bluuebunny/crossref_metadata_2025 huggingface dataset:
Chemotherapy Regimen in Nonagenarian Cancer Patients: A Bi-Institutional Experience
Authors: Rivoirard Romain , Chargari Cyrus , Kullab Sharif , Trone Jane-Chloé , Langrand-Escure Julien , Moriceau Guillaume , Guy Jean-Baptiste , Annede Pierre , Méry Benoîte , Moncharmont Coralie , Falk Alexander Tuan , Vedrine Lionel , Merrouche Yacine , Fournel Pierre , Magné Nicolas
Published: November 2015

Background: The elderly population in Western countries is growing and constitutes a public health issue. Concomitantly, age-related diseases such as cancer increase. There are few data on the efficacy, tolerability and toxicity of specific anticancer therapy in the very elderly patients; therefore, their management is not standardized. Methods: In this bi-institutional study, we reviewed medical records of patients who received or continued specific anticancer therapy beyond the age of 90 years. Geriatric assessment was not reported for our patients. Twelve patients were enrolled. Their general health condition was good, and half of them were living in elderly institutions. Ten patients had a solid tumor and 2 were treated for hematological malignancies. Most were diagnosed with a locally advanced or metastatic disease, and the goal of treatment was curative for only 1 patient. Six patients received chemotherapy as first-line treatment, 4 patients received targeted therapy and 2 received concomitant chemoradiation. Four patients received a second-line treatment. Results: Despite a significant reduction in treatment posology in half of the patients, 8 acute grade 3/4 toxicities were reported and 2 patients died of treatment-related septic shock. Median duration of first-line treatment was 3.2 months, and progression-free survival ranged from 18 to 311 days. Overall survival ranged from 18 days to 11 years. Conclusion: Aging is a heterogeneous process, and management of elderly patients is a multidisciplinary approach. Geriatric assessment helps to identify older patients with a higher risk of morbidity/mortality and allows to assess the risks and benefits of specific anticancer therapy. The choice of treatment should be based primarily on the expected symptomatic benefit, and treatment should not compromise the quality of life.
Relevance of Retinal Thickness Changes in the OCT Inner and Outer Rings to Predict Progression to Clinical Macular Edema: An Attempt of Composite Grading of Macular Edema
Authors: Vujosevic Stela , Varano Monica , Egan Catherine , Sivaprasad Sobha , Menon Geeta , Erginay Ali , Verbraak Frank D. , Lund-Andersen Henrik , Martinez Jose P. , Jürgens Ignasi , Smets Erica , Coriat Caroline , Wiedemann Peter , Ágoas Victor , Querques Giuseppe , Holz Frank G. , Nunes Sandrina , Alves Dalila , Neves Catarina , Santos Torcato , Ribeiro Luisa , Bandello Francesco , Tejerina Amparo Navea , Cunha-Vaz José ,   for the EVICR.net
Published: November 2015

Purpose: To characterize the relevance of macular thickness changes in the inner and outer rings in the progression of macular edema in eyes/patients with diabetes type 2. Methods: A total of 374 type 2 diabetic patients with mild nonproliferative diabetic retinopathy (ETDRS levels 20-35) were included in a 12-month prospective observational study to identify retinopathy progression. Retinal thickness analyses were performed in 194 eyes/patients using Cirrus SD- OCT and 166 eyes/patients using Spectralis SD-OCT. The DRCR.net classification of subclinical and clinical macular edema was used. A composite grading of macular edema is proposed in this study. Results: A total of 317 eyes/patients completed the study. SD-OCT identified clinical macular edema in 24 eyes/patients (6.7%) and subclinical macular edema in 104 eyes/patients (28.9%) at baseline. Increased thickness of the central subfield is the best predictor for the development of clinical macular edema, with 85.7% sensitivity and 71.9% specificity (OR: 2.57, 95% CI: 0.82-7.99). However, the involvement of the inner and outer rings is a cumulative predictor of progression to clinical macular edema (OR: 8.69, 95% CI: 2.85-26.52). Conclusions: A composite OCT grading of macular edema taking into account the retinal thickness changes in the inner and outer macular rings offers a simple way to characterize macular edema, with added clinical value.
Emergency Laparoscopic Sigmoidectomy for Perforated Diverticulitis with Generalised Peritonitis: A Systematic Review
Authors: Vennix Sandra , Boersema Geesien S. , Buskens Christianne J. , Menon Anand G. , Tanis Pieter J. , Lange Johan F. , Bemelman Willem A.
Published: November 2015

Background: Laparoscopic sigmoidectomy for diverticulitis has initially been confined to the elective setting. However, open acute sigmoidectomy for perforated diverticulitis is associated with high morbidity rates that might be reduced after laparoscopic surgery. The aim of this systematic review was to assess the feasibility of emergency laparoscopic sigmoidectomy for perforated diverticulitis. Methods: We performed a systematic search of PubMed, EMBASE and CENTRAL. All studies reporting on patients with perforated diverticulitis (Hinchey III-IV) treated by laparoscopic sigmoidectomy in the acute phase were included, regardless of design. Results: We included 4 case series and one cohort study (total of 104 patients) out of 1,706 references. Hartmann's procedure (HP) was performed in 84 patients and primary anastomosis in 20. The mean operating time varied between 115 and 200 min. The conversion rate varied from 0 to 19%. The mean length of hospital stay ranged between 6 and 16 days. Surgical re-intervention was necessary in 2 patients. In 20 patients operated upon without defunctioning ileostomy, no anastomotic leakage was reported. Three patients died during the postoperative period. Stoma reversal after HP was performed in 60 out of 79 evaluable patients (76%). Conclusions: Acute laparoscopic sigmoidectomy for the treatment of perforated diverticulitis is feasible in selected patients provided they are handled by experienced hands.
Utility of Continuous Metabolic Syndrome Score in Assessing Risk of Type 2 Diabetes: The Isfahan Diabetes Prevention Study
Authors: Janghorbani Mohsen , Amini Masoud
Published: November 2015

Background/Aim: It is not clear whether levels of continuous metabolic syndrome (cMetS) are associated with type 2 diabetes (T2D). The aim of this study was to determine the ability of the cMetS score to predict progression to T2D in non-diabetic first-degree relatives (FDRs) of patients with T2D in Isfahan, Iran. Methods: A total of 1,869 non-diabetic FDRs 30-70 years old in 2003-2005 were followed through 2014 for the occurrence of T2D. At baseline and through follow-ups, participants underwent a standard 75 g 2-h oral glucose tolerance test. MetS was defined by the National Cholesterol Education Program-Adult Treatment Panel III. The cMetS score was calculated using age- and gender-standardized Z-score for MetS components. Receiver operating characteristic (ROC) curve was used to assess the association between cMetS and components of MetS with T2D. Results: During 13,571 person-years of follow-up, 72 men and 210 women developed diabetes. Those in the top quartile of cMetS were 8.0 times more likely to develop diabetes than those in the bottom quartile (OR 7.96; 95% CI 4.88-12.99). On ROC curve analysis, a higher area under the ROC were found for FPG (74.3%; 95% CI 70.8-77.8), than for cMetS (69.4%; 95% CI 66.0-72.8). Conclusions: The cMetS score is a robust predictor of T2D and may be more effective and efficient than the current binary definition of MetS in predicting progression to T2D in our study population.
Telephone Assessment and Skill-Building Kit for Stroke Caregivers
Authors: Bakas Tamilyn , Austin Joan K. , Habermann Barbara , Jessup Nenette M. , McLennon Susan M. , Mitchell Pamela H. , Morrison Gwendolyn , Yang Ziyi , Stump Timothy E. , Weaver Michael T.
Published: November 2015

Background and Purpose—

There are few evidence-based programs for stroke family caregivers postdischarge. The purpose of this study was to evaluate efficacy of the Telephone Assessment and Skill-Building Kit (TASK II), a nurse-led intervention enabling caregivers to build skills based on assessment of their own needs.

Methods—

A total of 254 stroke caregivers (primarily female TASK II/information, support, and referral 78.0%/78.6%; white 70.7%/72.1%; about half spouses 48.4%/46.6%) were randomized to the TASK II intervention (n=123) or to an information, support, and referral group (n=131). Both groups received 8 weekly telephone sessions, with a booster at 12 weeks. General linear models with repeated measures tested efficacy, controlling for patient hospital days and call minutes. Prespecified 8-week primary outcomes were depressive symptoms (with Patient Health Questionnaire Depressive Symptom Scale PHQ-9 ≥5), life changes, and unhealthy days.

Results—

Among caregivers with baseline PHQ-9 ≥5, those randomized to the TASK II intervention had a greater reduction in depressive symptoms from baseline to 8, 24, and 52 weeks and greater improvement in life changes from baseline to 12 weeks compared with the information, support, and referral group (
P
<0.05); but not found for the total sample. Although not sustained at 12, 24, or 52 weeks, caregivers randomized to the TASK II intervention had a relatively greater reduction in unhealthy days from baseline to 8 weeks (
P
<0.05).

Conclusions—

The TASK II intervention reduced depressive symptoms and improved life changes for caregivers with mild to severe depressive symptoms. The TASK II intervention reduced unhealthy days for the total sample, although not sustained over the long term.

Clinical Trial Registration—

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT01275495.
Deadlock or Transformational Change? Exploring Public Discourse on REDD+ Across Seven Countries
Authors: Di Gregorio Monica , Brockhaus Maria , Cronin Tim , Muharrom Efrian , Mardiah Sofi , Santoso Levania
Published: November 2015

This article investigates the public discourses on reducing emissions from deforestation and forest degradation (REDD+) across seven countries, to assess whether they support policy reforms. We argue that transformational discourses have at least one of these characteristics: they advocate specific policy reforms that address the drivers of deforestation and forest degradation; take into account the potential risks of a REDD+ mechanism; go beyond technocratic solutions to reduce emissions; and explicitly challenge existing power relations that support drivers of deforestation. The evidence indicates the predominance of win-win storylines, a lack of engagement by state actors with debates on the potential negative socioeconomic outcomes of REDD+, and little attention to the drivers of deforestation. The article concludes that to achieve a shift toward transformational public discourse, reformist policy actors and the media need to engage dominant policy actors in debates about how to reduce pressure on the forest.
Sustainable Global Governance? Reduce, Reuse, and Recycle Institutions
Authors: Papa Mihaela
Published: November 2015

The growth of global governance—in terms of the proliferation of rules, laws, and institutional forms as well as their interactions—is an increasingly debated issue. Scholars are raising concerns about some of its negative impacts, but they are divided on the extent of these impacts and on the needed solutions. While some question the viability of international institutions and argue for embracing complexity, others see current growth concerns as a call for more order and a turn to constitutionalism. This article argues for a turn to sustainable development instead. This approach addresses the system’s underlying problem: its unsustainable development, which threatens to produce more rather than better governance arrangements and to enhance existing participation inequalities. The article uses the sustainable development paradigm to envision how to prevent rather than respond to growth concerns, and to integrate equity considerations into institutional strategies. A discussion of reducing, reusing, and recycling international institutions illustrates how to implement this approach and suggests areas for future research.
A new species of the rodent genus Hylomyscus from Angola, with a distributional summary of the H. anselli species group (Muridae: Murinae: Praomyini)
Authors: CARLETON MICHAEL D. , BANASIAK REBECCA A. , STANLEY WILLIAM T.
Published: November 2015

A new species of Hylomyscus, H. heinrichorum, is described from mountains in western Angola. Based on morphological traits and cranial morphometry, the new species is assigned to the H. anselli species group and is hypothesized to be most closely related to H. anselli Bishop proper, a species named from Zambia. Members of both the H. anselli and H. denniae species groups occupy the Afromontane Biotic Zone, found in various mountain systems to the south and east of the Congo Basin. Evidence is reviewed that supports the independent radiation of these two species groups within montane forest from different Guineo-Congolian ancestral stocks.
A new species of Platydecticus (Orthoptera: Tettigoniidae: Tettigoniinae;
Nedubini) from the Andes of Chile
Authors: SÁNCHEZ ALEJANDRO VERA
Published: November 2015

A new species of the genus Platydecticus is described based on adult male and female specimens and the egg. The new species, Platydecticus diaguita, inhabits the Andes Range at 27º S latitude, above 3000 m elevation. Both sexes are easily identifiable by genital morphology characters and by the external characters of the fastigium of the vertex and the reduced number of spines in the hind tibia. It is also the smallest species described for the genus.
Paradiopatra Ehlers, 1887 (Annelida: Onuphidae) from southwestern Europe with the description of a new species and new ultramorphological data for the genus
Authors: ARIAS ANDRÉS , PAXTON HANNELORE
Published: November 2015

This work recognises five species of Paradiopatra from southwestern Europe, represented in the Bay of Biscay, the Atlantic coasts of Iberia and the western Mediterranean Sea. One species, Paradiopatra florencioi sp. nov., is newly described from the Cantabrian slope, northern Spain. We are presenting detailed diagnoses of all species and report ontogenetic changes of P. bihanica and P. hispanica. Scanning electron microscopy elucidated previously known Methylene Blue or Green staining patterns of the ventral glandular pads as cuticular pores. A dichotomous key to all species is included.
Cheramus iranicus, a new species of ghost shrimp (Decapoda: Axiidea: Callianassidae) from the Persian Gulf, Iran
Authors: SEPAHVAND VAHID , MOMTAZI Farzaneh , TUDGE CHRISTOPHER
Published: November 2015

A new species of callianassid ghost shrimp is described from the Persian Gulf, Iran. Cheramus iranicus sp. nov. is the first member of Cheramus described from Iranian subtidal waters and can be differentiated by a large cheliped with a ventroproximal spine on the merus and 7 spines on the ventral margin of the ischium, the endopod of the uropod has 4 movable spines on the distal margin and the posterior margin of the telson is strongly bilobed with a prominent medial tooth and two pairs of lateral movable spines. It is compared to other described Cheramus-like species showing a high degree of morphological similarity.
Tanzawana flavomaculata (Hymenoptera, Ichneumonidae, Ctenopelmatinae), a new genus and species of parasitoid of Fagineura crenativora (Tenthredinidae, Nematinae), a serious pest of beech tree
Authors: WATANABE KYOHEI , TANIWAKI TOORU , KASPARYAN DMITRI
Published: November 2015

We describe a new genus, and a new species, of parasitoid—Tanzawana flavomaculata Watanabe & Kasparyan (Hymenoptera: Ichneumonidae: Ctenopelmatinae)—based on material collected in Honshu, Japan. As T. flavomaculata is found on Fagineura crenativora Vikberg & Zinovjev, 2000 (Hymenoptera: Tenthredinidae), a serious pest of beech tree, this parasitoid is an important natural enemy of F. crenativora that can be used for the biological control of this pest.
Setting the Parameters of Proportional–Integral–Derivative Controllers
Authors: Atherton Derek P
Published: November 2015

This note starts by discussing what is regarded as the pioneering work in proportional–integral–derivative controller tuning by Ziegler and Nichols. The basic concepts in their paper, rather than the specific tuning rules they presented, are held to be their major contributions. It is then explained with some brief theory how the ideas have been developed and how with modern technology the loop cycling method has been automated.
Rearticulating governance through carbon in theLao PDR?
Authors: Dressler Wolfram H , Mahanty Sango , Clendenning Jessica , To Phuc Xuan
Published: November 2015

Interventions to ‘improve’ the human condition through democratic and capitalist ideals increasingly draw on capital and markets to influence governance in line with Western mandates of state building. As a major recent example, Reducing Emissions from Deforestation and Forest Degradation ‘plus’ (REDD+) develops new market regimes to govern, finance, and trade carbon in line with donor discourses of civil liberties, market expansion, and, more broadly, state building. Emerging REDD + networks that aim to finance and trade carbon now align with the conditionality and ideals of democratic governance, transparency, and accountability through processes of institution building (for state stability). This paper examines the connection between REDD + projects and state-making ideals in policy and practice as bilaterals and NGOs fuse the conditions and governance of one with the other. In the Lao PDR we argue that the governance machinery and interventions associated with REDD + facilitate governance agendas to manage people, goods, and carbon in line with Western narratives of robust governance, free markets, and integrity. We contend that the adoption of REDD + will nudge local markets and governance in this postsocialist bureaucracy toward such principles, but in ways that partly reinforce the state's longer term political and economic objectives. We conclude that, rather than conserve carbon per se, REDD + governance reflects a tempered, less absolute ‘extraterritoriality’, where its transnational influence is differentiated depending on how assumptions and ideals align with state motives in the context of forest governance, democratic reform, and rural development.
The distributional consequences of future flood risk management in England and Wales
Authors: Penning-Rowsell Edmund , Pardoe Joanna
Published: November 2015

Much flood risk management (FRM) research has examined the predicted increased burden of risk from future climate change. In contrast, this paper examines the changing funding regime for FRM and arrangements for flood insurance in the UK today. These changes, after the 1998–2013 period of severe and repeated flooding, may considerably increase the burden for at-risk households, but affect different groups differently, raising the question as to how to manage the risk and who should pay for this risk management. We explore this through scenarios incorporating modelled changes both to government investment to reduce risk and to flood insurance. The key findings are that moving towards a more risk-based approach could move the burden hugely, particularly onto financially deprived at-risk households, such that both investment and insurance could be unaffordable or unavailable. As insurance becomes more risk based, deprived households are less likely to purchase cover, but higher costs might incentivise those at risk to adapt to the risk they face. In the end, society has to decide whether to promote more substantial incentives discouraging occupation of the floodplain, with the likely adverse consequences for those there who are financially deprived, or retain the current discouragement of self-help.
Doing the Paperwork
Authors: Rieske Constantin
Published: November 2015

Changing faith in early modern Europe created a significant amount of paperwork. Converts narrated their stories on numerous pages and thus (re)wrote their religious lives. Giving detailed insights into their conversion histories, their personal (re)turning to God, they created and exposed themselves in their autobiographical writings. Converts carefully composed conversion narratives to be recognized as “true believers” by their communities. Writing their spiritual autobiographies helped them to re-establish relations with both the world and themselves, which had been lost during their changes of faith. Converts not only fashioned a new self, they also became a new subject. Doing the paperwork was the final step in assuming both a new religious position and a new religious identity.
Talking to a Deity
Authors: Kawai Sachiko
Published: November 2015

A lack of sources makes it difficult to discover the personhood of premodern Japanese royal women—how they viewed themselves or wanted to be viewed by others. Hachijō-in (1137–1211), a royal heiress, strove to protect her lineage, which had begun to weaken in the political and military turmoil of the late twelfth century. Through a close analysis of her prayer of dedication (kōmon), this article explores how she reflected upon herself after undergoing a time of great difficulty as an unmarried royal daughter. In contrast to the historical overviews that typically emphasise the roles of medieval male royals and warriors, this study demonstrates that royal daughters also played significant religio-political roles. They developed a strong sense of responsibility for supporting royal authority and commemorating deceased family members. Hachijō-in’s prayer reveals her objectives, feelings and values as a woman through a deliberate construction of herself in front of the Great Bodhisattva Hachiman of Iwashimizu Shrine.
The Quest for Arabic Autobiography
Authors: Lunde Paul
Published: November 2015

The rich biographical literature of the Arabic-speaking world has been appreciated by European scholars since the inception of academic Arabic studies in the late seventeenth century and is one of the most important sources for Arabic cultural and historical studies. Less attention has been paid to Arabic self-narratives, various types of which have existed almost from the beginnings of Arabic literature in the late eighth and early ninth centuries; the majority was produced, as one might expect, by the learned elite. Dwight Reynolds has recently shown that by the thirteenth and fourteenth centuries, the scholarly autobiography had become a recognised genre, with particular features, which included childhood studies (or lack of them), higher studies under named teachers, academic controversies, positions held publications and self-justifications. These accounts seem to have almost always been attached to the beginning or end of some major work or sometimes appear as digressions within the main text. We also possess two free-standing memoirs by feudal lords, composed in the eleventh and twelfth centuries. They are filled with personal, even intimate recollections, and they both occasionally employ an informal variety of written Arabic for greater verisimilitude. This use of ‘Middle Arabic’ and the possible reasons for it are discussed, as is the sudden proliferation of autobiographical accounts written by Arabic speakers in European languages in the first half of the nineteenth century.
Exploring Contractual Relationships in Punjab
Authors: Sharma Nivedita , Singh S.P.
Published: November 2015

This article is an empirical analysis of contract farming (CF) practice in Punjab. The findings are based on the primary survey of three districts covering 300 contract farmers. The companies are found to be exploitative, which is apparent with the trends of agribusiness normalisation, such as, default in procurement, low prices and lack of extension services. CF, however, has induced a level of satisfaction among the farmers with good experiences in the past. Farmers are willing to continue with the CF in the future, provided the government plays a stringent role by enforcing a strong legal framework.
Impact of Micro-credit Programme on Women’s Empowerment
Authors: Bhaumik Sankar Kumar , Bera Sujata
Published: November 2015

This article examines the impact of the rural women’s participation in the micro-credit programme on their levels of empowerment in different domains, namely, savings, use of money, physical mobility, decision making, health and children’s education. For this purpose, we applied the method of propensity score matching to appropriately measure the empowerment gains after addressing the problem of selection biases arising out of differences in observable characteristics of the members of the treatment (participant) and the comparison (non-participant) groups. To measure the influences of various family/social conditions on the individuals’ agency freedom, we applied the framework suggested by the Self-Determination Theory (SDT). The data used in this study have been collected through a field survey in six blocks of Midnapore district of West Bengal. Our overall conclusion is that the participation in the micro-credit programme by the rural women in our study areas helped to enhance their levels of empowerment at least in some domains.
Design and implementation of a sexual health intervention for migrant construction workers situated in Shanghai, China
Authors: Mendelsohn Joshua B. , Calzavara Liviana , Light Lucia , Burchell Ann N. , Ren Jinma , Kang Laiyi
Published: November 2015

Background

China’s growing population of internal migrants has exceeded 236 million. Driven by rapid development and urbanization, this extreme population mobility creates opportunities for transmission of HIV and sexually-transmitted infections (STI). Large numbers of rural migrants flock to megacities such as Shanghai in search of employment. Although migrants constitute a key population at heightened risk of acquiring HIV or an STI, there is a lack of easily accessible sexual health services available for them. In response, we designed a short, inexpensive sexual health intervention that sought to improve HIV and STI knowledge, while reducing stigma, risky sexual behaviour, and sexual transmission of HIV and STI among migrant construction workers (MCW) situated in Shanghai, China.

Results

We implemented a three-armed, community-randomized trial spread across three administrative districts of Shanghai. The low-intensity intervention included educational pamphlets. The medium-intensity intervention included pamphlets, posters, and videos. The high-intensity intervention added group and individual counselling sessions. Across 18 construction sites, 1871 MCW were allocated at baseline to receive one intervention condition. Among baseline participants, 1304 workers were retained at 3-months, and 1013 workers were retained at 6-months, representing a total of 579 person-years of follow-up. All workers, regardless of participation, had access to informational materials even if they did not participate in the evaluation. Overall outputs included: 2284 pamphlets distributed, 720 posters displayed, 672 h of video shown, 376 participants accessed group counselling, and 61 participants attended individual counselling sessions. A multivariable analysis of participation found that men (aOR = 2.2; 95 % CI 1.1, 4.1; p = 0.036), workers situated in Huangpu district (aOR = 5.0; 95 % CI 2.6, 9.5; p < 0.001), and those with a middle school education (aOR = 1.9; 95 % CI 1.2, 3.0; p = 0.01) were more likely to have participated in intervention activities.

Conclusion

A brief educational intervention that prioritized ease of delivery to a highly mobile workforce was feasible and easily accessed by participants. Routine implementation of sexual health interventions in workplaces that employ migrant labour have the potential to make important contributions toward improving HIV and STI outcomes among migrant workers in China’s largest cities.
Extracorporeal therapies in pediatric severe sepsis: findings from the pediatric health-care information system
Authors: Ruth Amanda , McCracken Courtney E. , Fortenberry James D. , Hebbar Kiran B.
Published: November 2015

Introduction

Pediatric severe sepsis (PSS) continues to be a major health problem. Extracorporeal therapies (ETs), defined as extracorporeal membrane oxygenation (ECMO) and RRenal replacement therapyenal replacement therapy (RRT), are becoming more available for utilization in a variety of health conditions. We aim to describe (1) rates of utilization of ET in PSS, (2) outcomes for PSS patients receiving ET, and (3) epidemiologic characteristics of patients receiving ET.

Methods

We conducted a retrospective review of a prospectively collected database. Data from the Pediatric Health Information System (PHIS) database collected by the Children’s Hospital Association (CHA) from 2004–2012 from 43 US children’s hospitals’ pediatric intensive care units (PICUs) were used. Patients with PSS were defined by (1) International Classification of Diseases, 9th Revision (ICD-9) codes reflecting severe sepsis and septic shock and (2) ICD-9 codes of infection and organ dysfunction as defined by updated Angus criteria. Among the patients with PSS, those with a PHIS flag of ECMO or RRT were identified further as our main cohort.

Results

From 2004 to 2012, 636,842 patients were identified from 43 hospitals, and PSS prevalence was 7.7 % (49,153 patients). Nine point eight percent (4795 patients) received at least one form of ET, and the associated mortality rate was 39 %. Mortality rates were 47.8 % for those who received ECMO, 32.3 % in RRT, and 58.0 % in RRT + ECMO. Underlying co-morbidities were found in 3745 patients (78.1 %) who received ET (81 % for ECMO, 77.9 % in RRT, and 71.2 % in those who received both). There was a statistically significant increase in ECMO utilization in patients with at least three organ dysfunctions from 2004 to 2012 (6.9 % versus 10.3 %,P < 0.001) while RRT use declined (24.5 % versus 13.2 %,P < 0.001). After 2009, there was a significant increase in ECMO utilization (3.6 % in 2004–2008 versus 4.0 % in 2009–2012,P = 0.004). ECMO and RRT were used simultaneously in only 500 patients with PSS (1 %).

Conclusions

ETs were used in a significant portion of PSS patients with multiple organ dysfunction syndrome (MODS) during this time period. Mortality was significant and increased with increasing organ failure. ECMO use in PSS patients with MODS increased from 2004 to 2012. Further evaluation of ET use in PSS is warranted.
Genome sequence of Pedobacter glucosidilyticus DD6b, isolated from zooplankton Daphnia magna
Authors: Poehlein Anja , Daniel Rolf , Simeonova Diliana D.
Published: November 2015

The phosphite assimilating bacterium, P. glucosidilyticus DD6b, was isolated from the gut of the zooplankton Daphnia magna. Its 3,872,381 bp high-quality draft genome is arranged into 93 contigs containing 3311 predicted protein-coding and 41 RNA-encoding genes. This genome report presents the specific properties and common features of P. glucosidilyticus DD6b genome in comparison with the genomes of P. glucosidilyticus type strain DSM 23,534, and another five Pedobacter type strains with publicly available completely sequenced genomes. Here, we present the first journal report on P. glucosidilyticus genome sequence and provide information on a new specific physiological determinant of P. glucosidilyticus species.
Complete genome sequence of bacteriophage P8625, the first lytic phage that infects Verrucomicrobia
Authors: Choi Ahyoung , Kang Ilnam , Yang Seung-Jo , Cho Jang-Cheon
Published: November 2015

Bacteriophage P8625 is a lytic bacteriophage that infects the verrucomicrobial strain IMCC8625, a marine bacterium affiliated with Verrucomicrobia subdivision 4. Both the bacteriophage and the host bacterial strain were isolated from surface seawater samples collected off the east coast of Korea. The phage particle has an icosahedral capsid with a diameter of ~47 nm and a long tail of ~75 nm in length, showing the distinctive morphology of the Siphoviridae family. The complete genome sequence of phage P8625 is 32,894 bp long with 51.0 % G + C content. This is the first report of the complete genome sequence of a lytic phage that infects the Verrucomicrobia, for which the name “verrucophage” is proposed.
Reconstructing Eclecticism: Bulgarian Economic Thought in the Ottoman Empire in the Nineteenth Century
Authors: Nenovsky Nikolay , Penchev Pencho
Published: November 2015

This article deals with the explanation and reconstruction of the theoretical and methodological eclecticism typical of Bulgarian economic and social thought. This eclecticism brings together extremely opposite and mutually exclusive theoretical and methodological elements such as classical liberalism, physiocracy and mercantilism, protectionism, economic nationalism, Orthodox ethics, common sense, and a contradiction between economic policy objectives and means, among others. For this reason it is usually considered as immature economic thinking that is very hard to get ahold of within a logical framework. We propose an original theoretical reconstruction of eclecticism in Bulgarian economic and social thought from the Ottoman period by trying to bring its main components into a whole. Within this model we identify two main objectives of the economic studies from the period (national identity within the wider process of modernization and civilization), the main vehicles (liberalism, protectionism and economic nationalism, ethical principles, and sound reasoning), and two purely methodological features, the strong presence of French authors (and German to some extent) as well as extreme methodological diversity. The reconstruction of eclecticism is done in a comparative perspective with other European countries and regions.
EEG correlates of social interaction at distance
Authors: Giroldini William , Pederzoli Luciano , Bilucaglia Marco , Caini Patrizio , Ferrini Alessandro , Melloni Simone , Prati Elena , Tressoldi Patrizio E.
Published: November 2015

This study investigated EEG correlates of social interaction at distance between twenty-five pairs of participants who were not connected by any traditional channels of communication.

Each session involved the application of 128 stimulations separated by intervals of random duration ranging from 4 to 6 seconds. One of the pair received a one-second stimulation from a light signal produced by an arrangement of red LEDs, and a simultaneous 500 Hz sinusoidal audio signal of the same length. The other member of the pair sat in an isolated sound-proof room, such that any sensory interaction between the pair was impossible.

An analysis of the Event-Related Potentials associated with sensory stimulation using traditional averaging methods showed a distinct peak at approximately 300 ms, but only in the EEG activity of subjects who were directly stimulated. However, when a new algorithm was applied to the EEG activity based on the correlation between signals from all active electrodes, a weak but robust response was also detected in the EEG activity of the passive member of the pair, particularly within 9 – 10 Hz in the Alpha range. Using the Bootstrap method and the Monte Carlo emulation, this signal was found to be statistically significant.
Recommendations for assessing and preventing falls in adults of all ages with rheumatoid arthritis
Authors: Stanmore Emma K
Published: November 2015

Rheumatoid arthritis (RA) is a debilitating disease that affects younger as well as older adults. It is associated with a high risk of injurious falls due to problems such as lower-limb muscle weakness, balance impairment, swollen and tender joints, pain, and fatigue. Falls are typically associated with older people; hence, many professionals do not recognise the risks for younger persons with diseases such as RA. Falls can lead to devastating consequences, such as fatalities, hip fractures (with 50% of those affected never regaining their previous level of mobility and 30% dying within 1 year), or loss of independence and confidence. Research has shown that many people are either unaware or deny their risk of falling. Therefore, it is important that health professionals, such as community nurses, are aware of the risk factors, methods of assessment, and evidence-based preventative measures, so that falls can be avoided in this population. This article presents research and practice implications for community nurses to enable them to assess, treat, and appropriately refer adults with RA who are also at risk of falls.
Learning to deal with crisis in the home: Part 1 – developing community simulation scenarios
Authors: Gibson Caroline E , Dickson Caroline , Lawson Bill , McMillan Ailsa , Kelly Helena
Published: November 2015

Contemporary health care is increasingly being located in the community. From the evident changes in demographics and general health, it can be derived that the people whom student nurses care for are likely to have multiple comorbidities and be vulnerable to clinical deterioration. These nurses are required to develop a range of transferrable skills to meet the demands of the population. The challenge for educators of preregistration student nurses is to develop educational strategies to prepare them with the skills, knowledge, and confidence necessary to recognise and manage deterioration appropriately in any context. This article is the first of two papers discussing the stimulus, design, and delivery of an educational innovation that focuses on the recognition and management of the deteriorating patient. The article explores current literature about community-focused simulation highlighting the potential learning opportunities resulting from contextualising simulation scenarios specific to the community setting.
‘I can't walk away’: understanding the complexities in embedding a new nurse role
Authors: Randall Sue , Furze Gill , Thunhurst Colin
Published: November 2015

Background:

The community matron (CM) role was introduced in England to provide a single point of access to patients living with comorbid long-term conditions who had, or were at risk of, frequent emergency hospitalisation.

Aim:

This study explored the factors that affected embedding of the CM role. The qualitative study was undertaken in community health services in two cities and a rural area in central England.

Method:

Participants comprised health professionals (n=30) including CMs, community service managers, and service commissioners; patients (n=10); and their family carers (n=5).

Results:

Findings reveal that participants were largely positive about the role. However, difficulties with role setup had led to numerous changes in service delivery, which affected how the role has embedded.

Conclusion:

Many aspects of the CM role are invisible to other health professionals. Invisibility of community nursing, rather than autonomy of the CM role, seems to be a key factor in the challenges of embedding the role.
Pelvic girdle pain: Are we missing opportunities to make this a problem of the past?
Authors: Fishburn Sarah , Cooper Tracey
Published: November 2015

Pelvic girdle pain (PGP) continues to cause morbidity for a significant number of pregnant women (around one in five). Although research into the causes of PGP has not identified significant or preventable causes, the understanding of contributing factors has evolved significantly in recent years. It was previously thought that PGP was a hormonal problem caused by relaxin production and subsequent ‘loosening’ or laxity of pelvic joints; current evidence suggests that it is an asymmetry of mobility of the pelvic joints, in particular the sacroiliac joints. Treatment has evolved to provision of manual, hands-on therapy treatment, restoring symmetry of pelvic joint movement and function, rather than rest, crutches and support belts; hence the woman's overall biomechanical function and her mobility and independence are restored. This article seeks to raise awareness of this change of focus regarding treatment and promote its adoption across the UK, in line with national guidelines, with the goal of reducing the significant morbidity experienced by many women. Midwives are ideally placed to identify women with PGP early and make the most of the opportunity to access effective treatment, as well as supporting birth-planning that takes PGP into account, thus avoiding long-term physical and psychological morbidity.
Is frenotomy effective in improving breastfeeding in newborn babies with tongue-tie? A literature review
Authors: Burrows Sally , Lanlehin Rosemary
Published: November 2015

Aim:

This literature review explores whether frenotomy can result in more successful breastfeeding of newborn infants with ankyloglossia.

Method:

A systematic literature search was carried out. Nine pieces of research were chosen and appraised using two critical appraisal tools.

Findings:

Three main themes emerged: the mother's experiences of breastfeeding; duration of breastfeeding; and latch. The majority of studies found that frenotomy could improve latch and alleviate nipple pain. However, there is little information available about outcomes for babies with ankyloglossia who do not undergo the frenotomy procedure.

Conclusion:

Frenotomy is a procedure that can benefit breastfeeding mothers and babies, but the cultural and social background of families is not addressed in much of the research, nor is the risk of distress to the infant and parents.
Knowledge of pregnancy danger signs and associated factors among Malaysian mothers
Authors: Teng See Poh , Zuo Tey Chiao , Jummaat Fauziah Binti , Keng Soon Lean
Published: November 2015

Background:

Pregnancy complications are a main cause of maternal mortality. Studies suggest not all women regard pregnancy complications as abnormal, owing to a lack of knowledge about ‘danger signs’. Danger signs in pregnancy include vaginal bleeding, severe headache or blurred vision, severe abdominal pain, swollen hands and face, reduced fetal movement, weakness and difficulty in breathing.

Aims:

To assess the level and associated factors of knowledge about pregnancy danger signs among antenatal women in Malaysia.

Methods:

A cross-sectional design using a modified questionnaire was employed with 178 antenatal women.

Results:

More than half of the antenatal women were lacking in knowledge of pregnancy danger signs. A significant association was found between the age, level of education, working status and monthly household income of antenatal women and their level of knowledge.

Conclusion:

The study revealed the knowledge level of these antenatal women about pregnancy danger signs was inadequate. Therefore, it is necessary for maternal health services to empower antenatal women to understand the danger signs of pregnancy complications.
Diagnosing and treating hepatic encephalopathy
Authors: Tiberi Olivia , Tognarelli Joshua M , Cook Nicola A , Crossey Mary ME , Dhanjal Novraj S , Taylor-Robinson Simon D
Published: November 2015

Hepatic encephalopathy is a complex condition. This article considers the efficacy of the methods used in its diagnosis and management and discusses the impact of minimal hepatic encephalopathy on patients and the ethics of its treatment.
Investigating the pressure-reducing effect of wound dressings
Authors: Matsuzaki K. , Kishi K.
Published: November 2015

Objective:

Currently, polyurethane foam dressings are commercially available from many manufacturers. However, the pressure-reducing effect is expected to differ by the formulation and combination of the main and secondary ingredients and by manufacturing method. In this study, we investigated the effects of pressure reduction using dressing materials with various structural characteristics, including polyurethane foam dressings based on the engineering point of view, focusing on the dry state.

Method:

Pressure was measured in a model that simulated compression on the sacral region in a decubitus position. Pressure was measured for different dressings: ten products, consisting of five types of material (polyurethane foam, hydropolymeric, Hydrofiber, hydrocolloid, and low-adherent absorbent).

Results:

All dressings used in this study showed significantly reduced pressure. ALLEVYN Non-Adhesive had the lowest pressure at 35.833 ± 1.155 mmHg, and DuoDERM Extra Thin CGF had the highest pressure at 66.867 ± 1.060 mmHg. The pressure of the control was 74.667 ± 1.405 mmHg. The other dressings were: ALLEVYN Adhesive: 44.233 ± 0.777 mmHg; ALLEVYN Gentle Border: 46.967 ± 1.537mmHg; Mepilex Border: 53.867 ± 0.231 mmHg; Biatain Silicone: 56.000 ± 0.520 mmHg; TIELLE: 57.267 ± 3.403 mmHg;Versiva XC: 65.900 ± 0.800 mmHg; DuoDERM CGF: 57.267 ± 1.007 mmHg; and Melolin: 53.433 ± 1.973 mmHg.

Conclusion:

The pressure-reducing effect of dressing differs not only by material type but also by product. That is, the pressure-reducing effect can differ even if the dressings are of the same material type, such as polyurethane foam. Our study investigated only the effect of materials and structural characteristics on the cushion of dressings in the dry state. Therefore, further investigation is needed to confirm the effect of pressure reduction by dressing to meet the conditions in the clinic.
Dehydrated human amnion/chorion membrane treatment of venous leg ulcers: correlation between 4-week and 24-week outcomes
Authors: Serena T.E. , Yaakov R. , DiMarco D. , Le L. , Taffe E. , Donaldson M. , Miller M.
Published: November 2015

Objective:

To evaluate correct correlation between an intermediate rate of wound reduction (40% wound area reduction after 4-weeks treatment) and complete healing at 24 weeks in patients with a venous leg ulcer (VLU).

Method:

A retrospective follow-up study of patients completing a multicenter randomised controlled trial (RCT) comparing the number of patients achieving at least 40% healing of their VLU within 4-weeks of treatment with either dehydrated human amnion/chorion membrane (dHACM) allograft or multilayer compression only was conducted. Outcomes assessed were rates of complete healing within 24 weeks of enrolment and days to healing. Data were divided into two groups based on status at RCT completion (healed at least 40% yes or no). Correct correlation with status at 4 weeks and complete healing within 24 weeks was determined. Clinical characteristics were also compared for patients with and without correct correlation between 4-week and 24-week status.

Results:

We identified 55 patients at 5 study sites. Some 47 without complete healing during the initial study were eligible. As three patients were lost to follow-up we evaluated 44 records. Of these, 20 (45.4%) had reduced wound size of ≥40% and 24 (55%) had <40% reduction during the initial study. Complete healing occurred in 16/20 (80%) of the ≥40% group at a mean of 46 days, p=0.0027 and 8/24 (33.3%) of the <40% group at a mean of 103.6 days, p=0.0023. Overall, correct correlation of status at 4 weeks and ultimate healing status of VLU occurred in 32/44 patients (73%).

Conclusion:

These results confirm that the intermediate outcome used in our initial study is a viable predictor of ultimate VLU healing.
Probiotics in primary care: A survey of health professionals
Authors: Jordan Deirdre , Johnson Naomi , Thomas Linda
Published: November 2015

This article presents the results of a survey of primary care professionals, including practice nurses, into their understanding and use of probiotics. While probiotics were recommended by 56.8% of the practice nurses who responded, probiotic recommendation was even higher in dietitians (91.2%) and GPs (78%). The main reasons for recommending probiotics were: during and after a course of antibiotics; irritable bowel syndrome; diarrhoea; for patients run down and susceptible to infection; constipation; diverticulitis; ulcerative colitis; before travel abroad; for older persons; and mothers or babies in families with allergic tendencies. Formulating evidence-based decisions for this category might be difficult, however, as 32.5% of practice nurses said they had a poor or non-existent understanding of probiotics. As scientific evidence for probiotics continues to accumulate, with positive results reported in a wide range of health areas, health professionals need to keep up to date so that they can advise patients.