bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of coexistent Hashimoto's thyroiditis on the extent of cervical lymph node dissection and prognosis in papillary thyroid carcinoma
Authors: Song Eyun , Jeon Min Ji , Park Suyeon , Kim Mijin , Oh Hye‐Seon , Song Dong Eun , Kim Won Gu , Kim Won Bae , Shong Young Kee , Kim Tae Yong
Published: September 2017

Objective

Previous studies did not focus on the differences in the extent of cervical lymph node (LN) dissection according to coexistent Hashimoto's thyroiditis (HT) in patients with papillary thyroid carcinoma (PTC) and its clinical impact. We aimed to determine whether extensive cervical LN dissection is responsible for favourable clinical outcomes in PTC patients with HT and whether the coexistence of HT itself has an independent protective effect regardless of LN status.

Design

Retrospective cohort study.

Patients

1369 patients with PTC who underwent total thyroidectomy with central compartment neck dissection.

Measurements

Metastatic LN ratio, defined as number of metastatic LNs divided by number of removed LNs, was used to evaluate the extent of LN dissection as well as the status of LN metastasis. Disease‐free survival and dynamic risk stratification were compared for clinical outcomes.

Results

Presence of HT did not lower the risk of cervical LN metastasis (61.6% in patients with HT vs 65.1% in patients without HT, P = .292). Patients with HT had significantly larger numbers of removed LNs than patients without HT (11 vs 8, respectively, P < .001). Accordingly, metastatic LN ratio was smaller in patients with HT (P = .002), which was independently associated with structural persistent/recurrent disease (hazard ratio [HR] 2.33, 95% confidence interval [CI] 1.30‐4.16, P = .004). HT itself was negatively associated with structural persistent/recurrent disease after adjustment for other clinicopathological factors (HR 0.39, 95% CI 0.18‐0.87, P = .020).

Conclusions

Coexistence of HT itself is an independent factor associated with favourable outcome in PTC patients, regardless of the extent of LN dissection.
Olfaction and Selective Rendering
Authors: Harvey Carlo , Bashford‐Rogers Thomas , Debattista Kurt , Doukakis Efstratios , Chalmers Alan
Published: September 2017

Accurate simulation of all the senses in virtual environments is a computationally expensive task. Visual saliency models have been used to improve computational performance for rendered content, but this is insufficient for multi‐modal environments. This paper considers cross‐modal perception and, in particular, if and how olfaction affects visual attention. Two experiments are presented in this paper. Firstly, eye tracking is gathered from a number of participants to gain an impression about where and how they view virtual objects when smell is introduced compared to an odourless condition. Based on the results of this experiment a new type of saliency map in a selective‐rendering pipeline is presented. A second experiment validates this approach, and demonstrates that participants rank images as better quality, when compared to a reference, for the same rendering budget.
Call for a Paradigm Shift in the Genetic Management of Fragmented Populations
Authors: Ralls Katherine , Ballou Jonathan D. , Dudash Michele R. , Eldridge Mark D. B. , Fenster Charles B. , Lacy Robert C. , Sunnucks Paul , Frankham Richard
Published: September 2017

Thousands of small populations are at increased risk of extinction because genetics and evolutionary biology are not well‐integrated into conservation planning–a major lost opportunity for effective actions. We propose that if the risk of outbreeding depression is low, the default should be to evaluate restoration of gene flow to small inbred populations of diploid outbreeding organisms that were isolated by human activities within the last 500 years, rather than inaction. We outline the elements of a scientific‐based genetic management policy for fragmented populations of plants and animals, and discuss the reasons why the current default policy is, inappropriately, inaction.
The effects of menstrual cycle phase on the incidence of plateau at and associated cardiorespiratory dynamics
Authors: Gordon Dan , Scruton Adrian , Barnes Richard , Baker James , Prado Luciano , Merzbach Viviane
Published: September 2017

The purpose of this study was to examine the effect of menstrual cycle phase on maximal oxygen uptake () and associated cardiodynamic responses. A total of 16 active females volunteered of which n = 10 formed the non‐oral contraceptive pill group (n‐OCP), displaying a regular menstrual cycle of 28·4 ± 2·2 days (age 20·6 ± 1·6 years, height 169·9 ± 6·4 cm, mass 68·7 ± 7·9 kg) and n = 6 formed the oral contraceptive pill group (OCP) (monophasic pill) (age 21·7 years ± 2·16, height 168·1 cm ± 6·8 cm, mass 61·6 ± 6·8 kg). Each completed four incremental exercise tests for determination of , cardiac output, stroke volume and heart rate. Each test was completed according to the phases of the menstrual cycle as determined through salivary analysis of 17‐β oestrodiol and progesterone. Non‐significant differences were observed for across phases and between groups (P>0·05) with additional non‐significant differences for , HRmax and SVmax between groups. For ∆ during the final 60 s of the trial, significant differences were observed between OCP and n‐OCP (P<0·05) with OCP showing zero plateaus in three pseudo‐phases. Significant difference observed for a‐vO2dif n‐OCP between premenstruation and menstruation at 30–100% (P<0·05). Data suggest that the ‐plateau is effected by monophasic oral contraceptive pill, furthermore these data imply that test outcome is independent of menstrual cycle phase but caution should be applied when evaluating maximal oxygen uptake in females who are administered a monophasic oral contraceptive pill.
Reptiles and frogs conform to multiple conceptual landscape models in an agricultural landscape
Authors: Pulsford Stephanie A. , Lindenmayer David B. , Driscoll Don A.
Published: September 2017

Aim

Effective management of biodiversity in human‐modified landscapes demands an understanding of how biotas respond to landscape features and management actions. Yet, biotic responses are complex and varied, resulting in numerous conceptual models being developed to aid interpretation and generalization. We examined the relevance of a range of conceptual landscape models that describe how the distribution of habitat influences species richness, abundance, occurrence and spatial dynamics, using an empirical data set of reptile and frog responses to agricultural management.

Location

South‐eastern New South Wales, Australia.

Methods

We tested predictions developed from five conceptual landscape models using data collected from five land cover types and two grazing regimes.

Results

At least one species responded in a manner consistent with each of the five conceptual models tested. Most species responded to gradients of environmental variables and species‐specific responses were observed, in congruence with the Continuum model. No species were consistently congruent with predictions from concepts of Island Biogeography theory. One‐third of responses were congruent with the Matrix Quality model. The main prediction tested from the Matrix Tolerance model was upheld by both reptile and frog species. The predictions of the Habitat Amount hypothesis were upheld by rare reptile abundance and richness, and one frog species.

Main conclusions

Our study suggests that most conceptual models have some relevance to real‐world systems and can be useful for interpreting biotic responses to landscape change and management. Importantly, no one model fully captured the range of species responses to our agricultural landscape, but the Continuum model, Matrix Quality model, Matrix Tolerance model and Habitat Amount hypothesis had complementary predictions that together appeared to explain most of the assemblage's responses to the management and environmental conditions of the agricultural landscape.
Decline of insulin therapy and delays in insulin initiation in people with uncontrolled diabetes mellitus
Authors: Hosomura N. , Malmasi S. , Timerman D. , Lei V. J. , Zhang H. , Chang L. , Turchin A.
Published: September 2017

Aims

To design and validate a natural language processing algorithm to identify insulin therapy decline from the text of physician notes, and to determine the prevalence of insulin therapy decline and its impact on insulin initiation.

Methods

We designed the algorithm using the publicly available natural language processing platform Canary. We evaluated the accuracy of the algorithm on 1501 randomly selected primary care physicians’ notes from the electronic medical record system of a large academic medical centre. Using the validated language model, we then studied the prevalence of insulin therapy decline between 2000 and 2014.

Results

The algorithm identified documentation of insulin therapy decline with a sensitivity of 100% (95% CI 82.4–100), a positive predictive value of 95% (95% CI 74.4–99.9), and a specificity of 99.9% (95% CI 99.6–100.0). We identified 3295 insulin‐naïve adults with Type 2 diabetes who were recommended insulin therapy; 984 of them (29.9%) initially declined insulin. People with HbA1c ≥ 75 mmol/mol (9.0%) were more likely [766/2239 (34.2%)] to have declined insulin than people with HbA1c 53–63 mmol/mol (7.0–7.9%) and 64–74 mmol/mol (8.0–8.9%; P < 0.0001). Among the people who initially declined but ultimately started insulin [374/984 (38.0%)], mean time to insulin initiation was 790 days.

Conclusions

Insulin therapy decline is common, potentially leading to progression of hyperglycaemia and a delay in achievement of glycaemic control. Further investigation is needed to determine the reasons, risk factors and long‐term outcomes of this important clinical phenomenon.
Ultra‐early hematoma growth in antithrombotic pretreated patients with intracerebral hemorrhage
Authors: Roquer J. , Vivanco‐Hidalgo R. M. , Capellades J. , Ois A. , Cuadrado‐Godia E. , Giralt‐Steinhauer E. , Soriano‐Tárraga C. , Mola‐Caminal M. , Serra‐Martínez M. , Avellaneda‐Gómez C. , Jiménez‐Conde J. , Rodríguez‐Campello A.
Published: September 2017

Background and purpose

Patients with acute intracerebral hemorrhage (ICH) pretreated with antithrombotic drugs may have increased early hematoma growth, which would increase mortality risk. The effect of antiplatelet (AP) and vitamin K antagonist (VKA) pretreatment on ultra‐early hematoma growth (uHG) and its relationship with mortality in patients with acute supratentorial ICH was analyzed.

Methods

This is an observational retrospective study of a prospective register of 197 ICH patients with first computed tomography (CT) scan taken <6 h from ICH symptom onset. ICH volume was calculated by the ABC/2 formula and uHG by the baseline ICH volume/onset‐to‐CT time (ml/h) formula. The uHG analysis took into account the patient's pretreatment (none, AP or VKA) and the relationship between uHG and very‐early (first 24 h) and 3‐month mortality.

Results

In the pretreatment group, 50 (25.4%) patients were treated with AP and 37 (18.8%) with VKA. The median (interquartile range 25–75) uHG was 19.7 ml/h (2.9–44.8) for AP pretreated patients, 16.2 ml/h (5.1–42.5) for VKA pretreated patients and 8.4 ml/h (2.4–21.8) for non‐pretreated patients, P = 0.019. The uHG was higher in patients with very‐early [42.1 ml/h (20.1–79.6)] and total 3‐month mortality [28.0 ml/h (15.8–52.5)] compared with survivors [3.9 ml/h (1.5–10.4)], P < 0.0001. Adjusted by ICH severity and previous functional status, uHG was an independent factor related to very‐early (P = 0.028) and total 3‐month mortality (P = 0.014).

Conclusions

Patients pretreated with antithrombotics have much higher uHG, which would explain the increased mortality in these patients compared to untreated patients.
An international analysis of CEO social capital and corporate risk‐taking
Authors: Ferris Stephen P. , Javakhadze David , Rajkovic Tijana
Published: September 2017

This study examines the effects of CEO social capital on corporate risk‐taking around the world. We document a significant positive relation between CEO social capital and aggregate corporate risk‐taking. Further, we find that CEOs with large social capital prefer riskier investment and financial policies. We also determine that the effect of CEO social capital on corporate risk‐taking is moderated by the extent of legal protections provided to shareholders, the financial development, and the culture of the country in which a firm is incorporated. Our results are robust to alternative proxies of risk‐taking, alternative model specifications, and tests for endogeneity.
Associating metrics of hydrologic variability with benthic macroinvertebrate communities in regulated and unregulated snowmelt‐dominated rivers
Authors: Steel Anna E. , Peek Ryan A. , Lusardi Robert A. , Yarnell Sarah M.
Published: September 2017

Dams and diversions in rivers often alter flow regimes, which in turn can affect stream biota, particularly when the novel conditions are dramatically different from those under which native species evolved.

Management of regulated rivers can include development of environmental flows that seek to restore ecological integrity. However, designing a flow regime that adequately supports aquatic biodiversity requires quantifiable metrics of hydrologic variability that directly relate to aquatic species diversity.

This study examined both regulated and unregulated montane rivers over 3 years within the marked seasonality of California's Mediterranean climate to determine which quantifiable elements of a flow regime were most correlated with changes in the biologic community, using stream invertebrates during the summer low flow period as an indicator.

Boosted regression trees were used to assess relationships between quantifiable metrics of flow regimes and the invertebrate community. Non‐metric multidimensional scaling and a multi‐response permutation procedure were used to analyze general trends in invertebrate assemblage patterns between rivers and years. Results indicated that hydrologic alteration corresponded to differences in invertebrate community composition, and that metrics related to the spring snowmelt recession and variability in summer water temperature had the greatest relative influence on invertebrate community diversity.

Rivers exhibiting longer duration spring recessions, lower daily rates of change during the spring recession, and stable water temperatures during summer supported relatively higher invertebrate community diversity. These relationships suggest that quantifiable metrics associated with seasonal flow variability and predictability should be an integral part of environmental flow design and monitoring.
“You Just Don't Understand Me!” Determinants of Second Generation Asian and Latino Youth Self‐Esteem
Authors: Nguyen Emerald T. , Hale Jo Mhairi
Published: September 2017

To understand the integration of second‐generation Asians and Latinos, we study the association between acculturation and self‐esteem, an aspect of psychological wellbeing and belongingness. Using data from the Children of Immigrants Longitudinal Study (CILS), we find that Asians have lower self‐esteem than Latinos. Females, youth who are from lower socioeconomic status families, have been in the US for less than five years, have lower grade point averages, experience discrimination, or experience more family conflict, are at risk for lower self‐esteem. For Asians, identifying as American is associated with higher self‐esteem than identifying by nationality or having a hyphenated identity, but it does not provide a similar benefit to Latinos. Both groups benefit from being fluently bilingual, whereas English‐language dominance is protective only for Asian youths’ self‐esteem. Our analysis nuances the role that acculturation factors play in adolescent self‐esteem, signalling that future research should consider interactions between acculturation and race/ethnicity.
THE CHALLENGE OF NORTH OUEENSLAND FEVERS
Authors: DERRICK E. H.
Published: September 2017

The distribution of fevers in North Queensland may largely be correlated with latitude, altitude and rainfall.

In the Gulf country and on mining fields in the early days, typhcid and malaria were major causes of fever. Other cases were commonly designated “typho‐malaria”.

On the Pacific coast, the incidence of fevers has been high since the eighties. At first obscure in nature, they have been shown to consist mainly of leptospirosis and scrub typhus.

Many minds contributed to the elucidation of the northern fevers ; the staff of the Australian Institute of Tropical Medicine at Townsville played a notable part from 1910 to 193o. Repeatedly, an advance had to await the coming of the right man.

The disappearance of typhoid and malaria from the mainland of North Queensland is a public health victory. The means to prevent dengue and to lessen scrub typhus are to hand, but the prevention of leptospirosis is an unsolved problem.
BODY FAT AND BLOOD PRESSURE OF NATIVES IN NEW GUINEA : REFLECTIONS ON ESSENTIAL HYPERTENSION
Authors: WHYTE H. M.
Published: September 2017

Natives were examined in the highlands (221 males, 169 females), where salt is scarce, and on the coast (146 males, 87 females). Both groups eat little protein and fat. Measurements were made of height, weight, folds of skin and subcutaneous fat, circumference of arm and blood pressure.

Though shorter and lighter than average Europeans, the relative weight of young adult natives was “ideal”. Natives were more muscular and less obese than Europeans.

The blood pressure of young adults was the same as for Europeans (125/80 mm. Hg. at 25 years of age). With advancing age there was a decrease in diastolic pressure with an increase in pulse pressure in both sexes; systolic pressure increased in females but was constant in males. At 65 years of age the average for males was 130/70 mm. and for females 140/75 mm. Hg.

The pulse pressure and the rate of its rise with age resembled the findings in Europeans.

There was no apparent relationship between blood pressure and relative body weight or obesity when allowance was made for errors due to arm circumference. Coastal natives, whose appetite for salt is satisfied, did not have a higher blood pressure than the highlanders, who crave salt.

Results are interpreted to mean that natives are physically as bulky as Europeans (allowing for the difference in height); that the influence of sex and aging of elastic arteries affect both races alike; but that natives lack, while Europeans acquire, the complaint of muscular arteries which is sometimes called essential hypertension.
SERUM CHOLESTEROL AND LIPOPROTEINS IN NATIVES OF NEW GUINEA AND AUSTRALIANS
Authors: DE WOLFE M. S. , WHYTE H. M.
Published: September 2017

Measurements of total serum cholesterol were made in Australians and in natives living in the Central Highlands of New Guinea (Wabag and Chimbu) and on the coast. Dietary fat provides 0% to 5% of the caloric intake in natives and 35% to 40% in Australians.

The total cholesterol level in natives was lower than that of Australians. Males, 20 to 40 years of age, had 223 milligrammes of cholesterol per 100 millilitres of serum in Australia, 144 in Wabag, 130 in Chimbu, and 124 on the coast.

Unlike Australians, the natives showed no upward trend in cholesterol level with age, and the value was lower in males (in Wabag) than in females.

Paper electrophoresis of serum from males 20 to 40 years of age showed that the beta lipoproteins accounted for 78% of the total cholesterol in Australians, 80% in Chimbus and 86% in coastal natives. The percentage tended to increase with the total cholesterol level in Australians but to remain constant, regardless of total level, in the natives.

A group of employed natives who had been eating extra food (18% of calories from fat) for one to two years had the same average total serum cholesterol concentration and lipoprotein distribution as the ordinary village natives.
LEFT VENTRICULAR HYPERTROPHY : ELECTROCARDIOGRAPHIC DIAGNOSIS
Authors: MCPHIE JOHN
Published: September 2017

The specificity of diagnostic criteria previously proposed for the diagnosis of left ventricular hypertrophy have been analysed by correlation of the isolated ventricular weight and the twelve‐lead electrocardiogram, and by consideration of commonly associated clinical conditions and of the pathological state of the myocardium in 83 adult hearts.

As an aid to the clinical diagnosis of left ventricular hypertrophy in adults over 30 years of age it is concluded of the electrocardiogram: (a) That lesser degrees of left ventricular hypertrophy cannot be accurately diagnosed by any criteria described to date; (b) That, where left ventricular weight exceeds normal by 40%, accurate positive diagnosis can be made in approximately half the cases, and that this proportion increases with the degree of hypertrophy; (c) That only the QRS voltage in the electrocardiogram has any direct relationship to left ventricular weight and is therefore of diagnostic value; (d) That the useful diagnostic criteria may be reduced to two or possibly three: the maximum R+S voltage in the precordial “V” leads; maximal precordial R> 26 millimetres ; R1 + S3> 25 millimetres; (e) That the diagnostic application of relevant QRS voltage criteria is not materially restricted by the administration of digitalis or by the presence of congestive cardiac failure or lesser degrees of ischæmic heart disease. Advanced ischæmic disease involving extensive destruction of the myocardium may reduce QRS voltage and thence its diagnostic value.

The term “left ventricular strain” has little meaning, since the electrocardiographic patterns to which it is applied cannot be directly related to left ventricular hypertrophy or to any one physiological, biochemical or dynamic factor recognized at present.
PROGNOSIS IN THE NEPHROTIC SYNDROME
Authors: JOHNSON J. R. , READER RALPH
Published: September 2017

Eighty cases of the nephrotic syndrome are reviewed with respect to their immediate and remote prognosis.

Approximately 60% of patients with uncomplicated nephrotic syndrome lost their œdema in hospital, whilst this occurred in only 20% of patients with complicated syndromes (showing hypertension, hæmaturia or azotæmia). In 11 of 20 cases in which there was a biopsy finding of "normal renal tissue" there was loss of œdema in hospital, but this occurred in only two of 13 cases in which the biopsy findings were abnormal. Five of 10 patients admitted to hospital with gross œdema died during that admission, and none lost their œdema.

Results with corticosteroid therapy were not as satisfactory as the results claimed by others, probably owing to lower dosage, but were superior to the results with all other forms of therapy. Nine of 32 patients given a course of steroids lost their oedema completely in hospital (including four who went into remission).

The ultimate prognosis for the adults and older children followed for two or more years is discussed and compared with the prognosis for the young child. Seven of 15 patients with uncomplicated nephrotic syndrome in this series were in complete remission two or more years after the onset of the disease, whilst this was so in only one of 34 with complicated syndromes. Twenty‐one with the complicated syndrome, but only two with the uncomplicated syndrome, were dead at the time of follow‐up. The better overall prognosis of the nephrotic syndrome in the young child as compared with the adult and older child appears to be due to the far greater incidence of uncomplicated cases in the former age group.
STUDIES OF FAT METABOLISM IN ATHEROSCLEROSIS BY ISOTOPIC METHODS
Authors: HALL G. V. , GEORGE E. P. , HICKIE J. B.
Published: September 2017

An isotopic lipid tolerance test is described. An assessment of this test on 40 patients with abnormal lipid metabolism and 12 controls has given the following results : (i) I131 glyceryl trioleate is a satisfactory tracer of lipid metabolism. (ii) The results of the test are consistent and reproducible. (iii) Patients with coronary atherosclerosis show raised lipid blood radioactivity levels during the first few hours, and these persist to 72 hours, when there is more complete separation between atherosclerotic and normal subjects. (iv) The lipid clearance time is prolonged in almost all patients with coronary heart disease. (v) The results give further support to the apparent linkage of atherosclerosis and disordered lipid metabolism. (vi) The lipid tolerance test described gives a method of assessing the degree of lipid metabolic disorder.
THE SEASONAL DISTRIBUTION OF HOSPITAL ADMISSIONS FOR ASTHMA IN BRISBANE
Authors: DERRICK E. H. , THATCHER R. H. , TRAPPETT L. G.
Published: September 2017

The monthly distribution of admissions to the Brisbane Children's Hospital for asthma for the three years July, 1955, to June, 1958, showed a minor wave in the spring months of October and November, and a major wave in autumn and early winter culminating usually in May.

The monthly distribution of asthmatic bronchitis was almost identical with that of asthma. For a truer index of asthma admissions, the two conditions were combined.

The characteristic seasonal distribution of asthma was evident (a) in each sex, (b) in each year of age except the first, (c) in each of the three years of the study, (d) in different geographical sections of Brisbane City.

Among admissions of asthmatic children, about o% belonged to the spring wave and 45% to the autumn wave ; 45% were apparently non‐seasonal.

The monthly distribution of admissions for infective (non‐asthmatic) bronchitis to the Brisbane Children's Hospital over the same period was different. There was a single peak, in mid‐winter. This seasonal difference shows that the spring and autumn waves of asthma cannot be ascribed to bronchial infection.

Analysis of admissions for asthma to the Brisbane Hospital for the same three years showed that the seasonal variation diminished with age. In asthmatics aged 12 to 49 years, a spring wave was barely discernible and the autumn wave was responsible for only about 20% of admissions. In those aged over 50 years, no consistent seasonal variation was evident.

Males predominated among asthmatics admitted to the Brisbane Children's Hospital, females among those admitted to the Brisbane Hospital.

Monthly correlations did not show any consistent relation between the seasonal distribution of asthma and variation in atmospheric pressure, temperature, humidity, rainfall, hours of sunshine, or speed or direction of the wind. Low wind speeds and westerly winds usually prevailed at the time of the autumn wave of asthma, but the association was probably incidental.

The most likely cause of the spring and autumn waves of asthma was a prevalence of air‐borne pollens.
RENAL ISCHÆMIA AND HYPERTENSION : A REVIEW OF THE RESULTS OF SURGERY
Authors: KINCAID-SMITH PRISCILLA
Published: September 2017

A review of the results of renal surgery in patients with hypertension reveals that 37% have a reduction in the blood pressure to 140/90 mm. Hg for a year. About half the patients achieve worthwhile clinical benefit from operation. The percentage of successful results in patients with renal artery disease or chronic pyelonephritis is almost double that achieved in other forms of unilateral renal disease. Patients aged under 20 years, and those with retinitis or papillœdema, seem to have a better prognosis for alleviation of hypertension than older patients or those with lesser retinal changes. When pyelonephritic scarring of the “ ischæmic ” type is present in the nephrectomy specimen, the operation is likely to alleviate hypertension. In patients with renal artery disease, nephrectomy produces a far higher percentage of successful results than is achieved by arterial surgery.
THE VARIATIONS IN URINARY ALDOSTERONE LEVELS OF NORMAL FEMALES DURING THEIR MENSTRUAL CYCLE
Authors: REICH MAGDA
Published: September 2017

In a series of six subjects studied, a day‐to‐day fluctuation in urinary aldosterone excretion with a definite and characteristic pattern throughout the menstrual cycle was noted in all. The excretory level was lowest (mean value 8·5 μg. per 24 hours) 25 to 17 days before menstruation, with an increase (mean value 11 μg. per 24 hours) 17 to 14 days prior to menstruation. An increase in excretion was again noticed in the second half of the cycle, with a peak excretion (mean value 23 μg. per 24 hours) one to five days before menstruation. This was followed in most subjects by a sharp decrease in excretion one to two days before menstruation. During the first day of menstruation a relatively low level was found, followed in some subjects by an increase on certain days of menstruation.

The urinary sodium‐potassium concentration ratio fluctuated during the menstrual cycle with no direct relationship to aldosterone levels. The lowest urinary sodium‐potassium ratios were found in specimens one to five days before menstruation.

A premenstrual increase in body weight ranging from 0·5 to 2·3 kg., with the maximum three to one days prior to menstruation, was noted in five subjects. This weight increase either followed or preceded the maximum observed aldosterone excretion.

In one post‐menopausal subject observed over a period of 26 days, the urinary aldosterone excretion ranged from 8·5 to 14 μg. per 24 hours.

A detailed description of a chemical method for estimation of aldosterone in urine is given.
A FAMILY STUDY OF FALLOT'S TETRAD
Authors: PITT DAVID B.
Published: September 2017

The occasional familial concentration of cases of congenital heart disease is discussed. Twin evidence, gathered from relatively unselected sources, is presented for the incidence of congenital heart defects in twins.

The low incidence of concordance (6.9%) in monozygotic pairs suggests a very mild genetic background in their causation.

In this report is presented a large family of 275 descendants of one man, in which 11 members have been affected with congenital heart defects. Of these, three were “blue babies” who died without an exact diagnosis being recorded. Of the remaining eight, six had Fallot's tetrad (three) or reduced or atypical forms thereof; two had ventricular septal defect and two multiple lesions. It is proposed that these lesions arose as the pleiotrophic effects of a single dominant gene with reduced penetrance (10%). In two instances, however, in which the mothers (married to carrier fathers) gave a history of ovarian disease, the gene may have behaved with full penetrance (five affected children out of nine).

It is speculated that some maternal influence, acting on the gene through some defect in the ovum, may have permitted full penetrance in these instances.

In generations IV and V, the gene appears to have affected about 5% of the children.

It is suggested that dominant genes of low penetrance, revealed in this very large family, may also operate undetected in many other cases of congenital defect in smaller families.

Environmental causes of congenital heart defect, apart from maternal rubella, have yet to be clearly demonstrated.
TETRACYCLINE IN THE TREATMENT OF “Q” FEVER
Authors: POWELL O. W. , KENNEDY K. P. , MCIVER MARGOT , SILVERSTONE H.
Published: September 2017

The effect of tetracycline in the treatment of “Q” fever was investigated in 56 cases, by a technique of sequential analysis.

Tetracycline reduced the duration of fever after commencement of treatment by approximately 50%. However, treatment must be commenced within the first three days of illness for this to be of importance.

The severity of liver involvement, as estimated by “Bromsulphalein” retention, was significantly less in the treated group.

The incidence of phase 1 complement‐fixing antibody six months or more after the onset was significantly less in the treated group.

Treatment, essentially blind therapy, is probably justified only for patients who are severely ill, who are at risk of endocarditis because of previous cardiac disease, or who are in the older age groups.
AN EXPERIMENTAL MODEL OF AUTOIMMUNE HÆMOLYTIC ANÆMIA
Authors: BURNET F. M.
Published: September 2017

In the mouse strain NZB, all individuals develop signs of an autoimmune hæmolytic anæmia between the ages of four and eight months. At about the same age areas of lymphocytic proliferation appear in the thymic medulla. This strain provides a laboratory model of human autoimmune disease and the characteristic thymic lesions point to the need for further study of the thymus in the human conditions.
HEREDITARY FACTORS IN HUMAN LEUKÆMIA: A REPORT OF FOUR CASES OF LEUKÆMIA IN A FAMILY
Authors: GORDON R. D.
Published: September 2017

Four cases of leukæmia occurring in a family during two generations are described. The diagnosis in three is supported by full hæmatological and autopsy data. These patients were a female, aged 47 years, and a male, aged 29 years, both suffering from myeloblastic leukæmia, and a female, aged 58 years, suffering from acute leukæmia of uncertain type. In the fourth case, that of a female, aged two and a half years, evidence consists only of a death certificate bearing the diagnosis of acute leukæmia. Though a definite diagnosis of the variety of leukæmia has been made in only two cases, the result is already at variance with the reported high incidence of the lymphatic type in familial cases. The dissimilarity in age of these four patients may be contrasted with other reported families, in which the leukæmia tended to occur at about the same age in affected siblings.

The importance of hereditary factors in leukæmia in man is undecided, as is the genetic relationship of leukæmia to other neoplasias and blood disorders. Chromosomal abnormalities affecting all body cells have been described in association with chronic lymphatic leukæmia in the same patient and with acute leukæmia in the same sibship; this observation suggests a role for altered genetic structure in at least some cases of leukæmia, and chromosome studies are a promising tool in research into leukæmogenesis.
TETRACYCLINE ANTIBIOTICS AND THEIR EFFECTS ON CALCIFIED AND NON‐CALCIFIED TISSUES
Authors: STOREY E.
Published: September 2017

The incorporation of tetracycline antibiotics into hard tissues has been known for some time, and recently permanent discoloration and even hypoplasia of teeth have been attributed to administration of the drug. Tetracyclines are avid metal‐ion chelators in vitro, and although the precise mechanism by which they become attached to tissues in vivo is not known, they are bound at the time of administration into all calcifying tissues. The drug has been detected in the skeleton of man and of a number of animals by macroscopic staining and by fluorescence in ultra‐violet light, and is present in a number of soft‐tissue sites such as malignant neoplasms and hair.

Although defects have been induced under certain experimental conditions in chick embryos and Sand Dollar larvæ, skeletal abnormalities have not been reported in babies subjected to tetracyclines during development in utero.

Changes induced in teeth by tetracyclines are staining and possibly hypoplasia, although further evidence of a direct cause and effect relationship between the drug and the structural abnormality is required. In general, yellow‐brown staining of deciduous and permanent teeth occurs with low doses and hypoplasia is associated with high closes ; but it must be noted that children given large quantities of the drug are usually extremely ill, which of itself may be sufficient to affect formation of teeth. The drug is incorporated into calcifying dentine and into immature enamel, but appears to be removed or masked as the enamel calcifies, in contrast to its permanent retention in dentine.

While these defects should be kept to a minimum by using, where possible, antibiotics other than the tetracyclines during pregnancy and early post‐natal life, staining or hypoplasia of teeth may be a minor price to pay for the prevention of infection with its probably more serious and widespread sequelæ.
Low temperature synthesis of TaB2 nanorods by molten‐salt assisted borothermal reduction
Authors: Wei Tingting , Liu Zetan , Ren Donglou , Deng Xiangong , Deng Qihuang , Huang Qing , Ran Songlin
Published: September 2017

TaB2 powders were synthesized by a molten‐salt assisted borothermal reduction method at 900°C‐1000°C in flowing argon using Ta2O5 and amorphous B as starting materials. The results indicated that the presence of liquid phase, such as B2O3 and NaCl/KCl, accelerated the mass transfer of reactant species and resulted in the complete finish of the reaction at low temperatures. The obtained TaB2 powders exhibited a flow‐like shape assembled from nanorods grow along [001] direction or c‐axis. The morphology of the synthesized TaB2 powders could be tailored by the amount of B2O3 or NaCl/KCl.
Tainted love: Gothic imaging of nurses in popular culture
Authors: McAllister Margaret , Brien Donna Lee , Piatti‐Farnell Lorna
Published: September 2017

Aims

To discuss representations of nursing in popular culture using the Contemporary Gothic theory.

Background

Nursing is stereotypically known as a caring profession. Caring in both the natural and professional perspectives is inextricably attached to love and love, we are told, is universal. In popular culture, however, there are numerous examples of nurses being portrayed in ways where love—its expression and its practice—has been transgressed or tainted. Exploring this dark side of nursing, even if fictitious, is significant because it illuminates social and cultural tensions.

Design

Discussion paper.

Data sources

CINAHL, Scopus and Humanities International Databases were searched for terms related to nursing, love, abject and the gothic, published between 1990–2016. Four popular culture texts which ranged in genre and gothic elements were selected for analysis.

Implications for nursing

The types of transgressive love these nurses express to patients ranges from the obsessive and the pornographic, to the monstrous. We suggest this positioning illuminates a hidden reality that nursing work is at once intimate and personal but also hidden, profane, repellent, horrifying and feared. Nursing's allure for storytellers may rest in its association with the abject. How nurses find redemption, satisfaction and meaning in these locations is relevant for how we can imbue our lives and work with greater humanity.

Conclusion

The Contemporary Gothic is a useful tool in exposing and exploring ambiguous, challenging and taboo aspects of nursing in society. Such and analysis helps to explain phenomena—including nursing itself—which exists in the shadow of dominant and often stereotyped discourses.
Nursing service innovation: A case study examining emergency nurse practitioner service sustainability
Authors: Fox Amanda , Gardner Glenn , Osborne Sonya
Published: September 2017

Aim

This research aimed to explore factors that influence sustainability of health service innovation, specifically emergency nurse practitioner service.

Background

Planning for cost effective provision of healthcare services is a concern globally. Reform initiatives are implemented often incorporating expanding scope of practice for health professionals and innovative service delivery models. Introducing new models is costly in both human and financial resources and therefore understanding factors influencing sustainability is imperative to viable service provision.

Design

This research used case study methodology (Yin,).

Methods

Data were collected during 2014 from emergency nurse practitioners, emergency department multidisciplinary team members and documents related to nurse practitioner services. Collection methods included telephone and semi‐structured interviews, survey and document analysis. Pattern matching techniques were used to compare findings with study propositions.

Findings

In this study, emergency nurse practitioner services did not meet factors that support health service sustainability. Multidisciplinary team members were confident that emergency nurse practitioner services were safe and helped to meet population health needs. Organizational support for integration of nurse practitioner services was marginal and led to poor understanding of service capability and underuse.

Conclusion

This research provides evidence informing sustainability of nursing service models but more importantly raises questions about this little explored field. The findings highlight poor organizational support, excessive restrictions and underuse of the service. This is in direct contrast to contemporary expanding practice reform initiatives. Organizational support for integration is imperative to future service sustainability.
The relationship between emotional intelligence, previous caring experience and successful completion of a pre‐registration nursing/midwifery degree
Authors: Snowden Austyn , Stenhouse Rosie , Duers Lorraine , Marshall Sarah , Carver Fiona , Brown Norrie , Young Jenny
Published: September 2017

Aim

To examine the relationship between baseline emotional intelligence and prior caring experience with completion of pre‐registration nurse and midwifery education.

Background

Selection and retention of nursing students is a global challenge. Emotional intelligence is well‐conceptualized, measurable and an intuitive prerequisite to nursing values and so might be a useful selection criterion. Previous caring experience may also be associated with successful completion of nurse training.

Design

Prospective longitudinal study.

Method

Self‐report trait and ability emotional intelligence scores were obtained from 876 student nurses from two Scottish Universities before they began training in 2013. Data on previous caring experience were recorded. Relationships between these metrics and successful completion of the course were calculated inSPSSversion 23.

Results

Nurses completing their programme scored significantly higher on trait emotional intelligence than those that did not complete their programme. Nurses completing their programme also scored significantly higher on social connection scores than those that did not. There was no relationship between “ability” emotional intelligence and completion. Previous caring experience was not statistically significantly related to completion.

Conclusion

Students with higher baseline trait emotional intelligence scores were statistically more likely to complete training than those with lower scores. This relationship also held using “Social connection” scores. At best, previous caring experience made no difference to students' chances of completing training. Caution is urged when interpreting these results because the headline findings mask considerable heterogeneity. Neither previous caring experience or global emotional intelligence measures should be used in isolation to recruit nurses.
Using narrative inquiry to listen to the voices of adolescent mothers in relation to their use of social networking sites (SNS)
Authors: Nolan Samantha , Hendricks Joyce , Williamson Moira , Ferguson Sally
Published: September 2017

Aim

This article presents a discussion highlighting the relevance and strengths of using narrative inquiry to explore experiences of social networking site (SNS) use by adolescent mothers.

Background

Narrative inquiry as a method reveals truths about holistic human experience. Knowledge gleaned from personal narratives informs nursing knowledge and clinical practice. This approach gives voice to adolescent mothers in relation to their experiences withSNSas a means of providing social support.

Design

Discussion paper.

Data sources

This paper draws and reflects on the author's experiences using narrative inquiry and is supported by literature and theory. The following databases were searched:CINAHL, Cochrane Library, Medline, Scopus,ERIC, ProQuest, PsychINFO, Web of Science and Health Collection (Informit). Key terms and Boolean search operators were used to broaden the search criteria. Search terms included: adolescent mother, teenage mother, “social networking sites”, online, social media, Facebook, social support, social capital and information. Dates for the search were limited to January 1995–June 2017.

Implications for practice/research

Narrative research inherently values the individual “story” of experience. This approach facilitates rapport building and methodological flexibility with an often difficult to engage sample group, adolescents.

Conclusion

Narrative inquiry reveals a deep level of insight into social networking site use by adolescent mothers. The flexibility afforded by use of a narrative approach allows for fluidity and reflexivity in the research process.
Long‐term treatment costs for aggressive periodontitis in a German population
Authors: Schwendicke Falk , Biffar Anne Sophie , Graetz Christian
Published: September 2017

Aim

This study assessed the long‐term annual costs for treating aggressive periodontitis (AgP) patients.

Methods

A cohort of compliant AgP patients was retrospectively evaluated. Costs for active periodontal therapy (APT, including scaling and root planing, open flap debridement, root resections, but not pocket elimination or regenerative surgery) and supportive periodontal therapy (SPT, including also costs for restorative, endodontic, prosthetic and surgical treatments) were estimated from a mixed payer perspective in Germany. The impact of tooth‐ and patient‐level factors on annual costs was assessed using mixed modelling.

Results

A total of 52 patients (mean [SD] age: 35.2/6.8 years), with 26.5 (4.0) teeth (38% with bone loss >50%) were treated. Mean follow‐up (retention) time was 16.9 (5.4) years. Total treatment costs per patient and per tooth were 6,998 (3,807) and 267 (148) Euro, respectively. Approximately 87% of the costs were generated during SPT, 13% during APT. Annual patient‐ and tooth‐level costs were 536 (209) and 20.1 (65.0) Euro, respectively. Annual tooth‐level costs were significantly increased in patients aged 34 years or older, male patients, former or current smokers, teeth with furcation involvement degree II/III, and bone loss 50%–70%.

Conclusions

Annual treatment costs for treating AgP patients were similar to those found for chronic periodontitis patients. Certain parameters might predict costs.
Elemental turnover rates and trophic discrimination in juvenile Lebranche mullet Mugil liza under experimental conditions
Authors: Oliveira M. C. L. M. , Mont'alverne R. , Sampaio L. A. , Tesser M. B. , Ramos L. R. V. , Garcia A. M.
Published: September 2017

The aim of this study was to determine the isotopic‐turnover rate (RIT) and trophic‐discrimination factor (FTD) in muscle tissues of Lebranche mullet Mugil liza fed an experimental diet (δ13C = −27·1‰; δ15N = 1·0‰). Juvenile M. liza exhibited a relatively fast RIT, with a half‐life (t50) of only 16 and 14 days for δ13C and δ15N respectively and a nearly complete isotopic turnover (t95) of 68 and 60 days for δ13C and δ15N.