bluuebunny/crossref_metadata_2025 huggingface dataset:
Do Mergers Benefit Patients in Underperforming Administrations? Lessons from Area Health Service Amalgamation
Authors: Johar Meliyanni , Savage Elizabeth
Published: July 2014

Evidence supporting the effects of mergers in healthcare markets on quality is mixed. In this study we exploit a government policy in NSW that imposed mergers on area health services (AHSs) to evaluate the effects of the merger on patient waiting times, an indicator of quality. We focus on the specific question of whether the merger had a larger impact on worse‐performing AHSs. Our results show heterogeneous impacts, reducing waiting times for relatively urgent public patients but further delaying non‐urgent patients. In addition, we find the merger reduced the waiting time gap between public and private patients.
A Case of Toxic Shock due to Clandestine Abortion by Misoprostol self‐administration
Authors: Cittadini Francesca , Loyola Giovanni , Caradonna Letizia , Minelli Natalia , Rossi Riccardo
Published: July 2014

Maternal mortality and morbidity are the leading causes of death and illness, respectively, among women of reproductive age in many countries throughout the world. Of all maternal deaths, those related to unsafe abortions are the most widely underestimated, but they are also the most largely preventable. Medical abortion is a safe and reliable method for termination of a pregnancy in early gestation, although it is important to be aware of signs and symptoms of severe infection and toxic shock syndrome after the medical termination of pregnancy; case studies in literature are rarely fatal events. We report the first case of septic shock syndrome following a clandestine pregnancy termination with a misoprostol‐only regimen (12 tablets 200 μg each). Autopsy findings and histopathological examination proved that the woman died from septic shock. This case suggests to improve the forensic investigations in case of unsafe, often clandestine, abortion is suspected.
Smallholder cooperatives and agricultural performance in Rwanda: do organizational differences matter?
Authors: Verhofstadt Ellen , Maertens Miet
Published: July 2014

Agricultural policies in Rwanda focus on agricultural intensification and increased market orientation of the smallholder farm sector. Cooperatives are seen as key vehicles in this, but little is known about their effectiveness to achieve these goals. In this article, we analyze the impact of cooperative membership on the agricultural performance of rural households in Rwanda. We use cross‐sectional survey data, collected in 2012, to analyze the impact of cooperative membership on different agricultural performance indicators, including indicators on agricultural intensification, market orientation, farm revenue, and income. We use several econometric techniques to deal with potential selection bias in estimating the impact of cooperative membership, including a proxy variable method based on a willingness to pay measure and propensity score matching methods. We find that cooperative membership in general has a positive impact on farm performance but these effects are driven by specific types of cooperatives.
Bridge Estimation for Linear Regression Models with Mixing Properties
Authors: Lee Taewook , Park Cheolwoo , Yoon Young Joo
Published: July 2014

Penalized regression methods have for quite some time been a popular choice for addressing challenges in high dimensional data analysis. Despite their popularity, their application to time series data has been limited. This paper concerns bridge penalized methods in a linear regression time series model. We first prove consistency, sparsity and asymptotic normality of bridge estimators under a general mixing model. Next, as a special case of mixing errors, we consider bridge regression with autoregressive and moving average (ARMA) error models and develop a computational algorithm that can simultaneously select important predictors and the orders of ARMA models. Simulated and real data examples demonstrate the effective performance of the proposed algorithm and the improvement over ordinary bridge regression.
Diagnostic accuracy of magnetic resonance imaging (MRI) prostate imaging reporting and data system (PI‐RADS) scoring in a transperineal prostate biopsy setting
Authors: Grey Alistair D.R. , Chana Manik S. , Popert Rick , Wolfe Konrad , Liyanage Sidath H. , Acher Peter L.
Published: July 2014

Objectives

To determine the sensitivity and specificity of multiparametric magnetic resonance imaging (mpMRI) for significant prostate cancer with transperineal sector biopsy (TPSB) as the reference standard.

Patients and Methods

The study included consecutive patients who presented for TPSB between July 2012 and November 2013 after mpMRI (T2‐ and diffusion‐weighted images, 1.5 Tesla scanner, 8‐channel body coil). A specialist uro‐radiologist, blinded to clinical details, assigned qualitative prostate imaging reporting and data system (PI‐RADS) scores on a Likert‐type scale, denoting the likelihood of significant prostate cancer as follows: 1, highly unlikely; 3, equivocal; and 5, highly likely. TPSBs sampled 24–40 cores (depending on prostate size) per patient. Significant prostate cancer was defined as the presence of Gleason pattern 4 or cancer core length ≥6 mm.

Results

A total of 201 patients were included in the analysis. Indications were: a previous negative transrectal biopsy with continued suspicion of prostate cancer (n = 103); primary biopsy (n = 83); and active surveillance (n = 15). Patients' mean (±sd) age, prostate‐specific antigen and prostate volumes were 65 (±7) years, 12.8 (±12.4) ng/mL and 62 (±36) mL, respectively. Overall, biopsies were benign, clinically insignificant and clinically significant in 124 (62%), 20 (10%) and 57 (28%) patients, respectively. Two of 88 men with a PI‐RADS score of 1 or 2 had significant prostate cancer, giving a sensitivity of 97% (95% confidence interval [CI] 87–99) and a specificity of 60% (95% CI 51–68) at this threshold. Receiver–operator curve analysis gave an area under the curve of 0.89 (95% CI 0.82–0.92). The negative predictive value of a PI‐RADS score of ≤2 for clinically significant prostate cancer was 97.7%

Conclusion

We found that PI‐RADS scoring performs well as a predictor for biopsy outcome and could be used in the decision‐making process for prostate biopsy.
Limitations in the approach health caregivers can take in end‐of‐life care decisions
Authors: Bülbül S. , Sürücü M. , Karavaizoğlu C. , Eke M.
Published: July 2014

Background

In the terminal stages of neuro‐metabolic diseases, parents can begin to experience a sense of loss even before the child dies, and might accept death prematurely.

Cases

A 2.5‐year‐old female patient with Sandoff Disease (diagnosed at 9 months of age), and a 17‐month‐old male Krabbe patient (diagnosed at 5 months of age) were admitted to the hospital with hypernatraemic dehydration and bronchopneumonia, respectively, within 10 days of each other. Both patients developed respiratory arrest short after admission and were supported with mechanical ventilation. Both families gave written consent to end life support, but their wishes could not be accepted according to Turkish law.

Conclusions

Specialists are expected to communicate well with families and give continuous care while respecting the opinions of patients' families on the timing of the withdrawal of life support. However, ethical and legal regulations on the conduct of health care professionals in these circumstances are unclear in Turkey and should be developed rapidly.
Importance Sampling Microfacet‐Based BSDFs using the Distribution of Visible Normals
Authors: Heitz E. , d'Eon E.
Published: July 2014

We present a new approach to microfacet‐based BSDF importance sampling. Previously proposed sampling schemes for popular analytic BSDFs typically begin by choosing a microfacet normal at random in a way that is independent of direction of incident light. To sample the full BSDF using these normals requires arbitrarily large sample weights leading to possible fireflies. Additionally, at grazing angles nearly half of the sampled normals face away from the incident ray and must be rejected, making the sampling scheme inefficient. Instead, we show how to use the distribution of visible normals directly to generate samples, where normals are weighted by their projection factor toward the incident direction. In this way, no backfacing normals are sampled and the sample weights contain only the shadowing factor of outgoing rays (and additionally a Fresnel term for conductors). Arbitrarily large sample weights are avoided and variance is reduced. Since the BSDF depends on the microsurface model, we describe our sampling algorithm for two models: the V‐cavity and the Smith models. We demonstrate results for both isotropic and anisotropic rough conductors and dielectrics with Beckmann and GGX distributions.
A Physically‐Based BSDF for Modeling the Appearance of Paper
Authors: Papas Marios , de Mesa Krystle , Jensen Henrik Wann
Published: July 2014

We present a novel appearance model for paper. Based on our appearance measurements for matte and glossy paper, we find that paper exhibits a combination of subsurface scattering, specular reflection, retroreflection, and surface sheen. Classic microfacet and simple diffuse reflection models cannot simulate the double‐sided appearance of a thin layer. Our novel BSDF model matches our measurements for paper and accounts for both reflection and transmission properties. At the core of the BSDF model is a method for converting a multi‐layer subsurface scattering model (BSSRDF) into a BSDF, which allows us to retain physically‐based absorption and scattering parameters obtained from the measurements. We also introduce a method for computing the amount of light available for subsurface scattering due to transmission through a rough dielectric surface. Our final model accounts for multiple scattering, single scattering, and surface reflection and is capable of rendering paper with varying levels of roughness and glossiness on both sides.
Phylogeny and systematics of Protodrilidae (Annelida) inferred with total evidence analyses
Authors: Martínez Alejandro , Di Domenico Maikon , Rouse Greg W. , Worsaae Katrine
Published: July 2014

Protodrilidae is a group of small, superficially simple‐looking annelids, lacking chaetae and appendages, except for two prostomial palps. Originally considered to be one of the primitive “archiannelid” families, its affinity within Annelida is still highly debated. Protodrilids are found worldwide in the interstices of intertidal and subtidal marine sediments. Despite their simple appearance they constitute one of the most species‐rich interstitial families, with 36 described species in two genera, Protodrilus and the gutless Astomus. Here we present the first phylogenetic study of Protodrilidae employing five gene fragments, 55 morphological characters and 73 terminals (including seven outgroups) analysed under direct optimization and parsimony as well as model‐based methods. The large data set includes all 36 described species of Protodrilidae (17 of which are represented only by the morphological partition) as well as 30 undescribed or uncertain species (represented by both morphology and molecules). This comprehensive, inclusive and combined analysis revealed a new perspective on the phylogeny of Protodrilidae: the family is shown to contain six cosmopolitan subclades, each supported by several morphological apomorphies, and with the genus Astomus consistently nested among the other five clades rather than next to these. Consequently, the diagnosis of Protodrilus is emended, Astomus remains unchanged and the four remaining lineages are diagnosed and named Megadrilus n. gen, Meiodrilus gen. nov., Claudrilus n. gen and Lindrilus gen. nov. Character transformations showed that large size and presence of pigmentation, oviducts and eyes are plesiomorphies of the family, retained in Protodrilus, Megadrilus gen. nov. and Lindrilus gen. nov. These features are secondarily lost in the gutless Astomus with epidermal uptake of nutrients, as well as in Meiodrilus gen. nov. and some species of Claudrilus n. gen, with smaller size correlated to life in interstices of finer sediments.
High‐Density Lipoprotein: A Novel Target for Antirestenosis Therapy
Authors: Yin Kai , Agrawal Devendra K.
Published: July 2014

Restenosis is an integral pathological process central to the recurrent vessel narrowing after interventional procedures. Although the mechanisms for restenosis are diverse in different pathological conditions, endothelial dysfunction, inflammation, vascular smooth muscle cell (SMC) proliferation, and myofibroblasts transition have been thought to play crucial role in the development of restenosis. Indeed, there is an inverse relationship between high‐density lipoprotein (HDL) levels and risk for coronary heart disease (CHD). However, relatively studies on the direct assessment of HDL effect on restenosis are limited. In addition to involvement in the cholesterol reverse transport, many vascular protective effects of HDL, including protection of endothelium, antiinflammation, antithrombus actions, inhibition of SMC proliferation, and regulation by adventitial effects may contribute to the inhibition of restenosis, though the exact relationships between HDL and restenosis remain to be elucidated. This review summarizes the vascular protective effects of HDL, emphasizing the potential role of HDL in intimal hyperplasia and vascular remodeling, which may provide novel prophylactic and therapeutic strategies for antirestenosis.
NIH Career Development Awards in Clinical and Translational Science Award Institutions: Distinguishing Characteristics of Top Performing Sites
Authors: Guerrero Lourdes R. , Nakazono Terry , Davidson Pamela L.
Published: July 2014

Purpose

To identify and disseminate the organizational characteristics of “top performing” National Institute of Health (NIH) Clinical and Translational Science Awards (CTSA) institutions in regards to career development, using the number of new K awards received per year to rank institutions and comparing these with non‐CTSA institutions.

Methods

The authors analyzed the organizational characteristics of all 61 CTSA institutions from 2006 to 2013 using the American Association of Medical Colleges Organizational Characteristics Database and K Award funding details using NIH RePORT.

Results

Five of the “top 10 performing” institutions are in the western region, and six out of the ten are public schools. Three of the “top 10 performing” institutions receive most of their K awards through two funding mechanisms—the K08 (mentored clinical scientist research award) and K23 (mentored patient‐oriented research career development awards). Notably, these three institutions lack a KL2 program.

Conclusion

The CTSA network of institutions is committed to developing the next generation of physician scientists in order to meet the pressing health needs of society. Educators and evaluators within this network may need to provide training to junior investigators beyond the traditional KL2 programs in order to advance their career development as physician scientists and clinical translational researchers.
Double‐balloon enteroscopy for choledochojejunal anastomotic stenosis after hepato‐biliary‐pancreatic operation
Authors: Sakakihara Ichiro , Kato Hironari , Muro Shinichiro , Noma Yasuhiro , Yamamoto Naoki , Harada Ryo , Horiguchi Shigeru , Tsutsumi Koichiro , Okada Hiroyuki , Yamamoto Kazuhide , Sadamori Hiroshi , Yagi Takahito
Published: July 2014

Background and Aim

There have been few reports on the success rate of balloon dilation and stent deployment using endoscopic retrograde cholangiopancreatography by double‐balloon enteroscopy (DBE‐ERCP) or on the follow‐up period after stent removal in patients with a reconstructed digestive tract and stenosis of choledochojejunal anastomosis. The present study was designed to evaluate the usefulness of DBE‐ERCP in patients with a reconstructed digestive tract and stenosis of choledochojejunal anastomosis.

Methods

Forty‐four patients with stenosis of choledochojejunal anastomosis underwent DBE‐ERCP at Okayama University Hospital between April 2008 and January 2012 (107 procedures). Rates of reaching choledochojejunal anastomosis, stent deployment, and restenosis after stent removal were retrospectively evaluated.

Results

Insertion of DBE into the choledochojejunal anastomotic site succeeded in 38 of 44 patients (86.4%), and anastomotic dilation and stent deployment succeeded in 36 of 44 patients (81.8%). In 32 of 44 patients (72.7%), their anastomotic stenoses were improved, and they achieved stent removal. After stent removal, restenosis of choledochojejunal anastomosis was detected in seven of 32 patients; however, the resolution of restenosis was achieved in all seven of those patients.

Conclusion

Dilation of choledochojejunal anastomosis combined with stent deployment using DBE‐ERCP seems to be a viable first‐line treatment for patients with stenosis of choledochojejunal anastomosis.
Intrathecal treatment of anti‐N‐Methyl‐d‐aspartate receptor encephalitis in children
Authors: Tatencloux Sarah , Chretien Pascale , Rogemond Veronique , Honnorat Jerome , Tardieu Marc , Deiva Kumaran
Published: July 2014

Anti‐NDMA receptor (NMDAR) encephalitis is an auto‐immune condition. There is no uniformly agreed treatment strategy for the disorder in children. We report the use of intrathecal treatment with methotrexate and methylprednisolone in three children (one male, two females, age 10y, 11y, and 14y) with anti‐NMDAR encephalitis, who did not respond to steroids, plasmapheresis, or rituximab. There was significant clinical improvement and stabilization of the anti‐NMDAR antibody titers in cerebrospinal fluid (CSF) and blood in two patients. In the third patient, although anti‐NMDAR antibody titers in CSF decreased, clinical recovery was less satisfactory. Intrathecal treatment with methotrexate and methylprednisolone seems to be a promising alternative treatment for some paediatric cases of resistant anti‐NMDAR encephalitis.
Monetary Discipline as a Substitute for Fiscal Reforms and Market Liberalisations
Authors: Dalmazzo Alberto
Published: July 2014

In an economy with wage‐setting unions where the government has gains from redistribution, we analyse the incentive of incumbent politicians to implement monetary discipline (e.g. by joining a monetary union) against the adoption of fiscal reforms, or deregulation in product markets. We show that monetary discipline can be a ‘substitute’ both for better (i.e. less distortionary) fiscal policies and for deregulation in product markets.
Learning and Signals under Discretionary Monetary Policy
Authors: Marzioni Stefano
Published: July 2014

This paper aims at assessing the relevance of communicating central bank's forecasts to the private sector under discretionary monetary policy. In a New Keynesian environment, the central bank and the private sector have different information sets. The private sector uses the central bank's expectations as a signal in order to update its priors, which are constituted by standard adaptive learning expectations. E‐stability is positively affected by a high correlation between actual inflation and the signal about inflation. Numerical simulations show that the presence of signals is beneficial both in the long and in the short run.
Antennal and behavioral responses of female Maruca vitrata to the floral volatiles of Vigna unguiculata and Lablab purpureus
Authors: Wang Pan , Zhang Na , Zhou Li‐Lin , Si Sheng‐Yun , Lei Chao‐Liang , Ai Hui , Wang Xiao‐Ping
Published: July 2014

In many herbivorous insects, the attraction to suitable host plants is in part mediated by similar olfactory cues from different host plants. This study investigated the electrophysiological and behavioral responses of female Maruca vitrata Fabricius (Lepidoptera: Crambidae) to floral volatiles from two host plants, Vigna unguiculata (L.) Walpers and Lablab purpureus (L.) Sweet (both Fabaceae). Qualitative and quantitative differences were found between the odor profiles of two host plants by gas chromatography‐mass spectrometry (GC‐MS). Nine electroantennography‐active compounds were detected in the headspace collections of the two host plants by means of coupled GC‐electroantennographic detection. In a wind tunnel, female behaviors (upwind flight and source approach) were not affected by stimuli or their interaction with host plants, but the behaviors were influenced by host plants. A mixture of the nine bioactive compounds, including limonene, 1,3‐diethylbenzene, benzaldehyde, acetophenone, 4‐ethylbenzaldehyde, 1‐(4‐ethylphenyl)‐ethanone, 2‐methyl‐3‐phenylpropanal, 1H‐indol‐4‐ol, and 1,1′‐(1,4‐phenylene)bis‐ethanone mimicking L. purpureus (in a ratio of 0.4:9.7:2.4:5.7:78.1:4.8:100:0.6:30.3) attracted significantly more females approaching the sources compared with the mixture of compounds mimicking V. unguiculata (in a ratio of 0.3:1.4:1.6:3.7:50.8:3.2:100:4.2:16.7). Further bioassays revealed that a subtractive 4‐component blend [limonene, 1,3‐diethylbenzene, 4‐ethylbenzaldehyde, and 1‐(4‐ethylphenyl)‐ethanone in a ratio of 0.4:9.7:78.1:4.8] was essential for maximal attraction. Our study suggested that female M. vitrata might use similar odors from V. unguiculata and L. purpureus to locate suitable hosts and that an artificial lure, containing the major floral volatiles released by the two host plants, might be useful in exploring efficiency monitoring and/or control strategies of this moth in the field.
No association between multiple sclerosis and periodontitis after adjusting for smoking habits
Authors: Gustavsen M. W. , Celius E. G. , Moen S. M. , Bjølgerud A. , Berg‐Hansen P. , Nygaard G. O. , Sandvik L. , Lie B. A. , Harbo H. F.
Published: July 2014

Background and purpose

Periodontitis has been reported to be associated with several systemic disorders, and recently a possible relationship with multiple sclerosis (MS) was suggested. The aim of the present study was to investigate the association between periodontitis and MS in a Norwegian cohort.

Methods

A case−control study in 756 MS patients and 1090 controls was conducted, and logistic regression analysis, adjusting for age, gender, place of residence, mononucleosis and smoking, was performed to investigate the association between MS and periodontitis.

Results

In the unadjusted analysis a higher prevalence of periodontitis was seen in MS patients, but this difference was not statistically significant after adjusting for the covariates.

Conclusions

The previously suggested association between MS and periodontitis is not supported in this study. Our results underline the importance of adjusting for relevant covariates in epidemiological research.
‘Upgrading’ psoriasis responsibly
Authors: Boehncke Sandra , Boehncke Wolf‐Henning
Published: July 2014

Psoriasis is a ‘pacemaker’ in dermatology. Substantial progress has been made regarding our understanding of its pathophysiology and genetic background, fuelling developments in cutaneous biology in general. Besides, the clinical perspective on psoriasis is currently changing, taking into consideration comorbidity and the systemic dimensions of this seemingly organ‐specific inflammation. The availability of drugs exhibiting fewer contraindications and improved long‐term safety opened a discussion around replacing a relatively limited (regarding both objectives and duration) ‘therapeutic’ by a much broader ‘management’ approach when it comes to treating psoriasis as a systemic disease. The question arises whether this ‘upgrade’ is warranted.
Is Nox4 a key regulator of the activated state of fibroblasts in systemic sclerosis?
Authors: Böhm Markus , Dosoki Heba , Kerkhoff Claus
Published: July 2014

The family of nicotinamide adenine dinucleotide phosphate (NADPH) oxidases consists of phagocytic gp91phox and six‐related isoforms. Recent evidence indicates that the NADPH oxidase isoform Nox4 controls vascular, renal and pulmonary injury. We propose that Nox4 is an intrinsic regulator of the activated state of dermal fibroblasts in systemic sclerosis (SSc). Profibrotic cytokines on the one hand and antifibrogenic factors such as α‐melanocyte‐stimulating hormone on the other hand may target Nox4 as an intracellular nodal point. Via increased or decreased generation of reactive oxygen species and/or hydrogen peroxide, Nox4 could orchestrate collagen synthesis, differentiation of dermal fibroblasts into a profibrotic myofibroblast phenotype and thus dermal fibrosis. Confirmation of this hypothesis will have important consequences in our understanding of the activated state of dermal fibroblasts in SSc. Based on the availability of clinically useful Nox4 inhibitors, novel antifibrotic therapies of SSc can be envisioned.
Joint Hypermobility and Headache: Understanding the Glue That Binds the Two Together – Part 1
Authors: Neilson Derek , Martin Vincent T.
Published: July 2014

Background

Heritable connective tissue disorders (HCTD) present with a wide array of findings, including headache. Because of their unusual substrate, headaches in HCTD can derive from both common and uncommon circumstances.

Methods

Literature review.

Results

Ehlers–Danlos hypermobile type can be recognized by multiple joint findings and its tendency to progress to a multisystem chronic pain syndrome. Ehlers–Danlos classic type also manifests joint laxity and similar pain complaints, but is differentiated by its skin laxity and fragility. Ehlers–Danlos vascular type presents the most severe risk due to blood vessel and hollow organ rupture. Marfan syndrome demonstrates skeletal abnormalities, lens dislocations, and aortic root dilation that can result in dissection.

Conclusions

In a headache patient, recognizing the presence of an HCTD improves the strategy for diagnosis and management. A brief review of findings related to joints, skin, and arteries may prompt further investigation into the HCTDs.
The influence of educational level and oral hygiene behaviours on DMFT index and CPITN index in an adult Italian population: an epidemiological study
Authors: Vano M , Gennai S , Karapetsa D , Miceli M , Giuca MR , Gabriele M , Graziani F
Published: July 2014

Objectives

To estimate the influence of educational level and oral hygiene behaviours on the prevalence and severity of dental caries and periodontal disease in an adult Italian population attending the Oral Hygiene department of a public Dental Clinic.

Methods

Dental caries was diagnosed according to the World Health Organization criteria. The DMFT index (decayed, missing, filled tooth) was used to record the dental caries' experience. The periodontal status was assessed using the community periodontal index of treatment needs (CPITN). Questionnaires on educational level and oral hygiene behaviours were also collected.

Results

A total of 350 patients were enrolled. The mean DMFT value reported was 4.37 ± 3.06, and higher values were observed for male patients (P < 0.05). Increased CPITN scores and DMFT values were significantly correlated with lower level of education (P < 0.05). Subjects of high educational status showed significantly better oral hygiene habits (P < 0.05).

Conclusions

The oral health status, in terms of periodontal disease and dental caries, appears correlated with patients' educational level.
Chitosan nanoparticle coatings reduce microbial growth on fresh‐cut apples while not affecting quality attributes
Authors: Pilon Lucimeire , Spricigo Poliana C. , Miranda Marcela , de Moura Márcia R. , Assis Odilio Benedito G. , Mattoso Luiz Henrique C. , Ferreira Marcos David
Published: July 2014

This study addressed the effects of chitosan‐based nanoparticles on microbiological quality, colour, polyphenol oxidase (PPO) and peroxidase (POD) and firmness of fresh‐cut ‘Gala’ apple slices during storage at 5 °C for 10 days. The treatments carried out were as follows: (i) slices pulverised with 110‐nm chitosan nanoparticles, (ii) slices pulverised with 300‐nm chitosan nanoparticles, (iii) 2 g L−1 chitosan dissolved in 2% citric acid and (iv) noncoated samples. There was an increase in chroma and a proportional decrease in hue angle and lightness. Browning of the slices coated with conventional chitosan and control was slightly intense than those coated with chitosan nanoparticles of 110 and 300 nm. The PPO and PDO activities increased with time for all samples, with irrelevant difference among the treatments. Flesh firmness did not change for any treatment and period. Coatings with chitosan nanoparticles of 110 nm showed higher antimicrobial activity against moulds and yeasts, and mesophilic and psychrotrophic bacteria than the other treatments. No Salmonella, and total and faecal coliforms were detected. This investigation supports the potential use of chitosan nanoparticles as edible coatings in controlling microbial activity in fresh‐cut apples.
Antioxidant activity and physicochemical properties of chitosan films incorporated with Lycium barbarum fruit extract for active food packaging
Authors: Wang Qian , Tian Fangyuan , Feng Ziqian , Fan Xueying , Pan Zetong , Zhou Jiang
Published: July 2014

Active packaging film was developed by incorporating Lycium barbarum fruit extract (LFE) into chitosan. The effects of LFE on physicochemical properties of the chitosan/LFE films were evaluated. When the weight ratio of LFE to chitosan was increased from 0:1 to 1:1, DPPH (2,2‐diphenyl‐1‐picrylhydrazyl) free radical scavenging activity of the chitosan/LFE films increased near ten‐folds and reached up to 35.8%; water vapour permeability of the chitosan/LFE films decreased 43.0% from 5.67 g m mm−2 day−1 kPa−1, and water solubility decreased from 100% to 24.52% because of interactions between LFE and hydrophilic groups of chitosan confirmed by FTIR. However, the chitosan/LFE films became darker after LFE was incorporated. The pure chitosan film showed better tensile strength (23.19 MPa) and elongation at break (22.29%) than the chitosan/LFE films (15.52 MPa and 9.58% for the one with weight ratio of LFE to chitosan of 0.6:1).
Efficacy of patient‐initiated follow‐up clinics in secondary care: a systematic review
Authors: Taneja A. , Su'a B. , Hill A. G.
Published: July 2014

Patient‐initiated follow up (PIFU) is an initiative that allows patients to initiate hospital follow‐up appointments on an ‘as required’ basis compared with the traditional ‘physician‐initiated’ model. The main principle is to reduce inappropriate regular follow‐up appointments. In this systematic review, we attempt to address its efficacy for outpatient secondary level care. Using Preferred Reporting Items for Systematic Reviews and Meta‐analyses guidelines, an electronic literature search was performed independently by two authors using pre‐defined search terms across EMBASE, Ovid MedLine, PubMed, PSYCINFO and the Cochrane Library databases. Articles were included if they specifically evaluated any aspect of PIFU. Studies evaluating non‐outpatient‐based, primary level‐based and nurse‐led clinic appointments were excluded. A total of 747 articles was reviewed, and six were finally included for the systematic review. Three studies analysed efficacy of PIFU with regards to rheumatological disease and found that there was no deleterious clinical effect and a trend towards increased satisfaction and quality of life including lower costs in the PIFU group. Two studies looked at PIFU and inflammatory bowel disease and identified some clinical benefit and lower costs and equivalent satisfaction and QoL with the PIFU group. A further study looked at PIFU in stage 1 breast cancer and did not find any significant differences in outcomes. There is evidence to suggest that PIFU systems result in fewer overall outpatient appointments in secondary care led services while maintaining equivalent if not better patient satisfaction, quality of life and clinical outcomes across a range of chronic conditions.
Polypharmacy among nonagenarians/centenarians in rural China
Authors: Lu J. , Yang M. , Luo L. , Hao Q. , Dong B.
Published: July 2014

Background

Little is known about the prevalence and relevant factors of polypharmacy in nonagenarian and centenarians.

Aim

The aim of this study is to examine the prevalence and associated factors of polypharmacy in a sample of nonagenarians and centenarians living in a rural area of China.

Methods

The data were from the ‘Project of Longevity and Aging in Dujiangyan’ study. Medication use and relevant covariates were obtained by face‐to‐face interviews. Minor polypharmacy was defined as the concomitant use of two to four medications, whereas major polypharmacy referred to the concomitant use of five or more medications.

Results

We included 859 participants with mean age of 93.7 ± 3.3 years. The number of chronic diseases was 1.4 ± 1.2 per subject, whereas the number of drugs was 0.8 ± 1.4 per subject. The prevalence of minor polypharmacy and major polypharmacy was 16.5% and 3.7% respectively. Illiteracy (odds ratio (OR) 2.93, 95% confidence interval (CI) 1.52 to 5.66), cognitive impairment (OR 3.15, 95% CI 1.44 to 6.88), hypertension (OR 2.88, 95% CI 1.46 to 5.67), respiratory disease (OR 2.22, 95% CI 1.08 to 4.58), osteoarthritis (OR 1.24, 95% CI 1.01 to 1.51), and cancer (OR 10.70, 95% CI 1.90 to 126.80) were positively associated with minor polypharmacy. Illiteracy (OR 4.24, 95% CI 1.53 to 11.81), hypertension (OR 3.40, 95% CI 1.22 to 9.49) and cancer (OR 3.40, 95% CI 1.14 to 10.12) were also positively associated with major polypharmacy.

Conclusions

Although most subjects suffer from some chronic diseases, minor polypharmacy and major polypharmacy are not common among nonagenarians/centenarians in rural China.
Understanding Public Attitudes to Science
Authors: Skinner Gideon , Shah Jayesh Navin
Published: July 2014

What does a medical records database in England have to do with genetically modified crops or climate change? Gideon Skinner and Jayesh Navin Shah of Ipsos MORI summarise a comprehensive new study on people's attitudes to science and scientists in the UK, and the lessons for policy-makers and researchers.
Who's Afraid of the Big Black Box?: Statisticians' Vital Role in Big Data and Predictive Modelling
Authors: Kuhn Max , Johnson Kjell
Published: July 2014

What goes on inside the black-box algorithms that turn big data into something useful? The answer, say Max Kuhn and Kjell Johnson, is statistical – so statisticians should come to the big data party.
In Situ Fabrication of B4C–NbB2 Eutectic Composites by Spark–Plasma Sintering
Authors: Demirskyi Dmytro , Sakka Yoshio
Published: July 2014

This contribution reports, for the first time, the sintering, microstructure and properties of in situ synthesized/consolidated eutectic composites by spark–plasma sintering (SPS). SPS involves a number of processing parameters that may be used to tailor the composition of eutectic composites. It was shown that pressure may be used as a means of controlling the eutectic formation. By changing the pressure, temperature and composition, we propose a processing route that results in the in situ formation of strengthened eutectic composites, consisting of a matrix (B4C, and B4C–NbB2 composite) and also containing regularly distributed whiskers of NbB2. The composites with the eutectic composition of 35 mol.% NbB2 obtained by SPS exhibit a high Vickers hardness (26–27 GPa) and indentation fracture toughness (~6 MPa·m1/2).
Long‐Range Ordered Structure of Ti–B–C–N in a TiB2–TiCxN1−x Eutectic Composite
Authors: Cheng Eric Jianfeng , Katsui Hirokazu , Tu Rong , Goto Takashi
Published: July 2014

A TiB2–TiCxN1−x quasi‐binary eutectic composite, with a rod‐like faceted texture and a long‐range ordered structure of Ti–B–C–N, was prepared by the arc‐melting of TiB2, TiC, and TiN powders. Hexagonal single‐crystalline TiCxN1−x rods were grown in a single‐crystalline TiB2 matrix with a crystal orientation relationship of TiB2 //TiCxN1−x and TiB2 [0001]//TiCxN1−x [111]. A long‐range ordered structure of Ti–B–C–N was formed by the intermixing of the coherent interplanar spacings of seven TiB2 (0001) and nine TiCxN1−x (111) planes.
Subsolidus Phase Relationship in the CaO–CuO–TiO2 Ternary System at 950°C in Air
Authors: Lee Sung‐Yun , Kim Hui Eun , Yoo Sang‐Im
Published: July 2014

The subsolidus phase relationship in the CaO–CuO–TiO2 ternary system at 950°C in air was investigated. Total 26 samples having various nominal compositions were prepared by the solid‐state reaction at 950°C in air, and their equilibrium phases were analyzed by powder X‐ray diffraction (XRD). The CaCu3Ti4O12 phase exhibits variable stoichiometry and forms as the Ca1−xCu3+xTi4O12‐type (−0.019 ≤x ≤0.048) solid solution at 950°C in air. On the basis of our results and previous reports on the binary phase diagrams, the subsolidus phase diagram of the CaO–CuO–TiO2 ternary system could be constructed at 950°C in air.
Older than the islands: origin and diversification of Galápagos leaf‐toed geckos (Phyllodactylidae: Phyllodactylus) by multiple colonizations
Authors: Torres‐Carvajal Omar , Barnes Charles W. , Pozo‐Andrade María J. , Tapia Washington , Nicholls Gabriela
Published: July 2014

Aim

We re‐examine the biogeography of the leaf‐toed geckos (Phyllodactylus) endemic to the Galápagos Islands. Our aim was to (1) test the multiple‐colonization hypothesis against the single‐colonization scenario proposed for most terrestrial organisms in the archipelago, (2) estimate the age of colonization of Phyllodactylus, and (3) evaluate the roles of dispersal and vicariance in the evolution of these lizards.

Location

Galápagos archipelago, Ecuador.

Methods

Phylogenetic relationships were evaluated with maximum‐likelihood and Bayesian methods, including the estimation of divergence times and species trees. Previous biogeographical hypotheses were evaluated with tree‐topology tests.

Results

Our results support a multiple‐colonization scenario: all but one species of Phyllodactylus in the Galápagos Islands belonged to a single radiation. The founders of this radiation colonized the archipelago 13.2 Ma when the islands currently above water had not yet emerged. Ten million years later, the ancestors of Phyllodactylus darwini colonized San Cristóbal.

Main conclusions

As with other Galápagos organisms, the Pacific coast of South America seems to have been the source for the founders that led to the oldest radiation of leaf‐toed geckos. Unlike most Galápagos endemics, however, P. darwini might have originated in the Andes. Our phylogenetic hypotheses and recent palaeogeographical data support both dispersal and vicariance as mechanisms leading to the radiation of leaf‐toed geckos in the Galápagos Islands.
A systematic review and Bayesian network meta‐analysis of randomized clinical trials on non‐surgical treatments for peri‐implantitis
Authors: Faggion Clovis M. , Listl Stefan , Frühauf Nadine , Chang Huei‐Ju , Tu Yu‐Kang
Published: July 2014

Background/Aim

It remains unclear which type of non‐surgical treatment is most appropriate as first‐line intervention against peri‐implantitis. This systematic review and Bayesian network meta‐analysis aimed to compare the clinical effect of various non‐surgical peri‐implantitis therapies.

Methods

The PubMed, SCOPUS, CINAHL, DARE and Web of Knowledge databases were searched in duplicate for randomized controlled trials (RCTs) up to and including 01 January 2014. Additional relevant literature was identified using handsearching of reference lists within published systematic reviews, and screenings of OpenGrey, ClinicalTrials.gov and Controlled‐Trials.com. Probing pocket depth (PPD) was the outcome measure assessed. Multilevel mixed modelling was used to perform the network meta‐analysis, and Markov Chain Monte Carlo simulation to obtain random effects.

Results

Eleven studies were included in the network meta‐analysis. Debridement in conjunction with antibiotics achieved the greatest additional PPD reduction in comparison to debridement only (0.490 mm; 95% credible interval: −0.647;1.252). The highest probabilities of being the most effective interventions were achieved by Vector system (p = 20.60%), debridement plus periochip (p = 20.00%) and photodynamic therapy (p = 18.90%).

Conclusion

The differences between various non‐surgical treatments were relatively small with large credible intervals. On the basis of currently available RCTs, there is insufficient evidence to support that any particular non‐surgical treatment for peri‐implantitis showed better performance than debridement alone.
Multigenerational response to artificial selection for biased clutch sex ratios in Tigriopus californicus populations
Authors: Alexander H. J. , Richardson J. M. L. , Anholt B. R.
Published: July 2014

Polygenic sex determination (PSD) is relatively rare and theoretically evolutionary unstable, yet has been reported across a range of taxa. Evidence for multilocus PSD is provided by (i) large between‐family variance in sex ratio, (ii) paternal and maternal effects on family sex ratio and (iii) response to selection for family sex ratio. This study tests the polygenic hypothesis of sex determination in the harpacticoid copepod Tigriopus californicus using the criterion of response to selection. We report the first multigenerational quantitative evidence that clutch sex ratio responds to artificial selection in both directions (selection for male‐ and female‐biased families) and in multiple populations of T. californicus. In the five of six lines that showed a response to selection, realized heritability estimated by multigenerational analysis ranged from 0.24 to 0.58. Divergence of clutch sex ratio between selection lines is rapid, with response to selection detectable within the first four generations of selection.
A Burning Issue: Rethinking the Transition from Hunter‐Gatherer to Industrial Sociometabolic Regimes
Authors: Rambo A. Terry
Published: July 2014

Hunter‐gatherers are commonly seen as having a fundamentally different sociometabolic regime from agrarian and industrial societies because they are thought to directly appropriate the products of natural ecosystems without modifying those systems in order to enhance their productivity. However, ethnographic and archeological evidence reveals that many hunter‐gatherers extensively employed fire to manage their ecosystems so as to increase production of desirable wild resources, thus engaging in “colonization of nature” that is not qualitatively different from that practiced by other types of society. They systematically burned wild vegetation in order to increase populations of edible wild plants consumed by humans and promote growth of forage for game animals. Deliberate ecosystem burning by Australian Aborigines represented an energy expenditure of 1,512 gigajoules per capita per year (GJ/capita/yr), a level of energy use that is more than three times higher than the United States (445 GJ/capita/yr). It is their profligate consumption of biomass energy that explains why the quality of life of many hunter‐gatherers was often better than that of traditional settled peasant farmers. Hence, the extent to which hunter‐gatherers have a distinct type of sociometabiolic regime is called into question. It can be argued that in the course of social evolution, there have been only two sociometabolic regimes. In one type, which includes hunter‐gatherers, swidden agriculturalists, and industrial societies, extrasomatic energy does most of the productive work, whereas in the other type, that of premodern settled agriculturalists, production is largely dependent on human muscle power.
Concussion in the National Football League: Viewpoint of an Elite Player
Authors: DeLamielleure Joe
Published: July 2014

Concussive injuries to the head and brain are relatively common in the National Football League (NFL). This is not news, since the issue has been covered in many articles in the popular press and many news specials on television. As an NFL offensive lineman for 13 years, I suffered a huge number of hits to the head — an estimated 215,000 at least. Nevertheless, I have fared better than many of the players of my era: many suffered from chronic traumatic encephalopathy (CTE). For example, some of my fellow Hall of Fame players from that era, Mike Webster, Jim Ringo, John Mackey, and Joe Perry, all suffered from CTE and all are now deceased. I count myself lucky that the main malady affecting me after those many blows to the head is a 60% hearing loss in my left ear — probably due to undiagnosed concussions and particularly to thousands of head slaps by defensive players, whose first hit after the snap was often a right-handed blow to the helmet's open hole over my left ear.
Post-Traumatic Stress Disorder: Ethical and Legal Relevance to the Criminal Justice System
Authors: Soltis Kathryn , Acierno Ron , Gros Daniel F. , Yoder Matthew , Tuerk Peter W.
Published: July 2014

New coverage of the recent wars in Afghanistan and Iraq, and the ensuing public education campaigns by the Department of Veterans Affairs and private veterans advocacy groups combine to call the public's attention to the many potential mental health problems associated with traumatic event exposure. Indeed, since 2001, Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) combat and peacekeeping missions have been characterized by high levels of exposure to acts of extreme violence, with often gruesome effects. Less publically discussed is the fact that a surprisingly large number of United States civilians also report exposure to traumatic events, such as severe interpersonal violence, natural disasters, and serious automobile accidents. In fact, approximately 70% of randomly sampled respondents indicated that they have experienced an incident characterized by significant perceived life threat at some point during their lives.
A Systematic Review of State and Manufacturer Physician Payment Disclosure Websites: Implications for Implementation of the Sunshine Act
Authors: Hwong Alison R. , Qaragholi Noor , Carpenter Daniel , Joffe Steven , Campbell Eric G. , Lehmann Lisa Soleymani
Published: July 2014

Public disclosure of industry payments to physicians is one way to address financial conflicts of interest in medicine. As part of the Patient Protection and Affordable Care Act, the Physician Payment Sunshine Act (PPSA) requires pharmaceutical, medical device, and biologics manufacturers who have at least one product reimbursed by Medicare or Medicaid to disclose payments to physicians and teaching hospitals on a public website starting in 2014. The physician payment data will contain individual physician names, monetary values, and specific products connected to payments.

According to the Final Regulations issued by the Centers for Medicare and Medicaid Services (CMS) in February 2013, the law will make transparent the extent and nature of relationships between physicians, teaching hospitals, and manufacturers.
Risk Disclosure and the Recruitment of Oocyte Donors: Are Advertisers Telling the Full Story?
Authors: Alberta Hillary B. , Berry Roberta M. , Levine Aaron D.
Published: July 2014

In vitro fertilization (IVF) using donated oocytes has proven to be an effective treatment option for many prospective parents struggling with infertility, and the usage of donated oocytes in assisted reproduction has increased markedly since the technique was first successfully used in 1984. Data published by the Centers for Disease Control and Prevention (CDC) on the use of assisted reproductive technologies (ARTs) in the United States indicate that approximately 12% of all ART cycles in the country now use donated oocytes. The increased use of oocyte donation in the United States has prompted discussion regarding risks associated with the process and how best to ensure the safety of oocyte donors.

Physical risks associated with oocyte donation include bleeding, infection, ovarian hyperstimulation syndrome and a potential, although unconfirmed, increased risk of developing various forms of cancer, such as uterine, colon, breast, ovarian, and endometrial cancers.