bluuebunny/crossref_metadata_2025 huggingface dataset:
Formation of Food‐Grade Nanoemulsions Using Low‐Energy Preparation Methods: A Review of Available Methods
Authors: Komaiko Jennifer S. , McClements David Julian
Published: January 2016

There is considerable interest in the production of emulsions and nanoemulsions using low‐energy methods due to the fact they are simple to implement and no expensive equipment is required. In this review, the principles of isothermal (spontaneous emulsification and emulsion phase inversion) and thermal (phase inversion temperature) low‐energy methods for nanoemulsion production are presented. The major factors influencing nanoemulsion formation using low‐energy methods and food‐grade components are reviewed: preparation conditions, oil type, surfactant type, surfactant‐to‐oil ratio, and cosolvent or cosurfactant addition. The advantages and disadvantages of different low‐energy and high‐energy methods for fabricating nanoemulsions are highlighted, and potential applications for these techniques are discussed.
Controlled oxygen therapy at emergency department presentation increases the likelihood of achieving target oxygen saturations in patients with exacerbations of chronic obstructive pulmonary disease
Authors: Chow Joanna Wai Yinn , Khullar Keshav , Katechia Kashyap , Klim Sharon , Kelly Anne‐Maree
Published: January 2016

Objective

This study aimed to determine whether initiation of controlled oxygen therapy at ED presentation increased the proportion of patients with chronic obstructive pulmonary disease (COPD) achieving the COPD‐X guideline target SpO2 range (88–92%) at 30 min and if it impacted total hospital length of stay or in‐hospital mortality.

Methods

Retrospective cohort study by medical record review of patients admitted to hospital with an exacerbation of COPD. The primary outcome of interest was the proportion of patients achieving the target SpO2 range at 30 min after ED arrival.

Results

The proportion of patients with SpO2 in the target range at 30 min was higher in the controlled oxygen therapy group (32% vs 16%: difference between proportions 16% (95% CI 7–24%); number needed to treat 6) and less likely to be over‐oxygenated (SpO2 > 95%), 29% versus 54%, difference between proportions 25% (95% CI 14–35%); number needed to harm 4, without an increased likelihood of hypoxia. Length of stay was not different between the groups. Mortality for the controlled oxygen group was 2.7% (95% CI 1.3–5.5%) versus 5.8% for the uncontrolled oxygen group (95% CI 2.9–11.6%); however, this trend was not statistically significant.

Conclusion

Patients with exacerbations of COPD receiving controlled oxygen therapy were more likely to achieve SpO2 within the COPD‐X guideline target range without being more likely to be hypoxic. The proportion of patients with SpO2 within the target range was low, suggesting that further work on processes to optimise oxygenation in this group of patients is needed.
Expression and modulation of neuroligin and neurexin in the olfactory organ of the cotton leaf worm Spodoptera littoralis
Authors: Durand Nicolas , Chertemps Thomas , Bozzolan Françoise , Maïbèche Martine
Published: January 2016

Carboxylesterases are enzymes widely distributed within living organisms. In insects, they have been mainly involved in dietary metabolism and detoxification function. Interestingly, several members of this family called carboxylesterase‐like adhesion molecules (CLAMs) have lost their catalytic properties and are mainly involved in neuro/developmental functions. CLAMs include gliotactins, neurotactins, glutactins, and neuroligins. The latter have for binding partner the neurexin. In insects, the function of these proteins has been mainly studied in Drosophila central nervous system or neuromuscular junction. Some studies suggested a role of neuroligins and neurexin in sensory processing but CLAM expression within sensory systems has not been investigated. Here, we reported the identification of 5 putative CLAMs expressed in the olfactory system of the model pest insect Spodoptera littoralis. One neuroligin, Slnlg4‐yll and its putative binding partner neurexin SlnrxI were the most expressed in the antennae and were surprisingly associated with olfactory sensilla. In addition, both transcripts were upregulated in male antennae after mating, known to modulate the sensitivity of the peripheral olfactory system in S. littoralis, suggesting that these molecules could be involved in sensory plasticity.
HOW THE U.S. PRISON BOOM HAS CHANGED THE AGE DISTRIBUTION OF THE PRISON POPULATION
Authors: PORTER LAUREN C. , BUSHWAY SHAWN D. , TSAO HUI‐SHIEN , SMITH HERBERT L.
Published: January 2016

This article provides a demographic exposition of the changes in the U.S prison population during the period of mass incarceration that began in the late twentieth century. By drawing on data from the Survey of Inmates in State Correctional Facilities (1974–2004) for inmates 17–72 years of age (N = 336), we show that the age distribution shifted upward dramatically: Only 16 percent of the state prison population was 40 years old or older in 1974; by 2004, this percentage had doubled to 33 percent with the median age of prisoners rising from 27 to 34 years old. By using an estimable function approach, we find that the change in the age distribution of the prison population is primarily a cohort effect that is driven by the “enhanced” penal careers of the cohorts who hit young adulthood—the prime age of both crime and incarceration—when substance use was at its peak. Period‐specific factors (e.g., proclivity for punishment and incidence of offense) do matter, but they seem to play out more across the life cycles of persons most affected in young adulthood (cohort effects) than across all age groups at one point in time (period effects).
CAN RATIONAL CHOICE BE CONSIDERED A GENERAL THEORY OF CRIME? EVIDENCE FROM INDIVIDUAL‐LEVEL PANEL DATA
Authors: LOUGHRAN THOMAS A. , PATERNOSTER RAY , CHALFIN AARON , WILSON THEODORE
Published: January 2016

In the last few decades, rational choice theory has emerged as a bedrock theory in the fields of economics, sociology, psychology, and political science. Although rational choice theory has been available to criminologists for many years now, the field has not embraced it as other disciplines have. Moreover, rational choice scholars have fueled this skepticism of the theory's generality by modeling offender decision making that is one‐sided—large on the costs of crime (sanction threats), short on the benefits of crime. In this article, we directly assess the generality of rational choice theory by examining a fully specified model in a population that is often presumed to be less rational—adolescents from lower socioeconomic families who commit both instrumental (property) and expressive crimes (violence/drugs). By using a panel of N = 1,354 individuals, we find that offending behavior is consistent with rational responses to changes in the perceived costs and benefits of crime even after eliminating fixed unobserved heterogeneity and other time‐varying confounders, and these results are robust across different subgroups. The findings support our argument that rational choice theory is a general theory of crime.
Implication of metabolomic profiles to wide thermoneutral zone in Mongolian gerbils (Meriones unguiculatus)
Authors: SHI Yaolong , WANG Dehua
Published: January 2016

Mongolian gerbils (Meriones unguiculatus) have evolved a wide thermoneutral zone (26.5–38.9 °C) and high upper critical temperature, and appear to have a high tolerance for heat exposure. Here, we use a metabolomic approach to measure global metabolite profiles for gerbils between lower (27 °C) and upper critical temperatures (38 °C) to investigate the role of metabolomic characterization in maintaining basal metabolic rates within a wide thermoneutral zone. We found that in serum and liver, 14 and 19 metabolites were significantly altered, respectively. In the aerobic respiration‐related tricarboxylic cycle (TCA), 5 intermediates (isocitric acid, cis‐aconitic acid, α‐ketoglutaric acid, fumaric acid and malic acid) were increased in serum in 38 °C animals; however, no such increase was found in the liver. A stable level of hepatic TCA cycle intermediates may be related to the steady state of aerobic respiration at 38 °C. Metabolomic results also revealed that acute heat exposure caused increased oxidative stress and low molecular weight antioxidants in Mongolian gerbils. Increased methionine and 2‐hydroxybutyrate suggest an accelerated synthesis of glutathione. Increased urate and its precursors, inosine and hypoxanthine, were detected at 38 °C. Glucuronate, threonate and oxalate involved in ascorbate synthesis and degradation were increased in serum at 38 °C. In conclusion, although dramatic metabolomic variation was found, a stable hepatic TCA cycle may contribute to maintaining a constant basal metabolic rate within a wide thermoneutral zone in Mongolian gerbils.
Does kinship affect spatial organization in a small and isolated population of a solitary felid: The Eurasian lynx?
Authors: SCHMIDT Krzysztof , DAVOLI Francesca , KOWALCZYK Rafał , RANDI Ettore
Published: January 2016

Social organization in wild carnivores is mostly determined by patterns of family bonds, which may shape the degree of relatedness among individuals in the population. We studied kinship in a small and isolated population of a solitary carnivore, the Eurasian lynx (Lynx lynx) to evaluate its effect on spatial distribution of individuals. We investigated the relationship between spatial location and pair‐wise kinship among 28 lynx individuals identified in 2004–2011 by telemetry, non‐invasive sampling and genotyping with the use of 12 autosomal microsatellites in the Białowieża Primeval Forest, Poland. The average relatedness of the lynx population was relatively low (Lynch and Ritland'sR= 0.03). Females were significantly more related to each other than males with other males. The inferred pedigree showed that the population was dominated by only 2 familial groups. We did not find significant correlations between the relatedness and the extent of home range overlap or the straight‐line distances between the home ranges’ central points. These results suggest that the dynamics of kinship in this solitary felid may not differ from the random mating processes described in social carnivores. Although the chances of random mating could be limited to a few resident males and females, the presence of unrelated floaters may provide a “breeding buffer” that may prevent an increase of relatedness and likely inbreeding in the population. This system is likely to fail in preserving genetic diversity in small, highly isolated populations; therefore, restoring habitat connectivity is crucial to ensure sufficient immigration from neighboring populations.
Ecology and local knowledge of the Baird's tapir (Tapirella bairdii) in the Sierra Madre de Oaxaca, Mexico
Authors: LAVARIEGA NOLASCO Mario César , BRIONES‐SALAS Miguel , MAZAS‐TEODOCIO Amado , DURÁN‐MEDINA Elvira
Published: January 2016

As well as being of global cultural importance (from local tribal folklore to being an iconic species for conservation), the tapir plays an important role in its ecosystem as a herbivore and seed disperser. However, the ecology and ethnozoology of the endangered Baird's tapir in the north of Oaxaca, Mexico is poorly understood. We used camera traps to estimate its relative abundance and density and to describe the activity patterns of the northernmost population of Baird's tapir in the Sierra Madre de Oaxaca. Local knowledge concerning the tapir was also documented, along with the conservation strategies undertaken by the 2 indigenous communities that own the land where the study site is located. Only adult tapirs were photographed, and these were active 14 h per day, but were mainly nocturnal and crepuscular. The estimated relative abundance (12.99 ± 2.24 events/1000 camera days) and density values (0.07–0.24 individuals/km2) were both similar to those found in another site in Mexico located within a protected area. Semi‐structured interviews revealed that people have a basic understanding of the eating habits, activity and main predators of the tapir. There were reports of hunting, although not among those respondents who regularly consume bush meat. Thus, the relative abundance and density estimates of tapir at the study site could be related to the favorable condition of the forest and the absence of hunting and consumption of tapir meat. Fortunately, the local people are conducting initiatives promoting the conservation of this ungulate and its habitat that combine to constitute a regional trend of habitat and wildlife protection.
Preventing species invasion: A role for integrative taxonomy?
Authors: MAZZAMUTO Maria V. , GALIMBERTI Andrea , CREMONESI Giacomo , PISANU Benoît , CHAPUIS Jean‐Louis , STUYCK Jan , AMORI Giovanni , SU Haijun , ALOISE Gaetano , PREATONI Damiano G. , WAUTERS Lucas A. , CASIRAGHI Maurizio , MARTINOLI Adriano
Published: January 2016

Integrative taxonomy, a multi‐disciplinary approach adding modern techniques to traditional morphology‐based methods (e.g. molecular and morphological criteria), can play an important role in bioinvasion research to identify introduced taxa, discover pathways of introduction and inform authorities to control and prevent future introductions. The present study is the first on introduced populations ofCallosciurus, Asiatic tree squirrels, known as potentially invasive species in Europe (Italy, Belgium and France). We combined molecular (mitochondrial DNA markers:CoxI, D‐loop) and morphometric analysis on skulls, comparing them to the widest morphological and molecular datasets ever assembled forCallosciurus. Squirrels collected in Italy and Belgium share the same haplotypes and skull characteristics, but are conspicuously different from the French population in Antibes. Genetic data revealed close similarity between French squirrels and Pallas's squirrels,Callosciurus erythraeus, from Taiwan, China. Italian and Belgian squirrels formed an independent taxonomic lineage in genetic analyses, whose taxonomic rank needs further investigation. The morphological and morphometric characteristics of these 2 populations are, however, similar to known specimens assigned toCallosciurus erythraeus. These results may indicate a common origin for the populations found in Belgium and Italy. In contrast, French specimens suggest an independent introduction event of squirrels originating from Asia.
Antimicrobial Efficacy of an Array of Essential Oils Against Lactic Acid Bacteria
Authors: Dunn Laurel L. , Davidson P. Michael , Critzer Faith J.
Published: January 2016

The essential oils of clove bud, cinnamon bark and thyme, and their individual compounds including allyl isothiocyanate (AIT), carvacrol, cinnamaldehyde, cinnamic acid, eugenol, and thymol were initially assessed for antimicrobial activity against 9 lactic acid bacteria (LAB) species. Carvacrol and thymol were the most inhibitory with MICs of 0.1% (v/v and w/v, respectively). Cinnamaldehyde, cinnamon bark oil, clove bud oil, eugenol, and thyme oil were moderately inhibitive (MICs = 0.2% v/v), while cinnamic acid required a concentration of 0.5% (w/v). AIT was not effective with MICs in excess of concentrations tested (0.75% v/v). The bactericidal capability of the oil components carvacrol, cinnamaldehyde, eugenol, and thymol were further examined against Pediococcus acidilactici, Lactobacillus buchneri, and Leuconostoc citrovorum. Thymol at 0.1% (w/v) was bactericidal against L. citrovorum (>4‐log reduction), but resulted in a 2‐log CFU/mL reduction against L. buchneri and P. acidilactici. Cinnamaldehyde at 0.2% to 0.25% (v/v) was effective against L. citrovorum, L. buchneri, and P. acidilactici, resulting in a >2‐log reduction. All 3 organisms were susceptible to 0.2% carvacrol with >3‐log reduction observed after exposure for 6 h. Eugenol was the least effective. Concentrations of 0.2% and 0.25% (v/v) were needed to achieve an initial reduction in population, >3‐log CFU/mL after 6 h exposure. However, at 0.2%, P. acidilactici and L. buchneri recovered to initial populations in 48 to 72 h. Results indicate essential oils have the capacity to inactivate LAB that are commonly associated with spoilage of shelf stable low‐acid foods.
Gelling Properties of Fish/Pork Mince Mixtures
Authors: Liu Ru , Zhao Siming , Regenstein Joe M , Liu Qing , Yang Hong , Xiong Shanbai
Published: January 2016

The gel properties of silver carp/pork mince mixtures were investigated as well as the protein structural changes and interactions during gelling using rheology, SEM, and FT‐Raman spectroscopy. The breaking force values for gels containing 0% to 40% pork was significantly lower (P < 0.05) compared with gels containing 50% to 100% pork. Gels containing 70% to 100% pork had significantly higher (P < 0.05) breaking force values compared with gels containing 50% to 60% pork. Deformation values were more mixed. Dynamic rheological data suggested that mixing fish and pork at 3:7 could strengthen the gel network. The addition of 40% pork or above, significantly decreased (P < 0.05) the water retention of the gels compared with the 100% fish gels. The dimensional ordering of gels was also reduced by addition of pork. The reduced ordering was one of the reasons for the low water retention for fish/pork mixed gels. Raman spectral analysis confirmed that mixing fish and pork in 7:3 and 3:7 ratios could promote hydrophobic interactions such as bringing tyrosine residues into the intermolecular interface. The interactions in the 3:7 fish/pork mixed gels were favorable for forming a stronger gel. However, the interactions in the 7:3 fish/pork mixed gels were adverse. The water retention of gels was related to both molecular interactions and secondary structures of protein as well as the microstructure of the gels.
Does robotics improve minimally invasive rectal surgery? Functional and oncological implications
Authors: Guerra Francesco , Pesi Benedetta , Amore Bonapasta Stefano , Perna Federico , Di Marino Michele , Annecchiarico Mario , Coratti Andrea
Published: January 2016

Objective

Robot‐assisted surgery has been reported to be a safe and effective alternative to conventional laparoscopy for the treatment of rectal cancer in a minimally invasive manner. Nevertheless, substantial data concerning functional outcomes and long‐term oncological adequacy is still lacking. We aimed to assess the current role of robotics in rectal surgery focusing on patients' functional and oncological outcomes.

Methods

A comprehensive review was conducted to search articles published in English up to 11 September 2015 concerning functional and/or oncological outcomes of patients who received robot‐assisted rectal surgery. All relevant papers were evaluated on functional implications such as postoperative sexual and urinary dysfunction and oncological outcomes.

Results

Robotics showed a general trend towards lower rates of sexual and urinary postoperative dysfunction and earlier recovery compared with laparoscopy. The rates of 3‐year local recurrence, disease‐free survival and overall survival of robotic‐assisted rectal surgery compared favourably with those of laparoscopy.

Conclusions

This study fails to provide solid evidence to draw definitive conclusions on whether robotic systems could be useful in ameliorating the outcomes of minimally invasive surgery for rectal cancer. However, the available data suggest potential advantages over conventional laparoscopy with reference to functional outcomes.
Adverse events associated with ribavirin in sofosbuvir‐based therapies for patients with chronic hepatitis C: A community practice experience
Authors: Tong Myron John , Chang Patrick Weijen , Huynh Thatcher Thi , Rosinski Alexander Anthony , Tong Lori Terese
Published: January 2016

Objective

Due to high sustained virological response (SVR) rates, sofosbuvir‐based regimens are currently a mainstay for hepatitis C virus (HCV) therapies. The addition of pegylated interferon (PEG‐IFN) and ribavirin impacts patients' quality of life during treatment. This study aimed to compare severe adverse events (SAEs) amongst therapeutic combinations for HCV in a community clinic setting.

Methods

From December 2013 to July 2014, 128 chronic HCV‐infected patients were treated with sofosbuvir, ribavirin and weekly PEG‐IFN for 12 weeks (cohort 1), 12 or 24 weeks of sofosbuvir and ribavirin (cohorts 2 and 3) or sofosbuvir plus simeprevir for 12 weeks (cohort 4). Adverse events were recorded from baseline to 12 or 24 weeks of treatment.

Results

SAEs appeared in 15.6–53.8% of ribavirin‐inclusive treated patients compared to 4.8% of the ribavirin‐free regimen. PEG‐IFN, sofosbuvir plus ribavirin had the highest frequencies of fatigue, headache and rash compared to either 12 or 24 weeks of ribavirin and sofosbuvir. However, sofosbuvir and ribavirin regimens led to significant increases in dyspnea, need for ribavirin dose reductions and withdrawal from treatment due to SAEs. Anemia was also more frequent in ribavirin‐inclusive combinations (P < 0.001). Conversely, sofosbuvir plus simeprevir reached similar SVR rates at week 12 post‐treatment compared to all ribavirin‐containing regimens, but with significantly fewer adverse events (P = 0.006). At week 12 post‐treatment, cirrhotic patients experienced a higher virological relapse rate than non‐cirrhotic patients (P = 0.019).

Conclusions

Ribavirin‐inclusive HCV therapies increased the frequencies of SAEs, had higher dropout rates and increased patient morbidity.
CT angiography of the aorta using 80 kVp in combination with sinogram‐affirmed iterative reconstruction and automated tube current modulation: Effects on image quality and radiation dose
Authors: Boos Johannes , Aissa Joel , Lanzman Rotem S , Heusch Philipp , Schimmöller Lars , Schleich Christoph , Thomas Christoph , Antoch Gerald , Kröpil Patric
Published: January 2016

Introduction

The objective of this study was to evaluate image quality and radiation dose of a CT angiography (CTA) protocol using 80 kVp in combination with iterative reconstruction and automated tube current modulation.

Methods

Ninety‐five aortic CTA examinations were included in this study. A novel 80 kVp aortic CTA‐protocol with iterative reconstruction was introduced in our department in March 2012 for patients with a body mass index (BMI) below 32 kg/m2. The first 72 consecutive examinations were retrospectively assigned to group A (56 patients, 42 men, 14 women, mean age 69.6 ± 10.7years, BMI range 19.7–31.1 kg/m2). For comparison, the last 23 consecutive examinations performed with the old protocol (100 kVp) were assigned to group B (21 patients, 13 men, 8 women, mean age 67.4 ± 11.1years, BMI range 19.7–31.9 kg/m2). Thoracic and abdominal contrast‐to‐noise ratio (CNR), signal‐to‐noise ratio (SNR) and aortic attenuation were assessed. Subjective image quality was rated on a 5‐point scale (1 = non diagnostic; 5 = excellent). Furthermore, dose length product (DLP) and volumetric computed tomography dose index (CTDIvol) were analysed.

Results

All examinations achieved diagnostic image quality. Attenuation of the aorta was significantly higher in group A compared with B (thoracic: 443.5 ± 90.5 Hounsfield units (HU) vs. 296.0 ± 61.0 HU; abdominal: 426.3 ± 94.2 HU vs. 283.6 ± 60.5 HU; P < 0.05, respectively). CNR, SNR and subjective image quality were comparable between both groups (CNR: 12.8 ± 3.7 vs. 13.0 ± 7.4; SNR 14.4 ± 3.9 vs. 14.9 ± 8.2; subjective image quality: 4.3 ± 0.6 vs. 4.5 ± 0.6; P > 0.05, respectively). CTDIvol and DLP were significantly lower in group A (1.9 ± 0.5 mGy; 139.2 ± 41.1 mGy × cm) as compared with group B (4.2 ± 1.4 mGy; 292.1 ± 91.5 mGy × cm; P < 0.001, respectively).

Conclusion

Low‐dose CTA of the aorta using 80 kVp with iterative reconstruction enables a significant dose reduction of up to 50% compared with a 100 kVp protocol in patients with a BMI below 32 kg/m2 while diagnostic image quality is maintained.
Screen‐detected breast carcinoma with macroscopic dystrophic calcification: A pictorial essay with radiolological pathological correlation
Authors: Ebrahim Lamya , Dissanayake Deepthi , Metcalf Cecily , Wylie Elizabeth
Published: January 2016

Breast calcifications are among the most common abnormal radiographic findings detected at screening mammography. This essay illustrates the clinico‐pathological features of nine screen‐detected breast carcinomas, which had benign‐appearing macrocalcifications, as a radiographically dominant presenting feature. We aimed to demonstrate that benign‐appearing calcifications within a breast lesion are not diagnostic of a benign process if the other imaging characteristics of the lesion are suspicious of malignancy.
Imaging of tarsal navicular stress injury with a focus on MRI: A pictorial essay
Authors: Harris Guy , Harris Craig
Published: January 2016

Predominantly diagnosed in athletes, stress fracture of the tarsal navicular is becoming increasingly recognised by clinicians as a cause of midfoot pain. Delayed diagnosis can increase the significant morbidity associated with this condition. Consequently the role of MRI is increasing, given the potential to identify a stress reaction in the navicular prior to the development of a discrete stress fracture. It is necessary for radiologists to be familiar with the typical and atypical appearances of this important condition.
The impact of IFRS goodwill reporting on financial analysts' equity valuation judgements: some experimental evidence
Authors: Hellman Niclas , Andersson Patric , Fröberg Emelie
Published: January 2016

This article uses an experiment to investigate how professional financial analysts evaluate a corporate acquisition announced by an IFRS preparer. The findings suggest that professional analysts are affected by preparers' acquisition premium allocations in a potentially misleading way as the participants considered the acquisition to be value‐enhancing when the premium was allocated to goodwill, but value‐reducing when allocated to identifiable intangible assets. These effects were mitigated at the aggregate level when additional discounted cash flow analysis information was provided; however, there were significant differences in information search behaviour as quite many participants focused primarily on the exploitation of earnings information.
The effectiveness of telephone counselling and internet‐ and text‐message‐based support for smoking cessation: results from a randomized controlled trial
Authors: Skov‐Ettrup Lise S. , Dalum Peter , Bech Mickael , Tolstrup Janne S.
Published: January 2016

Aim

To compare the effectiveness of proactive telephone counselling, reactive telephone counselling and an internet‐ and text‐message‐based intervention with a self‐help booklet for smoking cessation.

Design

A randomized controlled trial with equal allocation to four conditions: (1) proactive telephone counselling (n = 452), (2) reactive telephone counselling (n = 453), (3) internet‐ and text‐message‐based intervention (n = 453) and (4) self‐help booklet (control) (n = 452).

Setting

Denmark.

Participants

Smokers who had participated previously in two national health surveys were invited. Eligibility criteria were daily cigarette smoking, age ≥ 16 years, having a mobile phone and e‐mail address.

Measurements

Primary outcome was prolonged abstinence to 12 months from the end of the intervention period.

Findings

At 12‐month follow‐up, higher prolonged abstinence was found in the proactive telephone counselling group compared with the booklet group [7.3 versus 3.6%, odds ratio (OR) = 2.2, 95% confidence interval (CI) = 1.2–4.0]. There was no clear evidence of a difference in prolonged abstinence between the reactive telephone counselling group or the internet‐based smoking cessation program and the booklet group: 1.8 versus 3.6%, OR = 0.8, 95% CI = 0.6–1.2 and 5.3 versus 3.6%, OR = 1.6, 95% CI = 0.8–3.0, respectively. In the proactive telephone counselling group, the cost per additional 12‐month quitter compared with the booklet group was £644.

Conclusions

Proactive telephone counselling was more effective than a self‐help booklet in achieving prolonged abstinence for 12 months. No clear evidence of an effect of reactive telephone counselling or the internet‐ and text‐message‐based intervention was found compared with the self‐help booklet.
When psychopathology matters most: identifying sensitive periods when within‐person changes in conduct, affective and anxiety problems are associated with male adolescent substance use
Authors: Cerdá Magdalena , Prins Seth J. , Galea Sandro , Howe Chanelle J. , Pardini Dustin
Published: January 2016

Background and aims

There is a documented link between common psychiatric disorders and substance use in adolescent males. This study addressed two key questions: (1) is there a within‐person association between an increase in psychiatric problems and an increase in substance use among adolescent males and (2) are there sensitive periods during male adolescence when such associations are more evident?

Design

Analysis of longitudinal data collected annually on boys selected randomly from schools based on a comprehensive public school enrollment list from the Pittsburgh Board of Education.

Setting

Recruitment occurred in public schools in Pittsburgh, Pennysylvania, USA.

Participants

A total of 503 boys assessed at ages 13–19 years, average cooperation rate = 92.1%.

Measurements

Diagnostic and Statistical Manual (DSM)‐oriented affective, anxiety and conduct disorder problems were measured with items from the caregiver, teacher and youth version of the Achenbach scales. Scales were converted to t‐scores using age‐ and gender‐based national norms and combined by taking the average across informants. Alcohol and marijuana use were assessed semi‐annually by a 16‐item Substance Use Scale adapted from the National Youth Survey.

Findings

When male adolescents experienced a 1‐unit increase in their conduct problems t‐score, their rate of marijuana use subsequently increased by 1.03 [95% confidence interval (CI) = 1.01, 1.05], and alcohol quantity increased by 1.01 (95% CI = 1.0002, 1.02). When adolescents experienced a 1‐unit increase in their average quantity of alcohol use, their anxiety problems t‐score subsequently increased by 0.12 (95% CI = 0.05, 0.19). These associations were strongest in early and late adolescence.

Conclusions

When adolescent boys experience an increase in conduct disorder problems, they are more likely to exhibit a subsequent escalation in substance use. As adolescent boys increase their intensity of alcohol use, they become more likely to develop subsequent anxiety problems. Developmental turning points such as early and late adolescence appear to be particularly sensitive periods for boys to develop comorbid patterns of psychiatric problems and substance use.
First trimester screening cut‐offs for noninvasive prenatal testing as a contingent screen: Balancing detection and screen‐positive rates for trisomy 21
Authors: Maxwell Susannah , James Ian , Dickinson Jan E. , O'Leary Peter
Published: January 2016

Objective

To provide data on how screen‐positive and detection rates of first trimester prenatal screening for fetalDown syndrome vary with changes in the risk cut‐off and maternal age to inform contingency criteria for publicly funded noninvasive prenatal testing.

Materials and Methods

First trimester screening and diagnostic data were collected for all women attending for first trimester fetal aneuploidy screening inWesternAustralia between 2005 and 2009. Prenatal screening and diagnostic data were linked to pregnancy outcomes, including data from theMidwives'NotificationSystem and theWesternAustralianRegistry ofDevelopmentalAnomalies. The prevalence ofDown syndrome and performance of screening by risk cut‐off and/or for women >35 years were analysed.

Results

The current screening risk cut‐off of 1:300 has screen‐positive and detection rates of 3.5% and 82%. The screen‐positive rate increases by 0.7–0.8% for each 100 point change in risk, up to 19.2% at 1:2500 (96% detection rate). Including all women >35 years as screen positive would increase the screen‐positive rate and detection rates to 30.2% and 97.2%.

Conclusion

Variation in screening risk cut‐off and the use of maternal age to assess eligibility for noninvasive testing could significantly impact the demand for, and cost of, the test. A contingent first trimester screening approach for risk assessment is superior to the use of a combination of screening and maternal age alone. These data will inform decisions regarding the criteria used to determine eligibility for publicly funded noninvasive prenatal testing.
A randomised controlled trial of peri‐operative lidocaine infusions for open radical prostatectomy
Authors: Weinberg L. , Rachbuch C. , Ting S. , Howard W. , Yeomans M. , Gordon I. , McNicol L. , James K. , Story D. , Christophi C.
Published: January 2016

We allocated 76 men scheduled for radical retropubic prostatectomy to peri‐operative lidocaine 2% or saline 0.9%: a pre‐operative 0.075 ml.kg−1 intravenous bolus; an intra‐operative intravenous infusion at 0.075 ml.kg−1.h−1; and 24 hours' postoperative subcutaneous infusion at 0.075 ml.kg−1.h−1. Lidocaine reduced the postoperative hospital stay by a mean (95% CI) of 1.3 (0.3–2.4) days, p = 0.017, from a mean (SD) of 4.6 (3.2) days with saline. Lidocaine reduced pain at rest during the first 24 postoperative hours by a mean (95% CI) of 1.8 (0.7–2.9) mm.h−1, p = 0.001. Lidocaine reduced 24‐h morphine consumption by a mean (95% CI) of 13.9 (2.2–25.7) mg, p = 0.021, from a mean (SD) of 52.3 (26.9) mg with saline. There were no differences in other outcomes.
Serum hepatic enzyme activity in relation to semen quality and serum reproductive hormone levels among Estonian fertile Men
Authors: Ehala‐Aleksejev K. , Punab M.
Published: January 2016

The aim of this study was to investigate the relations of basic semen parameters and reproductive hormones with alanine aminotransferase (ALT) and gamma‐glutamyl transferase (GGT). In addition, to examine possible interaction between adiposity, alcohol consumption, and liver tests in relation to male reproductive health, standard semen analysis was performed and serum levels of reproductive hormones and liver tests were measured in 245 male partners of pregnant women at a University Hospital Andrology Centres in Estonia. Quartile analysis revealed that after adjustment for covariates GGT was negatively related to sperm concentration and total sperm count. These significant changes appeared from a GGT >35.5 U/L. Next to these changes ALT was not related to sperm parameters. Both enzymes, GGT and ALT, were not related to reproductive hormones. Alcohol consumption was positively related to GGT and in cases with elevated GGT alcohol use was negatively related to sperm concentration and total sperm count. Alcohol consumption was positively related to body mass index (BMI) and waist circumference (WC). Our findings also confirm results of previous studies that BMI and WC are associated positively with ALT and GGT. According to the study, increased GGT activity might represent a possible connection between adiposity, alcohol consumption, and semen quality.
MEF2 and NR2F2 cooperate to regulate Akr1c14 gene expression in mouse MA‐10 Leydig cells
Authors: Di‐Luoffo M. , Brousseau C. , Tremblay J. J.
Published: January 2016

Leydig cells are essential for male reproductive development and health throughout life. Production of androgens [testosterone, dihydrotestosterone (DHT)] as well as intermediate steroids [progesterone, dihydroprogesterone (DHP)] is tightly regulated. In the mouse, the 3α‐hydroxysteroid dehydrogenase enzyme (3α‐HSD, AKR1C14) catalyses the interconversion of DHP and DHT into less potent steroids. Despite its importance, nothing is currently known regarding the regulation of Akr1c14 expression in Leydig cells. Recently, the transcription factors MEF2 and NR2F2 were identified in the mouse testis including in Leydig cells where they were found to regulate expression of genes involved in steroidogenesis. Analyses of transcriptomic data from MEF2‐ or NR2F2‐deficient MA‐10 Leydig cells revealed a significant decrease in Akr1c14 mRNA levels. Using qPCR, we confirmed that Akr1c14 mRNA levels were decreased in MEF2‐ and in NR2F2‐deficient conditions. Conversely, overexpression of MEF2A or/and NR2F2 in MA‐10 Leydig cells led to an increase in endogenous Akr1c14 mRNA levels. Recruitment of MEF2 and NR2F2 to the Akr1c14 promoter was confirmed by ChIP while DNA precipitation assays revealed direct binding of MEF2 but not NR2F2 to this region. In functional promoter studies, NR2F2 was found to activate the Akr1c14 promoter while MEF2A on its own had no effect. Combination of both NR2F2 and MEF2A led to a cooperative activation of the Akr1c14 promoter and this required intact MEF2 and NR2F2 elements. Finally, co‐immunoprecipitation experiments showed that MEF2 and NR2F2 are present in the same protein complex. In conclusion, our results identify a novel cooperation between MEF2 factors and NR2F2 in the expression of the Akr1c14 gene involved in the regulation of DHP/DHT levels.
Retro‐rectus repair of complex incisional hernia leads to low recurrence rate
Authors: Warwick Andrea M. , Smart Neil J. , Daniels Ian R.
Published: January 2016

Background

To assess the outcome of retro‐rectus repair of complex abdominal wall repair (CAWR) in a single institution in relation to the use of biologic and synthetic mesh.

Method

A retrospective review was undertaken of complex abdominal wall repairs performed by a single surgical team, assessing the outcome of the retro‐rectus repair and factors affecting the outcome.

Results

Between 2007 and 2013, 57 (33 male) patients underwent CAWR retro‐rectus repair. The material used was assessed as either synthetic or biologic (cross‐linked porcine dermal collagen). The Ventral Hernia Working Group grades were similar between groups of patients having a repair with synthetic and biologic mesh. Median follow‐up in the synthetic group was 18 months (1–80.5) and 18.4 months (0.5–70.7) in the biologic group. There was no statistical difference in seroma, wound infection or haematoma rates. No fistulae occurred in either group. Overall recurrence was 3.4% and there was no statistical difference between groups.

Conclusion

The retro‐rectus repair technique is associated with a low rate of recurrence and is now the technique of choice. The choice of material, biologic or synthetic, in Ventral Hernia Working Group grades 1–3 remains controversial.
Surgical ward round checklist: does it improve medical documentation? A clinical review of Christchurch general surgical notes
Authors: Alamri Yassar , Frizelle Frank , Al‐Mahrouqi Haitham , Eglinton Tim , Roberts Ross
Published: January 2016

Background

Poor documentation of medical notes and plans not only adversely affects patient management but also has medico‐legal implications. A standardized ward round checklist (adhesive proforma sticker, PFS) was introduced at our institution in 2013 to improve documentation by junior doctors. We aimed to examine the current pattern of PFS documentation (2 years after its introduction) and to identify which fields, if any, have been the most problematic to complete.

Methods

Notes of all current general surgical inpatients admitted to Christchurch Public Hospital on or before the two study days were reviewed. All information written in the PFS, regardless of accuracy, authorship or completeness, was recorded. Documentation of the various PFS fields was classified as well documented (completed in >80% of PFS), inadequate (40–80%) or minimal (<40%).

Results

Four hundred and seventy‐nine PFS were reviewed. Most fields in the PFS were documented to an adequate level (i.e. >80%). Problematic fields identified were dietary plans, diagnosis, national health index number, estimated date of discharge and the patient's first name. Notes of patients on outlying ward contained significantly fewer PFS compared with home‐ward patients' notes (0.71 PFS/day versus 1.21 PFS/day, respectively, P < 0.001).

Conclusion

Our study has shown generally adequate patterns of medical note documentation in the General Surgery service. Certain fields remain challenging to document accurately. The proposed modified PFS was designed to help rectify this; electronic data record may be the step forward, however. It is hoped that other institutions in Australasia would benefit from our experience.
Risk factors for new vertebral compression fractures after vertebroplasty: a meta‐analysis
Authors: Cao Junming , Kong Lingde , Meng Fantao , Zhang Yingze , Shen Yong
Published: January 2016

Background

The risk factors for new vertebral compression fractures (VCFs) after vertebroplasty are unclear. The aim of this meta‐analysis was to identify potential risk factors.

Methods

A systematic electronic literature search was performed using the following databases: PubMed, Embase and Cochrane Library; the databases were searched from the earliest available records in 1966 to May 2015. Pooled odds ratios (ORs) or standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using random‐ or fixed‐effects models. The Newcastle–Ottawa scale was used to evaluate the methodological quality of the studies, and Stata 11.0 was used to analyse the data.

Results

The primary factors that were associated with new fractures after vertebroplasty were low bone mineral density (SMD −0.375; 95% CI −0.579 to −0.171), steroid usage (OR 2.632; 95% CI 1.399 to 4.950) and the presence of multiple treated vertebrae (OR 2.027; 95% CI 1.442 to 2.851). The data did not support that age, sex, body mass index, non‐steroidal anti‐inflammatory drug usage, vacuum cleft, thoracolumbar junction, cement volume, kyphosis correction, or intradiscal cement leakage could lead to infection after vertebroplasty.

Conclusions

The present analysis demonstrated that low bone mineral density, the presence of multiple treated vertebrae and a history of steroid usage were associated with the new VCFs after vertebroplasty. Patients with these factors should be informed of the potential increased risk.
Impact of malnutrition on 12‐month mortality following acute hip fracture
Authors: Bell Jack J. , Pulle Ranjeev C. , Crouch Alisa M. , Kuys Suzanne S. , Ferrier Rebecca L. , Whitehouse Sarah L.
Published: January 2016

Background

Studies investigating the relationship between malnutrition and post‐discharge mortality following acute hip fracture yield conflicting results. This study aimed to determine whether malnutrition independently predicted 12‐month post‐fracture mortality after adjusting for clinically relevant covariates.

Methods

An ethics approved, prospective, consecutive audit was undertaken for all surgically treated hip fracture inpatients admitted to a dedicated orthogeriatric unit (November 2010–October 2011). The 12‐month mortality data were obtained by a dual search of the mortality registry and Queensland Health database. Malnutrition was evaluated using the Subjective Global Assessment. Demographic (age, gender, admission residence) and clinical covariates included fracture type, time to surgery, anaesthesia type, type of surgery, post‐surgery time to mobilize and post‐operative complications (delirium, pulmonary and deep vein thrombosis, cardiac complications, infections). The Charlson Comorbidity Index was retrospectively applied. All diagnoses were confirmed by the treating orthogeriatrician.

Results

A total of 322 of 346 patients were available for audit. Increased age (P = 0.004), admission from residential care (P < 0.001), Charlson Comorbidity Index (P = 0.007), malnutrition (P < 0.001), time to mobilize >48 h (P < 0.001), delirium (P = 0.003), pulmonary embolism (P = 0.029) and cardiovascular complication (P = 0.04) were associated with 12‐month mortality. Logistic regression analysis demonstrated that malnutrition (odds ratio (OR) 2.4 (95% confidence interval (CI) 1.3–4.7, P = 0.007)), in addition to admission from residential care (OR 2.6 (95% CI 1.3–5.3, P = 0.005)) and pulmonary embolism (OR 11.0 (95% CI 1.5–78.7, P = 0.017)), independently predicted 12‐month mortality.

Conclusions

Findings substantiate malnutrition as an independent predictor of 12‐month mortality in a representative sample of hip fracture inpatients. Effective strategies to identify and treat malnutrition in hip fracture should be prioritized.
Impact of workflow on the use of the Surgical Safety Checklist: a qualitative study
Authors: Gillespie Brigid M. , Marshall Andrea P. , Gardiner Therese , Lavin Joanne , Withers Teresa K.
Published: January 2016

Background

Regardless of the benefits associated of the Surgical Safety Checklist, adherence across its three phases remains inconsistent. The aim of this study was to systematically identify issues around workflow that impact on surgical teams’ ability to use the Surgical Safety Checklist in a large tertiary facility in Queensland, Australia.

Method

Observational audit of 10 surgical teams and 33 semi‐structured interviews with 70 participants from nursing, medicine and the community were conducted. Data were collected during 2014–2015. Inductive and deductive approaches were used to analyse field observations and interview transcripts.

Results

The domain, impact of workflow on checklist utilization, was identified. Within this domain, seven categories illustrated the causal conditions which determined the ways in which workflow influenced checklist use. These categories included: ‘busy doing the task’; ‘clashing task priorities’; ‘being pressured, running out of time’; ‘adapting processes to work patterns’; ‘doubling up on work’; ‘a domino effect, leading to delays’ and ‘reality of the workflow’.

Conclusions

One of the greatest systemic challenges to checklist use in surgery is workflow. Process changes in the way that surgical safety checklists are used need to incorporate the temporal demands of the workflow. Any changes made must ensure the process is reliable, is easily embedded into existing work routines and is not disruptive.
Retinal artery occlusion due to Bartonella henselae infection: a case series
Authors: Eiger‐Moscovich Maya , Amer Radgonde , Oray Merih , Tabbara Khalid F. , Tugal‐Tutkun Ilknur , Kramer Michal
Published: January 2016

Purpose

To report a case series of six patients suffering from branch retinal artery occlusion due to Bartonella henselae infection, in order to raise awareness to this etiology in the differential diagnosis of retinal artery occlusion.

Methods

A retrospective case series of patients with branch retinal artery occlusion due to ocular cat scratch disease who presented at four tertiary medical centers in Israel, Turkey and Saudi Arabia between the years 2008‐2014. Data retrieved from the medical records included demographic data, exposure, complaints, visual acuity, clinical findings and imaging, laboratory assessment, treatment, disease course and visual outcome.

Results

The study group consisted of six patients who presented with branch retinal artery occlusion with or without neuroretinitis. One patient had multiple artery occlusions. Diagnosis of cat scratch disease was established based on positive serology and accompanying systemic symptoms, after ruling out other causes of retinal artery occlusion. Treatment included various regimens of antibiotics and systemic steroids. Visual outcome depended upon the obstructed artery.

Conclusion

Cat scratch disease may cause retinal artery occlusion in infected patients, leaving them with a permanent visual field defect. When retinal artery occlusion occurs as an early sign of the disease, prompt recognition may prevent further events. Thorough history and relevant tests may be of great value.