bluuebunny/crossref_metadata_2025 huggingface dataset:
An integrative review of the psychosocial facilitators and challenges of continuous subcutaneous insulin infusion therapy in type 1 diabetes
Authors: Payk Marlene , Robinson Tracy , Davis Deborah , Atchan Marjorie
Published: September 2017

Aim

To use systematic methods to explore the psychosocial facilitators and challenges of insulin pump therapy among people with type 1 diabetes.

Background

Insulin pump therapy is now widely accepted in the management of type 1 diabetes. Given the increasing use of insulin pumps, it is timely to review the evidence relating to the psychosocial impacts of this therapy which have not been addressed in previous reviews.

Design

An integrative review of the literature (January 2005–February 2017).

Data sources

A systematic search of electronic databases: CINAHL, Cochrane, Medline, PsycINFO and Scopus.

Review methods

Empirical literature reporting psychosocial facilitators and challenges of insulin pump therapy were eligible for inclusion. A constant comparative method was used to guide the review. Quality appraisal was performed using the Mixed Methods Appraisal Tool Version 2011.

Results

Thirty‐five potential articles identified from titles and abstracts were reviewed. Of these, 13 articles were included in the final review. Psychosocial facilitators of insulin pump therapy included the flexibility and freedom it provided for living with diabetes, enhancing social situations and daily management. In contrast, challenges included the demands of pump therapy, self‐consciousness in wearing the pump and fear of hypoglycaemia and pump failure.

Conclusion

Findings can be used by health professionals to inform people embarking on insulin pump therapy and prepare them with regard to expectations of the treatment. Further research is required to explore the role of diabetes health professional in providing psychosocial support to people with type 1 diabetes on insulin pump therapy.
CEO inside debt and convertible bonds
Authors: Li Wei‐Hsien , Rhee S. Ghon , Shen Carl Hsin‐han
Published: September 2017

The question whether convertible bonds are issued to combat the risk‐shifting problem is a subject of debate in the literature, primarily because of the unavailability of clear measures regarding managerial risk‐shifting incentives. Taking advantage of recently developed inside debt‐holding measures for CEOs, we find strong evidence in support of the risk‐shifting hypothesis. When a CEO holds a large amount of inside debt, three distinct patterns emerge: (i) the firm exhibits a lower ratio of outstanding convertibles to total debt; (ii) the firm is less likely to issue convertibles than straight debt; and (iii) the firm devises contract terms to decrease the chance of conversion when it issues convertibles.
Direct and maternal additive effects are not the main determinants of Iberian piglet perinatal mortality
Authors: Muñoz M. , Rodríguez M.C. , García‐Cortes L.A. , González A. , García‐Casco J.M. , Silió L.
Published: September 2017

Data of 127,800 Iberian piglets were used to study genetic parameters of mortality at birth at the piglet level. These records proceed from three data sets: 4,987 litter of 2,156 sows of a dam line, 2,768 litter of 817 sows of a complete diallel cross between four Iberian strains and 7,153 litter of 2,113 sows of the Torbiscal composite line. Perinatal mortality was considered as a binary trait, and Bayesian threshold animal models were fitted to separately analyse the three data sets. The posterior means of direct heritability were 0.010, 0.004 and 0.003, and those of maternal heritability were 0.034, 0.011 and 0.014 for dam line, diallel cross and Torbiscal line, respectively. Important effects of litter size and parity order were inferred in the three data sets, of within‐breed cross‐breeding parameters in the diallel cross and of sex and sow handling in the Torbiscal line Therefore, the inclusion of perinatal mortality in the objective of selection is questionable in this breed and strategies for reducing piglet mortality successful in other breeds should be considered.
Videodermoscopy and doppler‐ultrasound in spider naevi: towards a new classification?
Authors: Alegre‐Sánchez A. , Bernárdez C. , Fonda‐Pascual P. , Moreno‐Arrones O.M. , López‐Gutiérrez J.C. , Jaén‐Olasolo P. , Boixeda P.
Published: September 2017

Introduction

Spider naevi (SN) are considered a subtype of telangiectasias, currently classified as low‐flow vascular malformations.

Objective

To describe the videodermoscopy and Doppler‐ultrasound (US) features of a large group of SN.

Material and Methods

A retrospective study of cases of SN collected at our Dermatology department during the period between June 2015 and June 2017 was performed. Clinical images, dermoscopic, videodermoscopic and Doppler‐US files were reviewed. For each case, the age of the patient, time since onset, size and dermoscopic pattern of the lesions were recorded. The presence of pulsatility was also evaluated visually on the videodermoscopy.

Results

Two hundred and thirty‐three SN in 189 patients were included. The mean age was 39.5 years (range: 10–76 years). Mean size of the lesions was 4.1 ± 2.0 mm. We described three dermoscopic patterns: network, star and looping. Older age, longer time since onset and larger size were found associated with higher frequency of the looping and star patterns compared to that of network pattern (P < 0.01). Pulsatility during videodermoscopy was found in 88 patients (37%). This pulsatility phenomenon was more commonly associated with the looping pattern (64.7%) than star‐ (40.3%) or network‐like patterns (29.9%) (P < 0.001). In Doppler‐US studies, a high‐flow with arterial biphasic waveform was found.

Conclusions

In the light of the results, we support that SN could be reconsidered in upcoming classifications as lesions closer to the group of high‐flow arteriovenous malformations.
Secukinumab treatment of moderate to severe plaque psoriasis in routine clinical care: real‐life data of prior and concomitant use of psoriasis treatments from the PROSPECT study
Authors: Körber A. , Thaçi D. , von Kiedrowski R. , Bachhuber T. , Melzer N. , Kasparek T. , Kraehn‐Senftleben G. , Amon U. , Augustin M.
Published: September 2017

Background

Secukinumab, a fully human anti‐interleukin‐17A monoclonal antibody, has demonstrated efficacy and safety in patients with moderate to severe psoriasis. However, as per study protocols, transition periods from prior psoriasis treatments of a defined minimal length were required and use of concomitant psoriasis medication was prohibited. There is therefore a lack of data on the effect of shorter transition periods and concomitant psoriasis treatment with other pharmacologically active substances on the effectiveness and safety of secukinumab in routine clinical practice.

Objectives

The PROSPECT study was designed to assess prior and concomitant use of psoriasis treatments in subjects receiving secukinumab and the duration of transition periods from prior treatments to secukinumab. Here, we report the baseline characteristics and the duration of transition period in an interim analysis of the first 805 subjects.

Methods

PROSPECT is an ongoing 24‐week, single‐cohort, non‐interventional study. Subjects with moderate to severe psoriasis with a decision to receive secukinumab were included.

Results

The majority of subjects were male (491/796, 61.7%), with a mean age of 47.7 years (SD 13.7). The baseline Psoriasis Area and Severity Index (PASI) was available for 92.4% (744/805) of subjects, and mean baseline PASI was 17.5 (SD 13.1); 93.4% (752/805) of subjects had signs of high disease severity. Use of concomitant treatment increased with the number of signs. Within the last 12 months prior to inclusion, 10%, 40%, and 28% of subjects had received topical, conventional systemic, or biologic treatments as their last prior psoriasis therapy, respectively, and 22% of subjects had not received any psoriasis therapy. Discontinuation of prior treatment due to adverse events was high in subjects with conventional systemic treatment (93/413, 22.5%) compared to biologic treatment (5/210, 2.4%). The median duration of the transition period was 14.0, 30.5, and 38.0 days for prior topical, conventional systemic, and biologic treatments, respectively.

Conclusion

PROSPECT is the first study to investigate prior and concomitant use of psoriasis treatments in subjects receiving secukinumab in a real‐world setting. The majority of the subjects had a high disease burden and use of concomitant treatment increased with disease severity. The duration of the transition period depended on prior treatment.
Multiple switches between GP2015, an etanercept biosimilar, with originator product do not impact efficacy, safety and immunogenicity in patients with chronic plaque‐type psoriasis: 30‐week results from the phase 3, confirmatory EGALITY study
Authors: Gerdes S. , Thaçi D. , Griffiths C.E.M. , Arenberger P. , Poetzl J. , Wuerth G. , Afonso M. , Woehling H.
Published: September 2017

Background

EGALITY was a phase III confirmatory efficacy and safety study conducted in patients with plaque‐type psoriasis as a part of totality of evidence gathered during the development of GP2015, an etanercept biosimilar.

Objective

To demonstrate equivalent efficacy and comparable safety and immunogenicity of GP2015 and the etanercept originator product (ETN, Enbrel®) and evaluate effects of repeated switching between GP2015 and ETN. Results for efficacy, safety and immunogenicity during treatment period (TP) 2 (TP2) are presented pooling the two continued treatment arms (pooled continued) versus the two treatment arms with repeated switches (pooled switched).

Methods

Patients (n = 531) were randomized 1:1 to self‐administer GP2015 or ETN twice‐weekly subcutaneously during TP1. Patients with a ≥50% improvement in Psoriasis Area and Severity Index (PASI 50) at week 12 were re‐randomized for TP2 to continue the same treatment at once‐weekly dosing or to undergo three consecutive treatment switches between GP2015 and ETN until week 30. Patients continued the last‐assigned treatment during TP2, until week 52.

Results

Mean (standard deviation [SD]) PASI scores at baseline were similar in patients who underwent multiple switches compared to those with continued treatments during TP2. During TP2, PASI 50, PASI 75 and PASI 90 response rates, percent change from baseline in PASI scores and all other efficacy parameters were similar between the pooled switched and pooled continued treatment groups at all time points. The incidence of treatment‐emergent adverse events including injection site reactions was comparable between the pooled switched (36.7%) and pooled continued (34.9%) groups. None of the patients in either treatment group were positive for binding anti‐drug antibodies in TP2.

Conclusion

Treatment efficacy, safety and immunogenicity were similar between the pooled continued and pooled switched treatments during TP2, indicating that there are no effects in the short term on clinical data of multiple switches between GP2015 and ETN.
Risk of uncommon cancers in patients with psoriasis: a Danish nationwide cohort study
Authors: Jensen P. , Egeberg A. , Gislason G. , Thyssen J.P. , Skov L.
Published: September 2017

Background

Cancer‐associated mortality is increased in psoriasis. However, little is known about the risk of less common cancers.

Objective

We aimed to evaluate the risk of less common cancers in patients with psoriasis compared to persons without psoriasis using a nationwide cohort study.

Methods

Between 1 January 2008 and 31 December 2012, we identified all Danish patients with a first‐time hospital diagnosis of a less common cancer defined as <100 new cases/year/100.000 persons in Denmark. The primary endpoint was the occurrence of a diagnosis of cancer.

Results

We included 4 361 869 individuals. Of these, 58 138 were classified as having psoriasis. After adjusting for age, sex, socio‐economic status and healthcare consumption, we found significantly elevated hazard ratios for cancers of bone and cartilage (HR 4.97 [2.32–10.62], P < 0.0001) in patients with psoriasis on systemic treatment.

Conclusion

We provide further evidence of an increased cancer of bone and cartilage risk in patients with psoriasis.
Price and quality competition with quality positions
Authors: Kurokawa Shogo , Matsubayashi Nobuo
Published: September 2017

In this study, we investigate price and quality decisions in a duopoly in the presence of firms’ quality positions , which are determined by the quality levels of their existing core products. Into a standard model of vertical differentiation, we incorporate a “repositioning cost” that is proportional to the quality differences between firms’ current and new products. By varying the levels of quality positions, we analyze the impact of this cost on the equilibrium outcomes. Our results show that the presence of repositioning costs restricts firms’ abilities to improve profitability and differentiate themselves vertically. As a result, a high‐positioned firm does not necessarily have a competitive advantage over a low‐positioned firm, even if the former offers a superior new product in equilibrium. In addition, if a low‐positioned firm is significantly cost‐efficient compared with its rival with regard to repositioning, then that firm can earn higher profits than those of a high‐positioned firm by strategically offering its low‐end product. These results contrast sharply with those based on the standard vertical differentiation model.
Color of bulk‐fill composite resin restorative materials
Authors: Barutcigil Çağatay , Barutcigil Kubilay , Özarslan Mehmet Mustafa , Dündar Ayşe , Yilmaz Burak
Published: September 2017

Objective

To evaluate the color stability of novel bulk‐fill composite resins.

Materials and Methods

Color measurements of a nanohybrid composite resin (Z550) and 3 bulk‐fill composite resins (BLK, AFX, XTF; n = 45) were performed before polymerization. After polymerization, color measurements were repeated and specimens were immersed in distilled water or red wine, or coffee. Color change [CIEDE2000 (ΔE00)] was calculated after 24 h, 1 and 3 weeks. Data were analyzed with Kruskal‐Wallis, Mann‐Whitney U and Wilcoxon tests (α = 0.05).

Results

Color changes observed after polymerization were significant for all groups. Color changes observed in distilled water for Z550 and AFX were significant. Color changes after stored in red wine and coffee were significant for all groups. Bulk‐fill composite resin color change increased over time for all groups in red wine and coffee (P < .05).

Conclusion

Polymerization significantly changed the color of nanohybrid composite resin and bulk‐fill composite resins. AFX had the highest color change in distilled water. The color of tested bulk‐fill composite resins significantly changed after immersion in beverages and over time. Color change observed with the nanohybrid composite resin after 1 week was stable.

CLINICAL SIGNIFICANCE

Clinicians should keep in mind that tested composite resins may change color when exposed to water and significantly change color immediately after they are polymerized. In addition, the color change continues over time should the patient is a coffee and/or red wine consumer.
CAD/CAM ceramic fragments in anterior teeth: A clinical report
Authors: Sinhori Bruna S. , Monteiro Sylvio , Bernardon Jussara K. , Baratieri Luiz N.
Published: September 2017

Objective

The treatment of fractured teeth has become a great opportunity to investigate new approaches in the field of restorative dentistry. Restoring teeth with ceramic fragments is a great challenge, however, the computer aided design/computer aided manufacturing (CAD/CAM) technology allows the fabrication of both laminate veneers and ceramic fragments.

Materials and Methods

Thus, the aim of this article was to report a clinical case where anterior teeth, fractured due to a sport practice, were restored with CAD/CAM ceramic fragments.

Conclusions

It was observed that with this kind of restoration optimum esthetic results might be achieved when treating anterior fractured teeth.

Clinical significance

Ceramic fragments using CAD/CAM systems are a viable clinical alternative to composites for the reconstruction of fractured teeth. Function and esthetics can be restored with the use of this treatment quickly and efficiently.
The effect of chitosan‐essential oils complex coating on physicochemical, microbiological, and quality change of grass carp (Ctenopharyhgodon idella) fillets
Authors: Cai Luyun , Leng Liping , Cao Ailing , Cheng Xuanru , Li Jianrong
Published: September 2017

The effects of chitosan coating enriched with lemon and thyme essential oils on the physicochemical, microbiological, and quality changes of grass carp fillets during 2 °C storage were determined during 16 days of storage. The pH, total volatile basic nitrogen, thiobarbituric acid reactive substances, color, texture, sensory quality, total viable count, psychrotrophic bacteria, pseudomonads, Shewanella putrefaciens, Enterobacteriaceae, and lactic acid bacteria counts were analyzed. The results indicated that chitosan coating (1.5%) incorporated with lemon or thyme essential oils (0.5%) maintained higher hardness and retarded the oxidation of lipid and protein. The most effective treatment was chitosan coating (1.5%) enriched with lemon and thyme essential oils (0.25 and 0.25%) together, which maintained the color and texture properties, and reduced the microorganisms counts. The results suggested that the synergized use of lemon and thyme essential oils increased the efficiency of chitosan coating, maintained fish fillets quality and extended its shelf life to 16 days.

Practical applications

The commercial value of fresh fish fillets is lost in a few days. Many methods have been used to inhibit the spoilage caused by microorganisms, retard the degradation of protein, and extend the shelf life of fish fillets. As an alternative to chemical and synthetic preservatives, many studies are currently focused on using natural products to improve the quality of fish products. This study reports that chitosan coating incorporated with lemon and thyme essential oils together is a promising edible coating for use in commercial applications for prolonging the shelf life of fish fillets.
Searching for a definition for pharmacologically refractory constipation: A systematic review
Authors: Soh Alex Yu Sen , Kang Jin‐Yong , Siah Kewin Tien Ho , Scarpignato Carmelo , Gwee Kok‐Ann
Published: September 2017

Background and Aim

Surgery and other non‐pharmacological treatments such as sacral nerve stimulation are used for the treatment of difficult‐to‐treat chronic constipation. Novel pharmacological therapeutic agents are also being introduced. To evaluate the efficacy of these treatments, it is imperative to have a consistent definition of pharmacologically refractory constipation. A systematic review of studies on refractory, difficult‐to‐treat or surgically treated constipation was carried out to determine the criteria that various authors used to define this group of patients.

Methods

A systematic review was performed for literature published from June 2005 to June 2015 using PubMed, Cochrane, and Scopus databases, as well as manual searches. Studies on patients with refractory or intractable constipation were extracted. Criteria used for defining refractory constipation, as well as pharmacological agents tried including dosage, frequency, and duration, were reviewed.

Results

Sixty‐one studies were included in this review. Forty‐eight involved surgical treatment of constipation, while 13 examined non‐surgical therapies for refractory constipation. There is no generally accepted definition of refractory constipation. Authors consider constipation to be refractory when response to management is suboptimal, but there is no consensus on the choice of drug, order of usage, and dosage or treatment duration. Prior medical therapy was not mentioned at all in five studies.

Conclusions

There is need for a detailed definition of pharmacologically refractory constipation before submitting patients to invasive treatments and to evaluate new pharmacological agents.
Phosphodiesterase III inhibitor attenuates rat sinusoidal obstruction syndrome through inhibition of platelet aggregation in Disse's space
Authors: Miyata Takashi , Tajima Hidehiro , Hirata Miki , Nakanuma Shin‐ichi , Makino Isamu , Hayashi Hironori , Oyama Katsunobu , Miyashita Tomoharu , Takamura Hiroyuki , Ninomiya Itasu , Fushida Sachio , Iseki Shoichi , Harada Shin‐ichi , Wakayama Tomohiko , Ohta Tetsuo
Published: September 2017

Background and Aim

Sinusoidal obstruction syndrome (SOS) is a serious drug‐induced liver injury. However, the pathophysiology of the disease remains unclear. This study investigated the effects of cilostazol (CZ), a phosphodiesterase III inhibitor, in a monocrotaline (MCT)‐induced rat model of SOS.

Methods

Male Wistar rats were administrated MCT to induce SOS. Rats were divided into control, MCT, and MCT + CZ groups. In the MCT + CZ group, CZ was administered at 48 h, 24 h, and 30 min prior to and 8 h and 24 h after MCT administration. The MCT group was treated with water instead of CZ. At 48 h after MCT administration, blood and liver samples were collected to assess biochemistry and liver histology. Expression of rat endothelial cell antigen, CD34, CD41, P‐selectin, and caspase‐3 in the liver were analyzed. Plasminogen activator inhibitor‐1 (PAI‐1) in hepatocytes was analyzed using western blotting and polymerase chain reaction.

Results

In the MCT group, macroscopic findings showed a dark‐red liver surface. Histological findings showed sinusoidal dilatation, coagulative necrosis of hepatocytes, and endothelial damage of the central vein. These changes were attenuated in the MCT + CZ group. Elevated serum transaminase and decreased platelet counts were observed in the MCT + CZ group compared with those in the MCT group. Treatment with CZ reduced MCT‐induced damage to the liver sinusoidal endothelial cells, inhibited extravasated platelet aggregation, and suppressed hepatocyte apoptosis around the central vein. CZ attenuated hepatic PAI‐1 protein and mRNA levels.

Conclusions

Cilostazol attenuated MCT‐induced SOS by preventing damage to liver sinusoidal endothelial cells and extravasated platelet aggregation. Hepatic PAI‐1 levels were suppressed with CZ treatment.
Elder‐Friendly Emergency Department: Development and Validation of a Quality Assessment Tool
Authors: McCusker Jane , Minh Vu T. T. , Veillette Nathalie , Cossette Sylvie , Vadeboncoeur Alain , Ciampi Antonio , Cetin‐Sahin Deniz , Belzile Eric
Published: September 2017

Objectives

To develop and validate a comprehensive quality assessment tool for emergency department (ED) geriatric care.

Design

Four‐step study: (1) Content development of tool by a multidisciplinary panel, (2) survey of ED lead physicians and nurses, (3) development of subscales using principal component analysis and clinical judgment, (4) reliability and validity assessment.

Setting

Province of Quebec, Canada.

Participants

Lead ED nurses and physicians at 76 Quebec EDs who participated in a 2013/14 survey (66% of 116 adult nonpsychiatric EDs in the province).

Measurements

Geriatric care items (n = 62) grouped into seven preliminary content areas (screening and assessment, clinical protocols, discharge planning, staffing, physical environment, continuing education, quality assessment), lead nurse and physician perceptions of the quality of ED geriatric care, institutional prioritization of geriatric care, and ED type.

Results

Thirteen subscales were developed; most were associated with ED type and quality indicators.

Conclusion

Thirteen subscales for geriatric ED services are proposed for evaluation in various ED settings.
Quantitative imaging of Candida utilis and its organelles by soft X‐ray Nano‐CT
Authors: LIU J. , LI F. , CHEN L. , GUAN Y. , TIAN L. , XIONG Y. , LIU G. , TIAN Y.
Published: September 2017

Soft X‐ray microscopy has excellent characteristics for imaging cells and subcellular structures. In this paper, the yeast strain, Candida utilis, was imaged by soft X‐ray microscopy and three‐dimensional volumes were reconstructed with the SART‐TV method. We performed segmentation on the reconstruction in three dimensions and identified several types of subcellular architecture within the specimen cells based on their linear absorption coefficient (LAC) values. Organelles can be identified by the correlation between the soft X‐ray LAC values and the subcellular architectures. Quantitative analyses of the volume ratio of organelles to whole cell in different phases were also carried out according to the three‐dimensional datasets. With such excellent features, soft X‐ray imaging has a great influence in the field of biological cellular and subcellular research.
Structural characterization of SnS crystals formed by chemical vapour deposition
Authors: NALIN MEHTA A. , ZHANG H. , DABRAL A. , RICHARD O. , FAVIA P. , BENDER H. , DELABIE A. , CAYMAX M. , HOUSSA M. , POURTOIS G. , VANDERVORST W.
Published: September 2017

The crystal and defect structure of SnS crystals grown using chemical vapour deposition for application in electronic devices are investigated. The structural analysis shows the presence of two distinct crystal morphologies, that is thin flakes with lateral sizes up to 50 m and nanometer scale thickness, and much thicker but smaller crystallites. Both show similar Raman response associated with SnS. The structural analysis with transmission electron microscopy shows that the flakes are single crystals of α‐SnS with [010] normal to the substrate. Parallel with the surface of the flakes, lamellae with varying thickness of a new SnS phase are observed. High‐resolution transmission electron microscopy (TEM), scanning transmission electron microscopy (STEM), first‐principles simulations (DFT) and nanobeam diffraction (NBD) techniques are employed to characterise this phase in detail. DFT results suggest that the phase is a strain stabilised β’ one grown epitaxially on the α‐SnS crystals. TEM analysis shows that the crystallites are also α‐SnS with generally the [010] direction orthogonal to the substrate. Contrary to the flakes the crystallites consist of two to four grains which are tilted up to 15° relative to the substrate. The various grain boundary structures and twin relations are discussed. Under high‐dose electron irradiation, the SnS structure is reduced and β‐Sn formed. It is shown that this damage only occurs for SnS in direct contact with SiO2.
Screening the expression characteristics of several miRNAs in G93A‐SOD1 transgenic mouse: altered expression of miRNA‐124 is associated with astrocyte differentiation by targeting Sox2 and Sox9
Authors: Zhou Fenghua , Zhang Caixia , Guan Yingjun , Chen Yanchun , Lu Qiang , Jie Linlin , Gao Hailing , Du Hongmei , Zhang Haoyun , Liu Yongxin , Wang Xin
Published: September 2017

MicroRNAs (miRNAs) are suspected to be a contributing factor in amyotrophic lateral sclerosis (ALS). Here, we assess the altered expression of miRNAs and the effects of miR‐124 in astrocytic differentiation in neural stem cells of ALS transgenic mice. Differentially expressed miRNA‐positive cells (including miR‐124, miR‐181a, miR‐22, miR‐26b, miR‐34a, miR‐146a, miR‐219, miR‐21, miR‐200a, and miR‐320) were detected by in situ hybridization and qRT‐PCR in the spinal cord and the brainstem. Our results demonstrated that miR‐124 was down‐regulated in the spinal cord and brainstem. In vitro, miR‐124 was down‐regulated in neural stem cells and up‐regulated in differentiated neural stem cells in G93A‐superoxide dismutase 1 (SOD1) mice compared with WT mice by qRT‐PCR. Meanwhile, Sox2 and Sox9 protein levels showed converse change with miR‐124 in vivo and vitro. After over‐expression or knockdown of miR‐124 in motor neuron‐like hybrid (NSC34) cells of mouse, Sox2 and Sox9 proteins were noticeably down‐regulated or up‐regulated, whereas Sox2 and Sox9 mRNAs remained virtually unchanged. Moreover, immunofluorescence results indicated that the number of double‐positive cells of Sox2/glial fibrillary acidic protein (GFAP) and Sox9/glial fibrillary acidic protein (GFAP) was higher in G93A‐SOD1 mice compared with WT mice. We also found that many Sox2‐ and Sox9‐positive cells were nestin positive in G93A‐SOD1 mice, but not in WT mice. Furthermore, differentiated neural stem cells from G93A‐SOD1 mice generated a greater proportion of astrocytes and lower proportion of neurons than those from WT mice. MiR‐124 may play an important role in astrocytic differentiation by targeting Sox2 and Sox9 in ALS transgenic mice.

image

Cover Image for this issue: doi: 10.1111/jnc.14171.
Self‐management of medication during hospitalisation: Healthcare providers’ and patients’ perspectives
Authors: Vanwesemael Toke , Boussery Koen , Manias Elizabeth , Petrovic Mirko , Fraeyman Jessica , Dilles Tinne
Published: September 2017

Aims and objectives

To explore healthcare providers’ and patients’ perspectives on self‐management of medication during the patients’ hospital stay.

Background

Self‐administration of medications relates to the process in which hospitalised patients—instead of healthcare professionals—prepare and consume medications by themselves. Literature suggests possible advantages of medication self‐management such as increased patient satisfaction, adherence to pharmacotherapy and self‐care competence.

Design

A qualitative descriptive study design was adopted, using semistructured interviews and qualitative content analysis to examine data.

Methods

Six physicians, 11 nurses, six hospital pharmacists and seven patients were recruited from one regional hospital and two university hospitals, situated in Belgium. Interviews were conducted between October 2014–January 2015.

Results

Strengths of medication self‐management were described by participants, relating to benefits of self‐management for patients, time‐saving benefits for nurses and benefits for better collaboration between patients and healthcare providers. Weaknesses were also apparent for patients as well as for nurses and physicians. Opportunities for self‐management of medication were described, relating to the organisation, the patient and the process for implementing self‐management. Threats for self‐management of medication included obstacles related to implementation of self‐managed medications and the actual process of providing medication self‐management. A structured overview of conditions that should be fulfilled before allowing self‐management of medication concerned patient‐related conditions, the self‐managed medication and the organisation of self‐management of medication.

Conclusions

This study provides new insights on the strengths, weaknesses, opportunities and threats from the perspectives of key stakeholders. Interpretation of these findings resulted in an overview of adaptations in the medication management process to facilitate implementation of self‐management of medication.

Relevance to clinical practice

A medication management process for self‐management of medication was proposed. Further interventional studies are needed to test and refine this process before implementing it in daily practice.
When holistic care is not holistic enough: The role of sexual health in mental health settings
Authors: Hendry Avril , Snowden Austyn , Brown Michael
Published: September 2017

Aims and objectives

To explore the preparation that mental health nurses receive to address sexual health in practice.

Background

People who use the mental health services often have complex sexual health needs. Mental health nurses are well placed to offer support. However, this rarely happens in practice, and therefore, people's sexual health needs are not being routinely addressed. It is not known why this is the case.

Design

Systematic review and meta‐ethnography.

Methods

EBSCO, PsycINFO, MEDLINE and ASSIA databases were searched using Booleans with Mesh and key terms including “mental health nurse” and “sexual health”. Date range was June 2006 to June 2016. Discursive papers were excluded. Included papers (n = 7) were synthesised using a meta‐ethnographic approach.

Results

The search yielded seven studies. Five key themes were identified: the (not so) therapeutic relationship; personal values dictating professional ones; institutionalised fear; being human; and education: the answer but where is it?

Conclusions

The findings illustrate the complexity of supporting people with mental health and sexual health needs. They show the discomfort many nurses have about broaching sexual health. Arguably more than with most issues, personal values impacted strongly on professional practice. Understanding the depth and multifaceted nature of these themes is important, because strategies can then be developed to mitigate the barriers to best practice. For example, the findings presented here offer a framework from which structured education and support can be built.

Relevance to clinical practice

There is a need for Mental health nurses to be more responsive to concerns around sexual health and it should be routinely included in their practice. This study illuminates why this is not currently the case. By understanding this, remedial action can be taken by nurse educators. Implications are also discussed in relation to policy, research and practice.
Postnatal ER visits within 30 days—Pattern, risk factors and implications for care
Authors: Vikström Anna , Johansson Sven‐Erik , Barimani Mia
Published: September 2017

Aims and objectives

To (i) reveal care‐seeking patterns of emergency room visits within 30 days following childbirth (i.e., identify risk factors that trigger contact with emergency room, visit rate and diagnoses) and (ii) suggest clinical implications for postnatal follow‐up.

Design

The study had a longitudinal design; it used anonymised data from a county council database on all women in Stockholm County, Sweden, who gave birth in 2013.

Methods

Descriptive and inferential data analysis methods were used. Cox regression was applied to these variables: age when giving birth, diagnostic codes at birth, care encounters and types (e.g., visits or hospital admissions), day of discharge and care organisation and type. The data covered the period from childbirth through a 30‐day period following discharge from hospital.

Results

The database contained 28,963 births and 59,202 healthcare or medical care encounters. Of these encounters, 50.3% (n = 29,774) were planned visits to hospital postnatal care units within 7 days following discharge and 1.2% (n = 681) were admissions to hospitals. Of all women who gave birth, 12.2% (n = 3,533) visited the emergency room at least once. The number of visits peaked at day 6 following discharge. These factors significantly increased risk for emergency room visits: caesarean, assisted birth and sphincter injury.

Conclusions

Emergency room visits occurred most commonly immediately following discharge when there were no routine check‐ups. Greater risk of emergency room visits – following caesareans, assisted childbirths or sphincter injuries – indicated that early support for women with childbirth complications should be improved upon discharge from hospital. Other multiple risk factors for emergency room visits might exist.

Relevance to Clinical Practice

Many emergency room visits could be prevented through early, more qualified, appropriate follow‐up via maternity care systems and effective midwifery interventions. These initiatives could enhance care continuity and facilitate postpartum recovery.
Preterm infants’ mothers’ initiation and frequency of breast milk expression and exclusive use of mother's breast milk in neonatal intensive care units
Authors: Ikonen Riikka , Paavilainen Eija , Helminen Mika , Kaunonen Marja
Published: September 2017

Aims and objectives

To describe preterm infants’ mothers’ expressing practices and exclusive use of mother's breast milk in neonatal intensive care settings, as well as to explore whether mothers’ and infants’ characteristics are predictors of the mother's inadequate expressing practices and nonexclusive use of mothers’ breast milk.

Background

Use of their own mother's milk decreases preterm infants’ mortality and morbidity, but expression is exhausting for the mothers. Mothers’ and infants’ characteristics are associated with milk output and exclusive breastfeeding at discharge, as well as later in infancy.

Design

Cross‐sectional study.

Methods

The data were collected through questionnaires in two neonatal units. Multiple logistic regression was used to determine whether mothers’ and infants’ characteristics are predictors of late expression initiation (>6 hr from birth), inadequate expression frequency (≤6 times per a day) and nonexclusive use of own mother's milk.

Results

The sample consisted of 129 mothers. One‐third of the mothers had adequate expression practices. Half of the infants exclusively received their mother's own breast milk. Previous neonatal intensive care unit experience, poor psychological well‐being, an infant's male gender, caesarean section and high gestational birth age were significant predictors of late expression initiation. None of the studied variables were significant predictors of inadequate expression frequency. Furthermore, lack of previous expression experience, financial woes and high gestational age were predictors of nonexclusive use of own mother's milk.

Conclusions

Expression practices, as well as use of own mother's milk, were suboptimal. High gestational age was associated with both late expression initiation and nonexclusive breast milk use. The mothers maintained expression regardless of their well‐being.

Relevance to clinical practice

Counselling and support are needed to avoid suboptimal expression practices. Special attention should be paid to mothers with moderately preterm infants, caesarean delivery, poor psychological well‐being and financial woes.
Reply to ‘important factors affecting the choice of an oral anticoagulant may be missed in database studies’
Authors: Gundlund A. , Fosbøl E. L. , Olesen J. B.
Published: September 2017

Click here to view the Letter to the Editor by Aarnio et al.
Comparison of Clinical, Radiographic, and Immunologic Inflammatory Parameters around Crestally and Subcrestally Placed Dental Implants: 5‐Year Retrospective Results
Authors: Al Amri Mohammad D. , Alfadda Sara A. , Labban Nawaf Y. , Alasqah Mohammed N. , Alshehri Fahad A. , Al‐Rasheed Abdulaziz S.
Published: September 2017

Purpose

To compare changes in clinical (bleeding on probing [BOP] and probing pocket depth [PPD]), radiographic (crestal bone loss [CBL]), and immunologic inflammatory (interleukin‐1beta [IL‐1β] and matrix metalloproteinase‐9 [MMP‐9]) parameters around crestally and subcrestally placed dental implants 5 years after implant placement.

Materials and Methods

Fifty‐two patients were divided into 2 groups: group 1 (n = 27): patients with single implants placed approximately 2 mm below the alveolar crest; group 2 (n = 25): patients with single implants placed at bone level. In both groups, peri‐implant BOP, PPD, and CBL were measured, and levels of IL‐1β and MMP‐9 were determined in duplicates using enzyme‐linked immunosorbent assay. Full‐mouth debridement was performed biannually in both groups. Statistical analysis was performed using the Mann‐Whitney U test (significance set at p < 0.05).

Results

All measurements in groups 1 and 2 were performed 5.3 ± 0.2 and 5.2 ± 0.1 years after implant placement, respectively. The mean CBL was 1.2 ± 0.2 mm and 1.4 ± 0.2 mm in groups 1 and 2, respectively. There was no significant difference in mean BOP, PPD, CBL and in levels of IL‐1β, and MMP‐9 among implants in both groups.

Conclusion

Clinical, radiographic, and immunologic inflammatory parameters are comparable around crestally and subcrestally placed single dental implants up to 5 years after placement. The depth of implant placement appears to have no effect on clinical status and performance of single dental implants.
Clinical Performance and Epidemiologic Aspects of Fractured Anterior Teeth Restored with a Composite Resin: A Two‐Year Clinical Study
Authors: Vural Uzay Koc , Kiremitçi Arlin , Gökalp Saadet
Published: September 2017

Purpose

To investigate the etiologic factors, effect of age and gender on dental trauma, and to evaluate the performance of composite resin on the fractured crown of permanent anterior teeth.

Materials and Methods

Over a 2‐year period, 73 permanent teeth from 51 patients with dental trauma were treated with direct composite resin restoration. Informed consent and standardized trauma forms were completed by the patient; teeth were restored with a submicron hybrid composite resin (Spectrum TPH) and respective adhesive system (Prime&Bond NT). Sixty‐nine teeth were directly restored without fiber posts, while four were treated with fiber posts. Two experienced clinicians, besides the operator, evaluated each restoration at 6‐, 12‐, and 24‐month follow‐ups according to US Public Health Service (USPHS) criteria for the following characteristics: anatomical form, marginal adaptation, color match, marginal discoloration, surface roughness, and caries. Data were analyzed using the Wilcoxon Signed Rank, Kruskal‐Wallis, Mann‐Whitney U, and Siegel and Castellan tests.

Results

A total of 73 traumatized teeth in 51 patients aged from 14 to 64 years (mean age 25.47 ± 14.058 years) were assessed according to the Ellis classification and restored over a 2‐year period. Crown fractures were more common in the maxilla (84.9%) and caused by falls (58.8%). At the end of 24 months, a total of ten restorations were lost. The survival rate after 24 months was 82.14%. There were statistically significant differences in marginal adaptation between the 6‐, 12‐, and 24‐month follow‐ups. Although changes in marginal discoloration over time were not significant (p = 0.194), changes in color match were significant (p = 0.029).

Conclusion

Within the limitations of this study, direct composite restorations were accepted as clinically satisfactory.
Conservative post‐natal management of antenatally diagnosed congenital pulmonary airway malformations
Authors: Makhijani Allya V , Wong Flora Y
Published: September 2017

Aim

Management of congenital pulmonary airway malformations (CPAM) is controversial, especially for asymptomatic patients. We aim to describe the clinical manifestations and management of CPAM at a tertiary paediatric hospital using a retrospective audit.

Methods

Infants with CPAM were identified on the Fetal Diagnostic Unit database from 2007 to 2014. Information on antenatal and post‐natal management was collected from medical record.

Results

Thirty‐five infants with antenatally diagnosed CPAM were included. Fetal CPAM volume ratio (CVR) was calculated from antenatal ultrasound measurement and used to categorise the infants into three groups of large (CVR ≥ 1.6, n = 8), medium (CVR of 0.5–1.6, n = 12) and small CPAM (CVR of ≤0.5, n = 15), respectively. Ten infants (10/35 = 29%) were symptomatic in the neonatal period. Overall, nine infants (26%) had surgical resection, among whom eight had large or medium‐sized CPAM lesions as defined by the antenatal CVR. Three infants had neonatal emergency surgery and the remaining six had late elective surgery. Histology of eight cases showed CPAM, but one case showed congenital lobar emphysema. Criteria for surgery varied and included persistent symptoms after birth, complications during childhood and persistently abnormal chest X‐ray. Most asymptomatic infants with CPAM were safely managed using a conservative approach, with no significant increase in late symptoms or complications.

Conclusions

Conservative management of CPAM may be considered for infants/children who remain asymptomatic, especially those with a small lesion. For large and medium‐sized CPAM, delineation using computed tomography is required, and surgery may be beneficial to prevent late symptoms and the risk of emergency surgery.
Reference values for serum cystatin C in very low‐birthweight infants: From two centres of China
Authors: Yang Yang , Li Shu‐jun , Pan Jing‐Jing , Hu Yu‐Hua , Zhou Xiao‐Yu , Cheng Rui , Chen Xiao‐qing
Published: September 2017

Aim

To determine the level of cystatin C (Cys‐C) values in preterm babies for the purpose of becoming a good endogenous marker of renal function.

Methods

A total of 366 very low‐birthweight infants (including 70 extremely low‐birthweight babies) with gestational age <37 weeks born in two centres were studied.

Results

In very low‐birthweight infants, the mean level of Cys‐C was 1.96 ± 0.44 mg/L in blood samples taken on day 1, 1.78 ± 0.49 mg/L on day 7 and 1.71 ± 0.47 mg/L on day 28. In extremely low‐birthweight infants, the mean level of Cys‐C was 2.00 ± 0.49 mg/L on day 1, 1.63 ± 0.38 mg/L on day 7 and 1.62 ± 0.55 mg/L on day 28, respectively. Compared to serum creatinine and blood urea nitrogen, Cys‐C level was independent of birthweight and gestational age.

Conclusion

Cys‐C is regarded as an alternative for assessing renal function in very low‐birthweight infants, but its advantages over serum creatinine and blood urea nitrogen has not been fully proved yet. Hence, larger sample study is still necessary.
The roles of stochasticity and biotic interactions in the spatial patterning of plant species in alpine communities
Authors: Bowman William D. , Swatling‐Holcomb Samantha
Published: September 2017

Questions

Plant community composition can be influenced by multiple biotic, abiotic, and stochastic factors acting on the local species pool to determine their establishment success and abundance and subsequently the diversity of the community. We asked if the influences of biotic interactions on the composition of plant species in communities, as indicated by patterns of plant species spatial associations (independent, positive or negative), vary across a productivity gradient within a single ecosystem type. Do dominant species of communities show spatial patterning suggestive of competitive interactions with interspecific neighbors? Do species that span multiple community types exhibit the same heterospecific interactions with neighbours in each community?

Location

Three alpine communities in the southern Rocky Mountains.

Methods

We measured the occurrence of species in a 1‐cm spatial grid within 2 m × 2 m plots to determine the spatial patterns of species pairs in the three communities. A null model of independent species spatial arrangements was used to determine whether species pairs were positively, negatively or independently associated, and how these patterns differed among the communities across the gradient of resource supply and environmental stress.

Results

Positive associations, indicative of facilitation between species, were most common in the most resource‐poor and least productive community. However negative associations, suggestive of competitive interactions among species, were not more common in the two more resource‐rich, productive communities. The dominant species of these communities did exhibit higher negative than positive associations with neighbours relative to positive patterning. Independent interspecific patterning was equally common relative to positive and negative patterns in all communities. Species that previously were shown to either facilitate other species or compete with neighbours exhibited spatial patterning consistent with the earlier experimental work.

Conclusions

A large number of species exhibit a lack of net biotic interactions, and stochastic factors appear to be as important as competition and facilitation in shaping the structure of the three alpine plant communities we studied.