bluuebunny/crossref_metadata_2025 huggingface dataset:
Complex properties management
Authors: Moioli Rossella , Boniotti Cristina , Konsta Anthoula , Pili Alessandra
Published: June 2018

Purpose

The paper will present the case study of preventive and planned conservation applied to the Royal Villa and Park of Monza, which is one of the pilot projects within the general framework of Monza and Brianza Cultural District. Starting from an in-depth analysis of the Royal Villa, which represents a recent conservation and valorisation intervention developed by both public and private subjects, the purpose of this paper is to define an operative model for the management of complex properties, at communicating good practices for the maintenance of the built heritage and at identifying the priorities for the interventions.

Design/methodology/approach

The research project foresaw a first collection of data and information related to the previous conservation activities executed upon the case study, the design of a conservation plan in all its parts (technical handbook, conservation programme, economic budget, user handbook) through an information system dedicated to the conservation of built cultural heritage, and its fulfilment. In the meantime, a context analysis of the Royal Villa and Park of Monza was developed, with a specific attention to the diversified historical buildings located in the park.

Findings

The action research carried out has been evaluated in the framework of upstream perspective theories. This enabled to highlight the importance of an integrated approach; of the need of sharing the collection of data in order to set up evidence-based policies; and of the need to enhance the skills of involved professionals and decision makers.

Originality/value

A progress in protection measures, the understanding of conservation and valorisation as preventive activities, effectiveness of private business models for maintenance, dissemination of good practices, and creation of a network of local stakeholders.
Help Me Grow Utah and the impact on family protective factors development
Authors: Hill Karen D. , Hill Brian J.
Published: June 2018

Purpose

The purpose of this paper is to examine the development of family protective factors in participants of Help Me Grow Utah (HMGU), a community-based system that promotes child development, seeks early detection of developmental delays, and links families to services.

Design/methodology/approach

In this paper, standard quasi-experimental survey design was utilized. HMGU and control group participants completed the FRIENDS Protective Factors Survey, which was slightly modified into a retrospective pre-test and post-test format to address previous survey concerns of response-shift bias, self-serving assessments, and family maturation. Participants were asked to respond to ten questions at present and then again from the perspective of two years previous.

Findings

Participants in HMGU had statistically significant increases in protective factor scores in all but one subscale, with dramatic increases in two subscale questions on knowledge of parenting and child development. Control group scores statistically increased in four subscales, albeit at lower rates than HMGU participants. Interestingly, control group scores on two subscale questions relating to child maltreatment risk were significantly lower on post-tests as compared to their retrospective pre-test scores.

Research limitations/implications

Participants in HMGU clearly increased in the development of protective factors. Replication of this study is recommended and the need for a control group in protective factor studies is imperative.

Practical implications

Findings from this study suggest that child services focused on enhancing knowledge of parenting and child development might also expect to improve protective factors. One-on-one care coordination with families seems particularly effective. The findings might also benefit other social programs as they utilize retrospective pre-test, post-test, and control groups in their evaluations.

Originality/value

HMGU is the first affiliate to utilize retrospective pre-test/post-test methodology, which can overcome confounding results attributable to response-shift bias. Also, the use of a control group affords inclusion of natural maturation in considering findings.
Improving urban water supply in Mexico: a systematic review
Authors: Silva Rodríguez de San Miguel Jorge Alejandro , Trujillo Flores Mara Maricela , Lambarry-Vilchis Fernando
Published: June 2018

Purpose

The purpose of this paper is to analyse the measures taken by both the federal government of Mexico and its municipalities in relation to the country’s urban water supply and its management to improve it.

Design/methodology/approach

The PRISMA guidelines were chosen as the framework for this systematic review of the available literature on urban water supply in Mexico, considering the most important and relevant legal and institutional considerations. They were paired with critical qualitative review. Overall, 21 main documents, between 2000 and 2016, were acceptable for inclusion.

Findings

The review closes by proposing that the approach, at present, is excessively rigid, and that greater flexibility would permit municipalities to identify more suitable means of managing their own water supplies with minimal support from the federal government.

Originality/value

Several research articles have been written about the general nature of Mexico’s urban water supply and management at present. However, no attempt has been made to synthesise the evidence and arguments made in this significant body of research. Thus, the key purpose of this review is to do that with the intention of proposing a shift in the country’s approach to urban water management.
Towards a Step Change for Enhanced Delivery of Environmental and Social Benefits from EU Farming and Forestry
Authors: Maréchal Anne , Baldock David , Erjavec Emil , Juvancˇicˇ Luka , Rac Ilona , Dwyer Janet , Hart Kaley
Published: June 2018

More environmentally sensitive management of farmland and forestry is needed in Europe in response to increasing public demand and to meet the requirements of EU legislation for example on biodiversity. However, the provision of environmental and social public goods from farmland and forestry is not increasing at the required pace. A step change in approach is required: the opportunity could be provided by the current debate on adopting a more performance focussed model of the Common Agricultural Policy. Current policy mechanisms, including regulation and a range of incentives to individual farmers, meet part of the need but are not sufficient. Detailed analysis of 34 cases across the EU has convinced us that a new approach based on greater engagement with a wider range of key actors through collective actions could have greater ambition. It could aim for greater scale, longevity and coherence of action across a territory or along a supply chain. Building trust and establishing the right form of governance for highly diverse networks and types of cooperation is vital. Commercial actors in the supply chain could play a larger role. Links between flexible and extended forms of policy support, including for new initiatives, multi‐stakeholder partnerships and projects and for facilitators, will be needed.
Agri‐Environment Scheme Design: Past Lessons and Future Suggestions
Authors: Cullen Paula , Dupraz Pierre , Moran James , Murphy Pat , O'Flaherty Ronan , O'Donoghue Cathal , O'Shea Robert , Ryan Mary
Published: June 2018

This article summarises the views of a panel of experts from the areas of agricultural economics, ecology, agri‐environmental policy and agricultural extension who were bought together for a novel workshop on agri‐environment schemes conducted at the Agricultural Economics Society's 91st Annual Conference. The panel discussed the past, present and future of European Union agri‐environment schemes with emphasis on the movement from top‐down action‐based schemes to participatory‐partnership results‐based schemes. Pierre Dupraz, an expert in economic evaluations of agri‐environment schemes, pointed out past issues of agri‐environment schemes including the conflicting objectives and the growing complexity. James Moran, an ecologist who has been involved in the design of results‐based schemes, identified the importance of designing schemes that are adaptable and incentivise farmers to improve. Ronan O'Flaherty, a senior policymaker involved in new scheme design in Ireland, shone a light on the policy behind agri‐environment schemes and the importance of stakeholder buy‐in. Pat Murphy, a knowledge transfer specialist involved in the implementation of agri‐environment schemes, discussed the importance that knowledge transfer must play in the future of agri‐environment schemes. Together the speakers identified the challenges faced in designing and implementing agri‐environment schemes that improve environmental outcomes whether they be action or results‐based.
Use of a National Database to Assess Pediatric Emergency Care Across United States Emergency Departments
Authors: Michelson Kenneth A. , Lyons Todd W. , Hudgins Joel D. , Levy Jason A. , Monuteaux Michael C. , Finkelstein Jonathan A. , Bachur Richard G.
Published: June 2018

Objectives

Differences in emergency care for children exist between general and pediatric emergency departments (EDs). Some pediatric quality measures are available but are not routinely employed nationwide. We sought to create a short list of applied measures that would provide a starting point for EDs to measure pediatric emergency care quality and to compare care between general and pediatric EDs for these measures.

Methods

Previously reported lists comprising 465 pediatric emergency care quality measures were reconciled. Preset criteria were used to create a diverse list of quality measures measurable using a national database. We used the National Hospital Ambulatory Medical Care Survey from 2010 to 2015 to measure performance. Measures were excluded for total observation counts under a prespecified power threshold, being unmeasurable in the data set, or for missing clear definitions. Using survey‐weighted statistics, we reported summary performance (mean, proportion, or count) with 95% confidence intervals for each analyzed quality measure and compared general and pediatric ED performance.

Results

Among 465 quality measures, 28 (6%) were included in the analysis, including seven condition‐specific measures and 21 general measures. We analyzed a sample of 36,430 visits corresponding to 179.0 million survey‐weighted ED visits, of which 150.8 million (84.3%) were in general EDs. Performance was better in pediatric EDs for three of seven condition‐specific measures, including antibiotics for viral infections (–6.2%), chest X‐rays for asthma (–18.7%), and topical anesthesia for wound closures (+25.7%). Performance was similar for four of seven condition‐specific measures: computed tomography for head trauma, steroids for asthma, steroids for croup, and oral rehydration for dehydration. Compared with pediatric EDs, general EDs discharged and transferred higher proportions of children, had shorter lengths of stay, and sent patients home with fewer prescriptions. General EDs obtained fewer pain scores for injured children. Pediatric EDs had a lower proportion of pediatric visits in which patients left against medical advice. General and pediatric EDs had similar rates of mortality, left without being seen, incomplete vital signs, labs in nonacute patients, and similar numbers of medications given per patient.

Conclusions

Using a national sample of ED visits, we demonstrated the feasibility of using nationally representative data to assess quality measures for children cared for in the ED. Differences between pediatric and general ED care identify targets for quality improvement.
Prenatal Exposure to Alcohol Induces Functional and Structural Plasticity in Dopamine D1 Receptor‐Expressing Neurons of the Dorsomedial Striatum
Authors: Cheng Yifeng , Wang Xuehua , Wei Xiaoyan , Xie Xueyi , Melo Sebastian , Miranda Rajesh C. , Wang Jun
Published: June 2018

Background

Prenatal alcohol exposure (PAE) is a leading cause of hyperactivity in children. Excitation of dopamine D1 receptor‐expressing medium spiny neurons (D1‐MSNs) of the dorsomedial striatum (DMS), a brain region that controls voluntary behavior, is known to induce hyperactivity in mice. We therefore hypothesized that PAE‐linked hyperactivity was due to persistently altered glutamatergic activity in DMS D1‐MSNs.

Methods

Female Ai14 tdTomato reporter mice were given access to alcohol in an intermittent access, 2‐bottle choice paradigm before pregnancy, and following mating with male D1‐Cre mice, through the pregnancy period, and until postnatal day (P) 10. Locomotor activity was tested in juvenile (P21) and adult (P133) offspring, and alcohol‐conditioned place preference (CPP) was measured in adult offspring. Glutamatergic activity in DMS D1‐MSNs of adult PAE and control mice was measured by slice electrophysiology, followed by measurements of dendritic morphology.

Results

Our voluntary maternal alcohol consumption model resulted in increased locomotor activity in juvenile PAE mice, and this hyperactivity was maintained into adulthood. Furthermore, PAE resulted in a higher alcohol‐induced CPP in adult offspring. Glutamatergic activity onto DMS D1‐MSNs was also enhanced by PAE. Finally, PAE increased dendritic complexity in DMS D1‐MSNs in adult offspring.

Conclusions

Our model of PAE does result in persistent hyperactivity in offspring. In adult PAE offspring, hyperactivity is accompanied by potentiated glutamatergic strength and afferent connectivity in DMS D1‐MSNs, an outcome that is also consistent with the observed increase in alcohol preference in PAE offspring. Consequently, a PAE‐sensitive circuit, centered within the D1‐MSN, may be linked to behavioral outcomes of PAE.
Change in DSM‐5 Alcohol Use Disorder Criteria Count and Severity Level as a Treatment Outcome Indicator: Results from a Randomized Trial
Authors: Kiluk Brian D. , Frankforter Tami L. , Cusumano Michelle , Nich Charla , Carroll Kathleen M.
Published: June 2018

Background

Most clinical trials evaluating treatments for alcohol use target individuals meeting diagnostic criteria for alcohol use disorder (AUD), but few address change in diagnostic status following treatment or as a potential outcome indicator. This study evaluated whether DSM‐5 AUD total criteria count or severity category was sensitive to change over time and treatment effects.

Methods

Data were drawn from a randomized clinical trial that evaluated the efficacy of computer‐based cognitive behavioral therapy program (CBT4CBT) for AUD. Sixty‐eight individuals were randomized to 1 of the 3 weekly outpatient treatments for an 8‐week period: (i) treatment as usual (TAU), (ii) TAU+CBT4CBT, and (iii) CBT4CBT+brief monitoring. Structured clinical interviews were used to determine current (past 30 days) AUD diagnosis at baseline, end‐of‐treatment, and 6 months following end‐of‐treatment. Change in the total number of DSM criteria endorsed, as well as severity categories (mild, moderate, severe), was evaluated across time and by treatment condition.

Results

Generalized Poisson's linear mixed models revealed a significant reduction in the number of DSM criteria from baseline to treatment end point [time effect χ2(1) = 35.54, p < 0.01], but no significant interactions between time and treatment condition. Fewer total criteria endorsed, as well as achieving at least a 2‐level reduction in AUD severity category at end‐of‐treatment, were associated with better outcomes during follow‐up. Chi‐square results indicated a greater proportion of individuals assigned to TAU+CBT4CBT had at least a 2‐level reduction in severity category compared to TAU, at trend‐level significance [χ2(2, 54) = 5.13, p = 0.07], consistent with primary alcohol use outcomes in the main trial.

Conclusions

This is the first study to demonstrate change in DSM‐5 AUD total criteria count, as well as severity category, in a randomized clinical trial. These findings offer support for their use as a potential clinically meaningful outcome indicator.
Morphology of theOligoryzomys nigripesrespiratory system
Authors: Mario Lara Carolina , Borghesi Jéssica , G. Hayashi Rafael , O. Favaron Phelipe , N. Rodrigues Marcio , C. Carvalho Rafael , Miglino Maria A.
Published: June 2018

Rodents are important in the transmission of infectious diseases that affect the respiratory tract, including simple infections and those caused by specific pathogens. These animals are natural reservoirs of zoonoses that cause many public health diseases. Basic knowledge on the morphology of these animals is important as basic research is useful for applied studies, such as the development of clinical, therapeutic, surgical and clinical models. Morphological data of respiratory tract inOligoryzomys nigripesare absent in the literature. Therefore, the aim of this study was to perform a morphological analysis of the respiratory tract ofO. nigripes. Five adult females from the environmental reserve in São Joaquim da Barra, São Paulo were used, donated to the Museum of Veterinary Anatomy (FMVZ/USP). Several morphological features follow the same pattern seen in rodents; however, this species showed some differences such as the presence of three lobar bronchi, nonlobed left lung and the right lung constituted by two lobes. Respiratory epithelium lined the whole respiratory tract and was seen using scanning electron microscopy the oval shape of the parenchyma and alveoli.
The ability of a real‐time injection pressure monitoring system to discriminate between perineural and intraneural injection of the sciatic nerve in fresh cadavers
Authors: Saporito A. , Quadri C. , Capdevila X.
Published: June 2018

Injection pressure monitoring provides valuable information to prevent intraneural injections and possibly consequent nerve damage during peripheral nerve block. However, the measurement of injection pressure along the injection line is inaccurate as it is influenced by several variables. The aim of this study was to test a new system for precise injection pressure monitoring at the needle tip in a cadaveric model. The system consists of a miniaturised pressure sensor embedded within the needle shaft that is connected via an optical fibre to an external control unit. In order to test the capacity of the system to discriminate between perineural and intraneural injections, a total of 24 ultrasound‐guided injections at various locations of the sciatic nerve (12 perineural and 12 intraneural) were performed in fresh cadavers. The injections were delivered at a constant rate by an electronic pump (5 ml saline at 10 ml.min−1). Two perineural and two intraneural injections were excluded from analysis, since the operator could not confirm the exact needle‐tip location. Mean (SD) peak injection pressure was significantly lower for perineural compared with intraneural injections (14 (6) kPa vs. 131 (56) kPa; p < 0.001). This study shows that this system is a reliable method to accurately monitor injection pressure at the needle tip, allowing for discrimination between perineural and intraneural injections of the sciatic nerve in fresh cadavers.
Melatonin affects the motility and adhesiveness of in vitro capacitated boar spermatozoa via a mechanism that does not depend on intracellular ROS levels
Authors: Rocco Martina , Betarelli Rafael , Placci Anna , Fernández‐Novell Josep M. , Spinaci Marcella , Casao Adriana , Muiño‐Blanco Teresa , Cebrián‐Pérez José A. , Peña Alejandro , Rigau Teresa , Bonet Sergi , Castillo‐Martín Miriam , Yeste Marc , Rodríguez‐Gil Joan E.
Published: June 2018

This work sought to address the effects of melatonin during in vitro capacitation (IVC) and progesterone‐induced acrosome exocytosis (IVAE) in boar spermatozoa. With this purpose, two different experiments were set. In the first one, IVC and IVAE were induced in the absence or presence of melatonin, which was added either at the start of IVC or upon triggering the IVAE with progesterone. Different parameters were evaluated, including intracellular levels of peroxides and superoxides, free cysteine radicals and distribution of specific lectins. While melatonin neither affected most capacitation‐associated parameters nor IVAE, it dramatically decreased sperm motility, with a maximal effect at 5 μm. This effect was accompanied by a significant increase in the percentage of agglutinated spermatozoa, which was independent from noticeable changes in the distribution of lectins. Levels of free cysteine radicals were significantly lower in melatonin treatments than in the control after 4 h of incubation in capacitating medium. The second experiment evaluated the effects of melatonin on in vitro fertilising ability of boar spermatozoa. Spermatozoa previously subjected to IVC in the presence of 1 μm melatonin and used for in vitro fertilisation exhibited less ability to bind the zona pellucida (ZP) and higher percentages of monospermy. In conclusion, melatonin affects sperm motility and the stability of nucleoprotein structure and also modulates the ability of in vitro capacitated boar spermatozoa to bind the oocyte ZP. However, such effects do not seem to be related to either its antioxidant properties or changes in the sperm glycocalix.
Children's abilities to communicate with both parents in infancy were related to their social competence at the age of 15
Authors: Hedenbro Monica , Rydelius Per‐Anders
Published: June 2018

Aim

Studies of children's early ability to communicate have mainly focused on mother‐child dyads. That is why this study analysed the long‐term effects of triadic interactions involving both parents.

Method

This prospective pilot study monitored child‐mother‐father communication in 19 families from the general population in Sweden using the standardised Lausanne Trilogue Play method in a video studio. The families and their first‐born child were initially followed from three months to 48 months of age. Preschool teachers assessed the children at the age of four using the Preschool Behaviour Questionnaire and then their teachers assessed the subjects at the age of 15 using the Strengths and Difficulties Questionnaire. Early communication was analysed in relation to the children's social competence at the age of 15.

Results

The child's skills in initiating turn‐taking sequences and their parents’ responses to this correlated with the child's social competence at the age of four, as reported in a previous study from our group, and at the age of 15, as reported here.

Conclusion

The results of this study indicated that stimulating children's capacity to initiate turn‐taking sequences in infancy improved their social competence at the age of 15, confirming positive results at four years of age.
Smoking in pregnancy is a key factor for sudden infant death among Māori
Authors: MacFarlane M , Thompson J M D , Zuccollo J , McDonald G , Elder D , Stewart A W , Lawton B , Percival T , Baker N , Schlaud M , Fleming P , Taylor B , Mitchell E A
Published: June 2018

Aim

To examine the sudden unexpected death in infancy (SUDI) disparity between Māori and non‐Māori in New Zealand.

Methods

A nationwide prospective case–control study ran from March 2012 to February 2015. Exposure to established SUDI risk factors was analysed to investigate the disparity experienced by Māori. Infant ethnicity was based on mother's ethnicity. Māori ethnicity was prioritised. Non‐Māori includes Pacific, Asian, NZ European and Other.

Results

There were 137 cases and 649 controls. The Māori SUDI rate was 1.41/1000 live births compared to 0.53/1000 for non‐Māori. Parents/caregivers of 132 cases (96%) and 258 controls (40%) were interviewed. Smoking in pregnancy was associated with an equally increased SUDI risk for Māori (adjusted OR = 8.11, 95% CI = 2.64, 24.93) and non‐Māori (aOR = 5.09, 95% CI = 1.79, 14.47), as was bed‐sharing (aOR = 3.66, 95% CI = 1.49, 9.00 vs aOR = 11.20, 95% CI = 3.46, 36.29). Bed‐sharing prevalence was similar; however, more Māori controls smoked during pregnancy (46.7%) than non‐Māori (22.8%). The main contributor relating to increased SUDI risk for Māori/non‐Māori infants is the combination of smoking in pregnancy and bed sharing.

Conclusion

The association between known SUDI risk factors, including bed sharing and/or smoking in pregnancy and SUDI risk, is the same regardless of ethnicity. Māori infants are exposed more frequently to both behaviours because of the higher Māori smoking rate.
Laparoscopic diagnosis of retrograde peristalsis and intussusception in Roux‐en‐Y limb after laparoscopic gastrectomy: A case report
Authors: Yoshiyama Shigeyuki , Toiyama Yuji , Ichikawa Takashi , Shimura Tadanobu , Yasuda Hiromi , Hiro Jun‐ichiro , Ohi Masaki , Araki Toshimitsu , Kusunoki Masato
Published: June 2018

The cause of jejunojejunal intussusception, a rare complication after Roux‐en‐Y gastric surgery, remains unclear. Here, we present a case of retrograde jejunojejunal intussusception that occurred after laparoscopic distal gastrectomy with Roux‐en‐Y reconstruction. A 51‐year‐old woman who had undergone laparoscopic distal gastrectomy and Roux‐en‐Y reconstruction for early gastric cancer 6 years previously was admitted to our hospital with abdominal pain. Abdominal CT revealed the “target sign,” and she was diagnosed as having small bowel intussusception. Laparoscopic surgery resulted in a diagnosis of retrograde intussusception of the distal jejunum of the Roux‐en‐Y anastomosis with retrograde peristalsis in the same area. The Roux‐en‐Y anastomosis site and intussuscepted segment were resected laparoscopically. To the best of our knowledge, this is the first report of laparoscopic diagnosis of retrograde peristalsis in the distal jejunum of a Roux‐en‐Y anastomosis. Additionally, relevant published reports concerning this unusual condition are discussed.
Adjunctive thyroid hormone treatment in rapid cycling bipolar disorder: A double‐blind placebo‐controlled trial of levothyroxine (L‐T4) and triiodothyronine (T3)
Authors: Walshaw Patricia D , Gyulai Laszlo , Bauer Michael , Bauer Mark S , Calimlim Brian , Sugar Catherine A , Whybrow Peter C
Published: June 2018

Objectives

This report describes the first comparative double‐blind, placebo‐controlled trial of levothyroxine (L‐T4) and triiodothyronine (T3) as adjunctive treatments in rapid cycling bipolar disorder.

Methods

Thirty‐two treatment‐resistant, rapid cycling patients who had failed a trial of lithium were randomized into three treatment arms: L‐T4, T3, or placebo. They were followed for ≥4 months with weekly clinical and endocrine assessments.

Results

There were no statistically significant differences between the groups in age, gender, duration of illness, or thyroid status. Markov chain analyses were employed to assess treatment effects on cycling patterns among mood states (euthymia, depression, mania, and mixed). Within groups, post‐treatment the L‐T4 group spent significantly less time depressed or in a mixed state and greater time euthymic. The T3 and placebo groups did not differ significantly pre‐ and post‐treatment in any mood state, although the pattern of effects was the same for the T3 group as for the L‐T4 group. Between groups, the L‐T4 group had a significantly greater increase in time euthymic and decrease in time in the mixed state than the placebo group. Other group differences were not significant, although they were in the expected direction.

Conclusions

The findings in this first double‐blind study directly comparing the effects of L‐T4 and T3 therapy against placebo provide evidence for the benefit of adjunctive L‐T4 in alleviating resistant depression, reducing time in mixed states and increasing time euthymic. Adjunctive T3 did not show statistically significant evidence of benefit over placebo in reducing the time spent in disturbed mood states.
Semiparametric Regression Analysis of Interval-Censored Data with Informative Dropout
Authors: Gao Fei , Zeng Donglin , Lin Dan-Yu
Published: June 2018

Interval-censored data arise when the event time of interest can only be ascertained through periodic examinations. In medical studies, subjects may not complete the examination schedule for reasons related to the event of interest. In this article, we develop a semiparametric approach to adjust for such informative dropout in regression analysis of interval-censored data. Specifically, we propose a broad class of joint models, under which the event time of interest follows a transformation model with a random effect and the dropout time follows a different transformation model but with the same random effect. We consider nonparametric maximum likelihood estimation and develop an EM algorithm that involves simple and stable calculations. We prove that the resulting estimators of the regression parameters are consistent, asymptotically normal, and asymptotically efficient with a covariance matrix that can be consistently estimated through profile likelihood. In addition, we show how to consistently estimate the survival function when dropout represents voluntary withdrawal and the cumulative incidence function when dropout is an unavoidable terminal event. Furthermore, we assess the performance of the proposed numerical and inferential procedures through extensive simulation studies. Finally, we provide an application to data on the incidence of diabetes from a major epidemiological cohort study.
Exploring family members' experiences of the Assessment and Treatment Unit supporting their relative
Authors: Williamson Hannah , Meddings Susanne
Published: June 2018

Accessible summary

It is important to ask people who use services and their families about their experience of care, and to make service changes in line with what they want/need.

We asked four parents of adults with learning disabilities what they liked, disliked, and would like to be different about the ward (Assessment and Treatment Unit) where their relative was staying.

We summarised what these parents said and shared it with families and the staff team.

We want to use what they said to improve our service.

Background

Learning disability services must include the people who use them (individuals and their families/carers) in service commissioning, planning and delivery (Department of Health 2012. Transforming care: A national response to Winterbourne View Hospital. Department of Health review: Final report). One group of important stakeholders in learning disability services are the family members and carers of people with a learning disability. The aim of this study was to explore how family members experienced their involvement with one Assessment and Treatment Unit, with a view to shaping future service developments.

Materials and Methods

Qualitative methods were employed to explore family members' lived experiences. Four participants, all parents of service users, took part in semi‐structured interviews. Interview transcripts were analysed using thematic analysis.

Results

Analysis elicited four master themes under which subordinate themes clustered. The master themes were as follows: “Admission as traumatic, a relief, or both,” “Negotiating a new role,” “Valued features of the unit” and “Negative experiences.”

Conclusions

The findings have implications for learning disability services and future research. Findings are discussed with relevance to strengths, limitations, wider literature and policies driving learning disability services.
Wahlenbergfjord, eastern Svalbard: a glacier‐surrounded fjord reflecting regional hydrographic variability during the Holocene?
Authors: Bartels Martin , Titschack Jürgen , Fahl Kirsten , Stein Rüdiger , Hebbeln Dierk
Published: June 2018

Exceptionally high sedimentation rates in Arctic fjords provide the possibility to reconstruct environmental conditions in high temporal resolution during the (pre‐)Holocene. The unique geographical location of Svalbard at the intersection of Arctic and Atlantic waters offers the opportunity to estimate local (mainly glacier‐related) vs. regional (hydrographic) variabilities. Sedimentological, micropalaeontological and geochemical data from the very remote, glacier‐surrounded Wahlenbergfjord in eastern Svalbard provides information on glacier dynamics, palaeoceanographic and sea‐ice conditions during the Holocene. The present study illustrates a high meltwater discharge during the summer insolation maximum (c. 11.3–7.7 ka) when the intrusion of upwelled relatively warm Atlantic‐derived waters led to an almost open fjord situation with reduced sea ice in summer. Around 7.7 ka, a rapid hydrographic shift occurred: the dominance of inflowing Atlantic‐derived waters was replaced by a stronger influence of Arctic Water reflecting regional palaeoceanographic conditions evident in the benthic foraminiferal fauna also at Svalbard's margins. Neoglacial conditions characterized the late Holocene (c. 3.1–0.2 ka), when glaciers probably advanced as cold atmospheric temperatures were decoupled from the advection of relatively warm intermediate waters probably caused by an extending sea‐ice coverage. Accordingly, our data show that even a remote, glacier‐proximal study site reflects rapid as well as longer‐term regional changes.
Tonantzitlolone is a nanomolar potency activator of transient receptor potential canonical 1/4/5 channels
Authors: Rubaiy Hussein N , Ludlow Melanie J , Siems Karsten , Norman Katherine , Foster Richard , Wolf Dietmar , Beutler John A , Beech David J
Published: June 2018

Background and Purpose

The diterpene ester tonantzitlolone (TZL) is a natural product, which displays cytotoxicity towards certain types of cancer cell such as renal cell carcinoma cells. The effect is similar to that of (‐)‐englerin A, and so, although it is chemically distinct, we investigated whether TZL also targets transient receptor potential canonical (TRPC) channels of the 1, 4 and 5 type (TRPC1/4/5 channels).

Experimental Approach

The effects of TZL on renal cell carcinoma A498 cells natively expressing TRPC1 and TRPC4, modified HEK293 cells overexpressing TRPC4, TRPC5, TRPC4‐TRPC1 or TRPC5‐TRPC1 concatemer, TRPC3 or TRPM2, or CHO cells overexpressing TRPV4 were studied by determining changes in intracellular Ca2+, or whole‐cell or excised membrane patch‐clamp electrophysiology.

Key Results

TZL induced an elevation of intracellular Ca2+ in A498 cells, similar to that evoked by englerin A. TZL activated overexpressed channels with EC50 values of 123 nM (TRPC4), 83 nM (TRPC5), 140 nM (TRPC4‐TRPC1) and 61 nM (TRPC5‐TRPC1). These effects of TZL were reversible on wash‐out and potently inhibited by the TRPC1/4/5 inhibitor Pico145. TZL activated TRPC5 channels when bath‐applied to excised outside‐out but not inside‐out patches. TZL failed to activate endogenous store‐operated Ca2+ entry or overexpressed TRPC3, TRPV4 or TRPM2 channels in HEK 293 cells.

Conclusions and Implications

TZL is a novel potent agonist for TRPC1/4/5 channels, which should be useful for testing the functionality of this type of ion channel and understanding how TRPC1/4/5 agonists achieve selective cytotoxicity against certain types of cancer cell.
A recent history of nitroxyl chemistry, pharmacology and therapeutic potential
Authors: Fukuto Jon M
Published: June 2018

Due to the excitement surrounding the discovery of NO as an endogenously generated signalling molecule, a number of other nitrogen oxides were also investigated as possible physiological mediators. Among these was nitroxyl (HNO). Over the past 25 years or so, a significant amount of work by this laboratory and many others has disclosed that HNO possesses unique chemical properties and important pharmacological utility. Indeed, the pharmacological potential for HNO as a treatment for heart failure, among other uses, has garnered this curious molecule a considerable amount of recent attention. This review summarizes the events that led to this recent attention as well as poses important questions that are still to be answered with regards to understanding the chemistry and biology of HNO.

Linked Articles

This article is part of a themed section on Nitric Oxide 20 Years from the 1998 Nobel Prize. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v176.2/issuetoc
Effects of acute exercise on drug craving, self‐esteem, mood and affect in adults with poly‐substance dependence: Feasibility and preliminary findings
Authors: Ellingsen Maren Mikkelsen , Johannesen Sunniva Launes , Martinsen Egil W. , Hallgren Mats
Published: June 2018

Introduction and Aims

Novel treatments for substance use disorders are needed. Acute bouts of exercise can improve mood states in non‐clinical populations, but effects in those with poly‐substance dependence are understudied. We examined the feasibility and short‐term effects of three types of exercise on drug cravings, self‐esteem, mood and positive/negative affect in nine poly‐drug‐dependent inpatients.

Design and Methods

Using a cross‐over design, changes in the four study outcomes were assessed immediately before exercise and on four separate occasions post‐exercise (immediately after, then at 1, 2 and 4 h post‐exercise) enabling patterns of change over time (analysis of covariance) to be observed.

Results

Participants were willing and able to engage in different non‐laboratory based exercises. Football was associated with non‐significant short‐term reductions in drug cravings. A similar trend was seen for circuit‐training, but not walking. Football and circuit‐training were associated with brief improvements in mood and positive/negative affect. No adverse events were reported.

Discussion and Conclusions

Football, circuit training and walking are feasible therapeutic activities for inpatients with poly‐substance dependence. Controlled trials are needed to determine the long‐term effects of these activities.
Dulaglutide decreases plasma aminotransferases in people with Type 2 diabetes in a pattern consistent with liver fat reduction: a post hoc analysis of the AWARD programme
Authors: Cusi K. , Sattar N. , García‐Pérez L.‐E. , Pavo I. , Yu M. , Robertson K. E. , Karanikas C. A. , Haupt A.
Published: June 2018

Aims

To evaluate the effects of dulaglutide vs placebo on liver and glycaemic/metabolic measurements in a population with Type 2 diabetes and in a subgroup with non‐alcoholic fatty liver/non‐alcoholic steatohepatitis.

Methods

A total of 1499 participants from AWARD‐1, AWARD‐5, AWARD‐8 and AWARD‐9 clinical trials were included in this analysis (dulaglutide 1.5 mg, n=971 and placebo, n=528). Thresholds of alanine aminotransferase levels ≥30 IU/l in men and ≥19 IU/l in women were used to determine the subgroup who had non‐alcoholic fatty liver/non‐alcoholic steatohepatitis. Objectives included changes from baseline to 6 months in: (1) alanine aminotransferase, aspartate transaminase and gamma‐glutamyl transpeptidase levels in the overall population and (2) alanine aminotransferase, aspartate transaminase, gamma‐glutamyl transpeptidase and glycaemic/metabolic measurements (e.g. HbA1c, fasting serum glucose, body weight, lipids and homeostatic model assessment) in the non‐alcoholic fatty liver/non‐alcoholic steatohepatitis subgroup.

Results

In the overall population at 6 months, dulaglutide significantly reduced alanine aminotransferase, aspartate transaminase and gamma‐glutamyl transpeptidase levels vs placebo [least squares mean treatment differences: –1.7 IU/l (95% CI –2.8, –0.6), P=0.003; –1.1 IU/l (95% CI –2.1, –0.1), P=0.037; –6.6 IU/l (95% CI –12.4, –0.8), P=0.025, respectively]. In the subgroup with non‐alcoholic fatty liver/non‐alcoholic steatohepatitis (alanine aminotransferase levels greater than or equal to the upper limit of normal), mean baseline liver enzyme values were 38.0 IU/l, 27.8 IU/l and 43.9 IU/l for alanine aminotransferase, aspartate transaminase and gamma‐glutamyl transpeptidase, respectively. In this population, more pronounced reductions from baseline in alanine aminotransferase were observed with dulaglutide vs placebo (–8.8 IU/l vs –6.7 IU/l). In the subgroup of people with alanine aminotransferase levels less than the upper limit of normal, changes from baseline in alanine aminotransferase did not significantly differ between treatment groups (0.0 IU/l vs 0.7 IU/l).

Conclusions

Once‐weekly dulaglutide improved alanine aminotransferase, aspartate transaminase and gamma‐glutamyl transpeptidase levels compared with placebo in a pattern consistent with liver fat reductions. Our results add further weight to the notion that glucagon‐like peptide‐1 receptor agonists may provide benefit in lowering liver fat in addition to their other metabolic actions.
Morbidity of teeth in mandibular fracture lines—A retrospective study
Authors: Kheirallah Mouetaz , Ozzo Sameer
Published: June 2018

Background/Aim

Teeth in mandibular fracture lines are common in maxillofacial trauma, but their retention or extraction is a matter of controversy. The aim of this study was to determine the factors related to retaining or extracting teeth situated in mandibular fracture lines and to decide the best treatment option.

Methods

The study included 115 patients with a single mandibular fracture that had a tooth in the line of fracture. All patients were evaluated for complications and pulp status. Patient distribution was analysed according to the complications that occurred. Statistical analysis was performed using SPSS 13.0 software.

Results

There were significant effects of tooth type and tooth location on the occurrence of complications. There were no significant differences in the occurrence of complications between the retained teeth group and the extracted teeth group irrespective of age and gender in adult patients. There were significant differences in treatment procedures between the retained teeth group and the extracted teeth group.

Conclusion

Mandibular anterior teeth involved in the fracture line should be retained, while in the mandibular angle area, they should be extracted because retaining teeth in this region increases the predictability of complications. There is no role of pulp testing in the assessment of pulp status, but root canal treatment of retained teeth helps to reduce the occurrence of complications.
Quality of life in survivors of hematological malignancies stratified by cancer type, time since diagnosis and stem cell transplantation
Authors: Esser Peter , Kuba Katharina , Mehnert Anja , Johansen Christoffer , Hinz Andreas , Lordick Florian , Götze Heide
Published: June 2018

Objectives

Quality of life (QoL) has become an important tool to guide decision making in oncology. Given the heterogeneity among hematological cancer survivors, however, clinicians need comparative data across different subsets.

Methods

This study recruited survivors of hematological malignancies (≥2.5 years after diagnosis) from 2 German cancer registries. QoL was assessed with the EORTC QLQ‐C30. The sample was stratified by cancer type, time since diagnosis, treatment with stem cell transplantation (SCT) and type of SCT. First, levels of QoL were compared across subsamples when controlling for several covariates. Second, we contrasted subsamples with gender‐ and age‐matched population controls obtained from the general population.

Results

Of 2001 survivors contacted by mail, 922 (46%) participated in the study. QoL did not significantly differ between the subsamples. All subsamples scored significantly lower in functioning and significantly higher in symptom burden compared to population controls (all P < .001). Almost all of these group effects reached clinically meaningful sizes (Cohen′s d ≥ .5). Group differences in global health/QoL were mostly non‐significant.

Conclusions

Hematological cancer survivors are associated with practically relevant impairments irrespective of differences in central medical characteristics. Nevertheless, survivors seem to evaluate their overall situation as relatively well.
Biodiversity effects on ecosystem functioning respond unimodally to environmental stress
Authors: Baert Jan M. , Eisenhauer Nico , Janssen Colin R. , De Laender Frederik
Published: June 2018

Understanding how biodiversity (B) affects ecosystem functioning (EF) is essential for assessing the consequences of ongoing biodiversity changes. An increasing number of studies, however, show that environmental conditions affect the shape of BEF relationships. Here, we first use a game‐theoretic community model to reveal that a unimodal response of the BEF slope can be expected along environmental stress gradients, but also how the ecological mechanisms underlying this response may vary depending on how stress affects species interactions. Next, we analysed a global dataset of 44 experiments that crossed biodiversity with environmental conditions. Confirming our main model prediction, the effect of biodiversity on ecosystem functioning tends to be greater at intermediate levels of environmental stress, but varies among studies corresponding to differences in stress‐effects on species interactions. Together, these results suggest that increases in stress from ongoing global environmental changes may amplify the consequences of biodiversity changes.
Rapid evolution of generalized resistance mechanisms can constrain the efficacy of phage–antibiotic treatments
Authors: Moulton‐Brown Claire E. , Friman Ville‐Petri
Published: June 2018

Antimicrobial resistance has been estimated to be responsible for over 700,000 deaths per year; therefore, new antimicrobial therapies are urgently needed. One way to increase the efficiency of antibiotics is to use them in combination with bacteria‐specific parasitic viruses, phages, which have been shown to exert additive or synergistic effects in controlling bacteria. However, it is still unclear to what extent these combinatory effects are limited by rapid evolution of resistance, especially when the pathogen grows as biofilm on surfaces typical for many persistent and chronic infections. To study this, we used a microcosm system, where genetically isogenic populations of Pseudomonas aeruginosa PAO1 bacterial pathogen were exposed to a phage 14/1, gentamycin or a combination of them both in a spatially structured environment. We found that even though antibiotic and phage–antibiotic treatments were equally effective at controlling bacteria in the beginning of the experiment, combination treatment rapidly lost its efficacy in both planktonic and biofilm populations. In a mechanistic manner, this was due to rapid resistance evolution: While both antibiotic and phage selected for increased resistance on their own, phage selection correlated positively with increase in antibiotic resistance, while biofilm growth, which provided generalized resistance mechanism, was favoured most in the combination treatment. Only relatively small cost of resistance and weak evidence for coevolutionary dynamics were observed. Together, these results suggest that spatial heterogeneity can promote rapid evolution of generalized resistance mechanisms without corresponding increase in phage infectivity, which could potentially limit the effectiveness of phage–antibiotic treatments in the evolutionary timescale.