bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors associated with continued smoking after treatment of oral cavity cancer: An age and survival time‐matched study
Authors: Chang Su‐Ling , Lo Cheng‐Hsing , Peng Hsi‐Ling , Chen Chien‐Rong , Wu Shu‐Chen , Chen Shu‐Ching
Published: November 2017

Aims

The aims of this study of people with oral cavity cancer were to compare the social support, depression, nicotine dependence, physical function and social–emotional function of those who continued smoking with those who quit smoking, by matching age and survival time and to identify the predictors of continued smoking during the survival period.

Background

People who continue to smoke after cancer treatment may have an impact on treatment response and survival.

Design

A cross‐sectional survey was conducted.

Methods

This study compared 92 people with oral cavity cancer who continued smoking with 92 people who quit smoking, with matching for age and survival time between January 2015 ‐ November 2015. Conditional logistic regression analysis was used to compare the two groups.

Results

The quit smoking group had significantly more social support, less depression and greater social–emotional function than the continued smoking group. People who were unmarried, received surgery without reconstruction, had poor social support and had poor social–emotional function were more likely to continue smoking.

Conclusions

People with oral cavity cancer were more likely to continue smoking after the treatment if they had low social support, depression, greater nicotine dependence and poor social–emotional function. Healthcare professionals should pay more attention to social support, psychological status and nicotine dependence of people who were treated for oral cavity cancer.
Factors influencing nurse‐assessed quality nursing care: A cross‐sectional study in hospitals
Authors: Liu Ying , Aungsuroch Yupin
Published: November 2017

Aim

To propose a hypothesized theoretical model and apply it to examine the structural relationships among work environment, patient‐to‐nurse ratio, job satisfaction, burnout, intention to leave and quality nursing care.

Background

Improving quality nursing care is a first consideration in nursing management globally. A better understanding of factors influencing quality nursing care can help hospital administrators implement effective programmes to improve quality of services. Although certain bivariate correlations have been found between selected factors and quality nursing care in different study models, no studies have examined the relationships among work environment, patient‐to‐nurse ratio, job satisfaction, burnout, intention to leave and quality nursing care in a more comprehensive theoretical model.

Design

A cross‐sectional survey.

Methods

The questionnaires were collected from 510 Chinese nurses in four Chinese tertiary hospitals in January 2015. The validity and internal consistency reliability of research instruments were evaluated. Structural equation modelling was used to test a theoretical model.

Results

The findings revealed that the data supported the theoretical model. Work environment had a large total effect size on quality nursing care. Burnout largely and directly influenced quality nursing care, which was followed by work environment and patient‐to‐nurse ratio. Job satisfaction indirectly affected quality nursing care through burnout.

Conclusions

This study shows how work environment past burnout and job satisfaction influences quality nursing care. Apart from nurses’ work conditions of work environment and patient‐to‐nurse ratio, hospital administrators should pay more attention to nurse outcomes of job satisfaction and burnout when designing intervention programmes to improve quality nursing care.
Telocytes in the human sinoatrial node
Authors: Mitrofanova Lubov B. , Gorshkov Andrey N. , Konovalov Petr V. , Krylova Julia S.
Published: November 2017

The sinoatrial node (SAN) is composed mostly of pacemaker, transitional and Purkinje‐like cells. Pacemaker cells, especially in the centre of the SAN, are surrounded by dense fibrous tissue and do not have any contact with transitional cells. We hypothesize that the SAN contains telocytes that have contacts with pacemaker cells and contractile myocardium. Immunohistochemistry using antibodies against HCN4 and antibody combinations against CD34 and HCN4 was carried out on 12 specimens. Confocal laser scanning microscopy (CLSM) with two mixtures of primary antibodies, namely CD34/S100 and vimentin/S100, was performed in three cases. In two cases, CLSM was carried out with CD117 antibody. Specimens for electron microscopy and immunocytochemistry with HCN4 immunogold labelling were taken from another three patients. In our study, we found cells with the immunophenotype of telocytes in the SAN. There were twice as many of these cells in the centre of the SAN as in the periphery (20.3 ± 4.8 versus 10.8 ± 4.4 per high‐power field). They had close contact with pacemaker cells and contractile cardiomyocytes and expressed HCN4. The ultrastructural characteristics of these cells are identical to those of telocytes observed earlier in other organs. Our study provides evidence that telocytes are present in the SAN.
First isolation of Vibrio tapetis and an atypical strain of Aeromonas salmonicida from skin ulcerations in common dab (Limanda limanda) in the North Sea
Authors: Vercauteren M , De Swaef E , Declercq A , Bosseler L , Gulla S , Balboa S , Romalde J L , Devriese L , Polet H , Boyen F , Chiers K , Decostere A
Published: November 2017

Skin ulcerations rank amongst the most prevalent lesions affecting wild common dab (Limanda limanda) with an increase in prevalence of up to 3.5% in the Belgian part of the North Sea. A complex aetiology of these ulcerations is suspected, and many questions remain on the exact factors contributing to these lesions. To construct the aetiological spectrum of skin ulcerations in flatfish, a one‐day monitoring campaign was undertaken in the North Sea. Fifteen fish presented with one or more ulcerations on the pigmented and/or non‐pigmented side. Pathological features revealed various stages of ulcerations with loss of epidermal and dermal tissue, inflammatory infiltrates and degeneration of the myofibers bordering the ulceration, albeit in varying degrees. Upon bacteriological examination, pure cultures of Vibrio tapetis were retrieved in high numbers from five fish and of Aeromonas salmonicida in one fish. The V. tapetis isolates showed cross‐reactivity with the sera against the representative strain of serotype O2 originating form a carpet‐shell clam (Ruditapes descussatus). Moreover, the A. salmonicida isolates displayed a previously undescribed vapA gene sequence (A‐layer type) with possible specificity towards common dab. Further research is necessary to pinpoint the exact role of these agents in the development of skin ulcerations in common dab.
Experimental infection by Yersinia ruckeri O1 biotype 2 induces brain lesions and neurological signs in rainbow trout (Oncorhynchus mykiss)
Authors: Strøm H K , Ohtani M , Nowak B , Boutrup T S , Jones B , Raida M K , Bojesen A M
Published: November 2017

Pathological manifestations in rainbow trout (Oncorhynchus mykiss) following experimental waterborne infection with Yersinia ruckeri serotype O1 biotype 2 (strain 07111224) were investigated. Rainbow trout were exposed to 8 × 107 CFU/ml of Y. ruckeri by bath for 6 hr, and mortality was then monitored for 22 days post‐infection (dpi). Organs were sampled at 3 dpi and also from moribund fish showing signs of severe systemic infection such as bleeding, exophthalmia or erratic swimming behaviour. Y. ruckeri was observed in the meninges and diencephalon of the brain, and lamina propria of olfactory organ at 3 dpi. At 12 dpi, Y. ruckeri had spread throughout the brain including cranial connective tissues and ventricles and the infection was associated with haemorrhages and an infiltration with leucocytes. Y. ruckeri infection and associated with leucocyte infiltration were observed at 13 dpi. In conclusion, Y. ruckeri strain 07111224 causes encephalitis in the acute phase of infection, which could explain why Y. ruckeri‐affected fish show exophthalmia and erratic swimming known as signs of ERM.
The incidence of bent dorsal fins in free‐ranging cetaceans
Authors: Alves F. , Towers J. R. , Baird R. W. , Bearzi G. , Bonizzoni S. , Ferreira R. , Halicka Z. , Alessandrini A. , Kopelman A. H. , Yzoard C. , Rasmussen M. H. , Bertulli C. G. , Jourdain E. , Gullan A. , Rocha D. , Hupman K. , Mrusczok M.‐T. , Samarra F. I. P. , Magalhães S. , Weir C. R. , Ford J. K. B. , Dinis A.
Published: November 2017

Laterally bent dorsal fins are rarely observed in free‐ranging populations of cetaceans, contrary to captivity, where most killer whaleOrcinus orcaadult males have laterally collapsed fins. This topic has been poorly explored, and data/information on its occurrence and possible causes are limited. The present study: (i) undertakes a review of the available information on bent dorsal fins in free‐ranging cetaceans, and updates it with new records, (ii) reports on the proportion of bent fins in different study populations, and (iii) discusses possible causes. An empirical approach based on bibliographic research and compilation of 52 new records collected worldwide resulted in a total of 17 species of cetaceans displaying bent dorsal fins. The species with the highest number of records (64%) and from most locations wasO. orca. On average, individuals with bent dorsal fins represent < 1% of their populations, with the exception of false killer whalesPseudorca crassidensandO. orca. While line injuries associated with fisheries interactions may be the main cause forP. crassidens, and the vulnerability to health issues caused by the evolutionary enlargement of the fin may be the cause forO. orcaadult males, factors contributing to this abnormality for other species are still unclear. The occurrence of bent dorsals could be influenced by a set of variables rather than by a single factor but, irrespective of the cause, it is suggested that it does not directly affect the animals' survivorship. While still rare in nature, this incident is more common (at least 101 known cases) and widespread (geographically and in species diversity) than hypothesized, and is not confined only to animals in captive environments. Investigation into the occurrence of bent fins may be an interesting avenue of research.
Being there and reconnecting: Midwives' perceptions of the impact of Mindfulness training on their practice
Authors: Hunter Louise , Snow Sarah , Warriner Sian
Published: November 2017

Objective

To ascertain how midwives perceived attending a mindfulness course impacted on their professional practice, particularly in regard to any stress they experienced at work.

Design

A qualitative study using Interpretive Phenomenological Analysis. Semi‐structured interviews were conducted with nine midwives.

Setting

A large maternity Trust in the United Kingdom.

Intervention

An eight‐week mindfulness course, adapted from mindfulness‐based cognitive therapy.

Findings

Four superordinate themes were identified as follows: “being challenged and committing,” “containing the self,” “reconnecting” and “moving forward with confidence.” Focusing on the present moment enabled participants better to identify the boundary between self and other. This led to an increased sense of control and a reconnection with and reframing of relationships with colleagues and the women in their care.

Key conclusions

Mindfulness may provide an effective way to address the high levels of stress, role dissatisfaction and workplace bullying found in midwifery, by improving both the working environment and patient care. The pivotal role of positive workplace relationships in this process resonates with other nursing research and with contemporary philosophical thought.

Relevance to clinical practice

This study adds to a body of evidence which suggests investing in the well‐being of midwifery staff improves both job satisfaction and women's experiences of care.
Need of support in people with chronic obstructive pulmonary disease
Authors: Ali Lilas , Fors Andreas , Ekman Inger
Published: November 2017

Aim and objective

The aim of this study was to describe peoples’ experiences and expectations of support when living with chronic obstructive pulmonary disease.

Method

We conducted and analysed face‐to‐face or telephone interviews with 17 individuals (aged 44–77 years) diagnosed with chronic obstructive pulmonary disease. The interviewer asked open‐ended questions aimed at encouraging further narration, and we analysed the participants’ narratives using a phenomenological hermeneutical approach. This report adheres to the COREQ guidelines.

Results

The overall theme suggests that people with chronic obstructive pulmonary disease describe support as shared knowledge and experiences, based on the following subthemes; similar experiences, the need of genuine professional knowledge, self‐reliance versus self‐blame, and the Internet – feeling safe but uncertain.

Conclusions

People with chronic obstructive pulmonary disease find their strength through shared knowledge and dialogical support with others who have similar experiences and with professionals. A person‐centred eHealth approach may be suitable for this group as it offers both collaboration and support.

Relevance to clinical practice

There is a demand for access to genuine professional knowledge as additional support to patients’ own capabilities and needs. Patient associations were assessed as reliable sources of information and to some extent also support, but the importance of access to professional sources was also stressed.
Effect of a thermal care bundle on the prevention, detection and treatment of perioperative inadvertent hypothermia
Authors: Duff Jed , Walker Kim , Edward Karen‐Leigh , Ralph Nicholas , Giandinoto Jo‐Ann , Alexander Kimberley , Gow Jeff , Stephenson John
Published: November 2017

Aims and objectives

To improve the prevention, detection and treatment of perioperative inadvertent hypothermia in adult surgical patients by implementing a Thermal Care Bundle.

Background

Keeping patients normothermic perioperatively prevents adverse surgical outcomes. Hypothermia leads to serious complications including increased risk of surgical bleeding, surgical site infections and morbid cardiac events. The Thermal Care Bundle consists of three elements: (i) assess risk; (ii) record temperature; and (iii) actively warm.

Design

A pre‐ and postimplementation study was conducted to determine the impact of the Thermal Care Bundle on the prevention, detection and treatment of perioperative inadvertent hypothermia.

Methods

The Thermal Care Bundle was implemented using an adapted version of the Institute of Healthcare Improvement's Breakthrough Series Collaborative Model. Data were collected from auditing medical records.

Results

Data from 729 patients (pre‐implementation: n = 351; postimplementation: n = 378) at four sites were collected between December 2014–January 2016. Improvements were recorded in the percentage of patients with a risk assessment; at least one documented temperature recording per perioperative stage; and appropriate active warming. Despite this, the overall incidence of perioperative inadvertent hypothermia increased postimplementation.

Conclusion

The Thermal Care Bundle facilitated improved management of perioperative inadvertent hypothermia through increased risk assessment, temperature recording and active warming but did not impact on perioperative inadvertent hypothermia incidence. Increased temperature recording may have more accurately revealed the true extent of perioperative inadvertent hypothermia in this population.

Relevance to clinical practice

This study showed that a collaborative, context specific implementation method, such as the IHI Breakthrough Series Model, is effective at improving practices, which can improve thermal care.
Registered nurse and midwife experiences of using videoconferencing in practice: A systematic review of qualitative studies
Authors: Penny Robyn A , Bradford Natalie K , Langbecker Danette
Published: November 2017

Aim and objective

To synthesise evidence of registered nurses’ and midwives’ experiences with videoconferencing and identify perceptions of the appropriateness, meaningfulness and feasibility of this technology in professional and clinical practice.

Background

Videoconferencing is a form of telehealth that can facilitate access to high‐quality care to improve health outcomes for patients and enable clinicians working in isolation to access education, clinical supervision, peer support and case review. Yet use of videoconferencing has not translated smoothly into routine practice. Understanding the experiences of registered nurses and midwives may provide practitioners, service managers and policymakers with vital information to facilitate use of the technology.

Design

A qualitative meta‐synthesis of primary qualitative studies undertaken according to Joanna Briggs Institute methodology.

Method

A systematic search of 19 databases was used to identify qualitative studies that reported on registered nurses’ or midwives’ experiences with videoconferencing in clinical or professional practice. Two reviewers independently appraised studies, extracted data and synthesised findings to construct core concepts.

Results

Nine studies met the criteria for inclusion. Five key synthesised findings were identified: useful on a continuum; broader range of information; implications for professional practice; barriers to videoconferencing; and technical support, training and encouragement.

Conclusions

While videoconferencing offers benefits, it comes with personal, organisational and professional consequences for nurses and midwives. Understanding potential benefits and limitations, training and support required and addressing potential professional implications all influence adoption and ongoing use of videoconferencing.

Relevance to clinical practice

Registered nurses and midwives are well placed to drive innovations and efficiencies in practice such as videoconferencing. Nursing and midwifery practice must be reframed to adapt to the virtual environment while retaining valued aspects of professional practice. This includes ensuring professional standards keep pace with the development of knowledge in this area and addressing the findings highlighted in this meta‐synthesis.
The art of oral handovers: A participant observational study by undergraduate students in a hospital setting
Authors: Giske Tove , Melås Sunniva Nese , Einarsen Kari Anne
Published: November 2017

Aims and objectives

To explore the conditions for oral handovers between shifts in a hospital setting, and how these impact patient safety and quality of care.

Background

Oral handovers transfer patient information and nursing responsibilities between shifts. Short written summaries of patients can complement an oral handover. How to find the balance between a standardised protocol for handovers and tailoring variations to specific patients and situations is debated in the literature. Oral handovers provide time for discussion, debriefing and problem solving, which can lead to increased team cohesiveness.

Design

This study used a participant observation design.

Method

Fifty‐two undergraduate nursing students conducted 1100 hr of participant observation in seven different units in a hospital in Western Norway from 2014–2015. Field notes were analysed using qualitative content analysis.

Results

Six themes emerged from the data: (i) content and structure of the handover, (ii) awareness of nurses’ attitudes during oral handover, (iii) verbal and nonverbal communication, (iv) distractions, (v) relaying key information accurately, (vi) ensuring quality through oral handovers.

Conclusion

Developing a familiar structure for oral handovers and minimising the use of abbreviations and unfamiliar medical terms promote clarity and understanding. Limiting disturbances during handovers helps nurses focus on the content of the report. Awareness of one's attitudes and the use of verbal and nonverbal communication can enhance the quality of a handover. Time allocated for an oral handover should allow for professional discussions and student supervision. Involving nurse leaders in promoting the quality of oral handovers can impact the quality of care.

Clinical implications

Oral handovers serve many purposes, such as the safe transfer of patient information between shifts and staff education and debriefing, which enhance team cohesiveness.
Promoting person‐centred care in the perioperative setting through patient advocacy: An observational study
Authors: Sundqvist Ann‐Sofie , Nilsson Ulrica , Holmefur Marie , Anderzén‐Carlsson Agneta
Published: November 2017

Aims and objectives

To examine the extent to which the findings from an integrative review regarding perioperative patient advocacy could be empirically supported, and to describe Swedish registered nurse anaesthetists’ patient advocacy actions and interactions during the perioperative period.

Background

Patient advocacy is practiced by various healthcare professionals in promoting the well‐being of patients. It is complex, and in a general healthcare context, it has been described as supporting the patients both physiologically and psychologically. During general anaesthesia, the patient enters an unconscious state, and the registered nurse anaesthetist safeguards patient privacy and autonomy.

Design

Qualitative descriptive.

Methods

Individual, nonparticipant observations (n = 16) with eight registered nurse anaesthetists. The observer followed the nurses unobtrusively by shadowing them during the perioperative phase on two separate occasions. The analysis was conducted with a directed content analysis in the light of four predetermined categories, identified in a previous integrative review of patient advocacy in the perioperative setting: protecting, value preserving, supporting and informing.

Results

The predetermined categories were empirically supported. They were further refined by identifying 11 new subcategories leading to a conceptual extension of the theoretical frame. The registered nurse anaesthetists interacted with the patient and all members of the surgical team when practicing perioperative patient advocacy and the actions were mostly initiated by the registered nurse anaesthetists themselves.

Conclusions

The findings offer a new insight into the registered nurse anaesthetist's professional role. The observations deepen the understanding of the registered nurse anaesthetists’ perioperative patient advocacy actions and can contribute to a more reflective and theory‐oriented view of practice.

Relevance to clinical practice

The results from this study could be used to help registered nurse anaesthetists and their students understand practice in a more complete and insightful way.
Factors influencing the delivery of the fundamentals of care: Perceptions of nurses, nursing leaders and healthcare consumers
Authors: Conroy Tiffany
Published: November 2017

Aims and objectives

To explore the factors described by nurses and consumer representatives influencing the delivery of the fundamentals of care.

Background

An ongoing challenge facing nursing is ensuring the “basics” or fundamentals of care are delivered optimally. The way nurses and patients perceive the delivery of the fundamentals of care had not been explored. Once identified, the factors that promote the delivery of the fundamentals of care may be facilitated.

Design

Inductive content analysis of scenario based focus groups.

Methods

A qualitative approach was taken using three stages, including direct observation, focus groups and interviews. This paper reports the second stage. Focus groups discussed four patient care scenarios derived from the observational data. Focus groups were conducted separately for registered nurses, nurses in leadership roles and consumer representatives. Content analysis was used.

Results

The analysis of the focus group data resulted in three themes: Organisational factors; Individual nurse or patient factors; and Interpersonal factors. Organisational factors include nursing leadership, the context of care delivery and the availability of time. Individual nurse and patient factors include the specific care needs of the patient and the individual nurse and patient characteristics. Interpersonal factors include the nurse–patient relationship; involving the patient in their care, ensuring understanding and respecting choices; communication; and setting care priorities.

Conclusions

Seeking the perspective of the people involved in delivering and receiving the fundamentals of care showed a shared understanding of the factors influencing the delivery of the fundamentals of care. The influence of nursing leadership and the quality of the nurse–patient relationship were perceived as important factors.

Relevance to clinical practice

Nurses and consumers share a common perspective of the factors influencing the delivery of the fundamentals of care and both value a therapeutic nurse–patient relationship. Clinical nursing leaders must understand the impact of their role in shaping the delivery of the fundamentals of care.
Outcomes of primary percutaneous coronary intervention in acute myocardial infarction due to unprotected left main thrombosis: The Asia‐Pacific Left Main ST‐Elevation Registry (ASTER)
Authors: Yap Jonathan , Singh Gagan D. , Kim Jung‐Sun , Soni Krishan , Chua Kelvin , Neo Alvin , Koh Choong Hou , Armstrong Ehrin J. , Waldo Stephen W. , Shunk Kendrick A. , Low Reginald I. , Hong Myeong‐Ki , Jang Yangsoo , Yeo Khung Keong
Published: November 2017

Introduction

Prior studies of ULM STEMI have been confined to small cohorts. Recent registry data with larger patient cohorts have shown contrasting results. We aim to study the outcomes of patients with unprotected left main (ULM) ST‐elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI).

Methods

The Asia‐pacific left main ST‐Elevation Registry (ASTER) is a multicenter retrospective registry involving 4 sites in Singapore, South Korea, and the United States. The registry included patients presenting with STEMI due to an ULM coronary artery culprit lesion who underwent emergency PCI. The primary outcome was in‐hospital mortality. Secondary outcomes included major adverse cardiovascular events.

Results

A total of 67 patients (mean age 64.2 ± 12.8 years, 53 [79.1%] males) were included. The distal left main bifurcation was most commonly involved (85%, n = 57). Fifty one (76%) patients had TIMI 3 flow post‐PCI. The in‐hospital mortality rate was 47.8% (n = 32); 61% (n = 41) had cardiac failure, 4% (n = 3) had emergency coronary artery bypass grafting, 1% (n = 1) had a re‐infarction, 3% (n = 2) had stroke and 55% (n = 37) had malignant ventricular arrhythmias. On multivariate analysis, predictors of in‐hospital mortality included older age (odds ratio (OR) 1.085 (95% confidence interval (CI) 1.002‐1.175), P = 0.044), diabetes mellitus (OR 10.882 (95%CI 11.074‐110.287), P = 0.043) and absence of post‐PCI TIMI 3 flow (OR 71.429 (95%CI 2.985‐1000), P = 0.008).

Conclusions

STEMI from culprit unprotected left main coronary artery stenosis is associated with significant mortality and morbidity. Emergency PCI provides an important treatment option in this high‐risk group, but in‐hospital mortality remains high.
Association between a single‐nucleotide polymorphism in the GREM1 gene and non‐syndromic orofacial cleft in the Chinese population
Authors: Wang Xiaotong , Song Hongquan , Jiao Xiaohui , Hao Yanru , Zhang Wei , Gao Yuwei , Li Yong , Mi Na , Yan Jiaqun
Published: November 2017

Background

Non‐syndromic orofacial cleft (NSOC) is a common craniofacial deformity among newborns. The GREM1 gene is correlated with orofacial development. The aim of our study was to investigate the association between a single‐nucleotide polymorphism in the GREM1 gene and this malformation in the Chinese population.

Methods

The SNaPshot mini‐sequencing technique was used to genotype the locus rs1258763 of the GREM1 gene in 331 patients with NSOC and 271 individuals in a control group.

Results

For GREM1 rs1258763, there was a significant difference between the NSOC case group and control group (P = .022). Children carrying GA and GA/AA genotypes had an increased risk of NSOC (OR=1.62, 95%CI: 1.15‐2.30; OR=1.52, 95%CI: 1.09‐2.12). In the cleft subgroup, we found that the GREM1 rs1258763 GA genotype might contribute to the elevated risk of the cleft lip with or without cleft palate (CL/P) (P = .029). Non‐significant differences were found between the cleft palate only (CPO) and control groups (P = .077).

Conclusion

Our findings revealed that the GREM1 polymorphism was significantly associated with the risk of NSOC in the Chinese population.
Position Accuracy of Implant Analogs on 3D Printed Polymer versus Conventional Dental Stone Casts Measured Using a Coordinate Measuring Machine
Authors: Revilla‐León Marta , Gonzalez‐Martín Óscar , Pérez López Javier , Sánchez‐Rubio José Luis , Özcan Mutlu
Published: November 2017

Purpose

To compare the accuracy of implant analog positions on complete edentulous maxillary casts made of either dental stone or additive manufactured polymers using a coordinate measuring machine (CMM).

Material and Methods

A completely edentulous maxillary model of a patient with 7 implant analogs was obtained. From this model, two types of casts were duplicated, namely conventional dental stone (CDS) using a custom tray impression technique after splinting (N = 5) and polymer cast using additive manufacturing based on the STL file generated. Polymer casts (N = 20; n = 5 per group) were fabricated using 4 different additive manufacturing technologies (multijet printing‐MJP1, direct light processing‐DLP, stereolithography‐SLA, multijet printing‐MJP2). CMM was used to measure the correct position of each implant, and distortion was calculated for each system at x‐, y‐, and z‐axes. Measurements were repeated 3 times per specimen in each axis yielding a total of 546 measurements. Data were analyzed using ANOVA, Sheffé tests, and Bonferroni correction (α = 0.05).

Results

Compared to CMM, the mean distortion (μm) ranged from 22.7 to 74.9, 23.4 to 49.1, and 11.0 to 85.8 in the x‐, y‐, and z‐axes, respectively. CDS method (x‐axis: 37.1; z‐axis: 27.62) showed a significant difference compared to DLP on the x‐axis (22.7) (p = 0.037) and to MJP1 on the z‐axis (11.0) (p = 0.003). Regardless of the cast system, x‐axes showed more distortion (42.6) compared to y‐ (34.6) and z‐axes (35.97). Among additive manufacturing technologies, MJP2 presented the highest (64.3 ± 83.6), and MJP1 (21.57 ± 16.3) and DLP (27.07 ± 20.23) the lowest distortion, which was not significantly different from CDS (32.3 ± 22.73) (p > 0.05).

Conclusion

For the fabrication of the definitive casts for implant prostheses, one of the multijet printing systems and direct light processing additive manufacturing technologies showed similar results to conventional dental stone. Clinical significance: Conventional dental stone casts could be accurately duplicated using some of the additive manufacturing technologies tested.
DIRECTIONAND INTENSITYOF RISK PREFERENCEATTHE THIRD ORDER
Authors: Keenan Donald C. , Snow Arthur
Published: November 2017

ABSTRACT

In expected utility theory, aversion to risk, greater aversion, and the desire to substitute away from risk are each characterized by properties of the Arrow–Pratt index of absolute risk aversion, with comparative statics implications for such decisions as saving. At the third order, however, no single index suffices. We contrast alternative indices of third‐order risk preference and show that the substitution effect of downside risk is governed by the Schwarzian, and that where the degree of prudence governs the magnitude of precautionary saving, the Schwarzian governs the effect of background risk on the marginal rate of time preference.
The treatment of pyloric stenosis: Evolution in practice
Authors: Taghavi Kiarash , Powell Emma , Patel Bhaveshkumar , McBride Craig A
Published: November 2017

Over the last hundred years, idiopathic hypertrophic pyloric stenosis has undergone an evolution in treatment, with subsequent improvements in outcome. Initially, it was treated by physicians with antispasmodics and various alternative feeding and resuscitation modalities. The evolution of surgical approaches led to a revolution in outcome, from almost certain death to complete cure. The progression of surgical and medical treatments is reviewed in this article until, ultimately, Ramstedt's pyloromyotomy is reached. This distilled operation has remained the gold‐standard procedure for over a century.
Five lessons in uncomplicated appendicitis: Can we remove the surgery?
Authors: Read Andrew , Xu Jane , Adams Susan , Karpelowsky Jonathan
Published: November 2017

Appendicectomy has remained the treatment of choice for appendicitis for over a century and is the most commonly performed emergency operation in children. However, emerging evidence suggests that appendicectomy may not always be necessary in uncomplicated appendicitis, with early paediatric trials demonstrating that antibiotic‐only therapy can be safe and effective. Further rigorously designed and appropriately powered studies are necessarily to establish the place of non‐operative management of uncomplicated appendicitis in the future.
Undescended testis: What paediatricians need to know
Authors: Hutson John M , Vikraman Jaya , Li Ruili , Thorup Joergen
Published: November 2017

Undescended testis (UDT) occurs when something goes wrong with testicular descent from high in the abdominal cavity to the scrotum. Normal descent occurs in two steps, with the transabdominal phase controlled by a new testicular hormone, insulin‐like hormone 3, and the inguinoscrotal phase controlled by androgens. The latter phase requires a complex process of migration from the inguinal abdominal wall to the scrotum and is commonly defective, leading to the high incidence (2–4%) of UDT at birth. The clinical examination of babies and infants aims to confirm the persistence of congenital UDT by 3–6 months, so surgery can be optimally timed at 6–12 months. For those boys who develop acquired UDT later in childhood, the ‘ascending’ testis often needs surgery between 5 years and 10 years, so all boys should be screened again for UDT at school entry.
Common paediatric conditions of the lower limb
Authors: Dobbe Ashlee M , Gibbons Paul J
Published: November 2017

Growing children are susceptible to a number of disorders to their lower extremities of varying degrees of severity. The diagnosis and management of these conditions can be challenging. With musculoskeletal symptoms being one of the leading reasons for visits to general practitioners, a working knowledge of the basics of these disorders can help in the appropriate diagnosis, treatment, counselling, and specialist referral. This review covers common disorders affecting the hip, the knee and the foot. The aim is to assist general practitioners in recognising developmental norms and differentiating physiological from pathological conditions and to identify when a specialist referral is necessary.
Endocannabinoids modulate Gq/11 protein-coupled receptor agonist-induced vasoconstriction via a negative feedback mechanism
Authors: Karpińska Olga , Baranowska-Kuczko Marta , Kloza Monika , Kozłowska Hanna
Published: November 2017

Objectives

The endocannabinoid (eCB) system centrally and peripherally regulates cardiovascular parameters, including blood pressure, in health and disease. The relationship between Gq/11 protein-coupled receptor activation, regulation of eCBs release (mainly 2-arachidonoylglycerol) and subsequent CB1 receptor activation was initially observed in the central nervous system. Here, we review the latest findings from systemic physiological studies which include for the first time data from pulmonary arteries. We present evidence for direct CB1-dependent cannabinoid ligand-induced vasorelaxation, vascular expression of eCBs along with their degradation enzymes, and indicate the location of the described interaction.

Key findings

Endocannabinoids (mainly 2-arachidonoylglycerol), acting via CB1 receptors, evoke vasodilatory effects and may modulate responses of vasoconstrictors for Gq/11 protein-coupled receptors including angiotensin II, thromboxane A2, phenylephrine, noradrenaline in systemic or pulmonary arteries. However, the role of the endothelium in this interaction is not well-established, and the precise vascular location of eCB system components remains unclear, which contributes to discrepancies in the interpretation of results when describing the above-mentioned relationship.

Endocannabinoid's negative feedback is responsible for diminishing agonist-induced vasoconstriction, which may be clinically important in the treatment of arterial and pulmonary hypertension. Further research is required to establish the importance of the eCB system and its downstream signalling pathways.
Melatonin and serotonin: Mediators in the symphony of plant morphogenesis
Authors: Erland Lauren A. E. , Shukla Mukund R. , Singh Amritpal S. , Murch Susan J. , Saxena Praveen K.
Published: November 2017

Melatonin and serotonin are important signaling and stress mitigating molecules that play important roles across growth and development in plants. Despite many well‐documented responses, a systematic investigation of the entire metabolic pathway (tryptophan, tryptamine, and N‐acetylserotonin) does not exist, leaving many open questions. The objective of this study was to determine the responses of Hypericum perforatum (L.) to melatonin, serotonin, and their metabolic precursors. Two well‐characterized germplasm lines (#4 and 112) created by mutation and a haploid breeding program were compared to wild type to identify specific responses. Germplasm line 4 has lower regenerative and photosynthetic capacity than either wild type or line 112, and there are documented significant differences in the chemistry and physiology of lines 4 and 112. Supplementation of the culture media with tryptophan, tryptamine, N‐acetylserotonin, serotonin, or melatonin partially reversed the regenerative recalcitrance and growth impairment of the germplasm lines. Quantification of phytohormones revealed crosstalk between the indoleamines and related phytohormones including cytokinin, salicylic acid, and abscisic acid. We hypothesize that melatonin and serotonin function in coordination with their metabolites in a cascade of phytochemical responses including multiple pathways and phytohormone networks to direct morphogenesis and protect photosynthesis in H. perforatum.
Influence of the addition of soy product and wheat fiber on rheological, textural, and other quality characteristics of pizza
Authors: Glicerina Virginia , Balestra Federica , Capozzi Francesco , Dalla Rosa Marco , Romani Santina
Published: November 2017

The effect of partial replacement of wheat flour with soy paste and wheat fiber on rheological, textural, physicochemical, and organoleptic characteristics of an enriched pizza base (E) was investigated in comparison with those of a control pizza base (C). New ingredients (e.g., enriched cooked ham, whey cheese, and tomato sauce realized using food industry by‐products) were also used in E pizza topping to further increase its nutritional properties. Enriched dough was developed first at a laboratory level. Large and small deformation, moisture, leavening activity, and metabolic heat were tested. On the final product, produced at the industrial level, textural, color, sensory, and nutritional analyses were performed. Preliminary rheological analysis was essential to evaluate the suitability of the new pizza to be processed at industrial level. Both pizza dough samples showed a solid elastic‐like behavior; however, the addition of soy and fiber increased moisture content of E pizza, due to the water binding ability of soy protein and to the effect of fibers that also decreased E dough elasticity. No differences in extensibility between the two samples were observed, whereas significantly lower values of resistance to extension and dough force were shown in sample E. These differences were likely due to the presence of soy that interfere with gluten formation and to the dietary fibers that interact with water. Ingredients used in E pizza improved its nutritional quality increasing dietary fibers and protein, and decreasing saturated fatty acids and cholesterol content, which contributed to decrease energy value, in terms of kilocalorie reduction.

Practical applications

In this work, the effects of using new ingredients (e.g., soy paste, wheat fiber) on the rheological, textural, physicochemical, nutritional, and organoleptic characteristics of an enriched pizza type were investigated both at laboratory and industrial levels. The new pizza provides a product that combines solid technological performances, in terms of rheological properties and dough elasticity, with improved and balanced nutritional quality, thanks also to the ingredients used in the topping. Results demonstrate the possibility of obtaining new pizza products characterized by nutritional and sensorial properties tailored for different group of consumers.
Dental paleopathology in fossil rhinoceroses: etiology and implications
Authors: Böhmer C. , Rössner G. E.
Published: November 2017

The identification and interpretation of paleopathological findings in the dentition of mammals have the potential to shed light on disturbed development and stress conditions. In combination with knowledge about the timing of dental development, dental pathologies can provide a unique opportunity to reconstruct specific phases in the life history of fossil taxa, as well as animal‐environment interactions. The dental ontogeny of the extinct rhinoceros Prosantorhinus germanicus from the Miocene is well‐known from an exceptionally preserved sample of juvenile dentaries. Two of the represented juvenile individuals each revealed a dental anomaly, which were analyzed macroscopically and via X‐ray tomography in this study. One specimen documents decreased dental wear of deciduous cheek teeth, mandibular bone resorption as well as abnormal cemental deposition. At an early age, the extinct juvenile rhinoceros probably was affected by a gingival infection resulting from an accumulation of bacterial plaque. This led to a chronic gingivitis and eventually may have caused periodontitis. Furthermore, it suffered from inflammation‐induced hypercementosis. Another specimen revealed an abnormal reduction in thickness of enamel in the deciduous cheek tooth. The enamel hypoplasia indicates stress experienced during the prenatal period. During a phase of environmental stress (e.g. increased fluoride exposure) or physiological stress (e.g. malnutrition) the function of the secretory ameloblasts was disrupted in the developing embryo. The present work shows that the analysis of dental paleopathologies is a useful means for retrospective assessment of specific phases in the life history of extinct animals. This adds to the picture of the living conditions of the extinct rhinoceros P. germanicus.
Audiovisual Binding for Speech Perception in Noise and in Aging
Authors: Ganesh Attigodu Chandrashekara , Berthommier Frédéric , Schwartz Jean‐Luc
Published: November 2017

Speech perception involves fusion of multiple sensory inputs, but fusion is not automatic, likely depending on several external and internal factors (e.g., attention, noise, age). In this study, we exploited a specific paradigm in which a short audiovisual context made of coherent or incoherent speech material is displayed before an incongruent audiovisual target likely to provide fusion (McGurk & MacDonald, 1976). We confirmed that incoherent context leads to unbinding, that is, a reduction in the amount of fusion. Importantly, adding acoustic noise in the context though not in the target increases fusion. This suggests that listeners systematically evaluate the reliability of their sensory channels and weight them accordingly in the fusion process. We also showed that older participants display more unbinding than younger participants. We discuss the potential consequences concerning people's ability to understand speech in adverse conditions and relate our findings to a “Binding‐and‐Fusion” model of audiovisual speech perception.
Failing with grace: kids, Improv and embodied literacies
Authors: Lenters Kimberly , Whitford Alec
Published: November 2017

In this article, we explore the idea that comedy, with its often unorthodox ways of looking at, experiencing, and responding to the world, offers untold possibility for classroom literacy instruction. The article focuses on the potential of Improv comedy as socio‐materialist literacy in the classroom. It provides an account of Improv as a form of embodied literacy that operates as an assemblage created collectively between many people, practices, and material objects. We present findings from interviews with professional comedians regarding the possibilities of comedy for language and literacy instruction with elementary school children. The article then examines a moment from the subsequent classroom phase of the study to look at ways Improv can help students create stories and ways that laughter can be used to create a cohesive assemblage based around students' spontaneous creation of texts. The aim of the article is to provide educators with a practical means to apply socio‐materialist literacy in their classrooms through Improv, which will, in turn, allow students to create collectively generated texts and assemblages.
Defining and seeking to identify critical Internet literacy: a discourse analysis of fifth‐graders' Internet search and evaluation activity
Authors: Harrison Colin
Published: November 2017

Pedagogic focus is shifting increasingly from teaching students to search the Internet efficiently to encouraging critical Internet literacy, but this paper argues that these more complex and subtle skills are both challenging to teach and difficult to identify. The paper presents an analysis of the discourse of triads of fifth graders undertaking an Internet search task that emphasised decisions relating to the trustworthiness and relevance of websites. The analysis uses two lenses – the Vygotskian concept ofobuchenieand Mercer's notion of ‘inter‐thinking’ – to help identify discourse markers that could support teachers in identifying and teaching critical Internet literacy. More work is needed, but it is argued that if our goal is to develop critical Internet literacy, the concept of obuchenie helps us to understand the socio‐cognitive prerequisites of group learning in Internet searching tasks, while the concept of ‘interthinking’ offers us a distribution mechanism that can be applied in helping students acquire the skills of independent and critical analysis as they carry out those tasks.
Altered distal‐proximal temperature gradient as a possible explanation for sleep‐wake disturbances in cirrhotic patients
Authors: Weiss Nicolas , Attali Valérie , Bouzbib Charlotte , Thabut Dominique
Published: November 2017

See Article on Page 1833