bluuebunny/crossref_metadata_2025 huggingface dataset:
The Duke treadmill score with bicycle ergometer: Exercise capacity is the most important predictor of cardiovascular mortality
Authors: Salokari Esko , Laukkanen Jari A , Lehtimaki Terho , Kurl Sudhir , Kunutsor Setor , Zaccardi Francesco , Viik Jari , Lehtinen Rami , Nikus Kjell , Kööbi Tiit , Turjanmaa Väinö , Kähönen Mika , Nieminen Tuomo
Published: October 2018

Background

The Duke treadmill score, a widely used treadmill testing tool, is a weighted index combining exercise time or capacity, maximum ST-segment deviation and exercise-induced angina. No previous studies have investigated whether the Duke treadmill score and its individual components based on bicycle exercise testing predict cardiovascular death.

Design

Two populations with a standard bicycle testing were used: 3936 patients referred for exercise testing (2371 men, age 56 ± 13 years) from the Finnish Cardiovascular Study (FINCAVAS) and a population-based sample of 2683 men (age 53 ± 5.1 years) from the Kuopio Ischaemic Heart Disease study (KIHD).

Methods

Cox regression was applied for risk prediction with cardiovascular mortality as the primary endpoint.

Results

In FINCAVAS, during a median 6.3-year (interquartile range (IQR) 4.5–8.2) follow-up period, 180 patients (4.6%) experienced cardiovascular mortality. In KIHD, 562 patients (21.0%) died from cardiovascular causes during the median follow-up of 24.1 (IQR 18.0–26.2) years. The Duke treadmill score was associated with cardiovascular mortality in both populations (FINCAVAS, adjusted hazard ratio (HR) 3.15 for highest vs. lowest Duke treadmill score tertile, 95% confidence interval (CI) 1.83–5.42, P < 0.001; KIHD, adjusted HR 1.71, 95% CI 1.34–2.18, P < 0.001). However, after progressive adjustment for the Duke treadmill score components, the score was not associated with cardiovascular mortality in either study population, as exercise capacity in metabolic equivalents of task was the dominant harbinger of poor prognosis.

Conclusions

The Duke treadmill score is associated with cardiovascular mortality among patients who have undergone bicycle exercise testing, but metabolic equivalents of task, a component of the Duke treadmill score, proved to be a superior predictor.
Inhibition of ERK pathway decreases the synovial hyperplasia and angiogenesis of rheumatoid arthritis rats
Authors: Hu Haisheng , Jin Haiyan , Yu Longli , Qu Shiping
Published: October 2018

The purpose of this study was to explore the role and possible mechanism of inhibiting extracellular signal-regulated kinase (ERK) pathway on rheumatoid arthritis synovial hyperplasia and angiogenesis. Thirty six Sprague–Dawley rats were randomly assigned into normal group, model group, and intervention group, 12 rats in each group. The measures of enzyme-linked immunosorbent assay (ELISA), RT-PCR, Western blot, and HE immunohistochemical staining were used to examine specific indicators in this study. The levels of interleukin 1β (IL-1β), tumor necrosis factor α (TNF-α), and angiopoietin-1 (Ang-1) in the serum of model group were significantly increased ( P < 0.05) compared to the normal groups. In contrast with the model group rats, the levels of IL-1β, TNF-α, and Ang-1 in the intervention group were all significantly decreased ( P < 0.05). In addition, the mRNA expression of IL-1β, TNF-α, vascular endothelial growth factor (VEGF), and Ang-1 in the synovial tissue of the model group was distinctly higher than those in the normal group ( P < 0.05). Simultaneously, the levels of cytokines in the intervention group were obviously decreased compared to the model group ( P < 0.05). The expression of phosphorylated state of ERK1/2 (p-ERK1/2), p-JNK, and p-38 in model group rats were significantly higher than those in normal group ( P < 0.05), while the expression of p-ERK1/2 in intervention group rats was evidently decreased compared to model groups ( P < 0.05). Finally, the arthritis index and arthritis volume in intervention group were decreased obviously ( P < 0.05). Inhibition of ERK pathway could suppress the levels of inflammatory cytokines in synovial tissue and also inhibit the proliferation of synovial tissue, and reduce angiogenesis and pannus formation in synovial membrane.
Efficacy of Vitamin C Supplementation on Collagen Synthesis and Oxidative Stress After Musculoskeletal Injuries: A Systematic Review
Authors: DePhillipo Nicholas N. , Aman Zachary S. , Kennedy Mitchell I. , Begley J.P. , Moatshe Gilbert , LaPrade Robert F.
Published: October 2018

Background:

Recent investigations on the biochemical pathways after a musculoskeletal injury have suggested that vitamin C (ascorbic acid) may be a viable supplement to enhance collagen synthesis and soft tissue healing.

Purpose:

To (1) summarize vitamin C treatment protocols; (2) report on the efficacy of vitamin C in accelerating healing after bone, tendon, and ligament injuries in vivo and in vitro; and (3) report on the efficacy of vitamin C as an antioxidant protecting against fibrosis and promoting collagen synthesis.

Study Design:

Systematic review; Level of evidence, 2.

Methods:

A systematic review was performed, with the inclusion criteria of animal and human studies on vitamin C supplementation after a musculoskeletal injury specific to collagen cross-linking, collagen synthesis, and biologic healing of the bone, ligament, and tendon.

Results:

The initial search yielded 286 articles. After applying the inclusion and exclusion criteria, 10 articles were included in the final analysis. Of the preclinical studies evaluating fracture healing, 2 studies reported significantly accelerated bone healing in the vitamin C supplementation group compared with control groups. The 2 preclinical studies evaluating tendon healing reported significant increases in type I collagen fibers and scar tissue formation with vitamin C compared with control groups. The 1 preclinical study after anterior cruciate ligament (ACL) reconstruction reported significant short-term (1-6 weeks) improvements in ACL graft incorporation in the vitamin C group compared with control groups; however, there was no long-term (42 weeks) difference. Of the clinical studies evaluating fracture healing, 1 study reported no significant differences in the rate of fracture healing at 50 days or functional outcomes at 1 year. Vitamin C supplementation was shown to decrease oxidative stress parameters by neutralizing reactive oxygen species through redox modulation in animal models. No animal or human studies reported any adverse effects of vitamin C supplementation.

Conclusion:

Preclinical studies demonstrated that vitamin C has the potential to accelerate bone healing after a fracture, increase type I collagen synthesis, and reduce oxidative stress parameters. No adverse effects were reported with vitamin C supplementation in either animal models or human participants; thus, oral vitamin C appears to be a safe supplement but lacks clinical evidence compared with controls. Because of the limited number of human studies, further clinical investigations are needed before the implementation of vitamin C as a postinjury supplement.
ERS statement on harmonised standards for lung cancer registration and lung cancer services in Europe
Authors: Rich Anna L. , Baldwin David R. , Beckett Paul , Berghmans Thierry , Boyd Jeanette , Faivre-Finn Corinne , Galateau-Salle Françoise , Gamarra Fernando , Grigoriu Bogdan , Hansen Niels-Christian G. , Hardavella Georgia , Jakobsen Erik , Jovanovic Dragana , Konsoulova Assia , Massard Gilbert , McPhelim John , Meert Anne-Pascale , Milroy Robert , Mutti Luciano , Paesmans Marianne , Peake Michael D. , Putora Paul Martin , de Ruysscher Dirk K.M. , Sculier Jean-Paul , Schepereel Arnaud , Subotic Dragan R. , Van Schil Paul , Blum Torsten Gerriet
Published: October 2018

The European Respiratory Society (ERS) task force for harmonised standards for lung cancer registration and lung cancer services in Europe recognised the need to create a single dataset for use in pan-European data collection and a manual of standards for European lung cancer services.

The multidisciplinary task force considered evidence from two different sources, reviewing existing national and international datasets alongside the results of a survey of clinical data collection on lung cancer in 35 European countries. A similar process was followed for the manual of lung cancer services, with the task force using existing guidelines and national or international recommendations for lung cancer services to develop a manual of standards for services in Europe.

The task force developed essential and minimum datasets for lung cancer registration to enable all countries to collect the same essential data and some to collect data with greater detail. The task force also developed a manual specifying standards for lung cancer services in Europe.

Despite the wide variation in the sociopolitical landscape across Europe, the ERS is determined to encourage the delivery of high-quality lung cancer care. Both the manual of lung cancer services and the minimum dataset for lung cancer registration will support this aspiration.
Patterns of regional lung physiology in cystic fibrosis using ventilation magnetic resonance imaging and multiple-breath washout
Authors: Smith Laurie J. , Collier Guilhem J. , Marshall Helen , Hughes Paul J.C. , Biancardi Alberto M. , Wildman Martin , Aldag Ina , West Noreen , Horsley Alex , Wild Jim M.
Published: October 2018

Hyperpolarised helium-3 (3He) ventilation magnetic resonance imaging (MRI) and multiple-breath washout (MBW) are sensitive methods for detecting lung disease in cystic fibrosis (CF). We aimed to explore their relationship across a broad range of CF disease severity and patient age, as well as assess the effect of inhaled lung volume on ventilation distribution.

32 children and adults with CF underwent MBW and3He-MRI at a lung volume of end-inspiratory tidal volume (EIVT). In addition, 28 patients performed3He-MRI at total lung capacity.3He-MRI scans were quantitatively analysed for ventilation defect percentage (VDP), ventilation heterogeneity index (VHI) and the number and size of individual contiguous ventilation defects. From MBW, the lung clearance index, convection-dependent ventilation heterogeneity (Scond) and convection–diffusion-dependent ventilation heterogeneity (Sacin) were calculated.

VDP and VHI at EIVTstrongly correlated with lung clearance index (r=0.89 and r=0.88, respectively), Sacin (r=0.84 and r=0.82, respectively) and forced expiratory volume in 1 s (FEV1) (r=−0.79 and r=−0.78, respectively). Two distinct3He-MRI patterns were highlighted: patients with abnormal FEV1had significantly (p<0.001) larger, but fewer, contiguous defects than those with normal FEV1, who tended to have numerous small volume defects. These two MRI patterns were delineated by a VDP of ∼10%. At total lung capacity, when compared to EIVT, VDP and VHI reduced in all subjects (p<0.001), demonstrating improved ventilation distribution and regions of volume-reversible and nonreversible ventilation abnormalities.
Pathological mucus and impaired mucus clearance in cystic fibrosis patients result from increased concentration, not altered pH
Authors: Hill David B. , Long Robert F. , Kissner William J. , Atieh Eyad , Garbarine Ian C. , Markovetz Matthew R. , Fontana Nicholas C. , Christy Matthew , Habibpour Mehdi , Tarran Robert , Forest M. Gregory , Boucher Richard C. , Button Brian
Published: October 2018

Cystic fibrosis (CF) is a recessive genetic disease that is characterised by airway mucus plugging and reduced mucus clearance. There are currently alternative hypotheses that attempt to describe the abnormally viscous and elastic mucus that is a hallmark of CF airways disease, including: 1) loss of CF transmembrane regulator (CFTR)-dependent airway surface volume (water) secretion, producing mucus hyperconcentration-dependent increased viscosity, and 2) impaired bicarbonate secretion by CFTR, producing acidification of airway surfaces and increased mucus viscosity.

A series of experiments was conducted to determine the contributions of mucus concentrationversuspH to the rheological properties of airway mucus across length scales from the nanoscopic to macroscopic.

For length scales greater than the nanoscopic,i.e.those relevant to mucociliary clearance, the effect of mucus concentration dominated over the effect of airway acidification.

Mucus hydration and chemical reduction of disulfide bonds that connect mucin monomers are more promising therapeutic approaches than alkalisation.
Probiotic supplements containing Lactobacillus reuteri does not affect the levels of matrix metalloproteinases and interferons in oral wound healing
Authors: Twetman Svante , Pedersen Anne Marie Lynge , Yucel-Lindberg Tulay
Published: October 2018

Objective

The use of beneficial bacteria may stimulate wound healing. We performed a randomized, placebo-controlled double-blind cross-over study comprising ten healthy volunteers. The aim was to investigate the impact of topical and systemic applications of probiotic lactobacilli (Lactobacillus reuteri) on the healing of standardized wounds (punch biopsies) in the oral mucosa. The expression of selected matrix metalloproteinases (MMP’S) and interferons (IFN’s) was analyzed with multiplex immunoassays in the wound exudate during the first healing week (day 2, 5 and 8).

Results

All participants completed the study and in all cases, the healing after the punch biopsies was uneventful. The concentrations of MMP-1, MMP-2, MMP-3 decreased with time in both the test- and control group. The MMP levels were consistently lower during the probiotic intervention when compared with placebo but the differences were not statistically significant. Likewise, the concentrations if IFN-alpha2, IFN-beta and IFN-gamma decreased with time with no significant differences between the test and placebo interventions. Within the limitations of this pilot study, we were unable to demonstrate an influence of probiotic supplements containingL. reuterion the concentrations of selected matrix metalloproteinases and interferons from mucosal wounds within 1 week after a standardized punch biopsy.

Trial registrationClinicalTrials.gov Identifier NCT03210779. Date of registration: July 7, 2017
Blood mRNA Measurement (NETest) for Neuroendocrine Tumor Diagnosis of Image-Negative Liver Metastatic Disease
Authors: Malczewska Anna , Bodei Lisa , Kidd Mark , Modlin Irvin M
Published: October 2018

Context

Early cancer detection is critical to optimize treatment. This is particularly problematic in neuroendocrine tumors (NETs), which exhibit an ∼5-year diagnostic delay due to covert symptoms, limitations in imaging, and circulating biomarkers. Despite development of continuous monitoring strategies utilizing advanced modalities [CT/MRI or 68Gallium positron emission tomography (PET)/CT] or a repertoire of monoanalyte biomarkers [e.g., chromogranin A (CgA), pancreastatin, serotonin], detection of minimal residual disease or microrecurrence remains elusive. Emerging molecular liquid biopsies (e.g., NETest) provide a substantially improved threshold for disease detection.

Case Description

We describe the utility of a blood-based multigene PCR neuroendocrine measurement (NETest), which is representative of core molecular drivers of neuroendocrine tumorigenesis, to detect hepatic micrometastases in a patient with negative blood biomarkers and negative anatomical/functional imaging. The 52-year-old woman, who had undergone margin-negative resection for a NET of the ileocecal valve, developed persistently elevated NETest levels 8 months later. CT/MRI/68Gallium PET and biomarkers remained negative. Blood multigene analysis identified disease, and peptide receptor radionuclide therapy (PRRT) was undertaken. Over 9 months, NETest levels increased (conventional biomarkers/imaging remained normal). Liver biopsy was undertaken, and foci of a 3-mm NET in segment VI were histologically documented. At 3.3 years after PRRT, the disease remained as a microscopic burden and stable biomarker/68Gallium PET/MRI occult despite elevated blood levels of NET genes.

Conclusions

Blood measurement of NET transcripts can identify image- and CgA-negative disease. A NET liquid biopsy strategy has clinical utility in the early identification of residual or metastatic disease and optimizes consideration of adjuvant therapeutic intervention.
Comparative Effects of Sodium Bicarbonate and Intravenous Lipid Emulsions on Reversing Bupivacaine-Induced Electrophysiological Toxicity in a Porcine Experimental Model
Authors: Zaballos Matilde , Callejo David , Sevilla Raul , Quintela Oscar , López-Menchaca Ramiro , Melone Arturo , Varela Olalla , Anadón Baselga Mª José , Almendral Jesús
Published: October 2018

BACKGROUND:

Bupivacaine cardiotoxicity mainly manifests as inhibition of the cardiac sodium channel, which slows conduction, particularly at the ventricular level. Experimental studies have demonstrated that intravenous lipid emulsions (ILEs) can reduce the cardiotoxic effects of bupivacaine, but the extent of these effects is controversial. Sodium bicarbonate (B) represents the standard treatment of toxicity related to sodium channel–blocking drugs. The aim of this study was to compare the effects of ILEs and B on the speed of recovery from bupivacaine-induced effects on the electrocardiographic parameters.

METHODS:

Bupivacaine 4 mg/kg was administered to 24 anesthetized pigs. Three minutes after delivering the bupivacaine bolus, the animals were given the following: ILE 1.5 mL/kg followed by 0.25 mL/kg/min (ILE group) and B 2 mEq/kg followed by 1 mEq/kg/h (B group). Controls (C group) were given saline solution, 50 mL followed by 1 mL/kg/h. Electrophysiological parameters were evaluated in sinus rhythm and during right ventricular pacing at several time intervals up to 30 minutes. Data were analyzed as the area under the curve (AUC) for the first 10 minutes (AUC10) or 30 minutes (AUC30).

RESULTS:

Bupivacaine increased the sinus cycle length, PR interval, and QRS duration. AUC30 of the sinus rhythm QRS duration after antidote administration was significantly different among the 3 groups (P = .003). B group experienced faster recovery from intoxication than the C group (AUC10, P = .003; AUC30, P = .003) or the ILE group (AUC10, P = .018). During the first minute, 50% of the B group (versus 0% of the ILE and C groups) had recovered >30% of QRS duration (P = .011). The trend toward faster recovery in the ILE group than in the C group did not reach significance (AUC10, P = .23; AUC30, P = .06). Effects on the paced QRS duration at a rate of 150 bpm were more intense but with similar results (B versus C group: AUC10, P = .009; AUC30, P = .009; B versus ILE: AUC10, P = .015; AUC30, P = .024). The recovery process of the paced QRS tended to be slower for all antidotes.

CONCLUSIONS:

In a closed-chest swine model, B was an effective treatment for electrophysiological alterations caused by established bupivacaine toxicity. At clinical doses, B ameliorated bupivacaine electrocardiographic toxicity faster than ILE. Use-dependent effects of bupivacaine are prominent and delay the effects of both antidotes, but B produces faster recovery than ILE.
Pharmacokinetics of Cefazolin and Vancomycin in Infants Undergoing Open-Heart Surgery With Cardiopulmonary Bypass
Authors: Ingrande Jerry , Gutierrez Kathleen , Lemmens Hendrikus J. , Verma Archana , Nicolau David P. , Sutherland Christina A. , Ramamoorthy Chandra
Published: October 2018

BACKGROUND:

Gram-positive bacteria account for nearly three-quarters of all surgical site infections. Antibiotic prophylaxis against these bacteria with cephalosporins or, in select circumstances, with vancomycin is considered standard of care for prevention of surgical site infections. There is little evidence to describe the optimal dosing regimen for surgical site infection prophylaxis in infants undergoing cardiac surgery, and a great deal of institutional variability exists in dosing prophylactic antibiotics. We designed this study to describe an optimal dose regimen for cephalosporin and vancomycin based on pharmacokinetic evidence for infant open-heart surgery on cardiopulmonary bypass.

METHODS:

Two separate cohorts of infants undergoing cardiac surgery with cardiopulmonary bypass were evaluated. Plasma concentrations of vancomycin (cohort 1, N = 10) and cefazolin (cohort 2, N = 10) were measured, and mixed-effects pharmacokinetic models were constructed for each drug. Simulations of various dosing regimens were performed to describe an appropriate dosing regimen necessary to maintain antibiotic concentrations above the susceptibility cutoff for staphylococci.

RESULTS:

Both cefazolin and vancomycin plasma concentration versus time profiles were characterized by a 2-compartment model. Subject weight was a significant covariate for V1 for vancomycin. Subject age was a significant covariate for V1 for cefazolin. Cardiopulmonary bypass did not influence concentration versus time profiles. Simulations demonstrated that a 1-hour vancomycin infusion (15 mg·kg−1), repeated every 12 hours and a 10-minute infusion of cefazolin (30 mg·kg−1), repeated every 4 hours maintained plasma concentrations above 4 μg·mL−1 and 16 μg·mL−1, for vancomycin and cefazolin, respectively. Both concentrations are above the minimum inhibitory concentration 90 for most susceptible staphylococci.

CONCLUSIONS:

Prophylactic treatment of vancomycin 15 mg·kg−1 infused >1 hour with 12-hour redosing and cefazolin 30 mg·kg−1 infused >10 minutes with 4-hour redosing will maintain serum levels of each antibiotic above the susceptibility cut-offs for susceptible staphylococci in infants undergoing cardiac surgery. Cefazolin levels may be adequate for some, but not all, Gram-negative bacteria. The effect of cardiopulmonary bypass on pharmacokinetics is negligible.
A novel mutation in the NADH dehydrogenase (ubiquinone) 1 alpha subcomplex 4 (Ndufa4) gene links mitochondrial dysfunction to the development of diabetes in a rodent model
Authors: Yagil Chana , Varadi-Levi Ronen , Yagil Yoram
Published: October 2018

The mechanisms underlying diabetes remain unresolved. The Cohen diabetic rat represents a model of diet-induced diabetes, in which the disease is induced after exposure to a diabetogenic diet (DD) in the diabetes-sensitive (CDs/y) but not in the -resistant (CDr/y) strain. Diet imposes a metabolic strain that leads to diabetes in the appropriate genetic background. We previously identified, through whole-genome linkage analysis, a diabetes-related quantitative trait locus on rat chromosome 4 (RNO4), which incorporates NADH dehydrogenase (ubiquinone) 1 alpha subcomplex 4 (Ndufa4), a nuclear gene that affects mitochondrial function. Here, we sequenced the gene and found a major deletion in CDs/y that leads to lack of expression of the NDUFA4 protein that has been reported to be involved in the activities of mitochondrial complexes I and IV. In the absence of NDUFA4 in the diabetic CDs/y on DD, complex I activity is reduced in comparison to that in nondiabetic CDs/y on regular diet and CDr/y on either diet; complex IV activity is reduced in both strains provided DD, and thus as a result of diet and unrelated to the gene mutation. ATP fails to increase in diabetic CDs/y in response to DD, in comparison to nondiabetic CDr/y on DD. Plasma malondialdehyde levels are elevated in CDs/y on DD, whereas SOD1 and SOD2 levels fail to increase, indicating increased oxidative stress and inability of the pancreas to generate an appropriate antioxidative stress response. These findings suggest that the Ndufa4 mutation in CDs/y on DD is directly associated with mitochondrial dysfunction, which we attribute to the lack of expression of NDUFA4 and to diet, and which prevents the anticipated increase in ATP production. The resulting enhanced oxidative stress impairs the ability of the pancreas to secrete insulin, leading to the development of diabetes. This is the first demonstration of an inherited mutation in a nuclear gene that adversely affects mitochondrial function and promotes diet-induced diabetes.
Majority Choice of an Income-Targeted Educational Voucher
Authors: Epple Dennis , Romano Richard , Sarpça Sinan
Published: October 2018

A model of majority choice of voucher characteristics with quantitative counterpart explains observed income eligibility requirements for educational vouchers. Households differ by income and preference for religious schooling. They elect a policy maker who chooses public school expenditure, a voucher, a maximum income for voucher eligibility, and a tax to finance public expenditure. Equilibrium has a voucher below per student public expenditure, an eligibility threshold near 300 percent of the poverty level, and a majority in public school though with substantial voucher usage, all properties typical of US voucher programs. Disallowing a voucher leads to higher per student public expenditure (JEL D72, H44, H71, I21, I22, I28).
A Foundation for Efficiency Wage Contracts
Authors: Zhu John Y.
Published: October 2018

In many jobs, the worker generates only subjective performance measures privately observed by the employer, and contracts must rely on employer reports about these measures. This setting is a game with private monitoring, and prior work suggests that the optimal contract may be complex and non-recursive. I introduce a novel equilibrium refinement and show that the optimal contract simplifies to an efficiency wage contract: The worker receives a wage above his outside option and reports take a pass-fail form. Each report depends only on performance since the previous report, and effort incentives are provided purely through the threat of termination. (JEL D86, J41)
A Theory of Organizational Dynamics: Internal Politics and Efficiency
Authors: Cai Hongbin , Feng Hong , Weng Xi
Published: October 2018

We consider a three-member organization in which one member retires in each period and the incumbent members vote to admit a candidate to fill the vacancy. Candidates differ in quality and belong to one of two types, and majority-type members share the total rent of that period. We characterize the symmetric Markov equilibria with undominated strategies and compare the long-term welfare among them. Unanimity voting is better than majority voting at promoting long-term welfare. In addition, organizations with a certain degree of incongruity perform better in the long run than either harmonious or very divided organizations. (JEL D23, D71, D72)
Disclosure to a Psychological Audience
Authors: Lipnowski Elliot , Mathevet Laurent
Published: October 2018

We study how a benevolent expert should disclose information to an agent with psychological concerns. We first provide a method to compute an optimal information policy for many psychological traits. The method suggests, for instance, that an agent suffering from temptation à la Gul and Pesendorfer (2001) should not know what he is missing, thereby explaining observed biases as an optimal reaction to costly self-control. We also show that simply recommending actions is optimal when the agent is intrinsically averse to information but has instrumental uses for it. This result, which circumvents the failure of the Revelation Principle in psychological environments, simplifies disclosure and informs the debate regarding mandated disclosure. (JEL D11, D82, D83, D91)
Satisfaction Guaranteed: When Moral Hazard Meets Moral Preferences
Authors: Andreoni James
Published: October 2018

The fear of moral hazard—especially in the age of internet commerce—can depress or prevent profitable trades. Experiments show, however, that many people prefer honesty to deceit and would not succumb to moral hazard. This paper asks whether we can find a simple, voluntary institution that can empower moral traders, drive out amoral ones, reduce moral hazard, and restore profitable trade to markets. I find that selling goods with a “satisfaction guarantee,” accompanied by potentially minor legal or reputational enforcement, allows moral preferences to defeat moral hazard. (JEL C91, D63, D82, Z13)
Preface
Authors: Eisenschmidt Eve , Raudsaar Mervi , Venesaar Urve
Published: October 2018

Eesti Haridusteaduste Ajakirja erinumbri teema on "Ettevõtlikkuse ja ettevõtlusõppe arendamine põhikoolist kõrgkoolini". See erinumber on pisut tavapäratu, kuna kasvatusteadlastele lisaks on kaasatud ajakirja väljaandmisse ettevõtlusõppejõud ja majandusteadlased. Autorite hulgast leiab peale haridusvaldkonna eest põhiliselt vastutavate Tallinna Ülikooli ja Tartu Ülikooli õppejõudude ka õppejõude Tallinna Tehnikaülikoolist, Estonian Business Schoolist ja Eesti Ettevõtluskõrgkoolist Mainor. Eesmärk on neil aga ühine: käsitleda ettevõtte loomise või selle arendamise protsessi kompleksselt, juhtides tähelepanu vajadusele kujundada ettevõtlusõppe kaudu õppijate arusaama ettevõtjast ja ettevõtlikkusest (huvi, hoiakud, innovaatilisus), ettevõttest ja selle majandustegevuse eri külgedest, samuti ühiskonnast.
Principals’ utilization of external stakeholders in entrepreneurship education – Evidence from the general education
Authors: Hämäläinen Minna , Ruskovaara Elena , Pihkala Timo
Published: October 2018

Artikli eesmärk on uurida koolijuhtide tegevust ettevõtlusõpet toetavate võrgustike arendamisel. Uurimuses keskendume sellele osale koolijuhtide tegevusest, mis on seotud ettevõtlusõppe arendamisega koolides. Täpsemalt öeldes vaatleme, kuidas kaasavad koolijuhid väliseid huvirühmi koolide tegevusse. Uurimuse ajendiks sai asjaolu, et kuigi ettevõtlusõpet toetavad välised huvirühmad on olemas, ei kasuta koolijuhid ja koolid pakutavaid võimalusi täiel määral ära. Meie  arvates võib kooliväliste huvirühmade kaasamine sõltuda koolijuhtide isikuomadustest, mistõttu uurime, kas ja kuidas mõjutab koolijuhtide taust kooliväliste huvirühmade kaasamist. Sellele lisaks proovime selgusele jõuda, kuidas mõjutab  koolijuhtide osalemine ettevõtlusõppekoolitusel kooliväliste huvirühmade kaasamist. Uurimismeetodina kasutame dispersioonanalüüsi ja lineaarset regressioonanalüüsi. Valim koosneb 173 Soome üldhariduskooli koolijuhist. Artikliga täiendame ettevõtlusõppele pühendatud teaduskirjandust, analüüsides ettevõtlusõpet toetavaid kooliväliseid huvirühmi. Keskendume eeskätt koolijuhi rollile selles protsessis. Artikkel pakub empiirilisi tõendeid selle kohta, kuivõrd olulist osa täidab koolijuhtide koolitamine väliste huvirühmade kaasamisel ettevõtlusõppesse.
 Full text
Loovmõtlemise tõhustamiseks ja loovmõtlemise müütide ümberlükkamiseks
Authors: Tamm Elari
Published: October 2018

Organisatsioonipsühholoog ja Whartoni ülikooli professor Adam Grant toob Viking Pressi kirjastuse raamatus "Originals: How non-conformists move the world" ("Originaalsus: kuidas teisitimõtlejad maailma edasi viivad") lugejate ette pildid loovusest ja riskide võtmisest. Raamat on täis näiteid elust enesest edukate ja mitte nii edukate äride kohta ning ülevaateid arvukate uuringute tulemustest, mis võimaldavad luua seoseid võimaliku edu ja ebaedu vahele. Autor soovib näidata, et loovus ei ole ainult väljavalitutele, vaid kõigile, kes otsustavad olla loovad, innustades sellega lugejaid originaalsust otsima ja muudatusi tegema. Raamat sunnib end kriitiliselt analüüsima ning ümber hindama arusaama sellest, milline on 21. sajandil ettevõtluse ja loovuse paradigma.
Perigrapha cetrariae, a new lichenicolous ascomycete on Cetraria from Japan
Authors: Zhurbenko Mikhail P. , Ohmura Yoshihito
Published: October 2018

Perigrapha cetrariae growing on Cetraria laevigata is described from Japan. The new species differs from the generic type in having loculi completely embedded in a stroma and ascospores without caudate appendages.
Conservation management for forest fungi in Estonia: the case of polypores
Authors: Lõhmus Asko , Vunk Eike , Runnel Kadri
Published: October 2018

Conservation management for fungi has lagged behind animal and plant conservation, and remains largely restricted to protecting known locations of few conspicuous threatened species. We used Estonian polypores as an example of how conservation options can be systematically screened, based on the Red List of threatened species and in co-operation with practitioners. For a total of 61 species, we identified a broad range of management options representing diverse approaches (site protection; prescriptions of land use; protection of individuals; special management; protection via umbrella species). The results demonstrated the merits of systematic and multi-disciplinary assessments for fungal conservation and setting related research priorities. Our assessment also supported a theoretical expectation that some ecosystem conservation strategies should be explicitly designed based on functionally important groups of fungi. The advancement of fungal conservation appears largely dependent on co-operation between mycologists, conservationists and managers.

 

Eesti metsade seenestiku looduskaitsevõtted torikseente näitel Seenestiku looduskaitseks kasutatav võttestik on märksa halvemini välja arendatud kui loomade ja taimede puhul ning hõlmab peamiselt silmatorkavate ohustatud liikide leiukohtade kaitset. Töös kirjeldatakse Eesti torikseente näitel, kuidas sobivaid looduskaitsevõtteid saab süstemaatiliselt valida – lähtuvalt ohustatud liikide nimestikust ja koostöös looduskaitsepraktikutega. Kokku eristati 61 ohustatud torikseeneliigi kaitseks lai valik võtteid, mis hõlmasid erinevaid võimalusi alade kaitseks, üldisi maakasutusjuhiseid, isendite kaitset, intensiivseid kaitsevõtteid ja kaitset teiste liikide (katusliikide) kaudu.Tulemused näitavad süstemaatilise ja multidistsiplinaarse analüüsi efektiivsust seente kaitse ja sellega seotud uuringute planeerimisel. Analüüs kinnitas ka teoreetilist, torikseente funktsionaalsest tähtsusest lähtuvat eeldust, et mõned ökosüsteemide kaitse võttestikud tuleks kujundada just seente ökoloogiast lähtuvalt. Seenestiku looduskaitse peamine edenemistingimus paistab niisiis olevat koostöö mükoloogide, looduskaitseteadlaste ja -praktikute vahel.
A lesson in urban mycology: Critically Endangered polypore Trametes suaveolens (Basidiomycota) re-discovered in Estonia
Authors: Runnel Kadri , Järve Sulev , Lõhmus Asko
Published: October 2018

The conspicuous, mostly willow-inhabiting polypore Trametes suaveolens is a threatened species in Northern Europe. In Estonia it is listed as Critically Endangered, and has not been found since 1984. We report an apparently viable population discovered in Central Tallinn, inhabiting old Salix fragilis and S. alba trees and stumps along ca. 1.5 km of the Baltic seashore. The host trees are prone to removal due to city development and park care reasons. We discuss potential conservation measures for sustaining this unique population in the urban conditions.

 

Pajutagel (Trametes suaveolens) Eestis taasleitud Peamiselt remmelgatel silmatorkavaid viljakehi moodustav pajutagel (Trametes suaveolens) on Põhja-Euroopas ohustatud liik. Eestis on selle liigi seisund hinnatud kriitiliseks ja viimane dokumenteeritud leid pärineb 1984. aastast. Siinses artiklis kirjeldatakse Tallinnast avastatud populatsiooni, mis asustab u. 1,5 km mereäärsel lõigul rabeda remmelga (Salix fragilis) ja hõberemmelga (S. alba) vanu elus puid ja kände. See asurkond oli 2018. aastal küll elujõuline, kuid tema elupaika ohustavad linna arendustegevus ja pargihooldus. Artiklis esitatakse soovitusi nii pajutagla säilitamiseks Tallinnas kui ka üldiselt puitulagundavate ohustatud seeneliikide kaitseks linnatingimustes.
Diversity of lichens and allied fungi on Norway spruce (Picea abies) in the middle boreal forests of Republic of Karelia (Russia)
Authors: Androsova Vera I. , Tarasova Viktoria N. , Gorshkov Vadim V.
Published: October 2018

A detailed study of lichen diversity and estimation of epiphytic lichen cover characteristics on spruce as a key ecosystem component was performed in boreal forests of Karelia (NW Russia). The aims of the present paper are: (1) to study lichen diversity on Norway spruce in the middle boreal forests of southern Karelia (NW Russia), and (2) to estimate the main characteristics of epiphytic lichen cover on spruce trunks and branches. In total, 158 species of lichens and allied fungi were found on spruce, including 108 species on trunks, 78 on branches and 55 on snags. Seventeen species are listed in the Red Data Book of Republic of Karelia. Ten species are new for the biogeographical province Karelia transonegensis and two for the province Karelia onegensis. Twenty-two species are considered old-growth forest indicators. The total epiphytic lichen cover on spruce trees averaged 59% at the trunk base, 12% at a height of 1.3 m above ground level and 61% on branches. Predominantly, only 12 species contributed to the lichen cover of trunk and branches. Despite the predominance of crustose lichens colonising spruce trees, the main epiphytic lichen cover both on trunks and branches was provided largely by foliose species (57% of the total cover). Due to a variety of morphological features, spruce provides diverse microhabitats, which leads to high lichen species richness with different ecological requirements. Spruce trees play a significant role in maintaining the diversity and conservation of rare species.
El rol de la proximidad en la cooperación universidad-empresa-gobierno: el caso agroalimentario de la región de Coquimbo Chile
Authors: Chacana Ojeda Marcelo Andrés , Geldes González Cristian , Osorio Zelada Hugo
Published: October 2018

El presente estudio  propone  el enfoque de la proximidad de la geografía económica sobre la base teórica del modelo de la Triple Hélice para determinar las rela­ciones de cooperación entre la Univer­sidad – Empresa – Gobierno (U-E-G), la investigación se presenta a través de un estudio de caso del sector agroalimentario de la Región de Coquimbo Chile, el que pretende ser una aproximación respecto de la importancia de la proximidad para la Triple Hélice en la vincu­lación y cooperación para la creación de nuevos conocimientos, y de actividades de innovación. Para determinar dicha relación, se utilizaron los test estadísticos Chi-cuadrado con sus correspondientes medidas de asociación para variables cualitativas y Kruskal – Wallis para variables ordinales. Se puede señalar que el principal elemento que dificulta la cooperación de la Triple Hélice es el presentar visiones y objetivos diferentes entre las distintas organizaciones. En cuanto a la dimensión de la proximidad que favorece la cooperación Universidad – Empresa – Gobierno en el sector agroalimentario de la Región de Coquimbo a un nivel de significancia de   α = 0,1, resulto ser la dimensión social.
Decisión de diversificación y decisión de Spin-off. Ciclos de expansión y ciclos de enfoque: Analisis retrospectivo de las evidencias del caso Bavaria
Authors: Herrera-Eceheverri Hernan
Published: October 2018

Esta propuesta utiliza el caso del Antigüo Grupo Empresarial Bavaria para analizar tres aspectos relacionados con la diversificación no relacionada y el proceso de spin off de las firmas. Primero se establece que las empresas con unidades de negocio caracterizadas por excesos de liquidez, se diversifican de manera no relacionada, debido a que la existencia de un mercado interno de capitales, les permite derribar sus restricciones de financiación e incrementar la rentabilidad corporativa. Segundo, se demuestra que la decisión de diversificación de un gerente corporativo es inversamente proporcional a la magnitud del costo esperado por la dilución de esfuerzo del gerente de la nueva unidad de negocio. Y finalmente, se muestra como la diversificación no relacionada presenta un límite en su contribución al incremento de la rentabilidad corporativa, en cuyo caso se puede inducir la decisión de realizar un spin off, para delimitar, especializar y mejorar la calidad de las decisiones de asignación de recursos. Se concluye que lo anterior puede explicar porque en algunos grupos económicos se observan ciclos de diversificación y ciclos de enfoque. Cuando el grupo económico desea incrementar la rentabilidad inicia su proceso de diversificación, una vez llega al umbral que hace que la probabilidad de acierto en sus decisiones de inversión se reduzca, entonces empieza nuevamente su proceso de enfoque, realizando separación de sus unidades no relacionadas. Este ciclo se puede repetir en el desarrollo histórico de un grupo empresarial.
Just ask ‘could this be sepsis?’
Authors: Gillway Daniel , Cheng Leo
Published: October 2018

It is not uncommon for patients with odontogenic and non-odontogenic infection to present in general dental practice. Untreated infection can lead to life-threatening sepsis. This article aims to advise general dental practitioners on the relevance of sepsis and highlight the recent published NICE guidelines for interpretation in the dental setting. Sepsis is defined as a life-threatening organ dysfunction due to a deregulated host response to infection. It is paramount for dental professionals to understand head and neck infection, underlying systemic infection and concepts of fascial space infection. It is also essential to know the warning signs or ‘red flags’ of emerging sepsis.

CPD/Clinical Relevance: Following the recent published NICE guidelines and public awareness campaigns regarding sepsis, it is vitally important to raise awareness of the potential for sepsis to be identified in the general dental practice setting.
Fixed versus removable appliances – which one to choose?
Authors: Elhussein Mustafa , Sandler Jonathan
Published: October 2018

The use of removable appliances in modern clinical orthodontic practice can generally be considered an out-dated treatment modality for managing malocclusions. Their use and popularity has declined considerably largely due to their inefficiency at achieving significant quality tooth movement. There are, however, a couple of specific indications where removable appliances come into their own. This article will present and discuss several clinical scenarios where one technique clearly has significant advantages over the other.

CPD/Clinical Relevance: Orthodontists and general dental practitioners (GDPs) should be aware of the situations where removable appliances provide a solution in modern clinical orthodontics practice, but also when the fixed counterpart will provide a much more efficient and effective method of moving teeth.
Pre-eruptive diagnosis and management of occlusal dens evaginatus in premolar teeth
Authors: Naini Farhad B , Levisianos Ioannis , Foo Lee , Gill Daljit S
Published: October 2018

Dens evaginatus is an uncommon dental aberration that occurs primarily on the occlusal surfaces of premolar teeth. Developmentally, it is similar to a talon cusp, though the latter manifests on the palatal or lingual surfaces of anterior teeth. Its anatomical location is often the central fossa of the associated tooth; it can vary significantly in size and can be present symmetrically in the ipsilateral and contralateral quadrants. Histologically, the enamel protuberance may contain dentinal and pulpal tissue. If early, ideally pre-eruptive diagnosis is not made, there is a significant risk that, on eruption, these protuberances will shear off under occlusal forces, exposing the pulp, and potentially leading to loss of teeth in an otherwise healthy dentition. Therefore, its clinical implications are significant to the general dental practitioner, the paediatric dentist, the orthodontist and the restorative dentist.

CPD/Clinical Relevance: This review article aims to summarize the available dental literature and illustrate the appropriate management of a patient with dens evaginatus.
Communication is more than just a conversation: family members' satisfaction with end-of-life care
Authors: Jóhannesdóttir Silja , Hjörleifsdóttir Elísabet
Published: October 2018

Aim:

The main aim of this study was to investigate family member's experiences of communicating with health professionals (HP) during end-of-life care in acute medical wards and a nursing home.

Methods:

A qualitative approach using 19 semi-structured interviews to collect data was used. The text was analysed using a content analysis methodology, extracting content that reflected family member's experiences of end-of-life care in acute medical wards, and a nursing home in Iceland.

Results:

Four themes were identified as contributing to favourable communication with HPs in end-of-life care: establishing a relationship; flow of information; environment; acceptance at the time of death.

Conclusion:

Findings suggested that the context of communication in end-of-life care is more than just a conversation. It includes health professional's appearances, decision-making and respect. Satisfactory communication is a necessary factor of quality of care and the fundamental aspect of the establishment of a positive interpersonal relationship.
Development and implementation of the Steps to Success Palliative Care programme in residential care homes for people with a learning disability in England
Authors: Kinley Julie , Denton Lilette , Scott Sharon
Published: October 2018

Background:

For health and social care services to meet the needs of a growing and ageing population they need to respond appropriately. This response is only going to be possible if attention is paid to the individuals within it. This includes those people living with a learning disability (LD).

Aims:

To develop and implement a palliative care programme that would meet the needs of people with a LD, their families and care home staff.

Methods:

A palliative care programme and resource folder was created following a literature review and meetings with LD and specialist palliative care experts, organisations and care home managers. This folder was further developed collaboratively throughout the programme's implementation.

Findings:

39 homes were recruited and 86% completed the programme.

Conclusions:

This programme enabled the identification, assessment and management of the health and social care needs of people living and dying in a care home with a LD.
Politics and palliative care: Mozambique
Authors: Smyth Dion
Published: October 2018

Dion Smyth's review of palliative nursing on the internet
Periodontal exams for adult orthodontic patients
Authors: Greer Anna C , Murray Alison M , Vere Joseph W
Published: October 2018

Adult patients are increasingly interested in having orthodontic treatment but many of these patients have periodontal problems. A periodontal examination should involve a basic periodontal examination (BPE) as well as the identification of any mobility, recession and gingival overgrowth. Each BPE code indicates different investigations and treatment. The cause of any mobility, recession and gingival overgrowth needs to be identified and then treated appropriately. Periodontal treatment may involve input from the patient's general dental practitioner or, if more complex treatment is required, referral to a specialist. Any periodontal problems identified should be addressed prior to orthodontic treatment.

CPD/Clinical Relevance: This article details how to carry out a periodontal examination and considers the implications of the findings on the provision of adult orthodontic treatment.