bluuebunny/crossref_metadata_2025 huggingface dataset:
Examining maintenance care following infliximab salvage therapy for acute severe ulcerative colitis
Authors: Seah Dean , Choy Matthew C , Gorelik Alexandra , Connell William R , Sparrow Miles P , Van Langenberg Daniel , Hebbard Geoffrey , Moore Gregory , De Cruz Peter
Published: June 2017

Background and Aim

Data supporting the optimal maintenance drug therapy and strategy to monitor ongoing response following successful infliximab (IFX) induction, for acute severe ulcerative colitis (ASUC), are limited. We aimed to evaluate maintenance and monitoring strategies employed in patients post‐IFX induction therapy.

Methods

Patients in six Australian tertiary centers treated with IFX for steroid‐refractory ASUC between April 2014 and May 2015 were identified via hospital IBD and pharmacy databases. Patients were followed up for 1 year with clinical data over 12 months recorded. Analysis was limited to patient outcomes beyond 3 months.

Results

Forty one patients were identified. Five of the 41 (12%) patients underwent colectomy within 3 months, and one patient was lost to follow‐up. Six of 35 (17%) of the remaining patients progressed to colectomy by 12 months. Maintenance therapy: Patients maintained on thiopurine monotherapy (14/35) versus IFX/thiopurine therapy (15/35) were followed up. Two of 15 (13%) patients who received combination maintenance therapy underwent a colectomy at 12 months, compared with 1/14 (7%) patients receiving thiopurine monotherapy (P = 0.610). Monitoring during maintenance: Post‐discharge, thiopurine metabolites were monitored in 15/27 (56%); fecal calprotectin in 11/32 (34%); and serum IFX levels in 4/20 (20%). Twenty of 32 (63%) patients had an endoscopic evaluation after IFX salvage with median time to first endoscopy of 109 days (interquartile range 113–230).

Conclusion

Following IFX induction therapy for ASUC, the uptake of maintenance therapy in this cohort and strategies to monitor ongoing response were variable. These data suggest that the optimal maintenance and monitoring strategy post‐IFX salvage therapy remains to be defined.
What is the variability in shoulder, axillae and waist position in a group of adolescents?
Authors: Gardner Adrian , Berryman Fiona , Pynsent Paul
Published: June 2017

The clinical assessment of scoliosis is based on the recognition of asymmetry. It is not clear what the degree of asymmetry is in a population without scoliosis, which could make the differentiation between abnormal and normal uncertain. This study defines the range of normality in certain parameters of torso shape that are also associated with the clinical assessment of scoliosis. This was done by analysing the surface topography of a group of 195 children serially measured over a 5‐year period. The analysis considered both the spinal curvature and the relative position of shoulders, axillae and waist on each side. The bivariate relationships were examined using 95% confidence interval data ellipses. Our results showed that a degree of spinal curvature was seen, either as a main thoracic or main thoracolumbar curve. The distribution of the data about a mean point is illustrated by 95% confidence interval (CI) data ellipses with shoulder, axilla and waist data plotted against spinal curvature. The mean values were close to zero (exact symmetry) for all of the measured parameters, with the ellipses showing little differences in the distributions. We conclude that mild asymmetry of the measured torso parameters is normal. These results define what is normal and beyond what point asymmetry becomes abnormal. This information is of use for those managing and counselling patients with scoliosis both before and after surgery.
Clinical efficacy of utilizing Ultrapulse CO2 combined with fractional CO2 laser for the treatment of hypertrophic scars in Asians—A prospective clinical evaluation
Authors: Lei Ying , Li Shi Feng , Yu Yi Ling , Tan Jun , Gold Michael H.
Published: June 2017

Background and Objective

Hypertrophic scarring is seen regularly. Tissue penetration of laser energy into hypertrophic scars using computer defaults from some lasers may be insufficient and penetration not enough. We have developed a treatment with an interrupted laser “drilling” by the Ultrapulse CO2 (Manual Fractional Technology, MFT) and, a second pass, with fractional CO2. The MFT with fractional CO2 lasers to treat hypertrophic scars is evaluated.

Study Design/Materials and Methods

A total of 158 patients with hypertrophic scars had three sessions of MFT with fractional CO2 laser at 3‐month intervals. Evaluations made before and 6 months after the 3rd treatment: (1) the Vancouver Scar Scale (VSS), (2) the University of North Carolina (UNC) Scar Scale, and (3) a survey of patient satisfaction.

Results

All data were analyzed using a t‐test before and after treatment. The VSS score decreased from 9.35 to 3.12 (P<.0001), and the UNC Scar Scale score decreased from 8.03 to 1.62 (P<.0001). The overall satisfaction rate was 92%. No long‐term complications occurred in the clinical trial.

Conclusion

The interrupted laser drilling by MFT and a fractional CO2 laser had profound effects on the hypertrophic scars treated. It works by increasing the penetration depth of the CO2 laser in the scar tissue, exerting more precise effects on the hypertrophic scars. MFT combined with fractional CO2 laser has the potential to be a major advance in the treatment of hypertrophic scars.
Vaccination timeliness in preterm infants: An integrative review of the literature
Authors: Sisson Helen , Gardiner Eric , Watson Roger
Published: June 2017

Aims and objectives

To take a systematic approach to reviewing the scientific literature examining the timeliness of vaccination in preterm infants and to identify any factors associated with timeliness.

Background

Preterm infants are vulnerable to infection and guidance advocates they are vaccinated in accordance with their full‐term peers. Vaccination is well tolerated and protective immune responses are observed, yet some early enquiries suggest that preterm infants experience unwarranted delays. The recent surge in pertussis cases and the increase in vaccinations administered make this a topic requiring further exploration.

Design

An integrative review of the empirical literature.

Methods

Studies were identified following a search of Medline, Academic Search Premier, Cochrane Database of Systematic Reviews and the Cumulative Index to Nursing and Allied Health Literature. The review methods used were influenced by a narrative synthesis approach. The retrieval of papers adhered to recognised reporting standards.

Results

Fourteen studies were identified, which indicated that infants with the lowest gestational ages and birthweights experience the greatest delays. Vaccination timeliness is influenced by hospitalisation and increased postdischarge follow‐up. There was a lack of consensus to indicate that parental socio‐economic status and level of education were indicators for a delay. The studies propose that many delays are unjustified and not according to genuine contraindications.

Conclusion

This review indicates that preterm infants are not vaccinated in a timely manner. Those involved in vaccinating preterm infants must be informed of the genuine contraindications to avoid unnecessary delays putting preterm infants at an increased risk of infection.

Relevance to clinical practice

Care providers should acknowledge the risk of a delay in preterm infants and actively promote vaccination in this population. Regular training should help to negate the occurrence of inappropriate delays, and careful discharge planning is needed to ensure that preterm infants are vaccinated on time.
Nurses' knowledge on diabetic foot ulcer disease and their attitudes towards patients affected: A cross‐sectional institution‐based study
Authors: Kumarasinghe Sriyani A. , Hettiarachchi Priyadarshika , Wasalathanthri Sudharshani
Published: June 2017

Aims and objectives

To assess nurses' knowledge on diabetic ulcer disease and their attitudes towards patients suffering from it and to identify factors which influence them.

Background

Diabetic wound care is an evolving specialty with the rising prevalence of diabetes foot complications. As nurses play a key role in wound care, their knowledge and attitudes are important in providing optimum care to patients.

Design

Descriptive cross‐sectional survey design.

Methods

The study was conducted in three teaching hospitals. Data were collected using a pretested, validated, self‐administered questionnaire from purposively recruited, voluntarily participating nurses (n = 200) who were in diabetic wound care practice for ≥1 year.

Results

Lack of formal wound care training was reported by 91.2%. Mean knowledge score was 77.9 (range 53.3–100 on a scale from 0–100) with 57.8% of nurses obtaining ≥80%. Nurses demonstrated an overall positive attitude towards caring for diabetic ulcer patients (median = 41, range 23–50 on a scale from 10–50). However, the study identified deficits in core knowledge and some negative attitudes such as insensitivity to pain. Statistically significant associations were seen between nurses' knowledge and duration of nursing, wound care experience and the type of unit they are attached to. In‐service education (77.2%) and knowledge sharing with peers (77.9%) were the most popular knowledge‐updating sources. Although 98.6% of nurses were interested in wound care, only 8.3% wished to engage in research. No correlation was observed between nurses' knowledge and attitudes.

Conclusion

Gaps in core knowledge and negative attitudes may be attributed to inadequate training, suboptimal update of knowledge and lack of interest in wound care research.

Relevance to clinical practice

Wound care training should be made mandatory to improve quality of care given by nurses to patients with diabetic ulcers. Continuous professional development, evidence‐based practices and wound care research should be encouraged.
Factors influencing medication adherence in patients with gout: A descriptive correlational study
Authors: Chua Xin Hui Jasmine , Lim Siriwan , Lim Fui Ping , Lim Yee Nah Anita , He Hong‐Gu , Teng Gim Gee
Published: June 2017

Aims and objectives

To examine the factors influencing adherence to urate‐lowering therapy in patients with gout in Singapore.

Background

Gout is the most common type of chronic inflammatory arthritis. Urate‐lowering therapy is used to treat gout by reducing serum uric acid levels. However, adherence to urate‐lowering therapy among patients remains poor. To date, there have been no available studies based on a conceptual framework that examined factors influencing medication adherence in patients with gout.

Design

Cross‐sectional, descriptive correlational study.

Methods

A convenience sample of outpatients (n = 108) was recruited between October 2014–January 2015 from a tertiary hospital in Singapore. Outcomes were measured by relevant valid and reliable instruments. Descriptive statistics and parametric tests including multiple linear regression were used to analyse the data.

Results

Although 44.4% of the participants were high adherers to urate‐lowering therapy, the mean adherence level was moderate. Significant differences in medication adherence scores were found among the subgroups of gender, ethnicity, marital status, employment status and presence of comorbidity. Medication adherence was positively significantly correlated with age, number of comorbidities and beliefs about medicines. Linear regression showed that higher level of beliefs about medicines, presence of comorbidity and being married were factors positively influencing medication adherence.

Conclusions

This study revealed moderate adherence to urate‐lowering therapy in patients with gout in Singapore, indicating the need for strategies to improve adherence by considering its main influencing factors. Future research should be conducted to develop interventions targeted at modifying patients' beliefs about medicines in order to improve medication adherence.

Relevance to clinical practice

Findings from this study allow healthcare providers to quickly and easily identify patients who may have low adherence. Nurses should take the lead in educating patients on the mechanism of urate‐lowering therapy and highlight the importance of adhering to it.
“Pain relieved, but still struggling”—Critically ill patients experiences of pain and other discomforts during analgosedation
Authors: Berntzen Helene , Bjørk Ida Torunn , Wøien Hilde
Published: June 2017

Aims and objectives

To explore how critically ill patients treated according to a strategy of analgosedation experience and handle pain, other discomforts and wakefulness.

Background

Patients experience both pain and discomfort while in the intensive care unit. International guidelines recommend focused pain treatment and light sedation. An analgosedation protocol favouring pain management, light sedation and early mobilisation was implemented in our university hospital medical and surgical intensive care unit in Norway in 2014. The analgosedation approach may affect patients’ experiences of the intensive care unit stay.

Design

Exploratory, descriptive design using semi‐structured interviews.

Method

Eighteen adult patients treated in intensive care unit >24 hr and receiving mechanical ventilation were interviewed 1–9 days after intensive care unit discharge. Ten patients were re‐interviewed after 3 months. Data were analysed using the “systematic text condensation” approach.

Findings

Four main categories emerged from the analysis: “In discomfort, but rarely in pain,” “Struggling to get a grip on reality,” “Holding on” and “Handling emotionally trapped experiences.” “Pain relieved, but still struggling” was the overarching theme. Analgosedation provided good pain relief, but patients still described frequent physical and psychological discomforts, in particular related to mechanical ventilation, not understanding what was going on, and experiences of delusions. To come to terms with their intensive care unit stay, patients needed to participate, trust in others and endure suffering. After hospital discharge, patients described both repression of experiences and searching for recognition of what they had gone through.

Relevance to clinical practice

Despite good pain relief during analgosedation, other discomforts were commonly described. Critically ill patients still experience an intensive care unit stay as a traumatic part of their illness trajectory. Nurses need to attend carefully also to discomforts other than pain.
Influence of gender, BMI and body shape on theoretical injection outcome at the ventrogluteal and dorsogluteal sites
Authors: Larkin Theresa A , Ashcroft Elfriede , Hickey Blake A , Elgellaie Asmahan
Published: June 2017

Aims and objectives

This study aimed to determine the influences of gender, BMI and observed body shape on subcutaneous fat and muscle thicknesses, and theoretical injection outcome, at the ventrogluteal and dorsogluteal intramuscular injection sites.

Background

Debate continues as to whether the dorsogluteal or ventrogluteal injection site is more reliable for a successful intramuscular injection outcome. Subcutaneous fat and muscle thicknesses at the injection site are direct determinants of intramuscular injection outcome. BMI and observed body shape influence gluteal subcutaneous fat and muscle thicknesses, and therefore injection outcome, with potentially distinct effects at the ventrogluteal and dorsogluteal sites.

Design

This was a cross‐sectional study.

Methods

Demographic data were collected, and subcutaneous fat and muscle thicknesses were quantified bilaterally at the dorsogluteal and ventrogluteal injection sites using ultrasound, for 145 participants (57% female).

Results

Subcutaneous fat and muscle were significantly thicker at the dorsogluteal than the ventrogluteal site, and 75% and 86% of participants would receive a successful intramuscular injection at these sites, respectively. There were significant effects of gender, BMI and observed body shape on subcutaneous fat thickness and theoretical injection outcome at both sites. Females, obese individuals and endomorph individuals had thicker subcutaneous fat and were more likely to have a subcutaneous injection outcome.

Conclusions

Gender, BMI and observed body shape could be used to guide site and needle length selection when administering gluteal intramuscular injections to increase the likelihood of a successful intramuscular injection outcome.

Relevance to clinical practice

Both gluteal injection sites should be avoided in obese individuals and endomorph individuals. An intramuscular injection will be successful: using a 32‐mm needle at the ventrogluteal site for all males and normal‐weight females and using a 38‐mm needle for all females at the ventrogluteal site, and for all males and at least 98% of females at the dorsogluteal site.
Understanding nurses’ concerns when caring for patients from diverse cultural and ethnic backgrounds
Authors: Markey Kathleen , Tilki Mary , Taylor Georgina
Published: June 2017

Aims and objectives

To explore the experiences of both student and qualified nurses of caring for patients from diverse cultural, ethnic and linguistic backgrounds, in one region of Ireland. Hearing the stories, experiences and attitudes of nurses has the potential to influence future clinical practice and has implication for nurses, nurse educators and nurse managers and leaders.

Background

There is a wealth of international literature highlighting the importance of providing culturally sensitive care. However, global reports of culturally insensitive care continue. There is a paucity of in‐depth research exploring the actual concerns and challenges nurses experience when caring for patients from diverse cultural and ethnic backgrounds, as well as what influences their actions and omissions of care in practice.

Design

A qualitative exploratory descriptive design adopting the principles of a classic grounded theory approach was used.

Methods

Focus groups (n − 10) and individual face‐to‐face interviews (n − 30) were conducted with student and qualified nurses studying and working in one region of Ireland. As data were collected, it was simultaneously analysed using the classic grounded theory methodological principles of coding, constant comparison and theoretical sampling.

Findings

Uncertainty was the consistent main concern that emerged. Feelings of ambiguity of how to act were further influenced by a lack of knowledge, an awareness of ethnocentric beliefs and the culture of the organisation in which participants learn and work in. Instead of finding answers to uncertainties, participants demonstrated a lack of commitment to meeting patients’ needs in a culturally appropriate way.

Conclusions

This study adds new perspectives to our understanding of enablers and barriers to culturally sensitive care. It explains the poignant effect of uncertainty and describes how nurses were unable (or unwilling) to find answers when in doubt. It raises questions that remain unanswered in the existing literature, as to why nurses feel it is acceptable to choose to do nothing about their lack of cultural knowledge and the uncertainties which follow.

Relevance to clinical practice

Identifying the nature and implications of the uncertainty experienced when providing care for patients from diverse cultural and ethnic backgrounds is an important contributing factor to improving cultural sensitivity and quality care.
Open‐label randomised controlled trial about application of bundle care in prevention of unplanned extubation of nasobiliary drainage catheter after endoscopic retrograde cholangiopancreatography
Authors: Zhao Chun‐mei , Qian Jun‐bo , Zhang Chun‐mei , Lin Gang
Published: June 2017

Aims and objectives

To observe the effects of bundle care on preventing unplanned extubation of nasobiliary drainage catheter after endoscopic retrograde cholangiopancreatography.

Background

Preventing unplanned extubation has become a difficult problem for nursing staff because the catheter is stiff, fine and long.

Design

A total of 114 cases that experienced nasobiliary drainage after endoscopic retrograde cholangiopancreatography for the first time in our hospital from April 2015–July 2016 were enrolled in this study. According to receiving routine nurse or bundle nurse, these cases were randomly divided into control (n = 56) and intervention (n = 58) group.

Method

The unplanned extubation incidence, contact area between tape and catheter and tensile resistance were compared between the two groups.

Results

The contact area was one square centimetre in the control group and 5 cm2 in the intervention group. Tensile resistance was significantly higher in the intervention group than in the control (all p < .05). Unplanned extubation incidence was significantly lower in the intervention group (1.72%, 1/58) than in the control (12.5%, 7/56) (p = .0305).

Conclusion

Bundle care can effectively decrease unplanned extubation incidence after endoscopic retrograde cholangiopancreatography.

Relevance to clinical practice

This study provides a basis for decreasing unplanned extubation incidence.
Characteristics of an effective nursing clinical instructor: The state of the science
Authors: Collier Angela D
Published: June 2017

Aims and objectives

To analyse the perceived characteristics of an effective nursing clinical instructor and methods for measure instructor effectiveness. This review also examined importance of characteristics based on student age.

Background

The clinical instructor has a vital role in clinical education. While the role may be well defined, the characteristics these instructors need to do their jobs effectively are not.

Design

An integrative review from 1985 to present using four key terms: nursing, clinical, teaching and effectiveness. This review revealed 37 articles that met the inclusion criteria for analysis.

Methods

Inclusion criteria included studies related to nursing clinical teaching effectiveness of the clinical instructor in a direct patient care setting. An integrative review table of the studies was made by the author. Keywords were analyzed in the results column, and same concepts were grouped together.

Results

A synthesis of current research revealed three dominant themes: competency, the ability to develop interpersonal relationships and certain personality traits. The analysis of the literature suggests the ability to develop interpersonal relationships is the most valued skill. Overall, approachability emerged as the most important personality trait needed to be an effective clinical instructor. The analysis also revealed a difference regarding the priority of characteristics based on age of the student.

Conclusion

The analysis of the literature suggests the ability to develop interpersonal relationships is the most valued skill for clinical instructors. Overall, approachability emerged as the most important personality trait needed to be an effective clinical instructor.

Relevance to clinical practice

Future studies should continue to evaluate the extent of the dominant themes especially considering the rise of the millennial student generation.
Optimising implementation of a patient‐assessment framework for emergency nurses: A mixed‐method study
Authors: Munroe Belinda , Curtis Kate , Buckley Thomas , Lewis Melinda , Atkins Lou
Published: June 2017

Aims and objectives

To determine potential facilitators and barriers and tailor interventions to optimise future implementation of a patient‐assessment framework into emergency nursing practice.

Background

An evidence‐informed patient‐assessment framework HIRAID (History, Identify Red flags, Assessment, Interventions, Diagnostics, communication and reassessment) improves the quality of patient assessments performed by emergency nurses. Facilitators and barriers must be understood and tailored interventions selected to optimise implementation.

Design

A mixed‐method convergent study design was used.

Methods

Thirty eight early career emergency nurses from five Australian hospitals participated in an education workshop on the HIRAID assessment framework. Simulated clinical scenarios enabled participants to experience conducting a patient assessment with and without using the framework. All participants completed surveys, interviews and focus groups to identify potential facilitators and barriers. Twenty three participants completed follow‐up telephone surveys 4–6 months later. Quantitative and qualitative data were analysed separately using descriptive statistics and inductive content analysis, prior to integration. Implementation interventions were selected using the Behaviour Change Wheel.

Results

Nine facilitators and nine barriers were identified to potentially effect implementation of the HIRAID assessment framework. Twelve of the 23 participants (52.2%) who completed follow‐up surveys reported using the framework in the clinical setting. To optimise future implementation, the education workshop needs refinement, and environmental restructuring, modelling and social support are required.

Conclusion

A multimodal strategy is needed to promote future successful implementation of the HIRAID assessment framework into emergency nursing practice.

Relevance for clinical practice

The successful implementation of the HIRAID assessment framework has the potential to improve nursing assessments of patients in emergency and other acute care settings. This study demonstrates how to systematically identify facilitators and barriers to behaviour change and select interventions to optimise implementation of evidence‐informed nursing practices.
Democracy and competition: Vertical differentiation and labor in a general equilibrium model
Authors: Kahloul Amani , Lahmandi‐Ayed Rim , Lasram Hejer , Laussel Didier
Published: June 2017

We consider a general equilibrium model with vertical preferences and one or two firms, where workers and consumers are differentiated, respectively, by their sensitivity to effort and their preference for quality. The question in this paper is whether a decentralized choice through majority vote would lead to more or less competition. We compare the duopoly and the monopoly cases from the viewpoint of each individual, then we deduce the choice of the majority. We prove that, under concentrated ownership (where owners have a null density), duopoly is always preferred by the majority; while under egalitarian ownership (where firms are equally shared by all the population), the choice of the majority depends on the relative size of workers' and consumers' segments.
Effect of cross‐linked vs non‐cross‐linked collagen membranes on bone: A systematic review
Authors: Jiménez Garcia J. , Berghezan S. , Caramês J. M. M. , Dard M. M. , Marques D. N. S.
Published: June 2017

The aim of this study was to conduct a systematic review to compare the clinical outcomes of two different resorbable collagen membranes in terms of regenerated bone volume, postoperative complications and membrane degradation during bone regeneration procedures. Randomized controlled trials (RCT) or controlled trials (CT) that compared both techniques were reviewed on four electronic databases up to December 2015, a manual search was performed on the bibliography of the collected articles and the authors were contacted for additional references if undetected on the electronic and manual search. Membrane exposure was evaluated as a dichotomous outcome and the statistical unit was the membrane. The results were presented as relative risk (RR) with a 95% confidence interval. Eight RCTs and one CT were included in this study. The majority of the studies depicted a bone augmentation area, which ranged from 46.15% to 94.6% for the non‐cross‐link membranes and from 44% to 92.6% for the cross‐link membranes at the 4‐6 month re‐entry surgery. From a total of 289 patients, a forest plot concerning the membrane exposure was constructed using the obtained RR of the included studies. The overall RR was 1.43 (95% CI: 0.85‐2.39) with no statistically significant differences between the two groups, although with a marginal tendency towards higher exposure in the cross‐link membrane group. This systematic review suggests the different membranes present themselves as appropriate for bone regeneration procedures, although cross‐link membranes present higher rates of postoperative complications. However, more RCT with higher sample sizes are needed to evaluate the different membranes. The suggested lack of clinical differences between the compared membranes suggest that further cost‐benefit ratio, tissue integration and postoperative complication oriented studies should be performed so that clinicians can take a patient‐centred, evidence‐based decision.
Let's talk about sleep: a systematic review of psychological interventions to improve sleep in college students
Authors: Friedrich Anja , Schlarb Angelika A.
Published: June 2017

Sleep problems are a common occurrence in college students. Insomnia, nightmares and impaired sleep quality lead to several mental health issues, as well as impaired academic performance. Although different sleep programmes exist, a systematic overview comparing their effectiveness is still missing. This systematic review aims to provide an overview of psychological interventions to improve sleep in college students. Seven databases were searched from November to December 2016 (MEDLINE, EMBASE, PsycINFO, Cinahl, Cochrane Library, PubMed, OpenSigle). The search string included search terms from three different topics: sleep, intervention and college students. Outcome measures included subjective as well as objective measures and focused on sleep, sleep‐related and mental health variables. Twenty‐seven studies met the inclusion criteria. They were assigned to four intervention categories: (1) sleep hygiene, (2) cognitive–behavioural therapy (CBT), (3) relaxation, mindfulness and hypnotherapy and (4) other psychotherapeutic interventions. Fifteen studies were randomized controlled trials. While sleep hygiene interventions provided small to medium effects, the CBTs showed large effects. The variability of the effect sizes was especially large in the relaxation category, ranging from very small to very large effect sizes. Other psychotherapeutic interventions showed medium effects. CBT approaches provided the best effects for the improvement of different sleep variables in college students. Five studies included insomnia patients. The other three intervention categories also showed promising results with overall medium effects. In the future, CBT should be combined with relaxation techniques, mindfulness and hypnotherapy. Furthermore, the interventions should broaden their target group and include more sleep disorders.
Bathymetry and siltation rate for Dokan Reservoir, Iraq
Authors: Hassan Rebwar , Al‐Ansari Nadhir , Ali Ammar A. , Ali Salahalddin S. , Knutsson Sven
Published: June 2017

The Dokan Reservoir dam is a concrete cylindrical arch with gravity abutments, located on the Lesser Zab River about 60 km from the city of Sulaimani in north‐eastern Iraq. A bathymetric survey was conducted in November 2014 for a period of 10 days, using an echo sounder of 200‐kHz single beam. The survey results indicated an annual average sediment deposition of 3.8 million m3. Thirty‐two sediment samples were collected from the reservoir bed. The ratio of gravel, sand, silt and clay was 15:14:48:23, respectively. The reservoir bed is covered mainly with silt. The sediments are composed of silty clay (77.6%), silty sandy clay (10%), sandy gravely silty clay (1.2%) and gravely sandy silty clay (1%).
Bacterial transformation: ComFA is a DNA‐dependent ATPase that forms complexes with ComFC and DprA
Authors: Diallo Amy , Foster Hannah R. , Gromek Katarzyna A. , Perry Thomas N. , Dujeancourt Annick , Krasteva Petya V. , Gubellini Francesca , Falbel Tanya G. , Burton Briana M. , Fronzes Rémi
Published: June 2017

Pneumococcal natural transformation contributes to genomic plasticity, antibiotic resistance development and vaccine escape. Streptococcus pneumoniae, like many other naturally transformable species, has evolved sophisticated protein machinery for the binding and uptake of DNA. Two proteins encoded by the comF operon, ComFA and ComFC, are involved in transformation but their exact molecular roles remain unknown. In this study, we provide experimental evidence that ComFA binds to single stranded DNA (ssDNA) and has ssDNA‐dependent ATPase activity. We show that both ComFA and ComFC are essential for the transformation process in pneumococci. Moreover, we show that these proteins interact with each other and with other proteins involved in homologous recombination, such as DprA, thus placing the ComFA‐ComFC duo at the interface between DNA uptake and DNA recombination during transformation.
Expression atlas and comparative coexpression network analyses reveal important genes involved in the formation of lignified cell wall in Brachypodium distachyon
Authors: Sibout Richard , Proost Sebastian , Hansen Bjoern Oest , Vaid Neha , Giorgi Federico M. , Ho‐Yue‐Kuang Severine , Legée Frédéric , Cézart Laurent , Bouchabké‐Coussa Oumaya , Soulhat Camille , Provart Nicholas , Pasha Asher , Le Bris Philippe , Roujol David , Hofte Herman , Jamet Elisabeth , Lapierre Catherine , Persson Staffan , Mutwil Marek
Published: June 2017

While Brachypodium distachyon (Brachypodium) is an emerging model for grasses, no expression atlas or gene coexpression network is available. Such tools are of high importance to provide insights into the function of Brachypodium genes.

We present a detailed Brachypodium expression atlas, capturing gene expression in its major organs at different developmental stages. The data were integrated into a large‐scale coexpression database ( www.gene2function.de), enabling identification of duplicated pathways and conserved processes across 10 plant species, thus allowing genome‐wide inference of gene function.

We highlight the importance of the atlas and the platform through the identification of duplicated cell wall modules, and show that a lignin biosynthesis module is conserved across angiosperms. We identified and functionally characterised a putative ferulate 5‐hydroxylase gene through overexpression of it in Brachypodium, which resulted in an increase in lignin syringyl units and reduced lignin content of mature stems, and led to improved saccharification of the stem biomass.

Our Brachypodium expression atlas thus provides a powerful resource to reveal functionally related genes, which may advance our understanding of important biological processes in grasses.
Evidence of an evolutionary hourglass pattern in herbivory‐induced transcriptomic responses
Authors: Durrant Matthew , Boyer Justin , Zhou Wenwu , Baldwin Ian T. , Xu Shuqing
Published: June 2017

Herbivory‐induced defenses are specific and activated in plants when elicitors, frequently found in the herbivores’ oral secretions, are introduced into wounds during attack. While complex signaling cascades are known to be involved, it remains largely unclear how natural selection has shaped the evolution of these induced defenses.

We analyzed herbivory‐induced transcriptomic responses in wild tobacco, Nicotiana attenuata, using a phylotranscriptomic approach that measures the origin and sequence divergence of herbivory‐induced genes.

Highly conserved and evolutionarily ancient genes of primary metabolism were activated at intermediate time points (2–6 h) after elicitation, while less constrained and young genes associated with defense signaling and biosynthesis of specialized metabolites were activated at early (before 2 h) and late (after 6 h) stages of the induced response, respectively – a pattern resembling the evolutionary hourglass pattern observed during embryogenesis in animals and the developmental process in plants and fungi.

The hourglass patterns found in herbivory‐induced defense responses and developmental process are both likely to be a result of signaling modularization and differential evolutionary constraints on the modules involved in the signaling cascade.
Benefits of an individualized perioperative plan for children with autism spectrum disorder
Authors: Swartz Jo S. , Amos Karen E. , Brindas Mirna , Girling Linda G. , Ruth Graham M.
Published: June 2017

Background

Perioperative care for children with autism spectrum disorder may be challenging. Previous investigators recommend development of an individualized perioperative management plan with caregiver involvement.

Aim

The primary goal was to determine the usefulness of an individualized plan based on the decision to provide preoperative sedation stratified by autism spectrum severity level. Secondary goals were to assess the effectiveness of the plan based on subjective assessment of patient behavior at induction of anesthesia and caregiver satisfaction.

Methods

We developed an individualized plan for each child with autism spectrum disorder scheduled for anesthesia. Children were categorized by autism spectrum disorder severity level. With institutional ethics approval, we conducted a retrospective chart review to document need for preoperative sedation, sedation stratified by autism spectrum disorder severity level, behavior at induction, and caregiver satisfaction.

Results

Between 2012 and 2014, we successfully prepared a plan for 246 (98%) of 251 surgical or diagnostic procedures in 224 patients. Severity level was distributed as 45% Severity Level 1 and Asperger's, 25% Severity Level 2, and 30% Severity Level 3. The majority (90%) of cases were scheduled as day surgery. Preoperative sedation increased with increasing severity level: Severity Level 1 (21%) or Asperger's (31%), Severity Level 2 (44%), and Severity Level 3 (56%). The odds ratio for sedation use was 5.5 [CI: 2.6‐11.5, P<.001] with Severity Level 3 vs Severity Level 1 patients. Cooperation at induction of anesthesia was 90% overall with preoperative sedation administered to 94 (38%) of the entire cohort. Cooperation was greatest in Severity Level 1 (98%) and Asperger's patients (93%) and somewhat less (85%) in patients in Severity Levels 2 and 3. The plan was helpful to guide sedation choices as cooperation did not differ between sedated and unsedated children at any severity level (overall χ2=2.87 P=.09).

Satisfaction among caregivers contacted was 98%.

Conclusion

The results suggest that an individualized plan is helpful in the perioperative management of children with autism spectrum disorder and that knowledge of autism spectrum disorder severity level may be helpful in determining the need for preoperative sedation.
Non‐sibling hematopoietic stem cell transplantation using myeloablative conditioning regimen in children with Maroteaux‐Lamy syndrome: A brief report
Authors: Behfar Maryam , Dehghani S. Sharareh , Rostami Tahereh , Ghavamzadeh Ardeshir , Hamidieh Amir Ali
Published: June 2017

Maroteaux‐Lamy syndrome is a rare inherited lysosomal storage disorder with a progressive course. HSCT is a curable option for treatment in these patients. The following report describes our experience in HSCT for three patients with Maroteaux‐Lamy syndrome using non‐sibling donors. All of the patients received the same myeloablative regimen consisting of intravenous busulfan, cyclophosphamide, and rabbit antithymocyte globulin. Patients underwent HSCT from haploidentical other‐related (n=1), full‐matched other‐related (n=1), and one‐locus‐mismatched unrelated donor. Stem cell sources included bone marrow (n=1), peripheral blood (n=1), and cord blood (n=1). Currently, two patients who received transplant from other‐related donors showed full engraftment and regression of the symptoms of the disease, while for the patient with unrelated cord blood donor, graft failure resulted in progression of the disease and death. The result of our study showed beneficial effects of HSCT even from heterozygote donor. Due to rarity of the disease, future multicenter studies are recommended to find the best treatment approaches based on the patients’ status.
Survival Analysis with Functions of Mismeasured Covariate Histories: The Case of Chronic Air Pollution Exposure in Relation to Mortality in the Nurses’ Health Study
Authors: Liao Xiaomei , Zhou Xin , Wang Molin , Hart Jaime E. , Laden Francine , Spiegelman Donna
Published: June 2017

Environmental epidemiologists are often interested in estimating the effect of functions of time varying exposure histories, such as the 12-month moving average, in relation to chronic disease incidence or mortality. The individual exposure measurements that comprise such an exposure history are usually mismeasured, at least moderately, and, often, more substantially. To obtain unbiased estimates of Cox model hazard ratios for these complex mismeasured exposure functions, an extended risk set regression calibration method for Cox models is developed and applied to a study of long-term exposure to the fine particulate matter, PM2.5, component of air pollution in relation to all-cause mortality in the nurses’ health study. Simulation studies under several realistic assumptions about the measurement error model and about the correlation structure of the repeated exposure measurements were conducted to assess the finite sample properties of this new method and found that the method has good performance in terms of finite sample bias reduction and nominal confidence interval coverage.
Gun Ownership and Self‐Serving Attributions for Mass Shooting Tragedies*
Authors: Joslyn Mark R. , Haider‐Markel Donald P.
Published: June 2017

Objective

Individuals develop causal narratives that help explain events, behaviors, and conditions. Individuals ascribe events and behaviors to controllable components, such as individual choice, or uncontrollable components, such as broader forces in the environment. We join attribution theory with motivated reasoning and outline how gun ownership structures perceptions of mass shootings and subsequent blame.

Methods

Using individual‐level data from national surveys we examine the connection between causal attributions for mass shootings and gun ownership.

Results

Our findings suggest that firearm possession engenders self‐serving attributions about the causes of gun violence and resists calls for policy changes after mass shooting.

Conclusion

Given the significant proportion of citizens who own guns, the prospect for policy changes that address gun‐related causes of mass shootings is unlikely.
Policy Spillover and Gun Migration: The Interstate Dynamics of State Gun Control Policies*
Authors: Coates Michael , Pearson‐Merkowitzz Shanna
Published: June 2017

Objective

In this article, we examine state policy spillover by examining how differences between state gun control policies affect the migration of guns between states with lax regulatory environments for gun purchasing and licensing to states with relatively strict regulatory environments.

Method

We test our hypothesis using data from 2007 to 2013 from the Bureau of Alcohol, Tobacco and Firearms on the presence of criminal guns and from the Brady Campaign on state gun control laws.

Results

Our results suggest that a large proportion of criminal guns in states with strict gun control laws were originally purchased in states with fewer regulations. There is a direct correlation between where criminal guns were originally purchased, where criminal guns are uncovered, and the strength of state gun laws.

Conclusion

State gun control laws appear to make purchasing a gun through legal frameworks more difficult and shift the “market” for criminal guns to purchasing locations across state borders where purchasing is easier. Gun control laws appear, therefore, to be affected by policy spillover.
Herpes simplex virus‐2 transmission following solid organ transplantation: Donor‐derived infection and transplantation from prior organ recipients
Authors: Macesic Nenad , Abbott Iain J. , Kaye Matthew , Druce Julian , Glanville Allan R. , Gow Paul J. , Hughes Peter D. , Korman Tony M. , Mulley William R. , O'Connell Phillip J. , Opdam Helen , Paraskeva Miranda , Pitman Matthew C. , Setyapranata Stella , Rawlinson William D. , Johnson Paul D. R.
Published: June 2017

Background

Owing to limited availability of donor organs, previous solid organ transplant (SOT) recipients are increasingly considered as potential organ donors. We report donor‐derived transmission of herpes simplex virus type‐2 (HSV‐2) to two clusters of SOT recipients with transmission from the original donor and an HSV‐2–infected recipient who subsequently became a donor.

Methods

We reviewed medical records of the donors and recipients in both clusters. Pre‐transplant serology and virological features of HSV‐2 were characterized. Genotyping of HSV‐2 isolates to determine potential for donor transmission of HSV‐2 through transplantation of organs from prior organ recipients was performed.

Results

A kidney‐pancreas recipient died day 9 post transplant. Following confirmation of brain death, the lungs and recently transplanted kidney were donated to two further recipients. The liver was not retrieved, but biopsy confirmed HSV‐2 infection. Testing on the original donor showed negative HSV‐2 polymerase chain reaction and HSV immunoglobulin (Ig)M, but positive HSV‐2 IgG. The liver recipient from the original donor developed HSV‐2 hepatitis and cutaneous infection that responded to treatment with intravenous acyclovir. In the second cluster, lung and kidney recipients both developed HSV‐2 viremia that was successfully treated with antiviral therapy. Genotyping of all HSV‐2–positive samples showed 100% sequence homology for three recipients.

Conclusions

Donor‐derived HSV infection affected two clusters of recipients because of transplantation of organs from a prior organ recipient. HSV should be considered as a possible cause of illness in febrile SOT recipients in the immediate post‐transplant period and may cause disseminated disease and re‐infection in HSV‐2–seropositive recipients. Testing of HSV serology and prophylaxis may be considered in SOT recipients not receiving cytomegalovirus prophylaxis.
A multi‐component method to determine pesticides in surface water by liquid‐chromatography tandem quadrupole mass spectrometry
Authors: Ramos A. M. , Whelan M. J. , Cosgrove S. , Villa R. , Jefferson B. , Campo P. , Jarvis P. , Guymer I.
Published: June 2017

Pesticide pollution of surface water is a major concern in many agricultural catchments The development of rapid and accurate methods for determining pesticide concentrations in water samples is, therefore, important. Here we describe a method for the simultaneous analysis of six pesticides (metaldehyde, quinmerac, carbetamide, metazachlor, propyzamide and pendimethalin) in natural waters by direct aqueous injection with liquid chromatography‐tandem mass spectrometry. The method validation showed good linearity from 0.2 to 50.0 µg/L with correlation coefficients between 0.995 and 0.999. Method accuracy ranged from 84 to 100% and precision Relative standard deviation (RSD) from 4 to 15%. The limits of detection for the targeted pesticides ranged from 0.03 to 0.36 µg/L. No significant matrix effects on quantification were observed (t‐test). The method was tested on water samples from a small arable catchment in eastern England. Peak concentrations for the determinands ranged from 1 to 10 µg/L.