bluuebunny/crossref_metadata_2025 huggingface dataset:
Foetal tachyarrhythmia treatment remains challenging even if the vast majority of cases have a favourable outcome
Authors: Ekman‐Joelsson Britt‐Marie , Mellander Mats , Lagnefeldt Linda , Sonesson Sven‐Erik
Published: July 2015

Aim

The optimal treatment for foetal tachyarrhythmia remains controversial, and this study aimed to fill this gap in the knowledge.

Methods

We retrospectively reviewed all cases of foetal tachyarrhythmia diagnosed at two tertiary foetal cardiology centres in Sweden from 1990 to 2012.

Results

Of the 153 cases, 28% had atrial flutter (AF), 63% had atrioventricular reentrant tachycardia (AVRT) and 9% had other mechanisms. Hydrops was present in 45, less frequently in AF than in AVRT. Transplacental treatment was commenced in 99 and the rhythm normalised in two‐thirds, without any significant difference in cardioversion rates between AF and AVRT cases or nonhydropic and hydropic foetuses. Sotalol treatment had a higher cardioversion rate than digoxin in AVRT (63% versus 33%, p < 0.05) but not in AF (57% versus 56%). Two or more drugs were used in 38%. Neonatal survival was 100% in nonhydropic and 84% in hydropic cases. After a median of eight years, 11/134 patients still had arrhythmias, one had died due to arrhythmia and another had undergone cardiac transplantation.

Conclusion

Transplacental treatment was frequently insufficient to obtain cardioversion in nonhydropic and hydropic foetuses, but all nonhydropic cases had favourable outcomes. Larger prospective studies are needed to optimise the treatment of cases with hydrops.
Systematic review of the methodological quality of studies designed to create neonatal anthropometric charts
Authors: Giuliani Francesca , Ohuma Eric , Spada Elena , Bertino Enrico , Al Dhaheri Ayesha S. , Altman Douglas G. , Conde‐Agudelo Agustin , Kennedy Stephen H. , Villar Jose , Cheikh Ismail Leila
Published: July 2015

Babies all over the world are assessed at birth using neonatal anthropometric charts as a matter of clinical routine. This systematic review evaluated the methodological quality of studies designed to create neonatal anthropometric charts and to highlight features in the charts that could affect clinical decision‐making and comparisons between populations. The variety and quality of available charts could affect how newborns at risk are identified, together with the indications for treatment, especially nutritional interventions.

Conclusion

The studies that generated the charts currently recommended for clinical use have major methodological limitations and international and regional comparisons are very difficult.
‘I didn't know other people existed who hear voices…’ – qualitative perceptions of a hearing voices group for people with learning disabilities
Authors: Tomlins Rose , Cawley James
Published: July 2015

Accessible summary

We ran a new group for people with learning disabilities who heard voices.

We interviewed people who came to the group to see whether they liked the group. We also interviewed people who decided not to come to the group, to find out why.

We also asked family members and professionals what they thought about the group.

People thought the group would help them cope with their voices.

People who came enjoyed meeting other people who heard voices.

We found that some things stopped people coming to the group. We want to change these things for the next group so that more people will be able to come.

Group work for people who experience voice hearing in the mainstream population has been shown to have various benefits; however, there is little research describing hearing voices groups for people with learning disabilities. This study describes perceptions of a new hearing voices group for people with mild learning disabilities. Semi‐structured interviews with twelve participants were conducted. This included three clients who attended the hearing voices group, three of their family members/carers and one professional. In addition, of those who were referred to the group but chose not to attend, one client, two family members/carers and two professionals were interviewed. Interview data were transcribed verbatim and thematic analysis was used to identify three overarching themes; the first ‘benefits of our hearing voices group’ described participants’ evaluations and perceptions of the hearing voices group. The second ‘making the decision to attend’ covers factors that influence clients when deciding whether or not to attend a hearing voices group. In the final theme ‘positive and negative contributors to the voice‐hearing experience’, participants reflected on factors that affect the voice‐hearing experience. The hearing voices group was valued by participants; however, services should consider the barriers to attendance faced by some clients. Strategies for addressing these are discussed.
Collectin liver 1 and collectin kidney 1 and other complement-associated pattern recognition molecules in systemic lupus erythematosus
Authors: Troldborg A , Thiel S , Jensen L , Hansen S , Laska M J , Deleuran B , Jensenius J C , Stengaard-Pedersen K
Published: July 2015

The objective of this study was to explore the involvement of collectin liver 1 (CL-L1) and collectin kidney 1 (CL-K1) and other pattern recognition molecules (PRMs) of the lectin pathway of the complement system in a cross-sectional cohort of systemic lupus erythematosus (SLE) patients. Concentrations in plasma of CL-L1, CL-K1, mannan-binding lectin (MBL), M-ficolin, H-ficolin and L-ficolin were determined in 58 patients with SLE and 65 healthy controls using time-resolved immunoflourometric assays. The SLE patients' demographic, diagnostic, clinical and biochemical data and collection of plasma samples were performed prospectively during 4 months. CL-L1, CL-K1 and M-ficolin plasma concentrations were lower in SLE patients than healthy controls (P-values < 0·001, 0·033 and < 0·001, respectively). H-ficolin concentration was higher in SLE patients (P < 0·0001). CL-L1 and CL-K1 plasma concentrations in the individuals correlated in both patients and controls. Patients with low complement component 3 (C3) demonstrated a negative correlation between C3 and CL-L1 and CL-K1 (P = 0·022 and 0.031, respectively). Patients positive for anti-dsDNA antibodies had lower levels of MBL in plasma than patients negative for anti-dsDNA antibodies (P = 0·02). In a cross-sectional cohort of SLE patients, we found differences in the plasma concentrations of CL-L1, CL-K1, M-ficolin and H-ficolin compared to a group of healthy controls. Alterations in plasma concentrations of the PRMs of the lectin pathway in SLE patients and associations to key elements of the disease support the hypothesis that the lectin pathway plays a role in the pathogenesis of SLE.
Effect of glaucoma medications on 24‐hour intraocular pressure‐related patterns using a contact lens sensor
Authors: Mansouri Kaweh , Medeiros Felipe A , Weinreb Robert N
Published: July 2015

Background

The aim of this article was to study the circadian intraocular pressure (IOP)‐related effects of ocular hypotensive medications using a contact lens sensor (CLS).

Design

This is a university‐based prospective, randomized, crossover trial.

Participants

A total of 23 patients with primary open‐angle glaucoma participated.

Methods

Patients underwent ambulatory recording of IOP‐related patterns for 24 h in one eye during 3 monthly sessions using a CLS. Patients were untreated in session 1 (S1), were randomized to one of four classes of glaucoma drops for S2 and had a prostaglandin analogue add‐on for S3.

Main Outcome Measures

Changes in IOP‐related patterns were defined using (i) slopes from wake/sitting to sleep/supine; (ii) cosinor rhythmometry modelling; and (iii) area under receiver operating curve (AUC) of sleep period.

Results

Mean patient age was 63.8 ± 11.8 years. Positive linear slopes were seen from wake/sitting to sleep/supine at S1 (17.1 ± 14.2 mVeq/h) and S2 (5.5 ± 23.9 mVeq/h) and negative slopes at S3 (−1.9 ± 29.4 mVeq/h) (S1–S2, P = 0.01; S1–S3, P = 0.02). In the prostaglandin group, slopes changed significantly with introduction of drops (S1–S2, P < 0.024), whereas they did not in a mixed group combining the three other classes (S1–S2, P = 0.060). Overall, cosinor amplitudes were 98.4 ± 46.5 mVeq (S1), 113.0 ± 35.6 mVeq (S2) and 109.6 ± 58.3 mVeq (S3) (S1–S2, P = 0.23; S1–S3, P = 0.66; S2–S3, P = 0.93). AUC were 91.8 ± 63.0 mVeq (S1), 76.3 ± 102.7 mVeq (S2) and 19.9 ± 135.8 mVeq (S3). Differences between sessions were not statistically significant (S1–S2, P = 0.541; S1–S3, P = 0.083; S2–S3, P = 0.092).

Conclusions

Prostaglandin analogues, but not other medications, seem to flatten the IOP‐related increase at transition of the wake/sitting to the sleep/supine period, but do not seem to have an effect on acrophase and amplitude.
Five Frames to Promote Innovative Business Education: Lessons Learned from the Art and Science of Improv
Authors: Yin L. Roger , Kumta Shekhar M. , Werner Jon M.
Published: July 2015

Business education and workplace learning are addressed via five episodes or conversations between two business educators, one of whom is experienced and also an improvisational artist. Vaill (1989) compared managing to a performing art. Vendelø (2009) connected organizational learning to improvisation. In these constructed conversations, the improvisational nature of Decision Sciences is extended with dialogues on learning assessment, memory and pedagogical strategies, semiotics (learning via signs), technology and visual learning, and adult cognitive development. Connections to past and current writings on these topics are made, and practical examples provided for each conversation. It can be seen that improv adds insight into what McCormack et al. called “learning to work” and “learning a new kind of learning.” These conversations can be viewed as multiple frames to foster analytical and critical thinking skills by business students.
Haem uptake is essential for egg production in the haematophagous blood fluke of humans, Schistosoma mansoni
Authors: Toh Shu Qin , Gobert Geoffrey N. , Malagón Martínez David , Jones Malcolm K.
Published: July 2015

Schistosomes ingest host erythrocytes, liberating large quantities of haem. Despite its toxicity, haem is an essential factor for numerous biological reactions, and may be an important iron source for these helminths. We used a fluorescence haem analogue, palladium mesoporphyrin, to investigate pathways of haem acquisition, and showed that palladium mesoporphyrin accumulates in the vitellaria (eggshell precursor glands) and ovary of female Schistosoma mansoni. Furthermore, incubation of adult females in 10–100 μm cyclosporin A (IC50 = 2.3 μm) inhibits the uptake of palladium mesoporphyrin to these tissues, with tenfold reductions in fluorescence intensity of the ovary. In vitro exposure to cyclosporin A resulted in significant perturbation of egg production, reducing egg output from 34 eggs per female to 5.7 eggs per female over the incubation period, and retardation of egg development. We characterized a S. mansoni homologue of the haem‐responsive genes of Caenorhabditis elegans. The gene (Smhrg‐1) encodes a protein with a molecular weight of approximately 17 kDa. SmHRG‐1 was able to rescue growth in haem transport‐deficient HEM1Δ yeast. Transcriptional suppression of Smhrg‐1 in adult S. mansoni worms resulted in significant delay in egg maturation, with 47% of eggs from transcriptionally suppressed worms being identified as immature compared with only 27% of eggs laid by control worms treated with firefly luciferase. Our findings indicate the presence of transmembrane haem transporters in schistosomes, with a high abundance of these molecules being present in tissues involved in oogenesis.
Monotonic and low cycle fatigue behaviour of 2024‐T3 aluminium alloy between room temperature and 300 °C for designing VAWT components
Authors: Karakaş Ö. , Szusta J.
Published: July 2015

In the present study, the results of the monotonic tension tests and low cycle fatigue tests performed on aluminium alloy EN AW‐2024‐T3 under various operating temperatures are presented in order to assess the fatigue behaviour of the aluminium alloy under evaluated temperatures. Monotonic tests were performed to determine the influence of temperature on mechanical properties of the material. The aim of cyclic tests was to acquire the parameters required for Manson–Coffin equation in order to plot strain–fatigue life curves. Moreover, stress–strain behaviour of the alloy and the cyclic hardening behaviour were evaluated using Ramberg–Osgood equation. Finally, PSWT‐damage parameters for each temperature have been calculated for further investigation of the effects of the temperature on fatigue life using acquired data while taking the account of mean stress effect into calculations. Variations in the experimental data due to various test temperatures are presented for both monotonic and cyclic tests.
Population‐level responses of stream macroinvertebrates to drying can be density‐independent or density‐dependent
Authors: Lancaster Jill , Ledger Mark E.
Published: July 2015

The frequency and intensity of droughts and stream drying are likely to increase with climate change, but how freshwater macroinvertebrate populations respond to such disturbances is poorly understood. Theory predicts that stochastic disturbances should generate density‐independent mortality, but density dependence is possible if mortality arises indirectly through changes in consumer–resource dynamics, or if mortality is mediated by disturbance refugia. Empirical evidence for density‐dependent or density‐independent mortality in freshwater invertebrates is scarce, but important to predict how population sizes will alter with changing climate.

In a stream mesocosm experiment, we tested whether short‐term drying events (5–6 days) resulted in population losses of macroinvertebrates, and whether any losses were density‐dependent or density‐independent. On each of 10 replicate drying events over a year and over a naturally occurring range of invertebrate densities, we measured pre‐ and post‐disturbance densities. From these data, we calculated per capita mortality rates, tested statistically for associations between mortality rates and pre‐disturbance densities, and assessed whether mortality differed seasonally. Invertebrate assemblages in the channels were derived from a chalk stream in south‐west England. Analyses focussed on 12 core taxa that were common in the community, which included a taxonomically diverse group of worms, Gastropoda, Gammaridae, Diptera, Ephemeroptera and Trichoptera.

Responses to drying were species‐specific and three different response types were observed. Half of the taxa were resistant to drying and there was no apparent mortality, even in the near‐total loss of free water (Potamopyrgus antipodarum, Bezzia sp., Chironomini, Radix balthica and two groups of Naididae). Four taxa showed density‐independent mortality (Polycentropus flavomaculatus, Tanypodinae, Gammarus pulex, Baetis scambus), but differed in vulnerability with per capita loss rates ranging from 57 to 100%. Strong evidence of density‐dependent mortality was observed in Orthocladiinae and suggested also for Tanytarsini. Mortality varied seasonally for only one taxon (Tanytarsini), with higher mortality in warm versus cool months. Particular response types were not necessarily associated with particular taxonomic groups or body shapes.

This range of responses to drying by different, naturally co‐occurring, populations suggests that community‐level impacts of drying are underpinned by diverse, taxon‐specific responses. The experiment provides some support for theoretical predictions of density‐independent mortality, but also some of the first evidence that disturbance refugia can result in density‐dependent mortality.
Nitrous oxide and methane emissions from cryptogamic covers
Authors: Lenhart Katharina , Weber Bettina , Elbert Wolfgang , Steinkamp Jörg , Clough Tim , Crutzen Paul , Pöschl Ulrich , Keppler Frank
Published: July 2015

Cryptogamic covers, which comprise some of the oldest forms of terrestrial life on Earth (Lenton & Huntingford, ), have recently been found to fix large amounts of nitrogen and carbon dioxide from the atmosphere (Elbert et al., ). Here we show that they are also greenhouse gas sources with large nitrous oxide (N2O) and small methane (CH4) emissions. Whilst N2O emission rates varied with temperature, humidity, and N deposition, an almost constant ratio with respect to respiratory CO2 emissions was observed for numerous lichens and bryophytes. We employed this ratio together with respiration data to calculate global and regional N2O emissions. If our laboratory measurements are typical for lichens and bryophytes living on ground and plant surfaces and scaled on a global basis, we estimate a N2O source strength of 0.32–0.59 Tg year−1 for the global N2O emissions from cryptogamic covers. Thus, our emission estimate might account for 4–9% of the global N2O budget from natural terrestrial sources. In a wide range of arid and forested regions, cryptogamic covers appear to be the dominant source of N2O. We suggest that greenhouse gas emissions associated with this source might increase in the course of global change due to higher temperatures and enhanced nitrogen deposition.
Net effects of multiple stressors in freshwater ecosystems: a meta‐analysis
Authors: Jackson Michelle C. , Loewen Charlie J. G. , Vinebrooke Rolf D. , Chimimba Christian T.
Published: July 2015

The accelerating rate of global change has focused attention on the cumulative impacts of novel and extreme environmental changes (i.e. stressors), especially in marine ecosystems. As integrators of local catchment and regional processes, freshwater ecosystems are also ranked highly sensitive to the net effects of multiple stressors, yet there has not been a large‐scale quantitative synthesis. We analysed data from 88 papers including 286 responses of freshwater ecosystems to paired stressors and discovered that overall, their cumulative mean effect size was less than the sum of their single effects (i.e. an antagonistic interaction). Net effects of dual stressors on diversity and functional performance response metrics were additive and antagonistic, respectively. Across individual studies, a simple vote‐counting method revealed that the net effects of stressor pairs were frequently more antagonistic (41%) than synergistic (28%), additive (16%) or reversed (15%). Here, we define a reversal as occurring when the net impact of two stressors is in the opposite direction (negative or positive) from that of the sum of their single effects. While warming paired with nutrification resulted in additive net effects, the overall mean net effect of warming combined with a second stressor was antagonistic. Most importantly, the mean net effects across all stressor pairs and response metrics were consistently antagonistic or additive, contrasting the greater prevalence of reported synergies in marine systems. Here, a possible explanation for more antagonistic responses by freshwater biota to stressors is that the inherent greater environmental variability of smaller aquatic ecosystems fosters greater potential for acclimation and co‐adaptation to multiple stressors.
Contrasting impacts of continuous moderate drought and episodic severe droughts on the aboveground‐biomass increment and litterfall of three coexisting Mediterranean woody species
Authors: Liu Daijun , Ogaya Romà , Barbeta Adrià , Yang Xiaohong , Peñuelas Josep
Published: July 2015

Climate change is predicted to increase the aridity in the Mediterranean Basin and severely affect forest productivity and composition. The responses of forests to different timescales of drought, however, are still poorly understood because extreme and persistent moderate droughts can produce nonlinear responses in plants. We conducted a rainfall‐manipulation experiment in a Mediterranean forest dominated by Quercus ilex, Phillyrea latifolia, and Arbutus unedo in the Prades Mountains in southern Catalonia from 1999 to 2014. The experimental drought significantly decreased forest aboveground‐biomass increment (ABI), tended to increase the litterfall, and decreased aboveground net primary production throughout the 15 years of the study. The responses to the experimental drought were highly species‐specific. A. unedo suffered a significant reduction in ABI, Q. ilex experienced a decrease during the early experiment (1999–2003) and in the extreme droughts of 2005–2006 and 2011–2012, and P. latifolia was unaffected by the treatment. The drought treatment significantly increased branch litterfall, especially in the extremely dry year of 2011, and also increased overall leaf litterfall. The drought treatment reduced the fruit production of Q. ilex, which affected seedling recruitment. The ABIs of all species were highly correlated with SPEI in early spring, whereas the branch litterfalls were better correlated with summer SPEIs and the leaf and fruit litterfalls were better correlated with autumn SPEIs. These species‐specific responses indicated that the dominant species (Q. ilex) could be partially replaced by the drought‐resistant species (P. latifolia). However, the results of this long‐term study also suggest that the effect of drought treatment has been dampened over time, probably due to a combination of demographic compensation, morphological and physiological acclimation, and epigenetic changes. However, the structure of community (e.g., species composition, dominance, and stand density) may be reordered when a certain drought threshold is reached.
Experimental drought and heat can delay phenological development and reduce foliar and shoot growth in semiarid trees
Authors: Adams Henry D. , Collins Adam D. , Briggs Samuel P. , Vennetier Michel , Dickman L. Turin , Sevanto Sanna A. , Garcia‐Forner Núria , Powers Heath H. , McDowell Nate G.
Published: July 2015

Higher temperatures associated with climate change are anticipated to trigger an earlier start to the growing season, which could increase the terrestrial C sink strength. Greater variability in the amount and timing of precipitation is also expected with higher temperatures, bringing increased drought stress to many ecosystems. We experimentally assessed the effects of higher temperature and drought on the foliar phenology and shoot growth of mature trees of two semiarid conifer species. We exposed field‐grown trees to a ~45% reduction in precipitation with a rain‐out structure (‘drought’), a ~4.8 °C temperature increase with open‐top chambers (‘heat’), and a combination of both simultaneously (‘drought + heat’). Over the 2013 growing season, drought, heat, and drought + heat treatments reduced shoot and needle growth in piñon pine (Pinus edulis) by ≥39%, while juniper (Juniperus monosperma) had low growth and little response to these treatments. Needle emergence on primary axis branches of piñon pine was delayed in heat, drought, and drought + heat treatments by 19–57 days, while secondary axis branches were less likely to produce needles in the heat treatment, and produced no needles at all in the drought + heat treatment. Growth of shoots and needles, and the timing of needle emergence correlated inversely with xylem water tension and positively with nonstructural carbohydrate concentrations. Our findings demonstrate the potential for delayed phenological development and reduced growth with higher temperatures and drought in tree species that are vulnerable to drought and reveal potential mechanistic links to physiological stress responses. Climate change projections of an earlier and longer growing season with higher temperatures, and consequent increases in terrestrial C sink strength, may be incorrect for regions where plants will face increased drought stress with climate change.
Efficient production of T cells from mouse pluripotent stem cells by controlled expression of Lhx2
Authors: Kitajima Kenji , Kawaguchi Manami , Miyashita Kazuya , Nakajima Marino , Kanokoda Mai , Hara Takahiko
Published: July 2015

LIM‐homeobox transcription factor Lhx2 induces ex vivo amplification of adult hematopoietic stem cells (HSCs) in mice. We previously showed that engraftable HSC‐like cells are generated from mouse embryonic stem cells (ESCs) and induced pluripotent stem cells by enforced expression of Lhx2. However, when these HSC‐like cells were transplanted into irradiated congenic mice, donor‐derived T cells were barely detectable, whereas other lineages of hematopoietic cells were continuously produced. Here we investigated T‐cell differentiation potential of the Lhx2‐induced HSC‐like cells using ESCs carrying doxycycline (dox)‐inducible Lhx2 expression cassette. Dox‐mediated over‐expression of Lhx2 conferred a self‐renewing activity to ESC‐derived c‐Kit+CD41+ embryonic hematopoietic progenitor cells (HPCs), thereby converting them to HSC‐like cells. When these HSC‐like cells were transplanted into irradiated immunodeficient mice and they were supplied with a dox‐containing water, CD4/8 double negative T cells were detected in their thymi. Once the Lhx2 expression was terminated, differentiation of CD4/8 double positive and single positive T cells was initiated in the thymi of transplanted mice and mature T cells were released in the peripheral blood. These results showed that engraftable HSC‐like cells with full hematopoietic potential can be obtained from ESCs by the conditional expression of Lhx2.
Molecular typing for detection of high‐risk human papillomavirus is a useful tool for distinguishing primary bladder carcinoma from secondary involvement of uterine cervical carcinoma in the urinary bladder
Authors: Kao Hua‐Lin , Lai Chiung‐Ru , Ho Hsiang‐Ling , Pan Chin‐Chen
Published: July 2015

Aims

For patients with carcinoma of the urinary bladder and uterine cervix, distinguishing between metastasis and a second primary carcinoma has significant prognostic and therapeutic implications. The aim of this study was to investigate the prevalence of high‐risk human papillomavirus (HR‐HPV) in cervical carcinoma with secondary involvement of the bladder and primary bladder carcinoma, in order to explore whether the detection of HR‐HPV could help to differentiate between the two.

Methods and results

Paired bladder and cervix carcinoma specimens from 37 patients with cervical carcinoma with bladder involvement, four patients with bladder carcinoma with uterine cervical involvement and two patients with double primaries were studied with quantitative multiplex polymerase chain reaction and chromogenic in‐situ hybridization. Three hundred and seventy‐five bladder carcinomas and 220 cervical carcinomas were analysed as controls. All cases of cervical carcinoma with bladder involvement showed concordant HR‐HPV‐positive patterns. The four cases of bladder carcinoma with uterine involvement were negative for HR‐HPV. HR‐HPV was detected in the cervical carcinoma but not in the bladder carcinoma of the patients with double primaries. HR‐HPV was detected in 91.9% of cervical carcinomas but in none of the bladder carcinomas in the control group.

Conclusions

Molecular typing for HR‐HPV detection is useful to distinguish bladder carcinoma from secondary involvement of cervical carcinoma.
WhenEnglish just is not enough: ‘Multilingualism withEnglish’ in contemporaryEuropean higher education
Authors: Earls Clive. W.
Published: July 2015

English proficiency is viewed across societal levels as a necessary commodity for accessing the best educational and professional prospects. The high value associated withEnglish as symbolic capital may be seen to impact negatively upon the promotion of individual and societal multilingualism beyond an emergent dominant pattern ofL1+English. To date, few empirical studies have been conducted into the ecology and ideologies that prevail withinEuropeanEnglish‐medium degree programmes regarding English and the concomitant acquisition of additional languages. On the basis of empirical data generated from questionnaires and semi‐structured interviews, this paper explores the experiences of students and lecturers withinEnglish‐medium degree programmes inGermany as they negotiate theirEnglish‐speaking environments and explores their practices of multilingualism beyond theirL1 and English.
Multi‐Leader Teams in Review: A Contingent‐Configuration Perspective of Effectiveness
Authors: Dust Scott B. , Ziegert Jonathan C.
Published: July 2015

Multi‐leader teams are characterized by multiple leaders exhibiting mutual influence on each other while working towards a common team goal. An unexplored assumption in this literature is that increasing the number of leaders is related to heightened team effectiveness. The authors propose that this notion is oversimplified and suggest a contingency model of multi‐leader team effectiveness. The authors suggest that the context determines the effectiveness of a particular multi‐leader team configuration, because each formation has unique internal team mechanisms. To investigate this perspective, we review the multi‐leader team literature (175 articles) by categorizing the extant theory and research as falling within nine multi‐leader configurations along two key dimensions: (1) the proportion of leaders within a team; and (2) the dispersion of leadership through role co‐enactment of team leaders. This framework enables a more coherent understanding as to the benefits and the costs of each specific multi‐leader team configuration and a clearer evaluation of the contexts in which varying configurations are most effective. Four emerging themes related to configuration–contextualization are explained and theoretical implications for interpreting leadership effectiveness in multi‐leader team settings are discussed.
A semi‐quantitative and thematic analysis of medical student attitudes towards M‐Learning
Authors: Green Ben L. , Kennedy Iain , Hassanzadeh Hadi , Sharma Suneal , Frith Gareth , Darling Jonathan C.
Published: July 2015

Rationale, aims and objectives

Smartphone and mobile application technology have in recent years furthered the development of novel learning and assessment resources. ‘MBChB Mobile’ is a pioneering mobile learning (M‐Learning) programme at University of Leeds, United Kingdom and provides all senior medical students with iPhone handsets complete with academic applications, assessment software and a virtual reflective environment. This study aimed to evaluate the impact of MBChB Mobile on student learning.

Methods

Ethical approval was granted to invite fourth and fifth year medical students to participate in a semi‐quantitative questionnaire: data were collected anonymously with informed consent and analysed where appropriate using chi‐squared test of association. Qualitative data generated through focus group participation were subjected to both content and thematic analysis.

Results

A total of 278 of 519 (53.6%) invited participants responded. Overall, 72.6% of students agreed that MBChB Mobile enhanced their learning experience; however, this was significantly related to overall usage (P < 0.001) and self‐reported mobile technology proficiency (P < 0.001). Qualitative data revealed barriers to efficacy including technical software issues, non‐transferability to different mobile devices, and perceived patient acceptability.

Conclusions

As one of the largest evaluative and only quantitative study of smartphone‐assisted M‐Learning in undergraduate medical education, MBChB Mobile suggests that smartphone and application technology enhances students' learning experience. Barriers to implementation may be addressed through the provision of tailored learning resources, along with user‐defined support systems, and appropriate means of ensuring acceptability to patients.
Chronic stress of rainbow trout Oncorhynchus mykiss at high altitude: a field study
Authors: Hunt von Herbing I. , Pan T.‐C. F. , Méndez‐Sánchez F. , Garduño‐Paz M. , Hernández‐Gallegos O. , Ruiz‐Gómez M. L. , Rodríguez‐Vargas G.
Published: July 2015

The stress response of Oncorhynchus mykiss in high‐altitude farms in central Mexico was investigated over two seasons: the cool (9·1–13·7° C) dry winter season, and the warmer (14·7–15·9° C), wetter summer season. Fish were subjected to an acute stress test followed by sampling of six physiological variables: blood cortisol, glucose, lactate, total antioxidant capacity, haemoglobin concentration and per cent packed cell volume (VPC%). Multivariate analyses revealed that lactate and total antioxidant capacity were significantly higher in the summer, when water temperatures were warmer and moderate hypoxia (4·9–5·3 mg l−1) prevailed. In contrast, plasma cortisol was significantly higher in the winter (mean ± s.e.: 76·7 ± 4·0 ng ml−1) when temperatures were cooler and dissolved oxygen levels higher (6·05–7·9 mg l−1), than in the summer (22·7 ± 3·8 ng ml−1). Haemoglobin concentrations (mg dl−1) were not significantly different between seasons, but VPC% was significantly higher in the summer (50%) than in the winter (35%). These results suggest that in summer, effects of high altitude on farmed fish are exacerbated by stresses of high temperatures and hypoxia, resulting in higher blood lactate, increased total antioxidant capacity and elevated VPC% levels.
Promoting Industrial Symbiosis: Using the Concept of Proximity to Explore Social Network Development
Authors: Velenturf Anne P.M. , Jensen Paul D.
Published: July 2015

Industrial symbiosis (IS) has been identified as a strategy for promoting industrial sustainability. IS has been defined as the development of close working agreements between industrial and other organizations that, through the innovative reuse, recycling, or sharing of resources, leads to resource efficiency. Key to IS are innovation and social network development. This article critically reviews IS literature and concludes that, to inform proactive strategies for promoting IS, the understanding of the social processes leading to resource innovation needs to be improved. Industrial ecologists generally believe that close geographical proximity and trust are essential to the development of IS. This article argues, however, that there is a need to learn more about the meaning of, need for, and specific role of geographical proximity and trust in IS and, additionally, that other potentially important social factors have remained underexplored. To move IS research forward, this article suggests to engage with research in economic geography on the concept of ‘proximity,’ which draws attention to the ways in which geographical, cognitive, institutional, social, and organizational distances between actors might affect innovation. Arguably, the analytically distinct, but flexible, dimensions of proximity can be useful to explore how and why IS develops. The resulting qualitative knowledge would form a basis for researching whether general patterns for IS development exist and, more important, could inform public and private strategies that indicate which actions could be taken, as well as when and in what way to promote resource synergies and sustainable industrial development.
Implementing a School‐Located Vaccination Program in Denver Public Schools
Authors: Shlay Judith C. , Rodgers Sarah , Lyons Jean , Romero Scott , Vogt Tara M. , McCormick Emily V.
Published: July 2015

BACKGROUND

School‐located vaccination (SLV) offers an opportunity to deliver vaccines to students, particularly those without a primary care provider.

METHODS

This SLV program offered 2 clinics at each of 20 elementary schools (influenza vaccine) and 3 clinics at each of 7 middle/preschool—eighth‐grade schools (adolescent platform plus catch‐up vaccines) during the 2009‐2010 and 2010‐2011 school years. Established programmatic processes for immunization delivery in an outreach setting were used. Billing and vaccine inventory management processes were developed. Vaccines from the federal Vaccines for Children program were used for eligible students. Third‐party payers were billed for insured students; parents were not billed for services.

RESULTS

The proportion of enrolled students who received at least 1 dose of vaccine increased from year 1 to year 2 (elementary: 28% to 31%; middle: 12% to 19%). Issues identified and addressed included program planning with partners, development and implementation of billing processes, development of a solution to adhere to the Family Educational Rights and Privacy Act requirements, development and utilization of an easy‐to‐comprehend consent form, and implementation of standard work procedures.

CONCLUSIONS

This SLV program offered an alternative approach for providing vaccinations to students outside of the primary care setting. To be successful, ongoing partnerships are needed.
A cross‐sectional survey of the effect on emerging adults living with a depressed parent
Authors: Mechling B. M.
Published: July 2015

Accessible summary

Emerging adults, or those between ages 18 and 25, are at increased risk for mental health problems as they transition into adult roles and relationships. These risks are magnified when a parent has suffered with depression during that emerging adult's upbringing.

Studies examining children of depressed parents tend to focus on samples under the age of 18 when children have yet to develop abstract thinking (e.g. improved reasoning skills, greater understanding of life experiences) and have had less time to reflect on their own experience.

It has been difficult to decipher the most important elements experienced by these children and the impact on emerging adult outcomes and most studies lack theory guiding the work. Some evidence suggests that they encounter a form of loss.

This study is unique in that the retrospective experience of emerging adults who grew up with a depressed parent was examined using variables based on propositions from Ambiguous Loss Theory and the impact on current psychosocial well‐being.

A parent who is depressed is physically present, but may be psychologically absent, or different to their children. Changes in the parent–child relationship, feelings of loss, and increased stress can occur for the child. These factors can impair psychosocial well‐being throughout the child's upbringing, and the effects might impact that child the most in their transition to adulthood. The aim of this exploratory study was to examine factors experienced while growing up with a depressed parent that might contribute to the current psychosocial well‐being of emerging adults (individuals between the ages of 18 and 25) using ambiguous loss theory as a theoretical lens. A cross‐sectional, correlational design with multiple regression analysis was used to examine relationships between emerging adults' (n = 120) perceptions of retrospective duration and understanding of parent's depression, caregiving, stress, social support, hope, and boundary ambiguity and current psychosocial well‐being. Experiencing hope, stress, and then the length of parent's depression during their upbringing were the most predictive variables for emerging adult psychosocial well‐being. Findings from this study will help mental health professionals better understand factors contributing to outcomes for this population. The knowledge to be gained is important for developing or refining age and developmentally appropriate interventions aimed at improving outcomes of adult children of depressed parents.
Formation, Clearance and Mouthfeel Perception of Oral Coatings Formed by Emulsion‐Filled Gels
Authors: Camacho Sara , Liu Kun , van der Linden Anoek , Stieger Markus , van de Velde Fred
Published: July 2015

Four emulsion‐filled gelatin gels varying in fat content (5 and 15%) and type of emulsifier (whey protein isolate: fat droplets bound to matrix; Tween 20: fat droplets unbound to matrix) were studied. We investigated (1) the formation and clearance dynamics of fat deposition on the tongue using in vivo fluorescence during oral processing; (2) influence of fat droplet characteristics on fat deposition on tongue and fatty mouthfeel; and (3) effect of follow‐up consumption (water or gelatin gel) on the removal of fat deposition on the tongue.

We conclude that fat fraction deposited on tongue and fatty perception increased with increasing mastication time, and decreased after expectoration with increasing clearance time. Fat fraction deposited on tongue and fatty perception are higher in gels with unbound droplets compared to bound droplets, as well as in gels with 15% fat compared to 5% fat. Water removed deposited fat from the tongue faster than gelatin gel.

Practical Applications

Studies about oral coatings that are formed after consumption of semisolid and solid foods are limited. This paper shows the possibility of characterizing the fat fraction in oral coatings after consumption of semisolid food gels using in vivo fluorescence technique. Moreover, it provides knowledge on the dynamic formation and clearance of fat deposition in oral coatings of food gels. The importance of oral processing time as well as characteristics of fat droplets in food gels on the properties and perceptions of oral coatings is demonstrated. Together, this understanding on how fat behaves during oral processing creates valuable insights that guide the design of low‐fat products with organoleptic properties of full‐fat products.
Does tail autotomy affect thermoregulation in an accurately thermoregulating lizard? Lessons from a 2200‐m elevational gradient
Authors: Zamora‐Camacho F. J. , Reguera S. , Moreno‐Rueda G.
Published: July 2015

Tail autotomy is an antipredatory defense that allows lizards to escape predator attacks by shedding their tails. While the benefits of preserving life are indisputable, tail loss implies a number of physiological, social, reproductive and even metabolic costs derived from tail regeneration and reduced motility. In addition, predation risk is increased in lizards with autotomized tails. Metabolic rates increase with body temperature, which in ectotherms depends on external heat sources. Ectotherm thermoregulation is costly in terms of time consumption and exposure to predators, this cost depending on habitat thermal quality. In this work, we seek to disentangle the effects of tail autotomy on field and selected body temperature of an accurately thermoregulating lizard Psammodromus algirus in different thermal environments along a 2200‐m elevational gradient. We test two non‐mutually exclusive hypotheses. According to a physiological hypothesis, we expect lizards with autotomized tails to show higher body temperatures that allow them to regenerate lost tissues faster, at least when the thermal environment is not limiting (at mid and low elevations). By contrast, according to an ethological hypothesis, we expect lizards with autotomized tails to avoid exposure to predators by reducing thermoregulation time, thus showing lower temperatures than lizards with non‐autotomized tails. However, we found that the tail state did not significantly affect lizard field or selected body temperatures. On the one hand, a warmer thermal optimum could imply greater exposure to predators during basking, making motility‐impaired lizards with autotomized tails more vulnerable, which could explain why the physiological hypothesis of autotomy thermal effect does not apply. On the other hand, lower body temperatures could be physiologically costly for lizards, which, together with the other costs resulting from tail autotomy, could jeopardize lizard fitness. Therefore, both hypotheses were not supported.
Niche overlap between sympatric coyotes and bobcats in highland zones of Olympic Mountains, Washington
Authors: Witczuk J. , Pagacz S. , Gliwicz J. , Mills L. S.
Published: July 2015

The 20th century extensive range expansion of coyote Canis latrans throughout North America may impose negative effects on native carnivores. We investigated the interspecific niche relationships to assess potential for competition between sympatric coyote and a similar‐sized felid – bobcat Lynx rufus – throughout the highland zones (elevation >1000 m) of Olympic National Park, Olympic Peninsula, Washington. Through systematic collection and analyses of scats for both carnivores (May–September 2005–2006), we determined food habits (composition, diversity, overlap of diets) and habitat use patterns. To ensure correct determination of carnivore species, we used mtDNA analysis of scats. Scat analysis indicated extensive dietary overlap between coyote and bobcat (Pianka's overlap index = 0.97). For both carnivores medium‐sized mammals comprised the predominant prey: mountain beaver Aplodontia rufa and snowshoe hare Lepus americanus; each occurring in about 50% of the scats. High dietary similarity indicated the potential for interspecific exploitative competition for mammalian prey, especially in harsh climatic conditions of high mountains. However, observed patterns of habitat selection inferred from scat distribution showed differences between coyotes and bobcats, implying some degree of habitat partitioning. Bobcats preferred relatively dense montane forests (canopy cover >40%) at lower elevations, and avoided the alpine zone, while coyotes inhabited mainly alpine and subalpine zones and mostly avoided forest. We conclude that observed habitat separation may alleviate foraging competition between coyote and bobcat. Whether this habitat separation will decrease potential negative effects of coyote colonization on bobcat abundance, or whether it indicates ongoing displacement of bobcats by coyotes, remains an open question.
Heterozygous ABCB4 mutations in children with cholestatic liver disease
Authors: Gordo‐Gilart Raquel , Hierro Loreto , Andueza Sara , Muñoz‐Bartolo Gema , López Carola , Díaz Carmen , Jara Paloma , Álvarez Luis
Published: July 2015

Background & Aims

Monoallelic defects in ABCB4, which encodes the canalicular floppase for phosphatidylcholine MDR3, have been encountered in association with a variety of hepatobiliary disorders, particularly in adult subjects. In this study, we examined the presence of heterozygous ABCB4 variants in a cohort of children with chronic cholestasis and assessed the pathogenicity of the missense changes identified.

Methods

Sixty‐seven children with chronic liver dysfunction were studied by the sequencing of ABCB4 and multiplex ligation‐dependent probe amplification analysis. The molecular defects arising from missense variants were analysed in MDCK‐II and AD‐293 cells.

Results

Defects in a single allele of ABCB4 were identified in nine subjects. They included one small insertion (p.I1242Nfs), one nonsense mutation (p.R144X) and six missense changes (p.T175A, p.G228R, p.A250T, p.S320F, p.P352L and p.A934T). In four children, these defects in ABCB4 co‐existed with various medical conditions. In vitro phenotyping of the six missense variants revealed that four (T175A, G228R, S320F and A934T) led to reduced MDR3 protein levels. Two mutations (G228R and A934T) resulted in trapping of the protein in the endoplasmic reticulum. Phosphatidylcholine efflux activity was decreased to 56–18% of reference levels for MDR3 mutants T175A, A250T and S320F. The G228R, P352L and A934T mutants were found to be non‐functional.

Conclusions

These results illustrate the varying effects of ABCB4 missense mutations and suggest that even a modest reduction in MDR3 activity may contribute or predispose to the onset of cholestatic liver disease in the paediatric age.