bluuebunny/crossref_metadata_2025 huggingface dataset:
Simple and reliable predictor of urinary continence after radical prostatectomy: Serial measurement of urine loss ratio after catheter removal
Authors: Sato Yoshikazu , Tanda Hitoshi , Nakajima Hisao , Nitta Toshikazu , Akagashi Keigo , Hanzawa Tatsuo , Tobe Musashi , Haga Kazunori , Uchida Kosuke , Honma Ichiya
Published: February 2014

Objectives

To evaluate urine loss ratio after catheter removal as a predictive factor of urinary continence after radical prostatectomy.

Methods

A total of 190 patients who had undergone retropubic radical prostatectomy were evaluated. Urine loss ratio was measured using the 24‐h pad test during 7 consecutive days after removal of urethral catheters. Continence rates at 1, 3, 6 and 12 months after operation were evaluated with the urinary function domain of the University of California, Los Angeles Prostate Cancer Index. The desirable urine loss ratio for continent condition at 12 months after the operation was calculated. As desirable target urine loss ratio continence at 12 months was determined by using logistic analysis.

Results

Continence rates of all patients at 1, 3, 6 and 12 months after surgery were 13%, 37.8%, 58.9%, and 85.8%, respectively. Continence rates of patients who achieved ≤1% of urine loss ratio within 7 days or ≤5% urine loss ratio within 3 days after catheter removal was 100% at 12 months. Logistic regression analysis proved these urine loss ratio values were significant predictors of continence at 12 months.

Conclusions

Urine loss ratio after catheter removal within 7 days is a significant determinant of urinary continence after radical prostatectomy. This parameter could have clinical usefulness to estimate future recovery of urinary continence.
Balance between activating NKG2D, DNAM‐1, NKp44 and NKp46 and inhibitory CD94/NKG2A receptors determine natural killer degranulation towards rheumatoid arthritis synovial fibroblasts
Authors: Nielsen Natasja , Pascal Veronique , Fasth Andreas E. R. , Sundström Yvonne , Galsgaard Elisabeth D. , Ahern David , Andersen Martin , Baslund Bo , Bartels Else M. , Bliddal Henning , Feldmann Marc , Malmström Vivianne , Berg Louise , Spee Pieter , Söderström Kalle
Published: February 2014

Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic inflammation and synovial hyperplasia leading to progressive joint destruction. Fibroblast‐like synoviocytes (FLS) are central components of the aggressive, tumour‐like synovial structure termed pannus, which invades the joint space and cartilage. A distinct natural killer (NK) cell subset expressing the inhibitory CD94/NKG2A receptor is present in RA synovial fluid. Little is known about possible cellular interactions between RA‐FLS and NK cells. We used cultured RA‐FLS and the human NK cell line Nishi, of which the latter expresses an NK receptor repertoire similar to that of NK cells in RA synovial fluid, as an in vitro model system of RA‐FLS/NK cell cross‐talk. We show that RA‐FLS express numerous ligands for both activating and inhibitory NK cell receptors, and stimulate degranulation of Nishi cells. We found that NKG2D, DNAM‐1, NKp46 and NKp44 are the key activating receptors involved in Nishi cell degranulation towards RA‐FLS. Moreover, blockade of the interaction between CD94/NKG2A and its ligand HLA‐E expressed on RA‐FLS further enhanced Nishi cell degranulation in co‐culture with RA‐FLS. Using cultured RA‐FLS and the human NK cell line Nishi as an in vitro model system of RA‐FLS/NK cell cross‐talk, our results suggest that cell‐mediated cytotoxicity of RA‐FLS may be one mechanism by which NK cells influence local joint inflammation in RA.
Project management aided by verbal decision analysis approaches: a case study for the selection of the best SCRUM practices
Authors: Machado Thais Cristina Sampaio , Pinheiro Plácido Rogério , Tamanini Isabelle
Published: February 2014

Agile methodologies, in particular the framework SCRUM, are popular in software development companies. Most of the time, however, it is not feasible for these companies to apply every characteristic of the framework. This paper presents a hybrid application of verbal decision analysis methodologies in order to select some of the most relevant SCRUM approaches to be applied by a company. A questionnaire was developed and a group of experienced ScrumMasters was selected to answer it, aiming at characterizing every SCRUM approach into criteria values. The hybrid application consists in dividing the SCRUM practices into groups (stage supported by the ORCLASS method application), using the ORCLASSWEB tool. Then, the rank of the preferred practices will be generated by the application of the ZAPROS‐LM method.
Semantic dominance analysis for multicriteria decision‐making problems with unbalanced linguistic scale
Authors: Yang Wu‐E
Published: February 2014

The multicriteria decision‐making problem with an unbalanced linguistic scale is analyzed by multicriteria semantic dominance (MCSD) technique. The technique only requires the available partial semantics information about the scale. The MCSD rules on two types of unbalanced linguistic scale are introduced and proven. With these rules, alternatives are divided into two mutually exclusive sets called the efficient set and inefficient set. The decision maker with a specific type of linguistic scale will never choose the alternative from the corresponding inefficient set as the feasible one. Thus he/she can easily choose from the original alternative set. An example is also provided to illustrate the procedure of the proposed method.
A prospective, randomised comparative study of weekly versus biweekly application of dehydrated human amnion/chorion membrane allograft in the management of diabetic foot ulcers
Authors: Zelen Charles M , Serena Thomas E , Snyder Robert J
Published: February 2014

The aim of this study is to determine if weekly application of dehydrated human amnion/chorion membrane allograft reduce time to heal more effectively than biweekly application for treatment of diabetic foot ulcers.

This was an institutional review board‐approved, registered, prospective, randomised, comparative, non‐blinded, single‐centre clinical trial. Patients with non‐infected ulcers of ≥ 4 weeks duration were included for the study. They were randomised to receive weekly or biweekly application of allograft in addition to a non‐adherent, moist dressing with compressive wrapping. All wounds were offloaded. The primary study outcome was mean time to healing.

Overall, during the 12‐week study period, 92·5% (37/40) ulcers completely healed. Mean time to complete healing was 4·1 ± 2·9 versus 2·4 ± 1·8 weeks (P = 0·039) in the biweekly versus weekly groups, respectively. Complete healing occurred in 50% versus 90% by 4 weeks in the biweekly and weekly groups, respectively (P = 0·014). Number of grafts applied to healed wounds was similar at 2·4 ± 1·5 and 2·3 ± 1·8 for biweekly versus weekly groups, respectively (P = 0·841).

These results validate previous studies showing that the allograft is an effective treatment for diabetic ulcers and show that wounds treated with weekly application heal more rapidly than with biweekly application. More rapid healing may decrease clinical operational costs and prevent long‐term medical complications.
DO IRON GUIDELINES TRANSLATE INTO GOOD CLINICAL PRACTICE FOR PATIENTS ON HAEMODIALYSIS?
Authors: Morris Margaret , Snedeker Marianne , Reed Gail , Butcher Belinda , Bradley Jennifer
Published: February 2014

Background

Patients on haemodialysis (HD) have greater iron needs than the normal population. In 2004, the Caring for Australasians with Renal Impairment (CARI) group audited six Australian renal centres and found considerable variability in achievement of iron and haemoglobin targets.

Objectives

The aim of this study was to determine whether intravenous iron guidelines and evidence translate into good clinical outcomes for patients on HD.

Design and Measurement

Data were extracted from the Renal Anaemia Management database for the period of 2007–2009. These data were compared with the target levels described in the CARI guidelines.

Results

Most patients were not achieving recommended haemoglobin, ferritin or transferrin saturation levels. Australian Aboriginal and Torres Strait Islander people were less likely to achieve targets.

Conclusions

Iron guidelines are not translating into good clinical practice for patients on HD. This situation may be improved by updating the CARI guidelines (as has recently been carried out for haemoglobin targets), introduction of more consistent dosing protocols across hospitals and greater assessment of safe levels of cumulative iron and ferritin.
Measuring Country Differences in Enforcement of Accounting Standards: An Audit and Enforcement Proxy
Authors: Brown Philip , Preiato John , Tarca Ann
Published: February 2014

In this paper we present an index designed to capture differences between countries in relation to the institutional setting for financial reporting, specifically the auditing of financial statements and the enforcement of compliance with each country's accounting standards. The use of a common set of standards such as International Financial Reporting Standards (IFRS) aims, in broad terms, to promote the comparability and transparency of financial statements and to improve the quality of financial reporting. However, the effectiveness of IFRS adoption may be hampered by differences, across countries, in the institutional setting in which financial reporting occurs. Studies of outcomes from adopting IFRS use a range of legal system proxies to capture these country differences, but the proxies are deficient in that they seldom focus explicitly on factors that affect how compliance with accounting standards is promoted through external audit and the activities of independent enforcement bodies. To address this deficiency, we calculate measures of the quality of the public company auditors’ working environment (AUDIT) and the degree of accounting enforcement activity (ENFORCE) by independent enforcement bodies. We do this for 51 countries for each of the years 2002, 2005 and 2008, using publicly available data provided by the International Federation of Accountants (IFAC), the World Bank and the national securities regulators. Preliminary tests suggest our indices have additional explanatory power (over more general legal proxies) for country‐level measures of economic and market activity, financial transparency and earnings management. We expect they will prove useful to researchers and other interested parties who require country‐level measures that focus on the degree of enforcement of financial reporting practices.
Stability of a Neotropical microrefugium during climatic instability
Authors: Montade Vincent , Ledru Marie‐Pierre , Burte Julien , Martins Eduardo Sávio Passos Rodrigues , Verola Christiano Franco , Costa Itayguara Ribeiro da , Magalhães e Silva Francisco Hilder
Published: February 2014

Aim

The primary objectives of this study were (1) to assess, in the light of palaeoecological reconstruction, the climate stability hypothesis used by evolutionary biologists to explain high diversity in historically stable areas, and (2) to identify the response mechanisms of a tropical rain forest microrefugium to climatic variability.

Location

North‐eastern Brazil, Serra de Maranguape.

Methods

Vegetation and climatic changes were reconstructed using a pollen record in a sediment core from a forest hollow, and the chronology was based on accelerator mass spectrometry radiocarbon analyses.

Results

Past vegetation dynamics consisted of three main forest types, shown by major compositional changes in rain forest assemblages between 5000 and 1000 cal. yr bp. Dense ombrophilous forest was abruptly replaced by heliophilous early successional tree taxa at 4275 cal. yr bp. These early successional tree taxa were established over a period of c. 100 years, and their dominance lasted for c. 750 years and was associated with dry conditions until 3525 cal. yr bp. Subsequently, the expansion of secondary successional tree taxa over a period of c. 550 years enabled the recovery of ombrophilous forest.

Main conclusions

The vegetation changes in the Serra de Maranguape provide evidence for the high sensitivity of this rain forest microrefugium to climatic variability on a multidecadal to millennial time‐scale during the mid‐ to late Holocene. Despite the substantial compositional and climatic changes, this microrefugium apparently was continuously forested and responded to climatic instability by recruiting key species to its highly diverse stock. This evidence helps to address the joint concerns of evolutionary biologists and palaeoecologists regarding how forests can persist during periods of climatic variability by showing that some tropical regions can remain continuously forested despite reorganization during abrupt and short‐term climatic changes.
Pyrogeography, historical ecology, and the human dimensions of fire regimes
Authors: Roos Christopher I. , Bowman David M. J. S. , Balch Jennifer K. , Artaxo Paulo , Bond William J. , Cochrane Mark , D'Antonio Carla M. , DeFries Ruth , Mack Michelle , Johnston Fay H. , Krawchuk Meg A. , Kull Christian A. , Moritz Max A. , Pyne Stephen , Scott Andrew C. , Swetnam Thomas W.
Published: February 2014

In our 2011 synthesis (Bowman et al., Journal of Biogeography, 2011, 38, 2223–2236), we argued for a holistic approach to human issues in fire science that we term ‘pyrogeography’. Coughlan & Petty (Journal of Biogeography, 2013, 40, 1010–1012) critiqued our paper on the grounds that our ‘pyric phase’ model was built on outdated views of cultural development, claiming we developed it to be the unifying explanatory framework for all human–fire sciences. Rather, they suggest that ‘historical ecology’ could provide such a framework. We used the ‘pyric transition’ for multiple purposes but did not offer it as an exclusive explanatory framework for pyrogeography. Although ‘historical ecology’ is one of many useful approaches to studying human–fire relationships, scholars should also look to political and evolutionary ecology, ecosystems and complexity theories, as well as empirical generalizations to build an interdisciplinary fire science that incorporates human, ecological and biophysical dimensions of fire regimes.
Advancing towards novel tree lines? A multispecies approach to recent tree line dynamics in subarctic alpine Labrador, northern Canada
Authors: Trant Andrew J. , Hermanutz Luise
Published: February 2014

Aim

Comparisons of how different species respond to changing climatic conditions offer insight into future community composition and the potential formation of novel communities. This study investigated changes at a subarctic forest–tundra ecotone, or ‘tree line’. Our objectives were: (1) to explore species‐specific growth forms; (2) to identify temporal patterns of establishment and stand density; and (3) to explore relationships between climate and recruitment/survival amongst co‐dominant tree species, with the expectation that climate change will affect species differentially.

Location

The Mealy Mountains in the High Subarctic Tundra ecoregion in central Labrador, Canada.

Methods

We examined tree line dynamics for four tree species over the past two centuries. Using ecological and age‐structure data, we compared diameter/height relationships across the tree line and generated static age structures from which changes in stand density through time were compared. In addition, model residuals were used to quantify relationships between multi‐decadal windows of temperature/palaeotemperature/Palmer Drought Severity Index and decadal tree recruitment.

Results

Trees were more stunted as elevation increased, except for white spruce (Picea glauca) for which tree islands became the dominant growth form. The only tree seedlings found at the tree line were of larch (Larix laricina) and to a lesser extent black spruce (Picea mariana). From the age structure of trees (height > 2.0 m), only black spruce showed evidence of an advancing tree line. Larch and balsam fir (Abies balsamea) have become established at the tree line most recently and have undergone greater increases in density over the past few decades. Variability in recruitment increased with elevation: larch recruitment was positively correlated with temperature and negatively correlated with drought at low elevations but negatively correlated with temperature and positively correlated with drought at high elevations, whereas black spruce recruitment was consistently positively correlated with temperature and drought.

Main conclusions

The multispecies approach provides evidence that species are responding differentially to climate. With continued climate change, we expect density increases and advances of larch and black spruce, giving rise to novel tree line communities.
Diversity versus disparity and the role of ecological opportunity in a continental bird radiation
Authors: Schweizer Manuel , Hertwig Stefan T. , Seehausen Ole
Published: February 2014

Aim

The Neotropical parrots (Arini) are an unusually diverse group which colonized South America in the Oligocene. The newly invaded Neotropics may have functioned as an underused adaptive zone and provided novel ecological opportunities that facilitated diversification. Alternatively, diversification may have been driven by ecological changes caused by Andean uplift and/or climate change from the Miocene onwards. Our aim was to find out whether Arini diversified in a classical adaptive radiation after their colonization of South America, or whether their diversification occurred later and was influenced by more recent environmental change.

Location

Neotropics.

Methods

We generated a time‐calibrated phylogeny of more than 80% of all Arini species in order to analyse lineage diversification. This chronogram was also used as the basis for the reconstruction of morphological evolution within Arini using a multivariate ratio analysis of three size measurements.

Results

We found a concentration of size evolution and partitioning of size niches in the early history of Arini consistent with the process of adaptive radiation, but there were no signs of an early burst of speciation or a decrease in speciation rates through time. Although we detected no overall temporal shifts in diversification rates, we discovered two young, unexpectedly species‐rich clades.

Main conclusions

Arini show signs of an early adaptive radiation, but we found no evidence of the slowdown in speciation rate generally considered a feature of island or lake radiations. Historical processes and environmental change from the Miocene onwards may have kept diversification rates roughly constant ever since the colonization of the Neotropics. Thus, Arini may not yet have reached equilibrium diversity. The lack of diversity‐dependent speciation might be a general feature of adaptive radiations on a continental scale, and diversification processes on continents might therefore not be as ecologically limited as in isolated lakes or on oceanic islands.
Gender differences in online reading engagement, metacognitive strategies, navigation skills and reading literacy
Authors: Wu J‐Y.
Published: February 2014

This study examined how knowledge of metacognitive strategies and navigation skills mediate the relationship between online reading activities and printed reading assessment (PRA) and electronic reading assessment (ERA) across 19 countries using the PISA (Programme for International Student Assessment) 2009 database. Participants were 34 104 fifteen‐year‐old students (female: 50.1%). The results showed that information‐seeking activity, knowledge of metacognitive strategies and navigations skills positively predicted ERA and PRA. Social reading activities negatively predicted knowledge of metacognitive strategies and PRA but had no effect on ERA and the navigation skills in most countries. Increased information‐seeking reading resulted in higher ERA and PRA as demonstrated by navigation skills and knowledge of metacognitive strategies. Gender differences in online reading engagement were not statistically significant in most countries. However, girls performed better in knowledge of metacognitive strategies, navigation skills and PRA but were not significantly better on ERA. Multiple group comparisons of gender indicated that the hypothesized model held for both boys and girls. Besides the infrastructure of information and communications technology as a tool to access the cyber informational space, students should be empowered to use appropriate strategies and navigation skills to achieve their goals. Implications for teaching and learning practices are discussed.
Platform switch versus platform match in the posterior mandible – 1‐year results of a multicentre randomized clinical trial
Authors: Guerra Fernando , Wagner Wilfried , Wiltfang Jörg , Rocha Salomão , Moergel Maximilian , Behrens Eleonore , Nicolau Pedro
Published: February 2014

Objective

The purpose of this ongoing randomized study was to assess differences in bone level changes and success rates using implants supporting single crowns in the posterior mandible either with platform matched or platform switched abutments.

Material and Methods

Patients aged 18 and above, missing at least two teeth in the posterior mandible and with a natural tooth mesial to the most proximal implant site were enrolled. Randomization followed implant placement. Definitive restorations were placed after a minimum transgingival healing period of 8 weeks. Changes in crestal bone level from surgery and loading (baseline) to 12‐month post‐loading were radiographically measured. Implant survival and success were determined.

Results

Sixty‐eight patients received 74 implants in the platform switching group and 72 in the other one. The difference of mean marginal bone level change from surgery to 12 months was significant between groups (p < 0.004). Radiographical mean bone gain or no bone loss from loading was noted for 67.1% of the platform switching and 49.2% of the platform matching implants. Implant success rates were 97.3% and 100%, respectively.

Conclusions

Within the same implant system the platform switching concept showed a positive effect on marginal bone levels when compared with restorations with platform matching.
Double disadvantage: the influence of childhood maltreatment and community violence exposure on adolescent mental health
Authors: Cecil Charlotte A.M. , Viding Essi , Barker Edward D. , Guiney Jo , McCrory Eamon J.
Published: February 2014

Background

Childhood maltreatment is a key risk factor for maladjustment and psychopathology. Although maltreated youth are more likely to experience community violence, both forms of adversity are generally examined separately. Consequently, little is known about the unique and interactive effects that characterize maltreatment and community violence exposure (CVE) on mental health.

Methods

Latent Profile Analysis (LPA) was applied to data from a community sample of high‐risk adolescents and young adults (n = 204, M = 18.85) to categorize groups of participants with similar patterns of childhood (i.e. past) maltreatment exposure. Associations between childhood maltreatment, CVE and mental health outcomes were then explored using multivariate regression and moderation analyses.

Results

Latent Profile Analysis identified three groups of individuals with low, moderate and severe levels of childhood maltreatment. Maltreatment was associated with more internalizing, externalizing, and trauma‐related symptoms. By contrast, CVE showed independent associations with only externalizing and trauma‐related symptoms. Typically, childhood maltreatment and CVE exerted additive effects; however, these forms of adversity interacted to predict levels of anger.

Conclusions

Exposure to maltreatment and community violence is associated with increased levels of clinical symptoms. However, while maltreatment is associated with increased symptoms across a broad range of mental health domains, the impact of community violence is more constrained, suggesting that these environmental risk factors differentially impact mental health functioning.
Research Review: Two pathways toward impulsive action: an integrative risk model for bulimic behavior in youth
Authors: Pearson Carolyn M. , Riley Elizabeth N. , Davis Heather A. , Smith Gregory T.
Published: February 2014

Background

This study provides an integrative review of existing risk factors and models for bulimia nervosa (BN) in young girls. We offer a new model for BN that describes two pathways of risk that may lead to the initial impulsive act of binge eating and purging in children and adolescents.

Scope

We conducted a selective literature review, focusing on existing and new risk processes for BN in this select population.

Findings

We identify two ways in which girls increase their risk to begin engaging in the impulsive behavior of binge eating and purging. The first is state‐based: the experience of negative mood, in girls attempting to restrain eating, leads to the depletion of self‐control and thus increased risk for loss of control eating. The second is personality‐based: elevations on the trait of negative urgency, or the tendency to act rashly when distressed, increase risk, particularly in conjunction with high‐risk psychosocial learning. We then briefly discuss how these behaviors are reinforced, putting girls at further risk for developing BN.

Conclusions

We highlight several areas in which further inquiry is necessary, and we discuss the clinical implications of the new risk model we described.
A System‐Wide Enhanced Recovery Program Focusing on Two Key Process Steps Reduces Complications and Readmissions in Patients Undergoing Bowel Surgery
Authors: Loftus Terrence J. , Stelton Susan , Efaw Brett W. , Bloomstone Joshua
Published: February 2014

Enhanced recovery programs (ERPs) can improve outcomes following bowel surgery, but implementing an ERP across a large healthcare system remains challenging. In this study, a simplified ERP that focused on two process steps, early and frequent ambulation and early alimentation, was evaluated to determine its impact on outcomes. Data were collected on 5,000 adult patients undergoing elective small and large bowel operations over a 3‐year period. Complication, readmission, and mortality rates were evaluated before and after ERP implementation. A composite score was calculated based on the successful completion of the two process steps. Following implementation, there was a 35.1% increase in the composite score, which was associated with significant (p < .05) reductions in overall complications, gastrointestinal complications, pulmonary complications, and readmissions. A system‐wide ERP focusing on early and frequent ambulation and early alimentation is associated with decreased complications and readmissions in adult patients admitted for elective small or large bowel operations.
Motion compensation for in vivo subcellular optical microscopy
Authors: LUCOTTE B. , BALABAN R.S.
Published: February 2014

In this review, we focus on the impact of tissue motion on attempting to conduct subcellular resolution optical microscopy, in vivo. Our position is that tissue motion is one of the major barriers in conducting these studies along with light induced damage, optical probe loading as well as absorbing and scattering effects on the excitation point spread function and collection of emitted light. Recent developments in the speed of image acquisition have reached the limit, in most cases, where the signal from a subcellular voxel limits the speed and not the scanning rate of the microscope. Different schemes for compensating for tissue displacements due to rigid body and deformation are presented from tissue restriction, gating, adaptive gating and active tissue tracking. We argue that methods that minimally impact the natural physiological motion of the tissue are desirable because the major reason to perform in vivo studies is to evaluate normal physiological functions. Towards this goal, active tracking using the optical imaging data itself to monitor tissue displacement and either prospectively or retrospectively correct for the motion without affecting physiological processes is desirable. Critical for this development was the implementation of near real time image processing in conjunction with the control of the microscope imaging parameters. Clearly, the continuing development of methods of motion compensation as well as significant technological solutions to the other barriers to tissue subcellular optical imaging in vivo, including optical aberrations and overall signal‐to‐noise ratio, will make major contributions to the understanding of cell biology within the body.
Guanosine protects C6 astroglial cells against azide‐induced oxidative damage: a putative role of heme oxygenase 1
Authors: Quincozes‐Santos André , Bobermin Larissa Daniele , Souza Débora Guerini , Bellaver Bruna , Gonçalves Carlos‐Alberto , Souza Diogo Onofre
Published: February 2014

Guanosine, a guanine‐based purine, is an extracellular signaling molecule that is released from astrocytes and shows neuroprotective effects in several in vivo and in vitro studies. Our group recently showed that guanosine presents antioxidant properties in C6 astroglial cells. The heme oxygenase 1 signaling pathway is associated with protection against oxidative stress. Azide, an inhibitor of the respiratory chain, is frequently used in experimental models to induce oxidative and nitrosative stress. Thus, the goal of this study was to investigate the effect of guanosine on azide‐induced oxidative damage in C6 astroglial cells. Azide treatment of these cells resulted in several detrimental effects, including induction of cytotoxicity and mitochondrial dysfunction, increased levels of reactive oxygen/nitrogen species, inducible nitric oxide synthase expression and NADPH oxidase, decreased glutamate uptake and EAAC1 glutamate transporter expression, decreased glutathione (GSH) levels, and decreased activities of glutamine synthetase (GS), superoxide dismutase and catalase (CAT). The treatment also increased nuclear factor‐κB activation and the release of proinflammatory cytokines tumor necrosis factor α and IL‐1β. Guanosine strongly prevented these effects, protecting glial cells against azide‐induced cytotoxicity and modulating glial, oxidative and inflammatory responses through the activation of the heme oxygenase 1 pathway. These observations reinforce and support the role of guanosine as an antioxidant molecule against oxidative damage.

image

Guanosine protects against azide‐induced oxidative damage in C6 astroglial cells. Azide‐induced mitochondrial dysfunction (1); increased reactive oxygen species/reactive nitrogen species levels (2); decreased glutamate uptake (3), GS activity (4), GSH levels (5), and SOD (6) and CAT (7) activities; increased glutathione peroxidase (GPx) (8) and NADPH oxidase (9) activities and cellular superoxide levels (10); increased NF‐κB activation (11), TNF‐α and IL‐1β levels (12); and induced iNOS expression (13). Guanosine prevented these effects through the HO1 signaling pathway, thus our findings support the antioxidant effects of guanosine.
2,3,7,8‐Tetrachlorodibenzo‐p‐dioxin promotes astrocyte activation and the secretion of tumor necrosis factor‐α via PKC/SSeCKS‐dependent mechanisms
Authors: Zhang Yang , Nie Xiaoke , Tao Tao , Qian Wenbo , Jiang Shengyang , Jiang Junkang , Li Aihong , Guo Aisong , Xu Guangfei , Wu Qiyun
Published: February 2014

2,3,7,8‐tetrachlorodibenzo‐p‐dioxin (TCDD) is a ubiquitous environmental pollutant that could induce significant toxic effects in the human nervous system. However, the underlying molecular mechanism has not been entirely elucidated. Reactive astrogliosis has implicated in various neurological diseases via the production of a variety of pro‐inflammatory mediators. Herein, we investigated the potential role of TCDD in facilitating astrocyte activation and the underlying molecular mechanisms. We showed that TCDD induced rapid astrocyte activation following TCDD exposure, which was accompanied by significantly elevated expression of Src‐Suppressed‐C Kinase Substrate (SSeCKS), a protein involved in protein kinase C (PKC)‐mediated Nuclear Factor kappa B signaling, suggesting a possible involvement of PKC‐induced SSeCKS activation in TCDD‐triggered reactive astroglia. In keeping with the finding, we found that the level of phosphorylated Nuclear Factor kappa B p65 was remarkably increased after TCDD treatment. Furthermore, interference of SSeCKS attenuated TCDD‐induced inducible nitric oxide synthase, glial fibrillary acidic protein, phospho‐p65 expression, and tumor necrosis factor‐α secretion in astrocytes. In addition, pre‐treatment with PKC inhibitor also attenuated TCDD‐induced astrocyte activation, as well as SSeCKS expression. Interestingly, we found that TCDD treatment could lead to SSeCKS perinuclear localization, which could be abolished after treatment with PKC inhibitor. Finally, we showed that inhibition of PKC activity or SSeCKS expression would impair TCDD‐triggered tumor necrosis factor‐α secretion. Our results suggested that TCDD exposure could lead to astrocyte activation through PKC/SSeCKS‐dependent mechanisms, highlighting that astrocytes might be important target of TCDD‐induced neurotoxicity.

image

2,3,7,8‐tetrachlorodibenzo‐p‐dioxin (TCDD) elicits neurotoxic effects. Here, we show TCDD induces pro‐inflammatory responses in astrocytes. TCDD initiates an increase of [Ca2+]i, followed by the activation of PKC, which then induces the activation of Src‐suppressed C‐kinase substrate (SSeCKS). SSeCKS promotes NF‐κB activation and the secretion of TNF‐α and nitric oxide in astrocytes.
Testing a Measurement Model of Financial Capability Among Youth in Ghana
Authors: DESPARD MATHIEU R. , CHOWA GINA A. N.
Published: February 2014

Youth may benefit from having enhanced financial knowledge and skills and access to financial services to help them navigate transitions to adulthood, though reliable and valid measures of youth financial capability to help assess financial education and inclusion intervention outcomes are lacking. Using survey responses from 5,451 youth ages 12–18 in Ghana, we used exploratory and confirmatory factor analysis to assess 18 survey items concerning youth financial behavior and understanding and attitudes concerning financial services. A 12‐item, group invariant scale (α = .72) with three latent factors was retained in a well‐fitting model that may help practitioners assess financial education and inclusion outcomes. We found that six items were poor indicators of youth financial capability, possibly because these items measure other constructs like numeracy, or because these items were not sufficiently assessed for developmental and cultural validity using qualitative methods like cognitive interviewing.
Tensions of difference: reconciling organisational imperatives for risk management with consumer‐focused care from the perspectives of clinicians and managers
Authors: Clancy Leonie , Happell Brenda
Published: February 2014

Aims and objectives

To understand the impact of risk management and assessment on the delivery of mental health care from the perspectives of managers and clinicians.

Background

The concept of risk is now embedded in contemporary mental health services. A focus on risk has been identified as a barrier to the provision of consumer‐focused care; however, there is a paucity of research in this area, particularly being drawn from key stakeholders in the field.

Design

Qualitative exploratory methods.

Methods

In‐depth interviews were conducted with managers and clinicians from a large metropolitan aged‐care mental health service in Australia. The participants represented a range of disciplines and expertise across practice settings (community, inpatient and residential).

Results

The theme tensions of difference emerged from this research. This theme referred to the tensions between accountability and attending to risk issues and consumer‐centred care, with concerns being raised that procedural and bureaucratic accountability influence (often negatively) the provision of care. Differences in the perspectives of clinicians and managers were also evident in the perceived contribution of evidence‐based practice in relation to risk.

Conclusions

Prioritising risk management may be interfering with the capacity of clinicians and managers to provide quality and consumer‐focused mental health care.

Relevance to clinical practice

A deeper examination and reconceptualisation of the role and importance of risk in mental health care are needed to ensure the focus of service delivery remains consumer‐focused.
Intensive care nurses' experiences of providing end‐of‐life care after treatment withdrawal: a qualitative study
Authors: Efstathiou Nikolaos , Walker Wendy
Published: February 2014

Aims and objectives

To explore the experiences of intensive care nurses who provided end‐of‐life care to adult patients and their families after a decision had been taken to withdraw treatment.

Background

End‐of‐life care following treatment withdrawal is a common phenomenon in intensive care. Less is known about nurses' experiences of providing care for the dying patient and their family in this context, when compared to specialist palliative care.

Design

Descriptive exploratory qualitative study.

Methods

A purposive sample of 13 intensive care nurses participated in a semistructured face‐to‐face interview. Transcribed data were analysed using the principles of interpretative phenomenological analysis.

Results

The essence of nurses' experiences of providing end‐of‐life care after the withdrawal of treatment was interpreted as ‘doing the best to facilitate a comfortable and dignified death’. Four master themes included the following: caring for the dying patient and their family; providing and encouraging presence; reconnecting the patient and family; and dealing with emotions and ambiguity. Uncertainties were evident on processes and actions involved in treatment withdrawal, how to reconnect patients and their family effectively and how to reduce the technological environment.

Conclusions

Providing end‐of‐life care after a decision has been taken to withdraw treatment was a common aspect of intensive care. It was evident that nurses were doing their utmost to support patients and families at the end of life, despite the multiple challenges they faced.

Relevance to clinical practice

The interpretive findings from this study should assist intensive care unit nurses to better understand and develop their role in providing high‐quality end‐of‐life care after treatment withdrawal. Practice guidelines should be developed to reduce ambiguity and support the delivery of high‐quality care for adults as they approach the final stages of life in intensive care units.
Perspectives of patients with acute abdominal pain in an emergency department observation unit and a surgical assessment unit: a prospective comparative study
Authors: Schultz Helen , Qvist Niels , Mogensen Christian B , Pedersen Birthe D
Published: February 2014

Aims and objectives

To investigate the patient perspective when admitted with acute abdominal pain to an emergency department observation unit compared with the perspective when admitted to a surgical assessment unit.

Background

An increase in emergency department observation units has led to more short‐term admissions and has changed the patient journey from admission to specialised wards staffed by specialist nurses to stays in units staffed by emergency nurses.

Design

A comparative field study.

Methods

The study included 21 patients. Participant observation and qualitative interviews were performed, and the analyses were phenomenological–hermeneutic.

Results

Emergency department observation unit patients had extensive interaction with health professionals, which could create distrust. Surgical assessment unit patients experienced lack of interaction with nurses, also creating distrust. Emergency department observation unit patients had more encounters with fellow patients than the surgical assessment unit patients did, which was beneficial when needing assistance, but disturbing when needing rest. The limited contact with other patients in the surgical assessment unit revealed the opposite effect. In both units, there was nonpersonalised care, making it difficult for patients to make informed decisions.

Conclusion

The multibedded rooms in the emergency department observation unit had a positive influence on patient–nurse interaction, but a negative influence on privacy; the opposite was found in the surgical assessment unit with its rooms with fewer beds. The extensive professional–patient interactions in the emergency department observation unit created distrust. The limited professional–patient interaction in the surgical assessment unit did the same. That the emergency department observation unit was staffed by emergency nurses seemed to have a positive influence on the length of patient–nurse interactions, while the surgical assessment unit staffed by specialist nurses seemed to have the opposite effect. There was lack of information and personalised care in both units.

Relevance to clinical practice

Units receiving acute patients need to provide personalised care and information about how the unit functions and about care and treatment to improve the patients' ability to make decisions during admission.
User involvement in structured violence risk management within forensic mental health facilities – a systematic literature review
Authors: Eidhammer Gunnar , Fluttert Frans A J , Bjørkly Stål
Published: February 2014

Aims and objectives

To examine empirical literature on user involvement in collaboration between patients and nurses. The scope of the review was limited to structured violence risk management interventions in forensic mental health settings.

Background

Violence in forensic mental health settings represents a significant problem for patients and staff. Structured violence risk management interventions in forensic mental health have been reported to ignore patient participation, despite the growing attention on user involvement in clinical practice.

Design

A systematic review.

Method

Searches were conducted in six databases: the Cochrane Systematic Reviews, MEDLINE, CINAHL, ProQuest, ScienceDirect and PsycINFO. Papers were assessed according to a predetermined set of inclusion and exclusion criteria.

Results

After searches of the reference lists of retrieved articles were conducted, only three papers met the inclusion criteria.

Conclusions

This review has shown that empirical research on the topic of risk management interventions in which patients are involved is scarce.

Relevance to clinical practice

There is barely any research evidence of the clinical effect of user involvement approaches on violence risk management in forensic mental health practice. Therefore, we suggest that clinicians may learn from positive experiences concerning user involvement in general psychiatry and carefully adapt and test them out in the forensic treatment context.
Local Venturing as Compassion Organizing in the Aftermath of a Natural Disaster: The Role of Localness and Community in Reducing Suffering
Authors: Shepherd Dean A. , Williams Trenton A.
Published: February 2014

In contrast to models of compassion within existing organizations, this grounded theory study examines how ventures emerge relying on localness and community in direct response to ‘opportunities’ to alleviate suffering in the aftermath of a natural disaster. While a natural disaster is a surprising disruptive event devastating a local community, that local community is nested within a broader community, which can be a source of abundant resources. Ventures created in the aftermath of a natural disaster, given local knowledge and unencumbered by pre‐existing systems, procedures, and capabilities, are highly effective at connecting the broader community with the local community through customizing resources to meet victims' needs and to quickly delivering these resources to alleviate suffering.
Regional Reliability of Quantitative Signal Targeting with Alternating Radiofrequency (STAR) Labeling of Arterial Regions (QUASAR)
Authors: Tatewaki Yasuko , Higano Shuichi , Taki Yasuyuki , Thyreau Benjamin , Murata Takaki , Mugikura Shunji , Ito Daisuke , Takase Kei , Takahashi Shoki
Published: February 2014

BACKGROUND AND PURPOSE

Quantitative signal targeting with alternating radiofrequency labeling of arterial regions (QUASAR) is a recent spin labeling technique that could improve the reliability of brain perfusion measurements. Although it is considered reliable for measuring gray matter as a whole, it has never been evaluated regionally. Here we assessed this regional reliability.

METHODS

Using a 3‐Tesla Philips Achieva whole‐body system, we scanned four times 10 healthy volunteers, in two sessions 2 weeks apart, to obtain QUASAR images. We computed perfusion images and ran a voxel‐based analysis within all brain structures. We also calculated mean regional cerebral blood flow (rCBF) within regions of interest configured for each arterial territory distribution.

RESULTS

The mean CBF over whole gray matter was 37.74 with intraclass correlation coefficient (ICC) of .70. In white matter, it was 13.94 with an ICC of .30. Voxel‐wise ICC and coefficient‐of‐variation maps showed relatively lower reliability in watershed areas and white matter especially in deeper white matter. The absolute mean rCBF values were consistent with the ones reported from PET, as was the relatively low variability in different feeding arteries.

CONCLUSIONS

Thus, QUASAR reliability for regional perfusion is high within gray matter, but uncertain within white matter.
Identifying the Start of Multiple Sclerosis Injury: A Serial DTI Study
Authors: Ontaneda Daniel , Sakaie Ken , Lin Jian , Wang Xiaofeng , Lowe Mark J. , Phillips Michael D. , Fox Robert J.
Published: February 2014

BACKGROUND

The events leading up to the development of new multiple sclerosis (MS) lesions on conventional imaging are unknown. The purpose of this study is to use diffusion tensor imaging (DTI) to investigate prelesional changes in MS to better understand the pathological changes that lead to lesion development.

METHODS

Twenty‐one patients with relapsing MS starting natalizumab therapy underwent serial DTI for 12‐18 months. Regions of interest were outlined within normal‐appearing white matter and new gadolinium‐enhancing lesions that developed over the course of the study. Images from all time points were coregistered and nonparametric regression was used to assess DTI changes prior to lesion appearance.

RESULTS

A total of 31 newly enhancing lesions were identified. Significant changes in transverse diffusivity (TD) (P < .001), longitudinal diffusivity (LD) (P  = .025), mean diffusivity (MD) (P < .001), and fractional anisotropy (FA) (P = .04) were observed prior to gadolinium enhancement. A progressive increase in TD and LD occurred up to 10 months prior to lesion development. DTI measures in normal appearing white matter remained unchanged over the study period.

CONCLUSIONS

A significant change in diffusion measures can be seen prior to gadolinium enhancement. Changes in TD drove changes in FA and MD, providing evidence for impaired myelin integrity prior to gadolinium enhancement. DTI may be a sensitive measure for early detection of inflammatory disease activity in MS.
PSYCHOSOCIAL DISTRESS IN PATIENTS WITH END‐STAGE KIDNEY DISEASE
Authors: White Ciara , McDonnell Harvey
Published: February 2014

This is the first paper in a two‐part Continuing Education (CE) series focusing on psychosocial care of patients with end‐stage kidney disease (ESKD), which addresses a variety of psychological responses experienced by patients when adapting to the challenges posed by living with this long‐term condition. The second paper will examine further the issues of coping and adjustment to ESKD and the need for renal supportive care to ensure person‐centred holistic care is provided to patients.