bluuebunny/crossref_metadata_2025 huggingface dataset:
The representativeness of eligible patients in type 2 diabetes trials: a case study using GIST 2.0
Authors: Sen Anando , Goldstein Andrew , Chakrabarti Shreya , Shang Ning , Kang Tian , Yaman Anil , Ryan Patrick B , Weng Chunhua
Published: August 2017

Objective

The population representativeness of a clinical study is influenced by how real-world patients qualify for the study. We analyze the representativeness of eligible patients for multiple type 2 diabetes trials and the relationship between representativeness and other trial characteristics.

Methods

Sixty-nine study traits available in the electronic health record data for 2034 patients with type 2 diabetes were used to profile the target patients for type 2 diabetes trials. A set of 1691 type 2 diabetes trials was identified from ClinicalTrials.gov, and their population representativeness was calculated using the published Generalizability Index of Study Traits 2.0 metric. The relationships between population representativeness and number of traits and between trial duration and trial metadata were statistically analyzed. A focused analysis with only phase 2 and 3 interventional trials was also conducted.

Results

A total of 869 of 1691 trials (51.4%) and 412 of 776 phase 2 and 3 interventional trials (53.1%) had a population representativeness of <5%. The overall representativeness was significantly correlated with the representativeness of the Hba1c criterion. The greater the number of criteria or the shorter the trial, the less the representativeness. Among the trial metadata, phase, recruitment status, and start year were found to have a statistically significant effect on population representativeness. For phase 2 and 3 interventional trials, only start year was significantly associated with representativeness.

Conclusions

Our study quantified the representativeness of multiple type 2 diabetes trials. The common low representativeness of type 2 diabetes trials could be attributed to specific study design requirements of trials or safety concerns. Rather than criticizing the low representativeness, we contribute a method for increasing the transparency of the representativeness of clinical trials.
Barriers in Josephson Junctions: An Overview
Authors: Weides M.P.
Published: August 2017

This article considers Josephson junction barriers, focusing on barriers made from insulators, metals, semiconductors, magnets, and nanowires. The main characteristic of Josephson junctions is the local reduction or even suppression of the critical current in the barrier. These barriers affect the static and dynamics properties of Josephson junctions, including coupling strength, ground state, phase damping, and tunability of the critical current. The article first provides an overview of the fundamental physics of Josephson junctions, with particular emphasis on the Josephson effect, before describing the properties of two coupled superconductors. It then discusses tunnel barriers, metallic barriers, semiconducting barriers, and magnetic barriers.
Fluid Transport in Gels
Authors: Doi Masao
Published: August 2017

This article examines fluid transport and solvent dynamics in polymer gels, in equilibrium and under mechanical stress, and the effect of fluids on gel deformation. It also introduces a continuum model that describes the coupled phenomena of electric current, solvent flux, and deformation of gel network. This model is a generalization of the diffusio-mechanical coupling model of non-ionic gels. The discussion begins with an overview of the equilibrium state of non-ionic gels under the action of mechanical forces. This is followed by an analysis of the dynamics of non-ionic gels, especially the relaxation of mechanical responses caused by solvent flow. The article concludes with an assessment of the dynamics of ionic gels as well as the effect of electric field on solvent flow and the gel deformation.
Foams
Authors: Weaire Denis , Hutzler Stefan
Published: August 2017

This article focuses on foams, which consist of gas bubbles surrounded by liquid and closely packed together so that they are in contact with each other. As a mixture of two fluids, a foam is paradoxically a solid, at least under a small enough stress — surface tension and gas pressure maintain it in equilibrium when deformed. The corresponding mixture of two liquids is an emulsion, rendered stiff by surface tension under low stress. After explaining what a foam is, this article discusses various applications of foams. It then considers the statics and dynamics of foams, the simple rules that govern local equilibrium, and the structure of foams. It also examines the key properties of foams, such as coarsening due to diffusion, coalescence, drainage, foamability, rheology and rheometry, shear localization, conductivity, and light scattering. Finally, it describes the role of surfactants in foam stability and evaluates analogous systems such as emulsions.
A test for paedomorphism in domestic pig cranial morphology
Authors: Evin Allowen , Owen Joseph , Larson Greger , Debiais-Thibaud Mélanie , Cucchi Thomas , Vidarsdottir Una Strand , Dobney Keith
Published: August 2017

Domestic animals are often described as paedomorphic, meaning that they retain juvenile characteristics into adulthood. Through a three-dimensional landmark-based geometric morphometric analysis of cranial morphology at three growth stages, we demonstrate that wild boar (
n
= 138) and domestic pigs (
n
= 106) (
Sus scrofa
) follow distinct ontogenetic trajectories. With the exception of the size ratio between facial and neurocranial regions, paedomorphism does not appear to be the primary pattern describing the observed differences between wild and domestic pig cranial morphologies. The cranial phenotype of domestic pigs instead involves developmental innovation during domestication. This result questions the long-standing assumption that domestic animal phenotypes are paedomorphic forms of their wild counterparts.
NeatSeq-Flow: A Lightweight High-Throughput Sequencing Workflow Platform for Non-Programmers and Programmers Alike
Authors: Sklarz Menachem , Levin Liron , Gordon Michal , Chalifa-Caspi Vered
Published: August 2017

Biologists often find it necessary to execute bioinformatic workflows (WFs) as part of their research. However, operation of most WF-management platforms requires at least some programming expertise. Here we describe NeatSeq-Flow, a platform that enables users with no programming knowledge to design and execute complex high-throughput sequencing WFs on their own computer or computer cluster. Workflows are composed of modules. NeatSeq-Flow provides a large compendium of pre-built modules as well as a generic module. Advanced users can also generate custom-made, sophisticated modules using templates and only basic Python commands. Modules and WFs are easily shareable. To execute a WF, through either the graphical user interface or the command line, users need to only specify modules’ order and parameters (workflow design) and input file locations (sample information). WF execution is parallelized on both samples and analysis steps, and progress can be tracked in real time. Results are obtained in a neat directory structure, along with a self-sustaining WF backup for reproducibility. NeatSeq-Flow operates by shell-script generation, allowing full transparency of the WF process. NeatSe q-Flow supports CONDA for easy installation and portability of entire environments. All these features make NeatSeq-Flow an easy-to-use WF platform without compromising flexibility, reproducibility, transparency and efficiency.

Availability

http://neatseq-flow.readthedocs.io/en/latest/

Contact

sklarz@bgu.ac.il
Direction indices for crystal lattices
Authors: Nespolo Massimo
Published: August 2017

Direction indices [uvw] of rational directions in crystal lattices are commonly restricted to integer numbers. This restriction is correct only when primitive unit cells are used. In the case of centred cells, however, direction indices may take fractional values too, because the first lattice node after the origin along a direction can have fractional coordinates in a centred basis. This evidence is very often overlooked and an undue simplification of direction indices to integer values is usually adopted. Although such a simplification does not affect the identification of the direction, it is potentially a source of confusion and mistakes in crystallographic calculations. A parallel is made with the incorrect restriction of Miller indices to relatively prime integers in centred cells.
Adult learning theories: implications for online instruction
Authors: Arghode Vishal , Brieger Earl W. , McLean Gary N.
Published: August 2017

Purpose

This paper analyzes critically four selected learning theories and their role in online instruction for adults.

Design/methodology/approach

A literature review was conducted to analyze the theories.

Findings

The theory comparison revealed that no single theory encompasses the entirety of online instruction for adult learning; each theory explains some portion of adult online learning; theories are contextual; and components of all theories can be utilized to improve online learning.

Research limitations/implications

Adult learning theories and their roles in shaping online learning and instruction deserve more attention. The study of adult learning theories, combined with in-depth analysis of psychological and human resource literature, will enable researchers to delve deeper into the subject. More qualitative studies are needed to explore further how instructors’ ability to utilize theoretical principles can improve online learning.

Practical implications

This manuscript offers practical advice to instructors and other practitioners for utilizing adult learning theories for instructional enhancement.

Originality/value

This literature review uniquely contributes to filling the gap in human resource development literature by examining selected adult learning theories, comparing them and extending the theories’ applicability and value in online instruction.
Do resource bases enable social inclusion of students with Asperger syndrome in a mainstream secondary school?
Authors: Landor Floriane , Perepa Prithvi
Published: August 2017

This research identifies the way in which one secondary school with a resourced provision for students with Asperger syndrome promotes social inclusion for them, and the perceptions of staff members and parents on the social experience of schooling for these children. Interviews were conducted with five teachers, two learning support assistants, and the head of the resourced provision. Questionnaires were completed by eight parents of students with Asperger syndrome who attend the provision. The research found that a positive social experience of schooling was perceived by members of staff and parents due to the additional support of the resource in teaching social skills, providing a safe place and support from the learning support assistants. Some negative perceptions of social experience were also reported, which highlighted the need for educational provision for students on the autism spectrum to be considered at an individual level.
Sarcoidosis with Takayasu arteritis: a model of overlapping granulomatosis. A report of seven cases and literature review
Authors: Chapelon‐Abric Catherine , Saadoun David , Marie Isabelle , Comarmond Cloé , Desbois Anne Claire , Domont Fanny , Savey Léa , Cacoub Patrice
Published: August 2017

Objective

To describe the features of exceptional coexisting Takayasu arteritis (TA) and sarcoidosis, two conditions of unknown cause associated with a common immunologic pattern.

Methods

We report seven cases of concomitant sarcoidosis‐Takayasu or Takayasu‐like vasculitis, observed in two referral centers between 1995 and 2015.

Results

All patients were female. The mean age at sarcoidosis diagnosis and TA diagnosis was 36 and 37 years, respectively. Sarcoidosis occurred in 86% of cases before or together with TA. Sarcoidosis always had a classic expression except for one renal localization. Sarcoidosis was not severe and mostly non‐treated (86%). In all cases of TA, supra‐aortic arteries were involved; in only two TA cases a more diffuse inflammatory arterial involvement was noted. In one case, Takayasu arteritis occurred despite immunosuppressive therapy given for sarcoidosis. All patients received for TA a treatment with corticosteroids associated with methotrexate (four cases), infliximab (one case) or tocilizumab (one case). After a mean follow‐up of 89 months, TA always improved and no death was observed.

Conclusions

TA stands as pathology associated with sarcoidosis. TA occurred in three cases among 50. When sarcoidosis preceded TA, a recovery of sarcoidosis was achieved mostly without treatment. TA is a prognostic and therapeutic factor. Immunosuppressive treatment, including steroids, led to a good prognosis for TA as well as for sarcoidosis.
The delivery of doxorubicin of multifunctional β‐cyclodextrin‐modified CdSe/ZnS quantum dots for bioactivity and nano‐probing
Authors: Zhao Mei‐Xia , Zhu Bing‐Jie , Yao Wen‐Jing , Chen Di‐Feng , Wang Chaojie
Published: August 2017

The modified quantum dots (QDs) have been used in intracellular probing and drug delivery because of their special chemical and physical properties. In this paper, two β‐cyclodextrin (β‐CD)‐modified CdSe/ZnS QDs with strong optical emission properties were synthesized as drug carriers to induce apoptosis. The positively charged l‐Arginine (l‐Arg) and neutral l‐Tryptophan (l‐Trp) were selected as ligands to compare the effect of charge on bioactivity of QDs nanoparticles. The in vitro assays revealed that these modified QDs showed good Dox carrier ability and significantly high inhibition rate to cancer cells. Especially, the more positively charged β‐CD‐l‐Arg‐polyamine‐coated CdSe/ZnS QDs could effectively deliver the doxorubicin (Dox) into cells and exhibit excellent cell selectivity in cancer versus normal cells. The Dox‐loaded QDs could enter intracellular, which showed that the Dox can efficiently go through the membranes at the existence of β‐CD. Several lines of evidence suggest that the Dox‐loaded QDs can efficiently induce apoptosis likely related to the production of ROS. We expect that the modified QDs can enhance the amount of hydrophobic antitumor drugs in cells and can also be used as fluorescent imaging agents.
Agent‐oriented activity recognition in the event calculus: An application for diabetic patients
Authors: Kafalı Özgür , Romero Alfonso E. , Stathis Kostas
Published: August 2017

We present a knowledge representation framework on the basis of the Event Calculus that allows an agent to recognize complex activities from low‐level observations received by multiple sensors, reason about the life cycle of such activities, and take action to support their successful completion. Activities are multivalue fluents that change according to events that occur in the environment. The parameters of an activity consist of a unique label, a set of participants involved in the performing of the activity, and a unique goal associated with the activity revealing the activity's desired outcome. Our contribution is the identification of an activity life cycle describing how activities can be started, interrupted, suspended, resumed, or completed over time, as well as how these can be represented. The framework also specifies activity goals, their associated life cycle, and their relation with the activity life cycle. We provide the complete implementation of the framework, which includes an activity generator that automatically creates synthetic sensor data in the form of event streams that represent the everyday lifestyle of a type 1 diabetic patient. Moreover, we test the framework by generating very large activity streams that we use to evaluate the performance of the recognition capability and study its relative merits.
Comprehensive analyses of hox gene expression in Xenopus laevis embryos and adult tissues
Authors: Kondo Mariko , Yamamoto Takayoshi , Takahashi Shuji , Taira Masanori
Published: August 2017

From whole genome sequencing of an allotetraploid frog, Xenopus laevis, two homeologous sets (L and S) of four Hox clusters A through D (HoxA.L/S, HoxB.L/S, HoxC.L/S, and HoxD.L/S) and 13 paralogous groups (PGs) with 76 genes were identified, allowing us to carry out the first comprehensive analyses of hox gene expression in vertebrates. Expression of all hox genes during development and in adult tissues was analyzed by RNA‐sequencing. The expression levels of most hox genes were similar between homeologs, but in some pairs, large differences were observed and several of these were confirmed by RT‐PCR and whole mount in situ hybridization experiments. These results indicate that subfunctionalization of hox genes may have occurred since allotetraploidization. Furthermore, comprehensive analysis of hox gene expression during early development did not agree with the hypothesis of temporal collinearity especially in genes belonging to PG2 to PG10.
Constitutive loss and acute pharmacological manipulation of ErbB4 signaling do not affect attention and inhibitory control in mice
Authors: Marchisella E. , Wijnands R. , Koopmans B. , Spijker S. , Loos M.
Published: August 2017

The receptor tyrosine kinase ErbB4 and its ligand trophic factors of the neuregulin (NRG) family have been associated with schizophrenia and other mental disorders in human genetic studies. In vivo studies in mice have shown how abnormal Nrg–ErbB4 signaling leads to deviant behaviors relevant to distinct aspects of schizophrenia, including hyperactivity, sensory gating deficits, working and spatial memory deficits and impaired social behavior. However, so far little is known on the role of ErbB4 in attention and inhibitory control, two aspects of executive functions that are impaired in schizophrenia. Here we investigated the effects of constitutive loss of ErbB4 in the central nervous system of mice on performance in a 5‐choice serial reaction time task (5CSRTT) assessing attention and inhibitory control. In this task, ErbB4−/− mice did not show deficits in various parameters of attention, and premature responses as measure of inhibitory control. Nonetheless, ErbB4−/− mice recapitulated a specific set of behavioral phenotypes associated with schizophrenia, including a deficit in spatial learning and memory in the Barnes Maze and in contextual fear learning, and a trend for a deficit in sensorimotor gating. Furthermore, we investigated the effect of acute pharmacological inhibition of ErbB tyrosine kinase receptor using the pan‐ErbB kinase inhibitor JNJ‐28871063 (JNJ), in an automated version of the 5CSRTT. JNJ did not affect attention and inhibitory control. In conclusion, our data suggest no direct involvement of a classical Nrg‐ErbB4 pathway in attention and inhibitory control in mice, while it confirms the involvement of this pathway in other domains relevant to schizophrenia.
Significance of interferon gamma in the prediction of successful therapy of common warts by intralesional injection of Candida antigen
Authors: Nofal Ahmad , Marei Ayman , Amer Amin , Amen Hanaa
Published: August 2017

Background

Treatment of common warts remains a continuing challenge for both patients and physicians. Recently, intralesional immunotherapy by different antigens has proved efficacious in the treatment of warts, however, no definite predictive factors for successful therapy have been established. Herein, we evaluate the efficacy and safety of Candida antigen in the treatment of common warts and the significance of interferon gamma (IFN‐γ) in the prediction of successful therapy.

Methods

The study included 54 patients with multiple common warts. A blood sample was collected from patients before therapy, cultured, and treated with Candida antigen for evaluation of IFN‐γ. Candida antigen was directly injected into the largest wart at 2‐week intervals until complete clearance or for a maximum of five treatments. Follow‐up was made for 6 months to detect any recurrence.

Results

Complete clearance of the lesions was seen in 61.1% of the studied patients. IFN‐γ was statistically higher in responded cases as compared to nonresponders. Adverse effects were insignificant, and no recurrence of warts was observed.

Conclusions

Candida antigen is a promising, effective, and safe immunotherapeutic modality for common warts, and IFN‐γ may serve as a good predictor of its therapeutic response.
Characterization of influenza A(H1N1)pdm09 viruses isolated from Nepalese and Indian outbreak patients in early 2015
Authors: Nakamura Kazuya , Shirakura Masayuki , Fujisaki Seiichiro , Kishida Noriko , Burke David F. , Smith Derek J. , Kuwahara Tomoko , Takashita Emi , Takayama Ikuyo , Nakauchi Mina , Chadha Mandeep , Potdar Varsha , Bhushan Arvind , Upadhyay Bishnu Prasad , Shakya Geeta , Odagiri Takato , Kageyama Tsutomu , Watanabe Shinji
Published: August 2017

We characterized influenza A(H1N1)pdm09 isolates from large‐scale outbreaks that occurred in Nepal and India in early 2015. Although no specific viral features, which may have caused the outbreaks, were identified, an S84N substitution in hemagglutinin was frequently observed. Chronological phylogenetic analysis revealed that these Nepalese and Indian viruses possessing the S84N substitution constitute potential ancestors of the novel genetic subclade 6B.1 virus that spread globally in the following (2015/16) influenza season. Thus, active surveillance of circulating influenza viruses in the Southern Asia region, including Nepal and India, would be beneficial for detecting novel variant viruses prior to their worldwide spread.
Pain assessment by emergency nurses at triage in the emergency department: A qualitative study
Authors: Vuille Marilène , Foerster Maryline , Foucault Eliane , Hugli Olivier
Published: August 2017

Aims and objectives

To investigate the assessment of pain intensity in the specific context of triage.

Background

Acute pain affects most patients admitted to emergency departments, but pain relief in this setting remains insufficient. Evaluation of pain and its treatment at the time of patient triage expedites the administration of analgesia, but may be awkward at this time‐pressured moment. The assessment of pain intensity by a validated pain scale is a critical initial step, and a patient's self‐reporting is widely considered as the key to effective pain management. According to good practice guidelines, clinicians must accept a patient's statement, regardless of their own opinions.

Design

A qualitative methodology rooted in interactionist sociology and on the Grounded theory was used to provide an opportunity to uncover complex decision‐making processes, such as those involved in assessing pain.

Methods

A sociologist conducted semi‐structured interviews during the 2013–2014 winter months with twelve nurses and trained in the use of an established protocol, focusing on the assessment of pain intensity. The interviews were recorded, fully transcribed and analysed.

Results

The most frequently used pain scale was the Verbal Numerical Rating Scale. Discrepancies between self‐assessment and evaluation by a nurse were common. To restore congruence between the two, nurses used various tactics, such as using different definitions of the high‐end anchor of the scale, providing additional explanations about the scale, or using abnormal vital signs or the acceptance of morphine as a proof of the validity of severe pain ratings.

Conclusions

Nurses cannot easily suspend their own judgement. Their tactics do not express a lack of professionalism, but are consistent with the logic of professional intervention.

Relevance to clinical practice

This article presents triage nurses’ reality in a time‐pressured environment, and understanding this conflict may outline new educational targets to further improve pain management in ED.
Reflection on the cause and avoidance of recurrent venous leg ulcers: An interpretive descriptive approach
Authors: Stewart Ann , Edwards Helen , Finlayson Kathleen
Published: August 2017

Aims and objectives

To gain insight into the experience of recurrent venous leg ulcers from the individual's perspective and provide knowledge on potential risks of recurrence not previously investigated.

Background

Venous leg ulcers are a consequence of chronic venous disease and frequently recur. They are costly and can impact on physical and psychological health. Despite research suggesting the risk can be reduced through compression and lifestyle changes, recurrence rates are often high. This study provides an insight into individual's perceptions of the cause of their ulcers and how they try to avoid them.

Design

A qualitative design guided by the Chronic Illness Trajectory Model and Social Cognitive Theory.

Method

A purposive sample of three males and four females were recruited from a community nursing clinic. Participants were ulcer free, had experienced at least two previous venous leg ulcers and could speak and comprehend English. An interpretive descriptive approach was taken using semi‐structured interviews and thematic analysis.

Results

Three themes each containing three categories emerged: The Increasing Influence of the Recurring Wound on Mind and Body, Reflection on Past Experiences and Optimism in the Face of Adversity. Most participants reported traumatic injury and lower leg surgery triggered ulcer recurrence. Failure to replace compression stockings was also deemed a cause. Compression was reported essential, but some participants were unaware of the level they were wearing and how often it should be replaced. Other preventive activities included avoiding injury and securing immediate assistance if wounding occurred.

Conclusion

Clinicians need to be aware that lower leg surgery may trigger recurrent venous ulceration and that individuals require ongoing emotional, physical and financial support throughout the trajectory of venous disease. The continued use of old compression stockings should be avoided and recurrence prevented by adoption of evidence‐based practice rather than reflection on past experiences.

Relevance to clinical practice

This research raises the awareness of factors from the individual’s perspective which can influence the recurrence of venous leg ulcers.
Are characteristics of team members important for quality management of chronic patients at primary care level?
Authors: Klemenc‐Ketis Zalika , Poplas‐Susič Antonija
Published: August 2017

Aims and objectives

To determine the possible associations between higher levels of selected quality indicators and the characteristics of providers.

Background

In 2011, an ongoing project on a new model of family medicine practice was launched in Slovenia; the family physicians’ working team (a family physician and a practice nurse) was extended by a nurse practitioner working 0.5 full‐time equivalents. This was an example of a personalised team approach to managing chronic patients.

Methods

We included all family medicine practices in the six units of the Community Health Centre Ljubljana which were participating in the project in December 2015 (N = 66). Data were gathered from automatic electronic reports on quality indicators provided monthly by each practice. We also collected demographic data.

Results

There were 66 family medicine teams in the sample, with 165 members of their teams (66 family physicians, 33 nurse practitioners and 66 practice nurses). Fifty‐six (84.4%) of the family physicians were women, as were 32 (97.0%) of the nurse practitioners, and 86 (95.5%) of the practice nurses. Multivariate analysis showed that a higher level of the quality indicator “Examination of diabetic foot once per year” was independently associated with nurse practitioners having attended additional education on diabetes, duration of participation in the project, age and years worked since graduation of nurse practitioners, working in the Center unit and not working in the Bezigrad unit.

Conclusions

Characteristics of team members are important in fostering quality management of chronic patients. Nurse practitioners working in new model family practices need obligatory, continuous professional education in the management of chronic patients.

Relevance to clinical practice

The quality of care of chronic patients depends on the specific characteristics of the members of the team, which should be taken into account when planning quality improvements.
Lesbian, gay and bisexual parents’ experiences of nurses’ attitudes in child health care—A qualitative study
Authors: Andersen Anna‐Eva , Moberg Catherine , Bengtsson Tops Anita , Garmy Pernilla
Published: August 2017

Aims and objectives

To describe lesbian, gay and bisexual parents’ experiences of nurses′ attitudes in child healthcare.

Background

Lesbian, gay and bisexual people are often reluctant to disclose their gender identity for fear of discrimination. This fear may lead to avoidance of healthcare for themselves or their children and may negatively affect families’ health and well‐being.

Design

A qualitative inductive design was employed.

Methods

Semistructured interviews were conducted with 14 lesbian, gay or bisexual parents (11 mothers and three fathers) with child health care experiences in southern Sweden. Interviews were analysed using qualitative content analysis.

Results

Two themes were identified. One, a “sense of marginalisation,” included lesbian, gay and bisexual parents’ experiences of heteronormative attitudes among child healthcare nurses which led them to feel alienated and questioned as parents. Another, “being respected for who you are,” included experiences of being respected and included at child healthcare appointments.

Conclusions

Findings paint a complex picture of lesbian, gay and bisexual parents’ interactions with child healthcare nurses in that they experienced both positive and negative attitudes. Knowledge gaps about lesbian, gay and bisexual families within the child healthcare field must be filled.

Relevance to clinical practice

Child health care nurses should work with the entire family to provide the best care for the child; however, discrimination in health care is common and often caused by a lack of knowledge. The number of children living with same‐sex parents has increased more than ten‐fold since the end of the 1990s. It is therefore important to explore lesbian, gay and bisexual parents’ experiences with child healthcare nurses’ attitudes to improve quality of care.
Transitioning into new clinical areas of practice: An integrative review of the literature
Authors: Kinghorn Grant R , Halcomb Elizabeth J , Froggatt Terry , Thomas Stuart DM
Published: August 2017

Aims and objectives

To critically synthesise research related to the transition of registered nurses into new areas of clinical practice.

Background

Global workforce shortages and rising healthcare demands have encouraged registered nurses to move into new clinical settings. While a body of literature reports on the transition of newly qualified nurses, evidence surrounding the transition of more experienced registered nurses to new clinical areas remains poorly explored.

Design

An integrative review was conducted, guided by Whittemore and Knafl (Journal of Advanced Nursing,52, 2005, 546) framework.

Methods

An electronic database search was conducted for papers published between 1996–2016. Papers were then subjected to a methodological quality appraisal, with findings synthesised using thematic analysis into core themes.

Results

Ten articles met the inclusion criteria. Three themes emerged, namely Support, Professional Development and Emotional Impact. These themes suggest that transitioning nurses experience challenges in adapting to new clinical areas and developing necessary skills. Such challenges prompted various emotional and physical responses. While formal and informal support systems were regarded as valuable by transitioning nurses, they were inconsistent across the new clinical areas.

Conclusions

There is some evidence to highlight the initial shock and emotional stress experienced by registered nurses during transition to a new clinical area. However, the influence of formal and informal support systems for such registered nurses is far from conclusive. Further research is needed, to examine registered nurse transition into a variety of clinical areas to inform workforce support, policy and practices.

Relevance to clinical practice

The demand of health care is growing while global shortages of nursing workforce remain. To ensure retention and enhance the transition experience of registered nurses, it is important for nurse leaders, managers and policymakers to understand the transition experience and factors that impact this experience.
Factors that influence care priority for chest pain patients using the manchester triage system
Authors: Nonnenmacher Carine Lais , Pires Ananda Ughini Bertoldo , Moraes Vítor Monteiro , Lucena Amália de Fátima
Published: August 2017

Aims and objectives

To analyse crucial factors for determining care priority for patients with acute myocardial infarction based on the Manchester Triage System.

Background

Triage is the first potentially critical step in the care of myocardial infarction patients. However, there are still very few studies on the factors interfering in the lack of care priority for these patients, impacting their treatment and prognosis.

Design

Retrospective cohort study with 217 patients in the emergency department of a Brazilian hospital.

Methods

Data were collected from patients' records with a primary diagnosis of myocardial infarction, from March 2014–February 2015. Patients were divided into two groups for statistical analysis: high priority (immediate and very urgent) and low priority (urgent, standard and nonurgent).

Results

Most of the patients were male, with a mean age of 62.1 years, with a prevalence of high blood pressure and smoking as risk factors. Lower care priority level was assigned to 116 (53.4%) patients. Sixty‐four (29.5%) patients had ST‐segment elevation acute myocardial infarction, and 29 (45.3%) of these patients were assigned lower care priority level. Coughing, abdominal pain, onset of symptoms over 24 hr ago and pain of mild to moderate intensity were clinical predictors associated with lower care priority level. Sweating and high blood pressure were associated with high care priority level. Lower care priority level was associated with increased door‐to‐electrocardiogram and door‐to‐troponin times. There was no significant difference between the two groups for door‐to‐needle and door‐to‐balloon times.

Conclusions

Most of the patients with myocardial infarction were classified as low care priority, showing triage failure either due to symptom variability or need for professional qualification in clinical data collection and interpretation.

Relevance to clinical practice

The results may support clinical evaluation, bringing chest pain assessment into focus.
Innovation across cities
Authors: Soo Kwok Tong
Published: August 2017

This paper examines the distribution of patenting activity across cities in the OECD, using a sample of 218 cities from 2000 to 2008. We obtain three main results. First, patenting activity is more concentrated than population and GDP. Second, patenting activity is less persistent than population and GDP, especially in the middle of the distribution. Third, in a parametric model, patenting does not exhibit mean‐reversion, and is positively associated with GDP and population density. Our results suggest that policymakers can influence the amount of innovative activity through the use of appropriate policies.
Melatonin reduces inflammatory response in peripheral T helper lymphocytes from relapsing‐remitting multiple sclerosis patients
Authors: Álvarez‐Sánchez Nuria , Cruz‐Chamorro Ivan , Díaz‐Sánchez María , Sarmiento‐Soto Helia , Medrano‐Campillo Pablo , Martínez‐López Alicia , Lardone Patricia J. , Guerrero Juan M. , Carrillo‐Vico Antonio
Published: August 2017

Multiple sclerosis (MS) is a neuroinflammatory disease of the central nervous system in which the immune system plays a central role. In particular, effector populations such as T helper (Th) 1, Th9, Th17, and Th22 cells are involved in disease development, whereas T regulatory cells (Tregs) are associated with the resolution of the disease. Melatonin levels are impaired in patients with MS, and exogenous melatonin ameliorates the disease in MS animal models by modulating the Th1/Th17/Treg responses and also improves quality of life and several symptoms in patients with MS. However, no study has examined melatonin's effect on T cells from relapsing‐remitting MS (RR‐MS) patients. Therefore, the objectives of the present study were to evaluate the effects of the in vitro administration of melatonin to peripheral blood mononuclear cells (PBMCs) from 64 RR‐MS patients and 64 sex‐ and age‐matched healthy subjects on Th1, Th9, Th17, Th22, and Treg responses and to analyze the expression of the melatonin effector/receptor system in these cells. Melatonin decreased Th1 and Th22 responses in patients, whereas it did not affect the Th17 and Treg subsets. Melatonin also promoted skewing toward a more protective cytokine microenvironment, as shown by an increased anti‐inflammatory/Th1 ratio. Furthermore, for the first time, we describe the overexpression of the melatonin effector/receptor system in PBMCs from patients with MS; this alteration might be relevant to the disease because acetylserotonin O‐methyltransferase expression significantly correlates with disease progression and T effector/regulatory responses in patients. Therefore, our data suggest that melatonin may be an effective treatment for MS.
The messenger matters: Pollinator functional group influences mating system dynamics
Authors: Weber Jennifer J.
Published: August 2017

The incredible diversity of plant mating systems has fuelled research in evolutionary biology for over a century. Currently, there is broad concern about the impact of rapidly changing pollinator communities on plant populations. Very few studies, however, examine patterns and mechanisms associated with multiple paternity from cross‐pollen loads. Often, foraging pollinators collect a mixed pollen load that may result in the deposition of pollen from different sires to receptive stigmas. Coincident deposition of self‐ and cross‐pollen leads to interesting mating system dynamics and has been investigated in numerous species. But, mixed pollen loads often consist of a diversity of cross‐pollen and result in multiple sires of seeds within a fruit. In this issue of Molecular Ecology, Rhodes, Fant, and Skogen () examine how pollinator identity and spatial isolation influence multiple paternity within fruits of a self‐incompatible evening primrose. The authors demonstrate that pollen pool diversity varies between two pollinator types, hawkmoths and diurnal solitary bees. Further, progeny from more isolated plants were less likely to have multiple sires regardless of the pollinator type. Moving forward, studies of mating system dynamics should consider the implications of multiple paternity and move beyond the self‐ and cross‐pollination paradigm. Rhodes et al. () demonstrate the importance of understanding the roles that functionally diverse pollinators play in mating system dynamics.
Transcriptomic basis of genome by genome variation in a legume‐rhizobia mutualism
Authors: Burghardt Liana T. , Guhlin Joseph , Chun Chan Lan , Liu Junqi , Sadowsky Michael J. , Stupar Robert M. , Young Nevin D. , Tiffin Peter
Published: August 2017

In the legume‐rhizobia mutualism, the benefit each partner derives from the other depends on the genetic identity of both host and rhizobial symbiont. To gain insight into the extent of genome × genome interactions on hosts at the molecular level and to identify potential mechanisms responsible for the variation, we examined host gene expression within nodules (the plant organ where the symbiosis occurs) of four genotypes of Medicago truncatula grown with either Ensifer meliloti or E. medicae symbionts. These host × symbiont combinations show significant variation in nodule and biomass phenotypes. Likewise, combinations differ in their transcriptomes: host, symbiont and host × symbiont affected the expression of 70%, 27% and 21%, respectively, of the approximately 27,000 host genes expressed in nodules. Genes with the highest levels of expression often varied between hosts and/or symbiont strain and include leghemoglobins that modulate oxygen availability and hundreds of Nodule Cysteine‐Rich (NCR) peptides involved in symbiont differentiation and viability in nodules. Genes with host × symbiont‐dependent expression were enriched for functions related to resource exchange between partners (sulphate/iron/amino acid transport and dicarboxylate/amino acid synthesis). These enrichments suggest mechanisms for host control of the currencies of the mutualism. The transcriptome of M. truncatula accession HM101 (A17), the reference genome used for most molecular research, was less affected by symbiont identity than the other hosts. These findings underscore the importance of assessing the molecular basis of variation in ecologically important traits, particularly those involved in biotic interactions, in multiple genetic contexts.
Deciphering the origin of mito‐nuclear discordance in two sibling caddisfly species
Authors: Weigand Hannah , Weiss Martina , Cai Huimin , Li Yongping , Yu Lili , Zhang Christine , Leese Florian
Published: August 2017

An increasing number of phylogenetic studies have reported discordances among nuclear and mitochondrial markers. These discrepancies are highly relevant to widely used biodiversity assessment approaches, such as DNA barcoding, that rely almost exclusively on mitochondrial markers. Although the theoretical causes of mito‐nuclear discordances are well understood, it is often extremely challenging to determine the principal underlying factor in a given study system. In this study, we uncovered significant mito‐nuclear discordances in a pair of sibling caddisfly species. Application of genome sequencing, ddRAD and DNA barcoding revealed ongoing hybridization, as well as historical hybridization in Pleistocene refugia, leading us to identify introgression as the ultimate cause of the observed discordance pattern. Our novel genomic data, the discovery of a European‐wide hybrid zone and the availability of established techniques for laboratory breeding make this species pair an ideal model system for studying species boundaries with ongoing gene flow.
Long‐term outcome of dogs treated with ulnar rollover transposition for limb‐sparing of distal radial osteosarcoma: 27 limbs in 26 dogs
Authors: Séguin Bernard , O'Donnell Matthew D. , Walsh Peter J. , Selmic Laura E.
Published: August 2017

Objective

To determine outcomes in dogs with distal radial osteosarcoma treated with ulnar rollover transposition (URT) limb‐sparing surgery including: viability of the ulnar graft, complications, subjective limb function, disease‐free interval (DFI), and survival time (ST).

Study design

Retrospective case series.

Animals

Twenty‐six client‐owned dogs with distal radial osteosarcoma and no involvement of the ulna.

Methods

Data of dogs treated with URT were collected at the time of surgery and retrospectively from medical records and by contacting owners and referring veterinarians.

Results

URT technique was performed on 27 limbs in 26 dogs. The ulnar graft was determined to be viable in 17 limbs, nonviable in 3, and unknown in 7. Complications occurred in 20 limbs. Infection was diagnosed in 12 limbs. Biomechanical complications occurred in 15 and local recurrence in 2 limbs. Limb function graded by veterinarians or owners was poor in 2 limbs, fair in 4, good in 14, excellent in 3, and unknown in 4. Median DFI was 245 days and median ST was 277 days.

Conclusion

The URT technique maintained the viability of the ulnar graft. The complication rate was high but limb function appeared acceptable. Although sufficient length of the distal aspect of the ulna must be preserved to perform this technique, local recurrence was not increased compared to other limb‐sparing techniques when cases were appropriately selected.
The attitudes of recently‐arrived Polish migrants to Irish English
Authors: DISKIN CHLOÉ , REGAN VERA
Published: August 2017

This article presents a case study of six Polish migrants residing in Dublin, Ireland and examines their language ideologies through an analysis of the metalinguistic discourse surrounding Irish English, world Englishes, and notions of ‘standardness’ that arose in the course of six extended interviews in 2012. Adapting Bucholtz and Hall's concept of markedness or ‘hierarchical structuring of difference’, this study structures the migrants’ views towards world Englishes as operating along two axes of markedness and desirability. Overall, the migrants exhibit three broadly differing views of Irish English: positive, negative and ambivalent, and at times explicitly articulate their views in comparison with those of traditional Inner Circle varieties, such as British and American English.
Encapsulating Irish English in literature
Authors: AMADOR‐MORENO CAROLINA P. , TERRAZAS‐CALERO ANA MARÍA
Published: August 2017

This article examines the representation of Irish English in contemporary Irish writing, with particular reference to the narrative of the Ross O'Carroll‐Kelly saga, a series of comic novels created by Irish writer Paul Howard which has enjoyed phenomenal success in Ireland, due in part to the author's ability to convey contemporary spoken English in Dublin. Our study consists of a corpus analysis of three of his novels, where we are able to describe a number of key stylistic features which are distinctive of Howard's representation of Irish English, including the variable use of such discourse markers as like, roysh and yeah + no, as well as the use of the intensifying so.
I scream, you scream, we all scream for irisin
Authors: Shoemaker Ashley
Published: August 2017

Skeletal muscle may communicate with pancreatic beta cells through irisin, a muscle-derived hormone that promotes beta cell survival and insulin release.
Bilateral medial rectus aplasia and a modified surgical approach of transposition myopexy of vertical recti
Authors: Sharma Pradeep , Chaurasia Shweta , Rasal Abhijit
Published: August 2017

A 16-year-old girl presented with left eye large-angle exotropia. On examination, we found bilateral limitation of adduction. CT orbit showed hypoplastic medial rectus bilaterally, but intraoperatively we found absent medial recti on both sides. This case report explains discrepancy between the imaging and the intraoperative findings and discusses the management dilemma in view of the risk of anterior segment ischaemia and how marked exodeviation and adduction limitation was tackled by the new technique of transposition myopexy, a modification of the procedure described by Nishida along with recession of lateral rectus to achieve good alignment. This procedure changes the vector forces of the vertical rectus without splitting or tenotomy of the muscles.