and there is a lot of interest in improving candidate vaccine viruses.

Objectives

It has been shown elsewhere that mutations introduced in the non‐coding region of influenza genome segments can upregulate protein expression. Our objective was to assess a virus based on the laboratory strain A/PR/8/34 (PR8) containing a modified 3′ non‐coding region of RNA segment 4 (haemagglutinin).

Methods

NIBRG‐93 was generated using reverse genetics. HA protein expression and growth properties were assessed. The virus phenotype suggested that it could be a candidate for use as a live attenuated vaccine, so in vivo studies were performed to assess its suitability.

Results

NIBRG‐93 virus has enhanced haemagglutinin production and is significantly attenuated. Electron microscopy (EM) shows that the modified virus produces a large proportion of ‘virus‐like particles’ that consist of budded cell membrane covered in HA but lacking M1 protein. The virus was shown to be attenuated in mice and offered complete protection against lethal challenge.

Conclusions

We demonstrate that NIBRG‐93 is an effective live attenuated vaccine virus protecting mice against lethal challenge and reducing virus shedding.
Novel Approach to Temporal Lobectomy for Removal of a Cavernous Hemangioma in a Dog
Authors: Shihab Nadia , Summers Brian A. , Benigni Livia , McEvoy Andrew W. , Volk Holger A.
Published: August 2014

Objective

To report temporal lobe surgery for a cavernous hemangioma in a dog and outcome.

Study design

Clinical report.

Animals

Dog (n = 1).

Methods

Magnetic resonance (MR) imaging was used to identify a temporal lobe mass in 9‐year‐old, male neutered Labrador Retriever that had a 12 hour history of seizures. An approach to the temporal lobe allowed preservation of the zygomatic arch and mass removal.

Results

The mass was confirmed as a cavernous hemangioma on histopathology. Repeat MR imaging at 13 months showed no recurrence of gross structural disease; however, the dog's anti‐epileptic medication was administered for adequate seizure control.

Conclusion

Temporal lobe surgery can be performed in the dog's for the management of temporal lobe mass lesions.
Incisional Colopexy for Treatment of Chronic, Recurrent Colocloacal Prolapse in a Sulphur‐Crested Cockatoo (Cacatua galerita)
Authors: van Zeeland Yvonne R. A. , Schoemaker Nico J. , van Sluijs Freek J.
Published: August 2014

Objective

To report a surgical technique for treatment of chronic, recurrent cloacal prolapse in a sulphur‐crested cockatoo (Cacatua galerita).

Study Design

Clinical report

Animals

Sulphur‐crested cockatoo (n = 1)

Methods

The bird was admitted with a 2‐year history of periodic lethargy, decreased appetite, dyschezia, tenesmus, and colocloacal prolapse. An incisional colopexy was performed under general anesthesia to permanently reduce the colocloacal prolapse. To gain access to the coelomic cavity, a ventral U‐shaped incision was made, after which the colon and cloaca were restored in their normal anatomic position. Subsequently, the distal colon was sutured to the left abdominal wall.

Results

Colocloacal prolapse was successfully reduced. One month later, cloacoplasty was performed to reduce cloacal width. Long‐term follow‐up, including a barium contrast study, revealed normal function and an intact colopexy, without recurrence of the prolapse.

Conclusions

Incisional colopexy is feasible despite a bird's relative small body size.
Clinical Use of Computed Tomography and Surface Markers to Assist Internal Fixation Within the Equine Hoof
Authors: Gasiorowski Janik C. , Richardson Dean W.
Published: August 2014

Objective

To describe clinical use of computed tomography (CT) and hoof surface markers to facilitate internal fixation within the confines of the hoof wall.

Study Design

Retrospective case series.

Animals

Horses (n = 16) that had CT‐guided internal fixation of the distal phalanx (DP) or distal sesamoid bone (DSB).

Methods

Drill bit entry point and direction were planned from CT image series performed on hooves with grids of barium paste dots at proposed entry and projected exit sites. Post‐implantation CT images were obtained to check screw position and length as well as fracture reduction. Imaging, reduction, and surgical and general anesthesia times were evaluated. Outcome was recorded.

Results

Screw position and length were considered near optimal in all horses, with no consequential malposition of bits or screws. Fracture reduction was evident in all cases. Preoperative planning times (at least 2 CT image acquisitions and grid creation) ranged from 10 to 20 minutes. Surgery time ranged from 45 to 90 minutes (mean, 61 minutes) and general anesthesia time ranged from 115 to 220 minutes (mean, 171 minutes).

Conclusions

The combination of CT and surface marker grids allowed accurate positioning of screws in clinical DP and DSB fractures. The technique was simple and rapid. An aiming device is useful for the technique.
Short‐ and Long‐Term Outcomes After Arthroscopic Treatment of Young Large Breed Dogs With Medial Compartment Disease of the Elbow
Authors: Barthélémy Nicolas P. , Griffon Dominique J. , Ragetly Guillaume R. , Carrera Ines , Schaeffer David J.
Published: August 2014

Objectives

To report short‐ and long‐term outcomes after arthroscopic treatment in young large breed dogs affected by medial coronoid process disease (MCPD) and identify variables affecting outcome.

Study Design

Prospective observational case series.

Animals

Large breed dogs <3 years old (n = 15; 23 elbows).

Methods

MCPD was confirmed by radiography, computed tomography, and arthroscopy. Dogs were treated by arthroscopy. Variables recorded at time of treatment included radioulnar incongruity (RUI) and degree of cartilage erosion. Variables recorded before, 6 weeks, and ≥23 months after surgery included radiographic score for osteoarthritis, trochlear notch sclerosis, muscle circumference, range of motion (ROM), and the load distribution of vertical ground reaction forces between thoracic and pelvic limbs.

Results

A greater load distribution to the pelvic limbs was identified preoperatively in dogs with RUI than in dogs with congruent elbows. Load distribution was not significantly improved at 6 weeks compared with preoperatively. Muscle circumference and vertical impulse distributions were improved at long‐term evaluation despite an increased osteoarthritis score. This improvement was more obvious in dogs with RUI or a high degree of cartilage erosion at initial presentation.

Conclusion

Some evidence of improvement in long‐term function was found in dogs with MCPD after arthroscopic treatment. RUI and cartilage erosion at the time of diagnosis were associated with more lameness preoperatively but did not affect the final gait assessment or osteoarthritis score in this small cohort.
End‐to‐Side Versus Side‐to‐Side Jejunocecostomy in Horses: A Retrospective Analysis of 150 Cases
Authors: Brown Jennifer A. , Holcombe Susan J. , Southwood Louise L. , Byron Christopher R. , Embertson Rolf M. , Hauptmann Joe G.
Published: August 2014

Objectives

To determine factors associated with postoperative reflux, postoperative colic, repeat celiotomy, and survival in horses after end‐to‐side (E2S) or side‐to‐side (S2S) jejunocecostomy.

Study Design

Retrospective, multicenter study.

Sample Population

Horses (n = 150).

Methods

Admissions, intra‐ and postoperative data were collected from medical records of horses that had E2S or S2S jejunocecostomy. Descriptive statistics were calculated and data were analyzed using parametric and nonparametric tests, linear and multivariate logistic regression with significance set at P < .05. Kaplan–Meier estimate of the survival function was performed.

Results

One hundred fifty horses (S2S = 90, E2S = 60) were included. S2S procedures were performed using staples (n = 57) or hand‐sewn (33). Method of anastomosis was not significantly associated with development of postoperative reflux or colic, repeat celiotomy, whether the horse was alive at hospital discharge or 12 months after discharge. The number of years that the principal surgeon was boarded by the American College of Veterinary Surgeons significantly affected whether the horse was discharged from the hospital alive (P = .003). Age (P = .006) was significantly associated with 12‐month survival. Increased age (P = .013) and administration of prokinetic medication (P = .0006) were significantly associated with development of postoperative reflux. Sixty‐eight (76%) horses with S2S and 52 (87%) horses with E2S were discharged alive.

Conclusion

Age, patient related variables, and surgeon experience may influence morbidity and mortality more than method of jejunocecostomy.
The effects of a course of intranasal oxytocin on social behaviors in youth diagnosed with autism spectrum disorders: a randomized controlled trial
Authors: Guastella Adam J. , Gray Kylie M. , Rinehart Nicole J. , Alvares Gail A. , Tonge Bruce J. , Hickie Ian B. , Keating Caroline M. , Cacciotti‐Saija Cristina , Einfeld Stewart L.
Published: August 2014

Background

There is increasing interest in oxytocin as a therapeutic to treat social deficits in autism spectrum disorders (ASD). The aim of this study was to investigate the efficacy of a course of oxytocin nasal spray to improve social behavior in youth with ASD.

Methods

In a double‐blind, placebo‐controlled trial across two Australian university sites between February 2009 and January 2012, 50 male participants aged between 12 and 18 years, with Autistic or Asperger's Disorder, were randomized to receive either oxytocin (n = 26) or placebo (n = 24) nasal sprays (either 18 or 24 International Units), administered twice‐daily for 8 weeks. Participants were assessed at baseline, after 4‐ and 8‐weeks of treatment, and at 3‐month follow‐up. Primary outcomes were change in total scores on the caregiver‐completed Social Responsiveness Scale and clinician‐ratings on the Clinical Global Impressions‐Improvement scale. Secondary assessments included caregiver reports of repetitive and other developmental behaviors and social cognition. Clinical trial registration: Australian New Zealand Clinical Trials Registry www.anzctr.org.au ACTRN12609000513213.

Results

Participants who received oxytocin showed no benefit following treatment on primary or secondary outcomes. However, caregivers who believed their children received oxytocin reported greater improvements compared to caregivers who believed their child received placebo. Nasal sprays were well tolerated and there was no evidence of increased side effects resulting from oxytocin administration.

Conclusions

This is the first evaluation of the efficacy for a course of oxytocin treatment for youth with ASD. Although results did not suggest clinical efficacy, further research is needed to explore alternative delivery methods, earlier age of intervention, and the influence of caregiver expectation on treatment response.
ANGPTL2 promotes tumor metastasis in hepatocellular carcinoma
Authors: Gao Lin , Ge Chao , Fang Tao , Zhao Fangyu , Chen Taoyang , Yao Ming , Li Jinjun , Li Hong
Published: August 2014

Background and Aim

Angiopoietin‐like protein 2 (ANGPTL2) plays various roles in metabolism, vascular biology, inflammation, and tumor metastasis, but little is known about its function in human hepatocellular carcinoma (HCC) metastasis. This study aimed to further explore the function of ANGPTL2 on migration and invasion of liver cancer cells.

Methods

Quantitative real‐time polymerase chain reaction, Western blotting, immunohistochemistry, transwell migration, and invasion assays were performed to clarify the function of ANGPTL2 in the regulation of cell migration and invasion in human HCC.

Results

In HCC patients, ANGPTL2 expression was higher in HCC tissues compared with matched noncancerous liver tissues. And the ANGPTL2 levels of HCC tissues positively correlated with intrahepatic metastasis in HCC patients. Overexpression of ANGPTL2 significantly increased migration and invasion of HCC cells in vitro, and promoted intrahepatic and distal pulmonary metastasis in vivo, while knockdown of endogenous ANGPTL2 resulted in a reduced migration and invasion in vitro. Colony formation assay and 3‐(4,5‐Dimethylthiazol‐2‐yl)‐2, 5‐diphenyltetrazolium bromide (MTT) assay showed ANGPTL2 did not affect cell proliferation in vitro, whereas overexpression of ANGPTL2 promoted tumor formation in xenograft animal model.

Conclusions

Our findings show that ANGPTL2 drives human HCC metastasis and provides a potential therapeutic target for HCC treatment.
Plasminogen activator inhibitor‐1 is independently associated with non‐alcoholic fatty liver disease whereas leptin and adiponectin vary between genders
Authors: Chang Ming‐Ling , Hsu Chen‐Ming , Tseng Jeng‐Hwei , Tsou Yung‐Kuan , Chen Shu‐Chun , Shiau Shuen‐Shian , Yeh Chau‐Ting , Chiu Cheng‐Tang
Published: August 2014

Background and Aim

Alterations of adipocytokine levels and clinical parameters in non‐alcoholic fatty liver disease (NAFLD) are crucial for the prognosis and complications of the diseases. However, the key adipocytokines independently associated with NAFLD have not been identified, and we aimed to investigate them.

Methods

This study was conducted on a consecutive series of 210 Taiwanese NAFLD patients and 420 sex‐ and age‐matched controls. Fatty liver was diagnosed by magnetic resonance spectroscopy. The enrolled subjects' body mass indexes, homeostasis model of assessment‐insulin resistance, uric acid, total cholesterol, triglyceride, high‐density lipoprotein, low‐density lipoprotein, blood pressure, metabolic syndrome (yes/no), alanine aminotransferase, aspartate aminotransferase‐to‐platelet ratio indexes, leptin, adiponectin, and plasminogen activator inhibitor‐1 (PAI‐1) levels were analyzed to determine their association with NAFLD.

Results

Univariate analysis showed that all of the aforementioned factors were associated with NAFLD, whereas multivariate analysis revealed that only PAI‐1 (odds ratio: 1.39, P = 0.039) was independently associated with NAFLD. Subgroup analysis showed that females consistently had higher leptin (P < 0.001) and adiponectin (P < 0.001) levels than males, whereas their PAI‐1 levels were similar. Males with NAFLD had higher leptin but lower adiponectin levels than their subgroup counterparts (all P < 0.001). Among the female subgroups, hyperleptinemia and hypoadiponectinemia were only observed in the NAFLD patients ≥ 45 years.

Conclusions

PAI‐1 is independently associated with NAFLD after adjusting for other factors, including leptin and adiponectin. Male and female NAFLD patients show distinct patterns of leptin and adiponectin alterations; special attention is required when evaluating these alterations in female NAFLD patients < 45 years.
Exposure to early life stress regulates Bdnf expression in SERT mutant rats in an anatomically selective fashion
Authors: Calabrese Francesca , van der Doelen Rick H. A. , Guidotti Gianluigi , Racagni Giorgio , Kozicz Tamas , Homberg Judith R. , Riva Marco A.
Published: August 2014

Although the causes of psychiatric disorders are not fully understood, it is well established that mental illness originates from the interaction between genetic and environmental factors. In this regard, compelling evidence demonstrates that depression can be the consequence of altered, and often maladaptive, response to adversities during pre‐ and early post‐natal life. In this study, we investigated the impact of chronic maternal separation (MS) on the expression of the neurotrophin brain‐derived neurotrophic factor (BDNF) in serotonin transporter (SERT) knockout rats in the ventral and dorsal hippocampus as well as the ventromedial and dorsomedial prefrontal cortex (PFC). We found that both SERT deletion and the MS led to an overall reduction in Bdnf expression in the ventral hippocampus and the ventromedial PFC, whereas in the dorsal hippocampus and in the dorsomedial PFC, we observed a significant increase in the neurotrophin gene expression after MS exposure, specifically in the heterozygous SERT rats. In summary, we show that the modulation of Bdnf expression in SERT mutant rats exposed to MS reflects the complex functional consequences of this gene–environment interaction with a clear distinction between the ventral and the dorsal subfields of the hippocampus and of the PFC.

image

Early life stress differently affects the expression of Bdnf in an anatomically distinct manner as a function of SERT genotype. Specifically, both SERT deletion and the maternal separation (MS) led to an overall reduction in Bdnf expression in the ventral hippocampus and in the ventromedial prefrontal cortex, whereas in the dorsal hippocampus and in the dorsomedial prefrontal cortex, we observed a significant increase in the neurotrophin gene expression after MS exposure specifically in the heterozygous SERT rats. We think that these findings may provide novel cues for modulating neurotrophin function, which is dys‐regulated in several psychiatric conditions.