bluuebunny/crossref_metadata_2025 huggingface dataset:
Grapevine growth and fruit development.
Authors: Creasy G. L. , Creasy L. L.
Published: August 2018

This chapter reviews the growth cycle of the grapevine, along with factors that influence it. The fact that the vine is a perennial plant means that management is quite different to that for annual crops, as well as there being unique aspects to cultivating young versus established vines. An overarching concept, that of vine balance, is introduced as it has implications for decisions made from the very start of vineyard planning as to how the weather affects the vine after harvest. Some fruit quality parameters will also be mentioned, particularly with reference to grape berry maturation.
Harvest and postharvest processing.
Authors: Creasy G. L. , Creasy L. L.
Published: August 2018

After harvest, grapes may be consumed fresh, crushed or dehydrated. Fresh table grapes are handled, stored and marketed much like other fruits consumed fresh. Crushed grapes may be directly fermented into wine, pressed into juice that may be fermented into wine, consumed fresh or concentrated for later use. Dehydrated grapes or raisins are also a major product of the vine. The largest use of grapes in the world is still for making wine, although this is declining. This chapter discusses the production, quality, picking, packing, storage, drying, cultivars, processing (e.g. into juice, preserves), and uses of grapes.
Is it possible to regain 'silent' knowledge of farm animal behaviour? - Mini review.
Authors: Ekesbo I.
Published: August 2018

The modern veterinarian has, even though she or he has got a thorough ethology education, in many respects less practical knowledge of farm animal behaviour than a farmer's child 100 years ago. The book aims to complement and support this knowledge not only for veterinarians, but also for animal scientists, ethologists and other professionals.
Elastic modulus and damping of coatings based on microscopic defects
Authors: Zhai Jingyu , Song Xinyuan , Yu Yingdan , Wu Hongchun , Pan Xinwei
Published: August 2018

In this study, the influence of microscopic defects on the elastic modulus and damping of hard coatings was examined by finite element (FE) analysis. We present a method based on image processing and FE modelling to calculate the elastic modulus and loss factor of hard coatings. The calculated results agree with the results of the dynamic mechanical analysis. Furthermore, by using this method, the effects of the loading and friction coefficient between cracks on loss factor of hard coatings are studied. From the microscopic point of view, we study the relationship between the microscopic defects and macroscopic properties of the coating, thus providing a new idea for simulating and actively designing hard coatings.
Process-dependent photocatalytic performance of quantum sized ZnO nanoparticles
Authors: Ghaemi Behnaz , Kharrazi Sharmin , Amani Amir , Shahverdi Ahmad Reza
Published: August 2018

Photocatalytic properties of ZnO nanoparticles (NPs) strongly depend on their electronic characteristics which can be tuned by varying size, crystal defects and dopings. In this work, ZnO NPs were prepared using a simple chemical precipitation method. Effect of some independent process/synthesis parameters (i.e. reaction time and precursor concentration) on size and ROS generation in ZnO NPs was investigated. Based on TEM analysis and UV–vis absorption spectra, the synthesized nanoparticles ranged from 2.3 to 4.0 nm in size with the spherical morphologies. Moreover, XRD and SAED showed mono-crystal structures with noticeable diffraction peak at 2θ = 36.8° attributed to (101) plane. Using response surface methodology, OH−/Zn+ molar ratio, Zn+ concentration and reaction time were shown to have significant impacts on size of ZnO NPs. At fixed Zn+ concentrations, reaction time was found to be the most effective parameter on ROS generation and photocatalytic activity of NPs. Obtained results demonstrated that ROS generation is strongly dependent on synthesis reaction time as an indicator of oxygen deficiency and crystal formation in ZnO NPs. No clear relation was obtained between size of NPs and their ROS generation/photocatalytic activity in this size range.
Dot2dot: accurate whole-genome tandem repeats discovery
Authors: Genovese Loredana M , Mosca Marco M , Pellegrini Marco , Geraci Filippo
Published: August 2018

Motivation

Large-scale sequencing projects have confirmed the hypothesis that eukaryotic DNA is rich in repetitions whose functional role needs to be elucidated. In particular, tandem repeats (TRs) (i.e. short, almost identical sequences that lie adjacent to each other) have been associated to many cellular processes and, indeed, are also involved in several genetic disorders. The need of comprehensive lists of TRs for association studies and the absence of a computational model able to capture their variability have revived research on discovery algorithms.

Results

Building upon the idea that sequence similarities can be easily displayed using graphical methods, we formalized the structure that TRs induce in dot-plot matrices where a sequence is compared with itself. Leveraging on the observation that a compact representation of these matrices can be built and searched in linear time, we developed Dot2dot: an accurate algorithm fast enough to be suitable for whole-genome discovery of TRs. Experiments on five manually curated collections of TRs have shown that Dot2dot is more accurate than other established methods, and completes the analysis of the biggest known reference genome in about one day on a standard PC.

Availability and implementation

Source code and datasets are freely available upon paper acceptance at the URL: https://github.com/Gege7177/Dot2dot.

Supplementary information

Supplementary data are available at Bioinformatics online.
Silence and voice in participatory processes – causes, meanings and implications for empowerment
Authors: Brear Michelle
Published: August 2018

The empowerment-related outcomes of participation in development rely on community members contributing intellectually to deliberative processes. However, people are entitled to remain silent. Silence is conceptualized both as a form of resistance and a type of structured self-censorship. In participatory development, these divergent conceptualizations manifest as the incongruent recommendations to ‘give voice’ and ‘tolerate silence’. My aim is to advance understandings of the causes and meanings of silence in participatory development and discuss the implications for deliberative processes. I do this through an interpretive analysis of ethnographic data detailing a process of co-designing participatory action research (PAR) about health, which I facilitated. The analysis is informed by Bourdieu’s theory of social power relations and Nussbaum’s capabilities approach. The co-researcher participants often remained silent when provided an opportunity to contribute their voices because they were afraid, for example, of getting the wrong answer. The silences frustrated the co-researchers because they valued having a voice. They frustrated me because I expected and needed the co-researchers to contribute their voice to make the research design process participatory. I used a variety of strategies to disrupt silences, which when successful generated lived experiences through which the co-researchers could imagine themselves as important people, with entitlement and competence to speak. The study demonstrates the importance of considering the structural barriers to marginalized people contributing their voices, and incorporating strategies for disrupting marginalized silences into PAR and other participatory development processes.
Endothelial SIRT1 prevents age-induced impairment of vasodilator responses by enhancing the expression and activity of soluble guanylyl cyclase in smooth muscle cells
Authors: Guo Yumeng , Xu Cheng , Man Andy W C , Bai Bo , Luo Cuiting , Huang Yu , Xu Aimin , Vanhoutte Paul M , Wang Yu
Published: August 2018

Aims

Aged arteries are characterized by attenuated vasodilator and enhanced vasoconstrictor responses, which contribute to the development of diseases such as arterial hypertension, atherosclerosis, and heart failure. SIRT1 is a longevity regulator exerting protective functions against vascular ageing, although the underlying mechanisms remain largely unknown. This study was designed to elucidate the signalling pathways involved in endothelial SIRT1-mediated vasodilator responses in the arteries of young and old mice. In particular, the contributions of nitric oxide (NO), endothelial NO synthase (eNOS), cyclooxygenase (COX), and/or soluble guanylyl cyclase (sGC) were examined.

Methods and results

Wild type (WT) or eNOS knockout (eKO) mice were cross-bred with those overexpressing human SIRT1 selectively in the vascular endothelium (EC-SIRT1). Arteries were collected from the four groups of mice (WT, EC-SIRT1, eKO, and eKO-SIRT1) to measure isometric relaxations/contractions in response to various pharmacological agents. Reduction of NO bioavailability, hyper-activation of COX signalling, and down-regulation of sGC collectively contributed to the decreased vasodilator and increased vasoconstrictor responses in arteries of old WT mice. Overexpression of endothelial SIRT1 did not block the reduction in NO bioavailability but attenuated the hyper-activation of COX-2, thus protecting mice from age-induced vasoconstrictor responses in arteries of EC-SIRT1 mice. Deficiency of eNOS did not affect endothelial SIRT1-mediated anti-contractile activities in arteries of eKO-SIRT1 mice. Mechanistic studies revealed that overexpression of endothelial SIRT1 enhanced Notch signalling to up-regulate sGCβ1 in smooth muscle cells. Increased expression and activity of sGC prevented age-induced hyper-activation of COX-2 as well as the conversion of endothelium-dependent relaxations to contractions in arteries of EC-SIRT1 mice.

Conclusion

Age-induced down-regulation of sGC and up-regulation of COX-2 in arteries are at least partly attributable to the loss-of-endothelial SIRT1 function. Enhancing the endothelial expression and function of SIRT1 prevents early vascular ageing and maintains vasodilator responses, thus representing promising drug targets for cardiovascular diseases.
Gatekeeping function of primary care physicians under Japan’s free-access system: a prospective open cohort study involving 14 isolated islands
Authors: Kaneko Makoto , Motomura Kazuhisa , Mori Hideki , Ohta Ryuichi , Matsuzawa Hiroki , Shimabukuro Akira , Matsushima Masato
Published: August 2018

Background

Gatekeeping is important for strong primary care and cost containment. Under Japan’s free-access system, patients can access any medical institution without referral, which makes it difficult to evaluate the gatekeeping function of primary care physicians (PCPs).

Objectives

To examine the gatekeeping function of PCPs in Japan, we compared the frequencies of visits to primary care clinics, referrals to advanced care and hospitalizations between 14 remote islands and a nationwide survey.

Methods

This study was a prospective, open cohort study involving 14 isolated islands (12 238 inhabitants) in Okinawa, Japan. Participants were all patients who visited the clinics on these islands in 1 year. Main outcome measures were the incidence of on-island clinic visits and referrals to off-island advanced care.

Results

There were 54 741 visits to the islands’ clinics with 2045 referrals to off-island medical facilities, including 549 visits to emergency departments and 705 hospitalizations. The age- and sex-standardized incidences of healthcare use per 1000 inhabitants per month were: 360.0 (95% confidence interval: 359.9 to 360.1) visits to primary care clinics, 11.6 (11.0 to 12.2) referrals to off-island hospital-based outpatient clinics, 3.3 (2.8 to 5.2) visits to emergency departments and 4.2 (3.1 to 5.2) hospitalizations. Comparison with the nationwide survey revealed a lower incidence of visits to hospital-based outpatient clinics in this study, while more patients had visited PCPs.

Conclusions

The lower incidence of visits to secondary care facilities in this study might suggest that introduction of a gatekeeping system to Japan would reduce the incidence of referral to advanced care.
MicroRNA-141-3p Negatively Modulates SDF-1 Expression in Age-Dependent Pathophysiology of Human and Murine Bone Marrow Stromal Cells
Authors: Periyasamy-Thandavan Sudharsan , Burke John , Mendhe Bharati , Kondrikova Galina , Kolhe Ravindra , Hunter Monte , Isales Carlos M , Hamrick Mark W , Hill William D , Fulzele Sadanand
Published: August 2018

Stromal cell-derived factor-1 (SDF-1 or CXCL12) is a cytokine secreted by cells including bone marrow stromal cells (BMSCs). SDF-1 plays a vital role in BMSC migration, survival, and differentiation. Our group previously reported the role of SDF-1 in osteogenic differentiation in vitro and bone formation in vivo; however, our understanding of the post-transcriptional regulatory mechanism of SDF-1 remains poor. MicroRNAs are small noncoding RNAs that post-transcriptionally regulate the messenger RNAs (mRNAs) of protein-coding genes. In this study, we aimed to investigate the impact of miR-141-3p on SDF-1 expression in BMSCs and its importance in the aging bone marrow (BM) microenvironment. Our data demonstrated that murine and human BMSCs expressed miR-141-3p that repressed SDF-1 gene expression at the functional level (luciferase reporter assay) by targeting the 3′-untranslated region of mRNA. We also found that transfection of miR-141-3p decreased osteogenic markers in human BMSCs. Our results demonstrate that miR-141-3p expression increases with age, while SDF-1 decreases in both the human and mouse BM niche. Taken together, these results support that miR-141-3p is a novel regulator of SDF-1 in bone cells and plays an important role in the age-dependent pathophysiology of murine and human BM niche.
Vertical relatedness and services outsourcing: a firm-level analysis
Authors: Cainelli Giulio , Ganau Roberto , Iacobucci Donato
Published: August 2018

This paper analyzes the relationship between local-level vertical relatedness and firms’ services outsourcing, using a data set of 46,671 Italian manufacturing firms observed over the period 1999–2007. The analysis uses a firm-level index of services outsourcing based on the Adelman index, and it proposes a new measure of vertical relatedness. Overall, the results suggest that it is not agglomeration per se that matters for services outsourcing but rather the presence of vertically related industries. The role of firm-level heterogeneity in terms of size, geographic location, and technological regime also emerges.
The ‘Asia threat’ in the US–Australia relationship: then and now
Authors: Rollo Stuart
Published: August 2018

For almost a century before the formal alliance between the United States and Australia in 1941, a relationship was being formed around interrelated perceptions of shared identity and economic, political, and strategic interests. Perhaps the single most important factor in the recognition of shared interests lay in the mutually reinforcing fears of a multilayered ‘Asia threat’ that developed in parallel in both countries, originating as a demographic fear over Chinese migration during gold rushes of the 1850s, and progressing to focus on the growing military power of imperial Japan and geostrategic dominance of the Pacific. In recent years, the rise of China has been the central focus of US–Australia alliance, and, in many respects, the security architecture used to confront China is a legacy of the historical ‘Asia threat’. Understanding the historical context of the relationship is necessary for dispelling the anachronistic ‘Asia threat’ perceptions from the contemporary security policy.
Role of INSL4 Signaling in Sustaining the Growth and Viability of LKB1-Inactivated Lung Cancer
Authors: Yang Rongqiang , Li Steven W , Chen Zirong , Zhou Xin , Ni Wei , Fu Dongtao A , Lu Jianrong , Kaye Frederic J , Wu Lizi
Published: August 2018

Background

The LKB1 tumor suppressor gene is commonly inactivated in non-small cell lung carcinomas (NSCLC), a major form of lung cancer. Targeted therapies for LKB1-inactivated lung cancer are currently unavailable. Identification of critical signaling components downstream of LKB1 inactivation has the potential to uncover rational therapeutic targets. Here we investigated the role of INSL4, a member of the insulin/IGF/relaxin superfamily, in LKB1-inactivated NSCLCs.

Methods

INSL4 expression was analyzed using global transcriptome profiling, quantitative reverse transcription PCR, western blotting, enzyme-linked immunosorbent assay, and RNA in situ hybridization in human NSCLC cell lines and tumor specimens. INSL4 gene expression and clinical data from The Cancer Genome Atlas lung adenocarcinomas (n = 515) were analyzed using log-rank and Fisher exact tests. INSL4 functions were studied using short hairpin RNA (shRNA) knockdown, overexpression, transcriptome profiling, cell growth, and survival assays in vitro and in vivo. All statistical tests were two-sided.

Results

INSL4 was identified as a novel downstream target of LKB1 deficiency and its expression was induced through aberrant CRTC-CREB activation. INSL4 was highly induced in LKB1-deficient NSCLC cells (up to 543-fold) and 9 of 41 primary tumors, although undetectable in all normal tissues except the placenta. Lung adenocarcinomas from The Cancer Genome Atlas with high and low INSL4 expression (with the top 10th percentile as cutoff) showed statistically significant differences for advanced tumor stage (P < .001), lymph node metastasis (P = .001), and tumor size (P = .01). The INSL4-high group showed worse survival than the INSL4-low group (P < .001). Sustained INSL4 expression was required for the growth and viability of LKB1-inactivated NSCLC cells in vitro and in a mouse xenograft model (n = 5 mice per group). Expression profiling revealed INSL4 as a critical regulator of cell cycle, growth, and survival.

Conclusions

LKB1 deficiency induces an autocrine INSL4 signaling that critically supports the growth and survival of lung cancer cells. Therefore, aberrant INSL4 signaling is a promising therapeutic target for LKB1-deficient lung cancers.
Acute Kidney Injury in Patients Receiving Systemic Treatment for Cancer: A Population-Based Cohort Study
Authors: Kitchlu Abhijat , McArthur Eric , Amir Eitan , Booth Christopher M , Sutradhar Rinku , Majeed Habeeb , Nash Danielle M , Silver Samuel A , Garg Amit X , Chan Christopher T , Kim S Joseph , Wald Ron
Published: August 2018

Background

Patients undergoing treatment for cancer are at increased risk of acute kidney injury (AKI). There are few data on AKI incidence and risk factors in the current era of cancer treatment.

Methods

We conducted a population-based study of all patients initiating systemic therapy (chemotherapy or targeted agents) for a new cancer diagnosis in Ontario, Canada (2007–2014). The primary outcome was hospitalization with AKI or acute dialysis. We estimated the cumulative incidence of AKI and fitted Fine and Gray models, adjusting for demographics, cancer characteristics, comorbidities, and coprescriptions. We modeled exposure to systemic therapy (the 90-day period following treatments) as a time-varying covariate. We also assessed temporal trends in annual AKI incidence.

Results

We identified 163 071 patients initiating systemic therapy of whom 10 880 experienced AKI. The rate of AKI was 27 per 1000 person-years, with overall cumulative incidence of 9.3% (95% CI = 9.1% to 9.6%). Malignancies with the highest 5-year AKI incidence were myeloma (26.0%, 95% CI = 24.4% to 27.7%), bladder (19.0%, 95% CI = 17.6% to 20.5%), and leukemia (15.4%, 95% CI = 14.3% to 16.5%). Advanced cancer stage, chronic kidney disease, and diabetes were associated with increased risk of AKI (adjusted hazard ratios [aHR] = 1.41, 95% CI = 1.28 to 1.54; 1.80, 95% CI = 1.67 to 1.93; and 1.43, 95% CI = 1.37 to 1.50, respectively). In patients aged 66 years or older with universal drug benefits, diuretic, and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker coprescription was associated with higher AKI risk (aHR = 1.20, 95% CI = 1.14 to 1.28; 1.30, 95% CI = 1.23 to 1.38). AKI risk was further accentuated during the 90-day period following systemic therapy (aHR = 2.34, 95% CI = 2.24 to 2.45). The annual incidence of AKI increased from 18 to 52 per 1000 person-years between 2007 and 2014.

Conclusion

Cancer-related AKI is common and associated with advanced stage, chronic kidney disease, diabetes, and concomitant receipt of diuretics or angiotensin-converting enzyme inhibitors/angiotensin receptor blockers. Risk is heightened in the 90 days after systemic therapy. Preventive strategies are needed to address the increasing burden of AKI in this population.
Unusual polarimetric properties of (101955) Bennu: similarities with F-class asteroids and cometary bodies
Authors: Cellino A , Bagnulo S , Belskaya I N , Christou A A
Published: August 2018

We have obtained polarimetric measurements of asteroid (101955) Bennu, a presumably primitive near-Earth object (NEO) that is the target of NASA’s sample return mission OSIRIS-REx. During our observing campaign, Bennu was visible from Earth under a wide range of illumination conditions, with phase angle in the range 16°–57°. Together with (3200) Phaethon and (152679) 1998 KU2, observed very recently, Bennu is the only existing example of a primitive NEO observed in polarimetric mode over a wide interval of phase angles. Based on our polarimetric data, we propose that Bennu belongs to the unusual F taxonomic class defined in the 80s. According to previous works, the F-class includes objects with cometary features. This fact can be of great importance for the interpretation of the results of the exploration of this object by OSIRIS-REx. From polarimetry we also derive an estimate of the geometric albedo of Bennu: pR = 0.059 ± 0.003.
Functional features defining the efficacy of cholesterol-conjugated, self-deliverable, chemically modified siRNAs
Authors: Shmushkovich Taisia , Monopoli Kathryn R , Homsy Diana , Leyfer Dmitriy , Betancur-Boissel Monica , Khvorova Anastasia , Wolfson Alexey D
Published: August 2018

Progress in oligonucleotide chemistry has produced a shift in the nature of siRNA used, from formulated, minimally modified siRNAs, to unformulated, heavily modified siRNA conjugates. The introduction of extensive chemical modifications is essential for conjugate-mediated delivery. Modifications have a significant impact on siRNA efficacy through interference with recognition and processing by RNAi enzymatic machinery, severely restricting the sequence space available for siRNA design. Many algorithms available publicly can successfully predict the activity of non-modified siRNAs, but the efficiency of the algorithms for designing heavily modified siRNAs has never been systematically evaluated experimentally. Here we screened 356 cholesterol-conjugated siRNAs with extensive modifications and developed a linear regression-based algorithm that effectively predicts siRNA activity using two independent datasets. We further demonstrate that predictive determinants for modified and non-modified siRNAs differ substantially. The algorithm developed from the non-modified siRNAs dataset has no predictive power for modified siRNAs and vice versa. In the context of heavily modified siRNAs, the introduction of chemical asymmetry fully eliminates the requirement for thermodynamic bias, the major determinant for non-modified siRNA efficacy. Finally, we demonstrate that in addition to the sequence of the target site, the accessibility of the neighboring 3′ region significantly contributes to siRNA efficacy.
Prevalence of atheromatous and non-atheromatous cardiovascular disease by age in chronic kidney disease
Authors: Villain Cédric , Metzger Marie , Combe Christian , Fouque Denis , Frimat Luc , Jacquelinet Christian , Laville Maurice , Briançon Serge , Klein Julie , Schanstra Joost P , Robinson Bruce M , Mansencal Nicolas , Stengel Bénédicte , Massy Ziad A
Published: August 2018

Background

Although chronic kidney disease (CKD) and age are major risk factors for cardiovascular disease (CVD), little is known about the relative proportions of atheromatous and non-atheromatous CVD by age in CKD patients.

Methods

We used baseline data from the French Chronic Kidney Disease-Renal Epidemiology and Information Network (CKD-REIN) cohort of 3033 patients (65% men) with CKD Stages 3–4 to study crude and adjusted associations between age, the estimated glomerular filtration rate (eGFR), atheromatous CVD (coronary artery disease, peripheral artery disease and stroke) and non-atheromatous CVD (heart failure, cardiac arrhythmia and valvular heart disease).

Results

Mean age was 66.8 and mean Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) eGFR was 32.9 mL/min/1.73 m2. In the <65, (65–74), (75–84) and ≥85 year age groups, the prevalence was, respectively, 18.7, 35.5, 42.9 and 37.8% for atheromatous CVD, and 14.9, 28.4, 38.1 and 56.4% for non-atheromatous CVD. After adjusting for albuminuria, sex and CVD risk factors, the odds ratio (OR) [95% confidence interval (CI)] for (65–74), (75–84) and ≥85 age groups (compared with the <65 group) was, respectively, 1.99 (1.61–2.46), 2.89 (2.30–3.62), 2.72 (1.77–4.18) for atheromatous CVD and 2.07 (1.66–2.58), 3.15 (2.50–3.97), 7.04 (4.67–10.61) for non-atheromatous CVD. Compared with patients with an eGFR ≥30 mL/min/1.73 m2, those with an eGFR <30 mL/min/1.73 m2 had a higher OR for atheromatous CVD [1.21 (1.01–1.44)] and non-atheromatous CVD [1.16 (0.97–1.38)].

Conclusions

In this large cohort of CKD patients, both atheromatous and non-atheromatous CVD were highly prevalent and more frequent in older patients. In a given age group, the prevalence of atheromatous and non-atheromatous CVD was similar (except for a greater prevalence of non-atheromatous CVD after 85).
MODIFICATION INDUCED BY PROTON IRRADIATION IN BAYFOL UV1 7-2 NUCLEAR TRACK DETECTOR
Authors: Nouh S A , Gaballah N , Abou Elfadl A , Alsharif S A
Published: August 2018

Bayfol is a class of polymeric solid state nuclear track detector which has many applications in various radiation detection fields. It is a Makrofol polycarbonate/polyester blend. Samples from Bayfol film have been irradiated with different fluences (1011−1014 p/cm2) of 1 MeV protons at the University of Surrey Ion Beam Center, UK. The resultant effect of proton irradiation on the structural and optical properties of the Bayfol samples has been investigated using X-ray diffraction, Fourier Transform Infrared and UV spectroscopy. The optical energy gap was decreased from 4.24 to 4.03 eV with increasing the proton fluence from 1011 to 1013 p/cm2, and was accompanied by an increase in the Urbach energy from 0.79 to 1.29 eV. This could be correlated to the results obtained from XRD and FTIR spectroscopy. Further, the non-irradiated Bayfol is nearly colorless. It showed significant sensitivity to color by proton irradiation, associated with an increase in the red and yellow color components. The variation of optical and color parameters with the proton fluence indicate that the dynamic range of Bayfol UV1 7-2 is in the fluence range from 1011 to 1013 p/cm2.
Is social investment inimical to the poor?
Authors: Noël Alain
Published: August 2018

In the last two decades, the social investment strategy has been the main approach to welfare state reform. Concretely, two spending programs have dominated the agenda: the expansion of active labor market programs and the development of childcare services. Many authors have suspected, however, that these social investments were realized at the expense of income protection for the poor. This article assesses this potential trade-off with time-series cross-sectional models of the determinants of active labor market policies expenditures, childcare spending and the adequacy of minimum income protection (MIP), for 18 OECD countries between 1990 and 2009. It turns out that social investments are rather akin to traditional welfare state programs, and are explained by similar institutional, political and economic factors. More importantly, they do not develop at the expense of income protection. Social investment initiatives are consistent with the usual politics of the welfare state and, overall, they are not inimical to the poor.
Does Survey Nonresponse Bias Estimates of Religious Service Attendance? Evidence from an Address-Based Sample from the Boston Area
Authors: Brenner Philip S
Published: August 2018

This study investigates what role, if any, nonresponse plays in inflating survey estimates of religious behavior, using a multimode survey designed to allow estimation of nonresponse bias. A sample of 3,000 Boston-area households drawn from an address-based frame was randomly divided into two subsamples, contacted by mail, and invited to participate in a survey. The first subsample was asked to complete an interactive voice response interview. The second subsample was asked to complete a survey by telephone if a number was available for the address or by personal interview if not. Finally, random samples of nonrespondents were recontacted for a personal interview. Comparison of attendance estimates from initial interviews with nonrespondent interviews within sample segments yields minor or minimal differences that are not statistically significant. Findings suggest that the mechanism generating survey nonresponse is unlikely to be a major cause of bias in religious service attendance estimates in this study.
Why Are Women Still Dying of Pregnancy and Childbirth?
Authors: Sofer Dalia
Published: August 2018

Inequity is a key contributor.
Responding to Mass Shootings: Are Hospitals—and Nurses—Fully Prepared?
Authors: Sofer Dalia
Published: August 2018

Many aren't, but they can learn from those who have been through it.
Warning For Oral Drugs Containing Benzocaine
Authors: Aschenbrenner Diane S.
Published: August 2018

Benzocaine, a local anesthetic found in over-the-counter and prescription oral drugs, is associated with a rare serious adverse effect called methemoglobinemia.

The Food and Drug Administration has asked manufacturers to stop marketing benzocaine products for the treatment of teething pain in infants and oral pain in children under two years of age.
Vigorous Exercise Lowers Risk of Death in Childhood Cancer Survivors
Authors: Rosenberg Karen
Published: August 2018

According to this study:

Regular vigorous exercise in early adulthood in adult survivors of childhood cancer is associated with a significantly lower risk of death.

Increased exercise over eight years was also associated with a lower risk of death in these patients.
Mental Illness Associated With Increased Vulnerability To Crime
Authors: Rosenberg Karen
Published: August 2018

According to this study:

Mental illness is associated with a higher risk of being a victim of crime, in particular violent crime.

Substance use and personality disorders have the greatest associations with being subjected to crime.
The School Nurse
Authors: Hansen Frances
Published: August 2018

Updated several times a week with posts by a wide variety of authors, AJN*s blog Off the Charts allows us to provide more timely—and often more personal—perspectives on professional, policy, and clinical issues. Best of the Blog will be a regular column to draw the attention of AJN readers to posts we think deserve a wider audience. To read more, please visit: www.ajnoffthecharts.com.
The World Health Organization's Chief Nursing Officer
Authors: McSpedon Corinne
Published: August 2018

Elizabeth Iro assumes a key decision-making role at the WHO.
Urgent Repositioning After Venous Air Embolism During Intracranial Surgery in the Seated Position: A Case Series
Authors: Abcejo Arnoley S. , Pasternak Jeffrey J. , Perkins William J.
Published: August 2018

Background:

Venous air embolism (VAE) is a well-described complication of neurosurgical procedures performed in the seated position. Although most often clinically insignificant, VAE may result in hemodynamic or neurological compromise resulting in urgent change to a level position. The incidence, intraoperative course, and outcome in such patients are provided in this large retrospective study.

Methods:

Patients undergoing a neurosurgical procedure in the seated position at a single institution between January 2000 and October 2013 were identified. Corresponding medical records, neurosurgical operative reports, and computerized anesthetic records were searched for intraoperative VAE diagnosis. Extreme VAE was defined as a case in which urgent seated to level position change was performed for patient safety. Detailed examples of extreme VAE cases are described, including their intraoperative course, VAE management, and postoperative outcomes.

Results:

There were 8 extreme VAE (0.47% incidence), 6 during suboccipital craniotomy (1.5%) and 2 during deep brain stimulator implantation (0.6%). VAE-associated end-expired CO2 and mean arterial pressure reductions rapidly normalized following position change. No new neurological deficits or cardiac events associated with extreme VAE were observed. In 5 of 8, surgery was completed. Central venous catheter placement and aspiration during VAE played no demonstrable role in patient outcome.

Conclusions:

Extreme VAE during seated intracranial neurosurgical procedures is infrequent. Extreme VAE-associated CO2 exchange and hemodynamic consequences from VAE were transient, recovering quickly back to baseline without significant neurological or cardiopulmonary morbidity.
Medical Physics: Quality and Safety in the Cloud
Authors: Leuenberger Ronald , Kocak Ryan , Jordan David W. , George Tim
Published: August 2018

Science and technology have outpaced our human ability to process and analyze the myriad data systems that extend throughout an enterprise of health care networks. Medical physicists must learn to work collaboratively with computer programmers, data scientists, administrators, and health care providers in the data-rich environment of modern health care, embracing and practicing a new discipline: cloud-based medical physics. This article addresses four distinct topics: (1) Evolution of health care systems, networks and electronic medical records (EMR); (2) Evolution of medical physics with scientific discoveries and technological advancements; (3) Evolution of information technology including; metadata, enterprise and the cloud; and (4) Medical physics enterprise: adaptive approach to quality and safety for the 21st Century.
Investigation of Dose Rates Exterior to an Above-Ground Waste Storage Facility Using Radiation Transport Models
Authors: Mann Jenelle Elicia , Zoeger Norbert , Koppitsch Roman , Brandl Alexander
Published: August 2018

The dose rate profile at different heights above the ground and as a function of distance from the north, west, and south walls of an above-ground waste storage facility was analyzed using the Monte Carlo n-Particle Transport eXtended (MCNPX) radiation transport code. The waste storage facility houses 9,996 waste barrels of conditioned waste. The facility has concrete shielding added to the building walls on the north, west, and east sides, with no such additional shielding towards the roof or the south side wall; instead, the distance from the first row of barrels to the wall is extended to allow for maneuverability of a crane on the south side. The dose rate is computed as a function of distance using MCNPX and assuming a homogeneous 60Co distribution in each waste barrel. Different dose regions are identified and analyzed based on graphical features and best-fit functions. The dose rates were expected to be largest at the wall of the facility and subsequently decrease continuously with distance from the repository; however, our analysis indicates a peak in dose rate observed for all heights on the north and west sides of the facility. This peak is likely due to scattering in the shielding material and atmosphere, and possibly could be ascribed to skyshine. The difference between the dose rate at 1 m outside the wall and the peak dose rate is significant, and indicates that the dose rate measured close to the wall may not always be conservative for extended sources, such as an above-ground waste storage facility.
DILUTE POVIDONE-IODINE PROPHYLAXIS MAINTAINS SAFETY WHILE IMPROVING PATIENT COMFORT AFTER INTRAVITREAL INJECTIONS
Authors: Peden Marc C. , Hammer Mark E. , Suñer Ivan J.
Published: August 2018

Purpose:

To report the rates of postintravitreal injection (IVT) endophthalmitis with topical conjunctival application of various concentrations of povidone-iodine (PI), including no PI.

Methods:

Retrospective chart review of patients receiving IVTs performed in a single practice between January 2011 and June 2016. Concentration of PI for all injections was recorded and cases of endophthalmitis identified and reviewed.

Results:

A total of 35,060 IVTs in 1854 patients were included from the 5.5-year period. 29,281 injections were performed with standard 5% PI, 5,460 injections with diluted PI (3,731 with 2.5%, 1,673 with 1.25%, 56 with 0.625%), and 319 IVTs with no PI. Incidence of patient-reported PI sensitivity occurred in 15.9% of patients. Fourteen cases of endophthalmitis were identified: 12 in eyes that received 5% PI, one in an eye that received 1.25% PI, and one in an eye receiving no PI. The incidence of endophthalmitis was 0.04% for 5% PI, 0.02% for dilute PI, and 0.31% for no PI prophylaxis. All cases underwent prompt vitrectomy and had positive cultures for coagulase-negative Staphylococcus.

Conclusion:

Application of dilute PI solution to the conjunctiva at the time of IVT is an effective alternative to 5% PI for endophthalmitis prophylaxis in betadine-sensitive patients.
Improving Provider Experience and Increasing Patient Access Through Nurse Practitioner–Physician Primary Care Teams
Authors: D'Afflitti Joanna , Lee Kristen , Jacobs Melissa , Pace Christine , Worcester Jason , Thornton Sophia , Lasser Karen E.
Published: August 2018

Team-based care may address burnout in primary care; few studies have examined the impact of nurse practitioner–physician (NP-MD) teams on provider burnout. This article describes a model of NP-MD care teams in an urban safety-net primary care practice. Average time to third next available appointment with a team provider (either NP or MD) decreased by nearly 20 days after implementation of the model. In total, 79% of MDs reported that the model was very or extremely helpful in reducing the burden of work between visits and 100% of NPs reported that they were very or extremely satisfied with their current job.
A Cost-Effective Myoelectric Prosthetic Hand
Authors: Atique MD Moin , Rabbani Siddique-e
Published: August 2018

Introduction

A cost-effective myoelectric prosthetic hand for persons with wrist amputations is a need for developing countries. Instead of trying to develop manipulation of all the fingers, which would be complex, expensive, and demanding on battery power, we took an approach to make the design simple but moderately usable.

Methods and Materials

Because a sizable number of tasks can be done by controlling the thumb only, we anticipate that it would be an efficient design where the user will control only the thumb using electromyographic (EMG) signals. The shape of the hand is such that it will let the user hold small objects, such as a pen. A mannequin's hand was used as the structure, and after specific modification, the necessary circuitry was set up. Surface electrodes were used to acquire the EMG signals, which were then amplified using a bioelectric amplifier specifically designed and developed for this purpose. A microcontroller-based interface detects EMG and controls the DC gear motor that moves the thumb.

Results

The thumb of the developed unit responded to contraction of the arm muscles as desired. The user can control the thumb using his or her EMG signal and write holding a pen. A box-and-blocks test was conducted in which, on average, the user was able to move 6.6 blocks per minute.

Conclusions

The design is moderately usable but needs some minor improvements before practical use.
Evaluation of the Loads Applied on the Hip Joints in Walking with and without Scottish Rite Orthosis in Subjects with Perthes Disease: A Pilot Study
Authors: Karimi Mohammad Taghi
Published: August 2018

Introduction

Although the main aims of treatment in Legg-Calvé-Perthes disease are to increase the containment of the femoral head within the acetabulum and to decrease the loads applied to the hip joint, none of the treatment approaches have been successful. There has been no research evaluating the effect of using an orthosis on joint reaction forces in the subjects with Perthes disease. Therefore, the aim of this study was to evaluate the joint reaction forces in the subject with this disease while walking with and without orthosis.

Methods

Two subjects with Perthes disease participated in this study. They were asked to walk with and without Scottish Rite orthosis. Open SIMM software was used to extract the joint reaction forces in both conditions. The difference between kinetic and kinematic parameters in walking with and without orthosis for each subject was evaluated by two-sample t-test.

Results

The results of this study showed that the ground reaction force applied on the leg increased. Use of orthosis influenced the kinematics of hip joint and pelvis.

Conclusion

Since joint reaction force is one of the main parameters influencing hip joint deformation, use of orthosis may not influence the final deformation. As this was a pilot study, it is recommended to do research with a larger number of subjects.
Factors Associated With Potential Progressive Course of Primary Biliary Cholangitis
Authors: Younossi Zobair M. , Stepanova Maria , Golabi Pegah , Epstein Robert S. , Strauss Marcie E. , Nader Fatema , Racila Andrei
Published: August 2018

Background and Aims:

Although relatively, primary biliary cholangitis (PBC) is an important cause of nonalcoholic chronic liver disease which may lead to liver transplantation. PBC patients with alkaline phosphatase (ALP) ≥1.5× the upper limit of normal (ULN) tend to have a more aggressive course. The study was designed to identify factors associated with ALP≥1.5×ULN or cirrhosis in PBC and to evaluate concomitant health care resource utilization.

Methods:

We used a large real-world database that contained comprehensive and continuous electronic medical recored/claims data from over 500 health care practices or systems from the United States.

Results:

Of 195 million patients included in the database, 36,317 were adults with PBC. After applying exclusion criteria, 15,875 patients comprised the final PBC cohort (63.0±13.5 y, 78% female, 71% privately insured, 5% covered by Medicaid, 57% with other autoimmune diseases, 46% with cirrhosis); 6083 (38%) had ALP≥1.5×ULN. Patients with ALP≥1.5×ULN were more frequently female, less covered by Medicaid, had more pruritus, cirrhosis, and other autoimmune diseases (P<0.05). In multivariate analysis, older age, female gender, the presence of other autoimmune diseases, and having compensated or decompensated cirrhosis were independently associated with having ALP≥1.5×ULN in PBC (P<0.05). In contrast, being male was associated with higher risk of cirrhosis in PBC [odds ratio 2.3 (95% confidence interval, 2.1-2.5)]. Patients with ALP≥1.5×ULN and/or with cirrhosis also incurred substantially more health care resource utilization (P<0.05).

Conclusions:

Many clinical, sociodemographic, and economic factors are associated with a potentially more aggressive profile of PBC with elevated ALP. These data may inform clinicians to implement management strategies to optimize care of these patients.
Brainwriting Premortem
Authors: Gilmartin Heather , Lawrence Emily , Leonard Chelsea , McCreight Marina , Kelley Lynette , Lippmann Brandi , Coy Andrew , Burke Robert E.
Published: August 2018

Background:

Many health care interventions encounter implementation challenges because of inadequate stakeholder engagement and identification of barriers. The brainwriting premortem technique is the silent sharing of written ideas about why an intervention failed. The method can engage stakeholders and identify barriers more efficiently than traditional brainstorming focus groups.

Purpose:

We evaluated the method during a transition of care intervention in the Veterans Health Administration (VA). Clinicians from 10 VA facilities participated in 10 brainwriting premortem sessions.

Methods:

Using descriptive and content analytic methods, we assessed the quantity and quality of ideas generated, facilitator experience, and participant psychological safety.

Results:

In total, 217 unique ideas were generated. Many were deemed high quality. The written data were immediately available for analysis, allowing rapid feedback and real-time decision making. Participants reported high satisfaction and psychological safety.

Conclusion:

The brainwriting premortem approach is a novel, efficient alternative to brainstorming focus groups that can rapidly inform program implementation at minimal cost.
A Comparison of GATA3, TTF1, CD10, and Calretinin in Identifying Mesonephric and Mesonephric-like Carcinomas of the Gynecologic Tract
Authors: Pors Jennifer , Cheng Angela , Leo Joyce M. , Kinloch Mary A. , Gilks Blake , Hoang Lynn
Published: August 2018

Mesonephric carcinomas of the gynecologic tract are neoplasms that are often under-recognized due to their varied morphologic appearances. Recently, GATA3 and TTF1 have been reported to be useful immunohistochemical markers for distinguishing mesonephric carcinomas from its morphologic mimics. Herein, we compared the performance of GATA3 and TTF1 to the traditional markers used for mesonephric carcinomas, CD10 and calretinin. We studied 694 cases: 8 mesonephric carcinomas (7 cervical [includes 3 mesonephric carcinosarcomas], 1 vaginal), 5 mesonephric-like carcinomas (4 uterine corpus, 1 ovarian), 585 endometrial adenocarcinomas, and 96 cervical adenocarcinomas. Mesonephric-like carcinomas were defined as tumors exhibiting the classic morphologic features of mesonephric carcinoma, but occurring outside of the cervix and without convincing mesonephric remnants. GATA3 had the highest sensitivity and specificity (91% and 94%) compared with TTF1 (45% and 99%), CD10 (73% and 83%), and calretinin (36% and 89%). GATA3, however, also stained a substantial number of uterine carcinosarcomas (23/113, 20%). TTF1 was positive in 5/5 (100%) mesonephric-like carcinomas and only 1/8 (13%) mesonephric carcinomas. In 4/6 (67%) TTF1 positive cases, GATA3 exhibited an inverse staining pattern with TTF1. In summary, GATA3 was the best overall marker for mesonephric and mesonephric-like carcinomas, but cannot be used to distinguish mesonephric carcinosarcomas from Müllerian carcinosarcomas. The inverse staining pattern between GATA3 and TTF1, suggests that TTF1 may be useful when GATA3 is negative in small biopsies where mesonephric or mesonephric-like carcinoma is suspected. The greater TTF1 positivity in mesonephric-like carcinomas suggests they may be biologically different from prototypical mesonephric carcinomas.