bluuebunny/crossref_metadata_2025 huggingface dataset:
Bridging existing governance gaps: five evidence-based actions that boards can take to pursue high quality care
Authors: Leggat Sandra G. , Balding Cathy
Published: November 2017

Objective To explore the impact of the organisational quality systems on quality of care in Victorian health services. Methods During 2015 a total of 55 focus groups were conducted with more than 350 managers, clinical staff and board members in eight Victorian health services to explore the effectiveness of health service quality systems. A review of the quality and safety goals and strategies outlined in the strategic and operating plans of the participating health services was also undertaken. Results This paper focuses on the data related to the leadership role of health service boards in ensuring safe, high-quality care. The findings suggest that health service boards are not fully meeting their governance accountability to ensure consistently high-quality care. The data uncovered major clinical governance gaps between stated board and executive aspirations for quality and safety and the implementation of these expectations at point of care. These gaps were further compounded by quality system confusion, over-reliance on compliance, and inadequate staff engagement. Conclusion Based on the existing evidence we propose five specific actions boards can take to close the gaps, thereby supporting improved care for all consumers. What is known about this topic? Effective governance is essential for high-quality healthcare delivery. Boards are required to play an active role in their organisation’s pursuit of high quality care. What does this paper add? Recent government reports suggest that Australian health service boards are not fully meeting their governance requirements for high quality, safe care delivery, and our research pinpoints key governance gaps. What are the implications for practitioners? Based on our research findings we outline five evidence-based actions for boards to improve their governance of quality care delivery. These actions focus on an organisational strategy for high-quality care, with the chief executive officer held accountable for successful implementation, which is actively guided and monitored by the board.
Examining the high users of hospital resources: implications of a profile developed from Australian health insurance claims data
Authors: Khoo Joanna , Hasan Helen , Eagar Kathy
Published: November 2017

Objective To develop and examine a profile of the demographic, hospital admission and clinical characteristics of high users of hospital resources within a cohort of privately insured Australians. Methods Hospital admissions claims data from a group of private health insurance funds were analysed. The top 1% of hospital users were selected based on three measures of resource utilisation: number of admissions, total bed days and total insurance benefits paid. The demographic, hospital admission and clinical characteristics data were compared for these three measures of resource utilisation. Results Compared with the general insured population, the three high-use cohorts are older, have more public hospital admissions and have more same-day admissions. The three high-use cohorts have the same top five principal diagnosis categories. These five categories account for more than two-thirds of admissions. The top 1% of users is responsible for a large proportion of total resource utilisation, accounting for 13% of total costs and 21% of total bed days. Conclusions The highest users of hospital resources have a distinct profile, accounting for a large proportion of total resource utilisation for a narrow range of health conditions. The age and hospital admission profile of this group suggest both policy and service considerations for the targeting of interventions to support this high-needs group. What is known about this topic? Statistics are regularly published on the uptake and use of private health insurance in Australia but there is little detailed information on resource utilisation in specific subgroups, particularly those with the highest levels of hospitalisation. What does this paper add? This paper provides a profile of high resource utilisation among a privately insured cohort, describing demographic, hospital admission and clinical characteristics across three measures of resource utilisation. Patterns of use are detailed in this profile, for example the top 1% of users have a higher proportion of public hospital admissions as a private patient. The clinical profile of admissions was similar for the three measures of resource utilisation and there was considerable overlap in the individuals categorised in each high-use group. What are the implications for practitioners? The narrow demographic and clinical profile of the high resource utilisation groups shows a chronic disease burden that is different to the focus of current chronic disease policy measures. The high-use conditions identified in this study are less amenable to preventive measures and new strategies may be required to target this high-needs group.
Human dimension of health service management
Authors: Martins Jo. M. , Isouard Godfrey , Freshman Brenda
Published: November 2017

This article identifies three relevant and valid constructs that are associated with personal and organisational performance that can be used in the training of current and future health service managers: personal engagement at work, emotional intelligence and conflict resolution. A review was undertaken of the literature in human resources management to identify key concepts that bind and strengthen the management of organisations. A curriculum content analysis was then performed of postgraduate health management courses in Australia to assess the extent of inclusion in these areas. Three concepts and practices of relevance to the human dimension of health management, namely personal engagement at work, emotional intelligence and conflict resolution, were found to: (1) have concept validity; (2) be associated with personal and organisational performance; and (3) be capable of being imparted by training. The analysis indicated that none of the competencies and/or skills identified has been given emphasis in postgraduate health management courses in Australia. Competence in the management of human relationships in health services has been given low priority in university postgraduate training in health management in Australia. The current situation poses challenges to all stakeholders of health services.
Stomata control is changed in a chlorophyll b-free barley mutant
Authors: Tyutereva Elena V. , Dmitrieva Valeria A. , Shavarda Alexey L. , Voitsekhovskaja Olga V.
Published: November 2017

The barley (Hordeum vulgare L.) chlorina f2 3613 mutant exhibits low photosynthesis and slow growth. This results from downregulation of the levels of photosynthetic antenna proteins caused by the absence of chl b, the major regulator of photosynthetic antennae in land plants. Here, we demonstrate that, when grown in the field in full sunlight, this mutant displays a changed pattern of stomatal responses compared with the parental wild-type cultivar Donaria. However, stomatal regulation of chlorina f2 3613 plants was restored when plants were placed under a shade cover for several days. The shade cover reduced incident PAR from 2000–2200 μmol m–2 s–1 to 800–880 μmol m–2 s–1 as measured at noon. Contents of ABA, the xanthophyll precursors of ABA biosynthesis and minor antenna proteins, as well as reactive oxygen species levels in stomata and the sensitivity of stomata to exogenously supplied ABA, were determined in leaves of wild-type Donaria and chlorina f2 3613 before and after shading. The results support the view that the restoration of stomatal control in barley chlorina f2 3613 is correlated with an increase in the levels of the minor antenna protein Lhcb6, which has recently been implicated in the enhancement of stomatal sensitivity to ABA in Arabidopsis thaliana (L.) Heynh.
Simulating daily field crop canopy photosynthesis: an integrated software package
Authors: Wu Alex , Doherty Al , Farquhar Graham D. , Hammer Graeme L.
Published: November 2017

Photosynthetic manipulation is seen as a promising avenue for advancing field crop productivity. However, progress is constrained by the lack of connection between leaf-level photosynthetic manipulation and crop performance. Here we report on the development of a model of diurnal canopy photosynthesis for well watered conditions by using biochemical models of C3 and C4 photosynthesis upscaled to the canopy level using the simple and robust sun–shade leaves representation of the canopy. The canopy model was integrated over the time course of the day for diurnal canopy photosynthesis simulation. Rationality analysis of the model showed that it simulated the expected responses in diurnal canopy photosynthesis and daily biomass accumulation to key environmental factors (i.e. radiation, temperature and CO2), canopy attributes (e.g. leaf area index and leaf angle) and canopy nitrogen status (i.e. specific leaf nitrogen and its profile through the canopy). This Diurnal Canopy Photosynthesis Simulator (DCaPS) was developed into a web-based application to enhance usability of the model. Applications of the DCaPS package for assessing likely canopy-level consequences of changes in photosynthetic properties and its implications for connecting photosynthesis with crop growth and development modelling are discussed.
Factors affecting frog species richness in the Solomon Islands
Authors: Pikacha Patrick , Morrison Clare , Filardi Chris , Leung Luke
Published: November 2017

Studies across large oceanic archipelagos often provide an opportunity for testing different processes driving patterns of species richness. Frogs are among the most abundant vertebrates in the Solomon Islands but little is known of the factors influencing their richness patterns. This study used modelling to determine important ecological and biogeographic factors affecting the species richness of frogs at multiple locations on major islands across the archipelago. Between March 2009 and August 2012, 16 frog species were recorded along 109 transects placed in coastal, lowland, ridge and montane forests across 13 islands. Mean species richness was higher in the North Solomon Islands arc (6.2 species) and decreased eastwards towards the New Georgia islands (4.7 species), and Malaita (3.2 species). A plausible explanation is that the North Solomon Islands arc is closest to New Guinea, a major centre of dispersal in the south-west Pacific. Coastal (4.6 species) and freshwater (4.8 species) forests had lower predicted species richness than lowland, ridge, and montane forest types (all with 6.2 species). In addition, more frogs were predicted in areas with thin leaf litter (6.2 species), dense shrub cover (7.7 species), and moist soils (7.7 species), which are characteristic of undisturbed forests. These results suggest that frog conservation activities in the Solomon Islands should target islands in the west with intact lowland, ridge, and montane forests. Specific knowledge of this nature is vital for amphibian conservation on tropical islands experiencing extensive habitat loss, habitat modification and widespread predicted climate change impacts.
Gap junctional coupling between retinal amacrine and ganglion cells underlies coherent activity integral to global object perception
Authors: Roy Kaushambi , Kumar Sandeep , Bloomfield Stewart A.
Published: November 2017

Significance

Neuron ensembles in the brain visual system often show correlated responses, but the sensory information encoded by this activity remains unclear. Here, we show that widely separated ganglion cells in the mouse retina show correlated activity when presented with a large, contiguous object, but not when the object is disjointed. We show that these long-range correlations are produced by electrical coupling via gap junctions made with polyaxonal amacrine cells, which can span distances greater than a millimeter. Blockade or ablation of these gap junctions eliminates correlations between distant ganglion cells and, moreover, diminishes an animal’s ability to discriminate large, solid objects from disjointed ones. Our findings indicate that long-range correlated activity in the retina encodes visual information critical for global object perception.
Insights into functions of the H channel of cytochrome
c
oxidase from atomistic molecular dynamics simulations
Authors: Sharma Vivek , Jambrina Pablo G. , Kaukonen Markus , Rosta Edina , Rich Peter R.
Published: November 2017

Significance

Cytochrome oxidase is a widespread respiratory enzyme that conserves energy released when oxygen is reduced by pumping protons across the membrane in which it is located. Here, we use atomistic simulations of the whole bovine enzyme to investigate properties of the H channel, a structure that has been proposed to provide the pathway for pumped protons in mammalian forms of the enzyme. These studies show that although parts of the structure could function in this manner, a gap persists. This gap could be bridged only if a buried histidine becomes protonated. Based on these simulations, we propose that the H channel acts as a dielectric well, modulating effects of buried charge changes.
RNA stem structure governs coupling of dicing and gene silencing in RNA interference
Authors: Koh Hye Ran , Ghanbariniaki Amirhossein , Myong Sua
Published: November 2017

Significance

RNAi is an RNA-induced gene-silencing pathway that is shared among various organisms. Better understanding of RNAi is urgently needed to improve our knowledge of RNA-mediated gene regulation and to advance the field of functional genomics and its application to gene therapy. We counted with high precision the number of transcripts in each cell’s nucleus and cytoplasm as a function of silencing time to investigate the role of small RNA secondary structures such as loop length and stem mismatches. We screened various structural features of small RNAs and discovered a distinct role of each structural element that contributes to gene-silencing kinetics. We provide a helpful guideline for designing small RNAs for more efficient gene silencing.
Selective killing of
Helicobacter pylori
with pH-responsive helix–coil conformation transitionable antimicrobial polypeptides
Authors: Xiong Menghua , Bao Yan , Xu Xin , Wang Hua , Han Zhiyuan , Wang Zhiyu , Liu Yeqing , Huang Songyin , Song Ziyuan , Chen Jinjing , Peek Richard M. , Yin Lichen , Chen Lin-Feng , Cheng Jianjun
Published: November 2017

Significance

Clinical treatment of
Helicobacter pylori
using combination therapy is greatly challenged by the undesired killing of commensal bacteria and progressive development of drug resistance. To address these issues, we developed pH-sensitive, helix–coil conformation transitionable, antimicrobial polypeptides as a single therapeutic agent to selectively kill
H. pylori
under acidic condition in the stomach with minimal toxicity to commensal bacteria and diminished drug resistance. Through the control of the secondary structure transition, the polypeptides showed unappreciable toxicity to commensal bacteria and tissues at physiological pH when they adopted random coiled conformation, while the restoration of helical structure in the acidic stomach allowed the polypeptide to regain membrane disruptive capability to effectively and selectively kill
H. pylori
, including drug-resistant strains.
Resident macrophages of pancreatic islets have a seminal role in the initiation of autoimmune diabetes of NOD mice
Authors: Carrero Javier A. , McCarthy Derrick P. , Ferris Stephen T. , Wan Xiaoxiao , Hu Hao , Zinselmeyer Bernd H. , Vomund Anthony N. , Unanue Emil R.
Published: November 2017

Significance

Our studies indicate that the resident macrophages of the pancreatic islets of Langerhans have a seminal role in the initiation and progression of autoimmune diabetes in NOD mice. In this study, islet macrophages were depleted by administration of a monoclonal antibody to the CSF-1 receptor. Macrophage depletion, either at the start of the autoimmune process or when diabetogenesis is active, leads to a significant reduction in diabetes incidence. Depletion of the islet macrophages reduces the entrance of T cells into islets and results in the absence of antigen presentation. Concordantly, a regulatory pathway develops that controls diabetes progression. We conclude that treatments that target the islet macrophages may have important clinical relevance for the control of autoimmune type 1 diabetes.
Loss of E-cadherin provides tolerance to centrosome amplification in epithelial cancer cells
Authors: Rhys Alexander D. , Monteiro Pedro , Smith Christopher , Vaghela Malti , Arnandis Teresa , Kato Takuya , Leitinger Birgit , Sahai Erik , McAinsh Andrew , Charras Guillaume , Godinho Susana A.
Published: November 2017

Centrosome amplification is a common feature of human tumors. To survive, cancer cells cluster extra centrosomes during mitosis, avoiding the detrimental effects of multipolar divisions. However, it is unclear whether clustering requires adaptation or is inherent to all cells. Here, we show that cells have varied abilities to cluster extra centrosomes. Epithelial cells are innately inefficient at clustering even in the presence of HSET/KIFC1, which is essential but not sufficient to promote clustering. The presence of E-cadherin decreases cortical contractility during mitosis through a signaling cascade leading to multipolar divisions, and its knockout promotes clustering and survival of cells with multiple centrosomes. Cortical contractility restricts centrosome movement at a minimal distance required for HSET/KIFC1 to exert its function, highlighting a biphasic model for centrosome clustering. In breast cancer cell lines, increased levels of centrosome amplification are accompanied by efficient clustering and loss of E-cadherin, indicating that this is an important adaptation mechanism to centrosome amplification in cancer.
A review of riverine ecosystem service quantification: Research gaps and recommendations
Authors: Hanna Dalal E. L. , Tomscha Stephanie A. , Ouellet Dallaire Camille , Bennett Elena M.
Published: November 2017

Increasing demand for benefits provided by riverine ecosystems threatens their sustainable provision. The ecosystem service concept is a promising avenue to inform riverine ecosystem management, but several challenges have prevented the application of this concept.

We quantitatively assess the field of riverine ecosystem services’ progress in meeting these challenges. We highlight conceptual and methodological gaps, which have impeded integration of the ecosystem service concept into management.

Across 89 relevant studies, 33 unique riverine ecosystem services were evaluated, for a total of 404 ecosystem service quantifications. Studies quantified between 1 and 23 ecosystem services, although the majority (55%) evaluated three or less. Among studies that quantified more than one service, 58% assessed interactions between services. Most studies (71%) did not include stakeholders in their quantification protocols, and 34% developed future scenarios of ecosystem service provision. Almost half (45%) conducted monetary valuation, using 16 methods. Only 9% did not quantify or discuss uncertainties associated with service quantification. The indicators and methods used to quantify the same type of ecosystem service varied. Only 3% of services used indicators of capacity, flow and demand in concert.

Our results suggest indicators, data sources and methods for quantifying riverine ecosystem services should be more clearly defined and accurately represent the service they intend to quantify. Furthermore, more assessments of multiple services across diverse spatial extents and of riverine service interactions are needed, with better inclusion of stakeholders. Addressing these challenges will help riverine ecosystem service science inform river management.

Synthesis and applications. The ecosystem service concept has great potential to inform riverine ecosystem management and decision‐making processes. However, this review of riverine ecosystem service quantification uncovers several remaining research gaps, impeding effective use of this tool to manage riverine ecosystems. We highlight these gaps and point to studies showcasing methods that can be used to address them.
Demonstrating multiple benefits from periodically harvested fisheries closures
Authors: Goetze Jordan S. , Claudet Joachim , Januchowski‐Hartley Fraser , Langlois Timothy J. , Wilson Shaun K. , White Crow , Weeks Rebecca , Jupiter Stacy D.
Published: November 2017

Periodically harvested closures (PHCs) are one of the most common forms of fisheries management in Melanesia, demonstrating multiple objectives, including sustaining fish stocks and increasing catch efficiency to support small‐scale fisheries. No studies have comprehensively assessed their ability to provide short‐term fisheries benefits across the entire harvest regime.

We present a novel analytical framework to guide a meta‐analysis and assist future research in conceptualizing and assessing the potential ofPHCs to deliver benefits for multiple fisheries‐related objectives.

TenPHCs met our selection criteria and on average, they provided a 48% greater abundance and 92% greater biomass of targeted fishes compared with areas open to fishing prior to being harvested.

This translated into tangible harvest benefits, with fishers removing 21% of the abundance and 49% of the biomass withinPHCs, resulting in few post‐harvest protection benefits.

WhenPHCs are larger, closed for longer periods or well enforced, short‐term fisheries benefits are improved. However, an increased availability of fish withinPHCs leads to greater removal during harvests.

Synthesis and applications. Periodically harvested closures (PHCs) can provide short‐term fisheries benefits. Use of the analytical framework presented here will assist in determining long‐term fisheries and conservation benefits. We recommendPHCs be closed to fishing for as long as possible, be as large as possible, that compliance be encouraged via community engagement and enforcement, and strict deadlines/goals for harvesting set to prevent overfishing.
For me or for them: how in‐group identification and beliefs influence the comprehension of controversial texts
Authors: Maier Johanna , Richter Tobias , Nauroth Peter , Gollwitzer Mario
Published: November 2017

This study investigated the impact of readers' prior beliefs and level of in‐group identification on the comprehension of controversial texts. Psychology students from a university that is known for its specialisation on psychoanalysis in clinical psychology read two controversial texts on the issue of whether cognitive behavioural therapy or psychoanalysis is more effective. Participants' beliefs and their in‐group identification were assessed before reading and comprehension was assessed with a verification task. Results revealed a better comprehension of the belief‐consistent text for high identifiers – regardless of whether this text was socially affirming or socially threatening. Low identifiers favouring psychoanalysis exhibited weak situation models for both texts, whereas a stronger comprehension for the social‐affirming text was found for low identifiers favouring cognitive behavioural therapy. These results suggest that readers' beliefs and their level of in‐group identification with a relevant social group are both sources for a biased comprehension of social scientific issues.
Drug interactions between rifamycin antibiotics and hormonal contraception: a systematic review
Authors: Simmons KB , Haddad LB , Nanda K , Curtis KM
Published: November 2017

Background

Rifamycin antibiotics are commonly used for treatment of tuberculosis, but may reduce the effectiveness of hormonal contraception (HC).

Objectives

To determine whether interactions between rifamycins and HC result in decreased effectiveness or increased toxicity of either therapy.

Search strategy

We searched MEDLINE, Embase, Cochrane and clinicaltrials.gov through May 2017.

Selection criteria

We included trials, cohort, and case‐control studies addressing pregnancy rates, pharmacodynamics or pharmacokinetic (PK) outcomes when HC and rifamycins were administered together versus apart. Of 7291 original records identified, 11 met inclusion criteria after independent review by two authors.

Data collection and analysis

Two authors independently abstracted study details and assessed study quality using the United States Preventive Services Task Force grading system. Findings are reported descriptively.

Main results

Studies only addressed combined oral contraceptives (COCs) and none reported pregnancy rates. Quality ranged from good to poor. Rifampin increased the frequency of ovulation in two of four studies, and reduced estrogen and/or progestin exposure in five studies. Rifabutin led to smaller PK changes than rifampin in two studies. In one study each, rifaximin and rifalazil did not alter hormone PK.

Conclusions

No studies evaluated pregnancy risk or non‐oral HCs. PK and ovulation outcomes support a clinically concerning drug interaction between COCs and rifampin, and to a lesser extent rifabutin. Data are limited for other rifamycins.

Tweetable abstract

Rifampin and rifabutin reduce systemic exposure of oral contraceptives, but no studies have evaluated pregnancy risk.
The Economic Cost of Communicable Disease Surveillance in Local Public Health Agencies
Authors: Atherly Adam , Whittington Melanie , VanRaemdonck Lisa , Lampe Sarah
Published: November 2017

Objective

We identify economic costs associated with communicable disease (CD) monitoring/surveillance in Colorado local public health agencies and identify possible economies of scale.

Data Sources/Study Setting

Data were collected via a survey of local public health employees engaged in CD work. Survey respondents logged time spent on CD surveillance for 2‐week periods in the spring of 2014 and fall of 2014. Forty‐three of the 54 local public health agencies in Colorado participated.

Study Design

We used a microcosting approach. We estimated a statistical cost function using cost as a function of the number of reported investigable diseases during the matched 2‐week period. We also controlled for other independent variables, including case mix, characteristics of the agency, the community, and services provided.

Data Collection/Extraction Methods

Data were collected from a microcosting survey using time logs.

Principal Findings

Costs increased at a decreasing rate as cases increased, with both cases (β = 431.5, p < .001) and cases squared (β = −3.62, p = .05) statistically significant.

Conclusions and Implications

The results of the model suggest economies of scale. Cost per unit is estimated to be one‐third lower for high‐volume agencies as compared to low‐volume agencies. Cost savings could potentially be achieved if smaller agencies shared services.
Australia's Health Star Rating policy process: Lessons for global policy‐making in front‐of‐pack nutrition labelling
Authors: Kumar Medha , Gleeson Deborah , Barraclough Simon
Published: November 2017

Aim

This study explored factors that shaped the development of Australia's Health Star Rating system for front‐of‐pack labelling (FoPL) on packaged foods and whether insights could be drawn from this experience to inform the development of global FoPL standards.

Methods

Ten individual semi‐structured interviews were conducted with public health or consumer advocates, academics in the field of nutrition labelling and policy, a food industry employee, and Australian public servants. Thematic analysis was undertaken, guided by Kingdon's Multiple Streams Framework, to identify factors which shaped Australian and international FoPL policy processes.

Results

Senior Australian bureaucrats played the policy entrepreneur role to facilitate the development of the Health Star Rating system. The public health and consumer advocacy groups formed an alliance to counter‐balance the influence of the food industry in the Health Star Rating development process. Public health and consumer groups have less influence at Codex Alimentarius, where policy‐making is constrained by political alliances and consensus voting structures.

Conclusions

Strong leadership, policy entrepreneurship and a coherent alliance between public health and consumer groups enabled the development of a FoPL system in Australia and could contribute to advancing FoPL standards at the international level.
Quality of information about success rates provided on assisted reproductive technology clinic websites in Australia and New Zealand
Authors: Hammarberg Karin , Prentice Tess , Purcell Isabelle , Johnson Louise
Published: November 2017

Background

Many factors influence the chance of having a baby with assisted reproductive technologies (ART). A 2016 Australian Competition and Consumer Commission (ACCC) investigation concluded that ART clinics needed to improve the quality of information they provide about chance of ART success.

Aim

To evaluate changes in the quality of information about success rates provided on the websites of ART clinics in Australia and New Zealand before and after the ACCC investigation.

Materials and Method

Desktop audits of websites of ART clinics in Australia and New Zealand were conducted in 2016 and 2017 and available information about success rates was scored using a matrix with eight variables and a possible range of scores of 0–9.

Results

Of the 54 clinic websites identified in 2016, 32 had unique information and were eligible to be audited. Of these, 29 were also eligible to be audited in 2017. While there was a slight improvement in the mean score from 2016 to 2017 (4.93–5.28), this was not statistically significantly different. Of the 29 clinics, 14 had the same score on both occasions, 10 had a higher and five a lower information quality score in 2017.

Conclusions

To allow people who consider ART to make informed decisions about treatment they need comprehensive and accurate information about what treatment entails and what the likely outcomes are. As measured by a scoring matrix, most ART clinics had not improved the quality of the information about success rates following the ACCC investigation.
C‐reactive protein is linked to disease activity, impact, and response to treatment in patients with chronic spontaneous urticaria
Authors: Kolkhir P. , Altrichter S. , Hawro T. , Maurer M.
Published: November 2017

Background

Elevated levels of C‐reactive protein (CRP), a sensitive marker of inflammation, have been consistently reported in chronic spontaneous urticaria (CSU). Here, we retrospectively analyzed data from 1253 CSU patients from 2 centers to answer the following questions: (i) What is the prevalence of elevated levels of CRP in CSU? (ii) Why do CSU patients show elevated levels of CRP? (iii) Are elevated CRP levels relevant?

Methods

Serum levels of CRP were measured by the nephelometric method. We collected information regarding various laboratory tests including ESR, CBC with differential, D‐dimer, fibrinogen, C3, C4, IL‐6, etc. For most patients, we also collected data on age, gender, duration of CSU, presence of angioedema, activity (UAS at the time of blood sampling and for 7 days), quality of life (CU‐Q2oL and/or DLQI), comorbidities and possible causes of CSU, and autologous serum skin test (ASST) response. The efficacy of second‐generation antihistamines was evaluated on the day of blood collecting.

Results

One‐third of CSU patients had elevated levels of CRP. Higher levels of CRP were associated with ASST positivity (P = .009) and arterial hypertension (P = .005), but not with other possible causes or comorbidities of CSU. C‐reactive protein correlated with urticaria activity (P < .001), quality of life impairment (P = .026), and inflammatory and coagulation markers (P < .001). C‐reactive protein levels were significantly higher in nonresponders to antihistamines as compared to responders (P < .001).

Conclusion

Elevated levels of CRP are common and relevant in CSU patients. The assessment of CRP levels may help to optimize the management of patients with CSU.
Development of a surgical trainer assessment questionnaire
Authors: Dean Benjamin J. F. , Keeler Barrie , Garfjeld Roberts Patrick , Rees Jonathan L.
Published: November 2017

Background

The assessment of surgical trainees has become well‐established in practice; however, this is not yet the case for surgical trainers. The aim of this study was to develop a trainer assessment questionnaire (OxTrAQ) based on the 12 key trainer attributes identified by a previous systematic review, to then explore this questionnaire's potential domains and test its reliability.

Methods

TheOxTrAQwas piloted at two surgical training centres in two surgical sub‐specialities. At each centre, every trainee assessed every trainer while under their clinical supervision.

Results

Internal consistency (Cronbach's alpha) was calculated for this 12‐item questionnaire as 0.958. Factor analysis revealed two domains which accounted for 77.997% of the variance; these were the general domain (nine items) and the independence domain (three items). Inter‐observer reliability was shown by the intraclass correlation coefficients (ICCs) (average measures) for the overallOxTrAQscore, general domain score and independence domain score which were 0.951, 0.945 and 0.955 for centre 1 and 0.857, 0.819 and 0.883 for centre 2, respectively. Intra‐observer reliability was shown by theICCs(average measures) for the overallOxTrAQscore, general domain score and independence domain score which were 0.925, 0.913 and 0.940, respectively. Construct validity was demonstrated by a high correlation (Spearman rho = 0.886,P= 0.019) between trainer scores and the scores predicted by the trainers themselves.

Conclusions

TheOxTrAQis a simple trainer assessment questionnaire which has demonstrated both high inter‐ and intra‐observer reliability.
Comparison of self‐made cryopreservative fibrin glue and commercial fibrin glue kit in pterygium surgery: 1‐year follow‐up
Authors: Gong Jingwen , Fan Jiaqi , Shen Ting , Jiang Jin
Published: November 2017

Purpose

To assess long‐term efficacy and safety of self‐made cryopreservative fibrin glue (SMC) applied in pterygium surgery.

Methods

Prospective, comparative, interventional case series. Forty eyes of 40 patients with nasal primary pterygium, 24 male and 16 female, were enrolled. The patients were assigned to two groups and each contained 12 male and eight female based on the pterygium area encroaching onto the cornea. In one group, the conjunctival autograft was attached to the sclera with SMC stored for 2 months, and in the other group, commercial fibrin glue kit (CK) was applied after the pterygium was removed. All the patients were followed up postoperatively on days 1, 3, 7 and 14 then at months 1, 3, 6, 12. The main outcome measures included operating time, postoperative discomfort, recurrence rate and complications.

Results

There were no significant differences in surgery time (p = 0.713) and postoperative discomfort (day 1, 3, 7; p = 0.747, p = 0.766, p = 0.983, respectively) between the two groups. By the end of 1‐year follow‐up, the recurrence rate was 0% in the SMC group and 5% in the CK group (p = 1.000). There were no infections and severe visual acuity (VA) threatening complications in either group.

Conclusion

Self‐made cryopreservative fibrin glue (SMC) is as effective as standard CK for autograft fixation in pterygium surgery and it also has good safety after long‐term follow‐up. For its convenience and low cost, this new methods should be popularized, especially in underdeveloped area.
Primary antibiotic resistance of Helicobacter pylori strains among adults and children in a tertiary referral centre in Lithuania
Authors: Dargiene Gintare , Kupcinskas Juozas , Jonaitis Laimas , Vezbavicius Mindaugas , Kadusevicius Edmundas , Kupcinskiene Eugenija , Frandsen Tove Havnhoj , Kucinskiene Ruta , Kupcinskas Limas , Andersen Leif Percival
Published: November 2017

The study evaluated primary antibiotic resistance of Helicobacter pylori within the period 2013–2015 and trends of antibiotic consumption over the last decade in Lithuania; 242 adults and 55 children were included in the study. E‐tests were performed for amoxicillin, metronidazole, clarithromycin, ciprofloxacin, rifampicin and tetracycline. The presence of H. pylori and clarithromycin resistance was additionally tested by PCR. Helicobacter pylori culture was positive in 67 of 242 (28%) adult and in 12 of 55 (21.8%) children samples. Resistance rates among adults by E‐tests were as follows: metronidazole – 32.8% (95% confidence interval (CI): 22.7–44.7%), ciprofloxacin – 7.5% (95% CI: 3.2–16.3%), rifampicin – 7.5% (95% CI: 3.2–16.3%), amoxicillin – 0%, whereas resistance rates in children were as follows: metronidazole – 25% (95% CI: 8.9–53.2%), rifampicin – 8.3% (CI: 1.5–35.4%), amoxicillin and ciprofloxacin – 0%. Accumulated clarithromycin resistance rates by E‐tests and PCR were 8.2% (95% CI: 4.1–16.0%) in adults and 17.7% (95% CI: 6.2–41.0%) in children. Total use of macrolides and lincosamides in Lithuania increased from 1.26 to 1.86 defined daily dose (DDD)/1000 inhabitants/day among adults, while it has doubled from 1.10 to 2.22 DDD/1000/children/day in children within 2003–2015. There are no significant changes in the susceptibility of H. pylori to the most widely used antibiotics in adults over the last years in Lithuania; however, clarithromycin resistance among children exceeds 15% and mandates further larger‐scale studies in paediatric population.
Reading Emotion From Mouse Cursor Motions: Affective Computing Approach
Authors: Yamauchi Takashi , Xiao Kunchen
Published: November 2017

Affective computing research has advanced emotion recognition systems using facial expressions, voices, gaits, and physiological signals, yet these methods are often impractical. This study integrates mouse cursor motion analysis into affective computing and investigates the idea that movements of the computer cursor can provide information about emotion of the computer user. We extracted 16–26 trajectory features during a choice‐reaching task and examined the link between emotion and cursor motions. Participants were induced for positive or negative emotions by music, film clips, or emotional pictures, and they indicated their emotions with questionnaires. Our 10‐fold cross‐validation analysis shows that statistical models formed from “known” participants (training data) could predict nearly 10%–20% of the variance of positive affect and attentiveness ratings of “unknown” participants, suggesting that cursor movement patterns such as the area under curve and direction change help infer emotions of computer users.
Public Policy Issues and Campaign Strategies: Examining Rationality and the Role of Social Media in a Legislative Election Within a Middle Eastern Context
Authors: Yaghi Abdulfattah , Antwi‐Boateng Osman
Published: November 2017

While most studies from western countries emphasize rationality in electoral behavior, the present study proposes that rationality is also a driver of candidates’ behavior in a non‐Western context. The purpose of the present study is to map campaign content as well as campaign strategies of 214 candidates in the 2015 United Arab Emirates legislative elections. The qualitative analysis showed rational consideration drove the selection of both campaign strategies and public policy positions. Candidates decided to include patriotism and social and economic policy issues in their campaigns to attract votes. In addition, while candidates utilized social meda in their campaigns hoping to maximize their voter outreach, doing so was not necessarily decisive in garnering more votes. Thus, juxtaposed with social meda channels like Twitter, Facebook, Instagram, YouTube, SnapChat, and GooglePlus, traditional campaigning strategies remained very potent.
Angiotensin 1‐7 modulates electrophysiological characteristics and calcium homoeostasis in pulmonary veins cardiomyocytes via MAS/PI3K/eNOS signalling pathway
Authors: Lu Yen‐Yu , Wu Wen‐Shiann , Lin Yung‐Kuo , Cheng Chen‐Chuan , Chen Yao‐Chang , Chen Shih‐Ann , Chen Yi‐Jen
Published: November 2017

Background

Atrial fibrillation (AF) is the most common sustained arrhythmia, and pulmonary veins (PVs) play a critical role in triggering AF. Angiotensin (Ang)‐(1‐7) regulates calcium (Ca2+) homoeostasis and also plays a critical role in cardiovascular pathophysiology. However, the role of Ang‐(1‐7) in PV arrhythmogenesis remains unclear.

Materials and methods

Conventional microelectrodes, whole‐cell patch‐clamp and the fluo‐3 fluorimetric ratio technique were used to record ionic currents and intracellular Ca2+ in isolated rabbit PV preparations and in single isolated PV cardiomyocytes, before and after administration of Ang‐(1‐7).

Results

Ang (1‐7) concentration dependently (0.1, 1, 10 and 100 nmol/L) decreased PV spontaneous electrical activity. Ang‐(1‐7) (100 nmol/L) decreased the late sodium (Na+), L‐type Ca2+ and Na+‐Ca2+ exchanger currents, but did not affect the voltage‐dependent Na+ current in PV cardiomyocytes. In addition, Ang‐(1‐7) decreased intracellular Ca2+ transient and sarcoplasmic reticulum Ca2+ content in PV cardiomyocytes. A779 (a Mas receptor blocker, 3 μmol/L), L‐NAME (a NO synthesis inhibitor, 100 μmol/L) or wortmannin (a specific PI3K inhibitor, 10 nmol/L) attenuated the effects of Ang‐(1‐7) (100 nmol/L) on PV spontaneous electric activity.

Conclusion

Ang‐(1‐7) regulates PV electrophysiological characteristics and Ca2+ homoeostasis via Mas/PI3K/eNOS signalling pathway.
Seasonal variation in abundance and diversity of eavesdropping frog‐biting midges (Diptera, Corethrellidae) in a neotropical rainforest
Authors: LEGETT HENRY D. , BARANOV VIKTOR A. , BERNAL XIMENA E.
Published: November 2017

1. In the tropics, precipitation patterns result in seasonal fluctuations in the abundance and distribution of plant and animal species. Tropical predators and parasites are therefore faced with seasonal changes in prey and host availability.

2. This study investigates the seasonal interaction among a specialised ectoparasite, eavesdropping frog‐biting midges (Corethrella spp.), and their anuran hosts, examining how the abundance and diversity of the frog‐biting midge community fluctuate between the rainy (host abundant) and dry (host sparse) seasons.

3. Midges were captured in both the rainy and dry seasons using acoustic playbacks of calls from a common frog species that breeds during the rainy season, the túngara frog (Engystomops, Physalaemus, pustulosus). During the dry season túngara frog choruses are absent. To explore seasonal shifts in host preference or changes in the midge community due to host specificity, midges were also captured using playbacks of calls from a frog that breeds during the dry season, the pug‐nosed tree frog (Smilisca sila).

4. While the overall abundance of midges decreased in the dry season, only slight differences in the relative abundance between midge species were found. These results suggest that midge populations can shift between hosts as they become available across seasons, allowing adult populations of frog‐biting midges to persist year‐round. To overcome the challenge of detecting and localising different host species, it is proposed that frog‐biting midges have evolved a generalised acoustic template, allowing them to respond to a broad range of available hosts, regardless of seasonal host composition.
Exploring patient‐reported outcomes following percutaneous coronary intervention: A qualitative study
Authors: Ayton Darshini R. , Barker Anna L. , Peeters Geeske M. E. E. , Berkovic Danielle E. , Lefkovits Jeffrey , Brennan Angela , Evans Sue , Zalcberg John , Reid Christopher , Stoelwinder Johannes (Just) , McNeil John
Published: November 2017

Background

Percutaneous coronary intervention (PCI) is a common cardiac procedure used to treat obstructive coronary artery disease. Patient‐centred care is a priority in cardiovascular health having been shown to increase patient satisfaction, engagement with rehabilitation activities and reduce anxiety. Evidence indicates that patient‐centred care is best achieved by routine collection of patient‐reported outcomes (PROs). However, existing patient‐reported outcome measures (PROMs) have limited the patient involvement in their development.

Aims

To identify and explore outcomes, patients perceive as important following PCI.

Methods

A qualitative design was adopted. Eight focus groups and five semi‐structured interviews were conducted with 32 patients who had undergone PCI in the previous 6 months. Outcomes were identified and mapped under the U.S. Food and Drug Administration (FDA) patient‐reported outcome (PROs) domains of feeling (physical and psychological outcomes), function and evaluation. Inductive and deductive analysis methods were used with open, axial and thematic coding.

Results

Consistent with prior studies, patients identified feeling and function outcomes such as reductions in physical and psychological symptoms and the ability to perform usual activities as important. Participants also identified a range of new outcomes, including confidence to return to usual activities and evaluation domains such as adverse effects of medications and the importance of patient communication.

Conclusion

The findings of this research should be considered in the design of a cardiac PROM for PCI patients. A PROM which adequately assesses these outcomes can provide clinicians and hospital staff with a foundation in which to address these concerns or symptoms.
Demographic modelling reveals a history of divergence with gene flow for a glacially tied stonefly in a changing post‐Pleistocene landscape
Authors: Hotaling Scott , Muhlfeld Clint C. , Giersch J. Joseph , Ali Omar A. , Jordan Steve , Miller Michael R. , Luikart Gordon , Weisrock David W.
Published: November 2017

Aim

Climate warming is causing extensive loss of glaciers in mountainous regions, yet our understanding of how glacial recession influences evolutionary processes and genetic diversity is limited. Linking genetic structure with the influences shaping it can improve understanding of how species respond to environmental change. Here, we used genome‐scale data and demographic modelling to resolve the evolutionary history of Lednia tumana, a rare, aquatic insect endemic to alpine streams. We also employed a range of widely used data filtering approaches to quantify how they influenced population structure results.

Location

Alpine streams in the Rocky Mountains of Glacier National Park, Montana, USA.

Taxon

Lednia tumana, a stonefly (Order Plecoptera) in the family Nemouridae.

Methods

We generated single nucleotide polymorphism data through restriction‐site associated DNA sequencing to assess contemporary patterns of genetic structure for 11 L. tumana populations. Using identified clusters, we assessed demographic history through model selection and parameter estimation in a coalescent framework. During population structure analyses, we filtered our data to assess the influence of singletons, missing data and total number of markers on results.

Results

Contemporary patterns of population structure indicate that L. tumana exhibits a pattern of isolation‐by‐distance among populations within three genetic clusters that align with geography. Mean pairwise genetic differentiation (FST) among populations was 0.033. Coalescent‐based demographic modelling supported divergence with gene flow among genetic clusters since the end of the Pleistocene (~13‐17 kya), likely reflecting the south‐to‐north recession of ice sheets that accumulated during the Wisconsin glaciation.

Main conclusions

We identified a link between glacial retreat, evolutionary history and patterns of genetic diversity for a range‐restricted stonefly imperiled by climate change. This finding included a history of divergence with gene flow, an unexpected conclusion for a mountaintop species. Beyond L. tumana, this study demonstrates the complexity of assessing genetic structure for weakly differentiated species, shows the degree to which rare alleles and missing data may influence results, and highlights the usefulness of genome‐scale data to extend population genetic inquiry in non‐model species.