bluuebunny/crossref_metadata_2025 huggingface dataset:
Gleason grade 4 prostate adenocarcinoma patterns: an interobserver agreement study among genitourinary pathologists
Authors: Kweldam Charlotte F , Nieboer Daan , Algaba Ferran , Amin Mahul B , Berney Dan M , Billis Athanase , Bostwick David G , Bubendorf Lukas , Cheng Liang , Compérat Eva , Delahunt Brett , Egevad Lars , Evans Andrew J , Hansel Donna E , Humphrey Peter A , Kristiansen Glen , van der Kwast Theodorus H , Magi‐Galluzzi Cristina , Montironi Rodolfo , Netto George J , Samaratunga Hemamali , Srigley John R , Tan Puay H , Varma Murali , Zhou Ming , van Leenders Geert J L H
Published: March 2016

Aims

To assess the interobserver reproducibility of individual Gleason grade 4 growth patterns.

Methods and results

Twenty‐three genitourinary pathologists participated in the evaluation of 60 selected high‐magnification photographs. The selection included 10 cases of Gleason grade 3, 40 of Gleason grade 4 (10 per growth pattern), and 10 of Gleason grade 5. Participants were asked to select a single predominant Gleason grade per case (3, 4, or 5), and to indicate the predominant Gleason grade 4 growth pattern, if present. ‘Consensus’ was defined as at least 80% agreement, and ‘favoured’ as 60–80% agreement. Consensus on Gleason grading was reached in 47 of 60 (78%) cases, 35 of which were assigned to grade 4. In the 13 non‐consensus cases, ill‐formed (6/13, 46%) and fused (7/13, 54%) patterns were involved in the disagreement. Among the 20 cases where at least one pathologist assigned the ill‐formed growth pattern, none (0%, 0/20) reached consensus. Consensus for fused, cribriform and glomeruloid glands was reached in 2%, 23% and 38% of cases, respectively. In nine of 35 (26%) consensus Gleason grade 4 cases, participants disagreed on the growth pattern. Six of these were characterized by large epithelial proliferations with delicate intervening fibrovascular cores, which were alternatively given the designation fused or cribriform growth pattern (‘complex fused’).

Conclusions

Consensus on Gleason grade 4 growth pattern was predominantly reached on cribriform and glomeruloid patterns, but rarely on ill‐formed and fused glands. The complex fused glands seem to constitute a borderline pattern of unknown prognostic significance on which a consensus could not be reached.
Primary intra‐articular sarcoma: a clinicopathological study of 15 cases
Authors: Chebib Ivan , Rosenberg Andrew E , Fletcher Christopher D M , Rosenthal Daniel I , Hornicek Francis J , Nielsen G Petur
Published: March 2016

Aims

To assess the clinical and histopathological spectrum of primary intra‐articular sarcomas.

Methods and results

Fifteen patients were identified as having primary intra‐articular sarcomas and the clinical and pathological features were evaluated. There were nine males and six females who ranged in age from 16 to 84 (mean 44) years. All tumours originated in the knee joint. The pathological diagnoses included: five synovial sarcoma, three extraskeletal myxoid chondrosarcomas, two high‐grade myxofibrosarcoma (one conventional, one epithelioid), two undifferentiated pleomorphic sarcoma (one with giant cells) and one each myxoinflammatory fibroblastic sarcoma, conventional hyaline chondrosarcoma, and high‐grade myofibroblastic sarcoma. All tumours were treated by segmental resection or amputation. Adjuvant therapy was given in selected cases. Follow‐up ranged from 11 to 150 months. Of patients with follow‐up, two died of disease; one developed pulmonary metastases after 6 years and was then lost to follow‐up. Nine patients were alive and free of disease 12–150 months after diagnosis.

Conclusions

Primary sarcomas of the joints are very rare and most frequently affect the knee. Our experience indicates that synovial sarcoma and extraskeletal myxoid chondrosarcoma are the most common intra‐articular sarcomas.
Changes in liver steatosis evaluated by transient elastography with the controlled attenuation parameter in HIV‐infected patients
Authors: Macías J , Real LM , Rivero‐Juárez A , Merchante N , Camacho A , Neukam K , Rivero A , Mancebo M , Pineda JA
Published: March 2016

Objectives

There are scant data on the progression of hepatic steatosis (HS) in HIV infection. We therefore evaluated changes in HS over time in HIV‐infected patients using the controlled attenuation parameter (CAP).

Methods

A prospective cohort of 326 HIV‐infected patients was included in this study. All patients underwent a CAP measurement. Changes in steatosis were evaluated by calculating the median (Q1–Q3) difference between baseline and 12‐month CAP values.

Results

The median (Q1–Q3) CAP was 221 (196–252) dB/m at baseline and 224 (198–257) dB/m at the 12‐month visit (P = 0.617). Significant steatosis, that is, CAP ≥ 238 dB/m, was observed in 76 individuals (37%) at baseline and in 80 (39%) at the 12‐month visit (P = 0.683). The following variables were associated with ΔCAP: plasma HIV RNA [< 50 vs. ≥ 50 HIV‐1 RNA copies/mL: median (Q1–Q3) ΔCAP, 4 (−21, 27) vs. −21 (−49, 4) dB/m, respectively; P = 0.024]; body mass index (BMI) [no increase vs. increase: −13 (−40, 4) vs. 14 (−6, 32) dB/m, respectively; P < 0.001]; triglycerides [no increase vs. increase: −1 (−30, 22) vs. 15 (−3, 40) dB/m, respectively; P = 0.001]; fasting plasma glucose [not impaired vs. impaired: −4 (−31, 16) vs. 30 (15, 49) dB/m, respectively; P < 0.001]; and raltegravir [no vs. yes: 5 (−20, 29) vs. −11 (−37.5, 15) dB/m, respectively; P = 0.018]. The only factor independently associated with ΔCAP was BMI [B (standard error): 9.03 (1.9); P < 0.001].

Conclusions

Increases in CAP values over a period of 12 months in HIV‐infected patients were strongly associated with elevations in BMI. Other metabolic factors and antiretroviral drugs were not predictors of CAP changes independent of BMI.
High‐level expression of periostin is significantly correlated with tumour angiogenesis and poor prognosis in osteosarcoma
Authors: Hu Fei , Shang Xi‐Fu , Wang Wei , Jiang Wei , Fang Ce , Tan Dong , Zhou Hang‐Cheng
Published: March 2016

Periostin (PN), originally named as osteoblast‐specific factor‐2 (OSF‐2), has been involved in regulating adhesion and differentiation of osteoblasts. Recently many studies have shown that high‐level expression of PN is correlated significantly with tumour angiogenesis and prognosis in many kinds of human cancer. However, whether and how periostin expression influences prognosis in osteosarcoma remains unknown. This study aimed to examine the expression of PN in patients with osteosarcoma and explore the relationship of PN expression with clinicopathologic factors, tumour angiogenesis and prognosis. Immunohistochemistry was performed to determine the expression of PN in osteosarcoma and osteochondroma respectively. Vascular endothelial growth factor (VEGF) and CD34 were also examined in tissues from the osteosarcoma patients mentioned above. The results showed that PN expression was significantly (P < 0.05) higher in osteosarcoma (80.9%) than in osteochondroma (14.7%). Increased PN protein expression was associated with histological subtype (P = 0.000), Enneking stage (P = 0.027) and tumour size (P = 0.009). The result also showed that high expression of PN correlated with VEGF expression (r = 0.285; P = 0.019) and that tumours with PN‐positive expression significantly had higher microvessal density (44.6 ± 13.7 vs. 20.6 ± 6.5; P = 0.000) compared to those in normal bone tissues. Additionally, the expression of PN was found to be an independent prognostic factor in osteosarcoma patients. In conclusion, our findings suggest that PN may have an important role in tumour progression and may be used as a prognostic biomarker for patients with osteosarcoma.
Effects of reaction parameters on generation of volatile compounds from the Maillard reaction between L‐ascorbic acid and glycine
Authors: Li Ya , Yang Yan , Yu Ai‐Nong
Published: March 2016

The formation of volatiles from the reaction between L‐ascorbic acid (ASA) and glycine (Gly) at different reaction parameters, such as temperature, time and pH, were reported and 20 different volatile compounds were identified using solid‐phase microextraction–gas chromatography–mass spectrometry (SPME‐GC‐MS). The results showed that the reaction parameters had the different effects on formation of volatiles, while the effect of pH was the most remarkable. When the initial solution pH was 4.5, the major volatiles were found to be furfural or derivatives of furan; while when pH ranged from 6.8 to 9.5, the major volatiles were found to be derivatives of pyrazines, including 2,5‐dimethyl‐pyrazine, 2‐ethyl‐5‐methyl‐pyrazine, trimethyl‐pyrazine, 3‐ethyl‐2,5‐dimethyl‐pyrazine and 2,3‐diethyl‐5‐methyl‐pyrazine. The quantity of 2,5‐dimethyl‐pyrazine and 2‐ethyl‐5‐methyl‐pyrazine reached the maximum when pH was 8.0. Finally, a possible reaction mechanism of ASA and Gly and the pathway for the formation of the various kinds of volatile products were proposed.
The effects of self‐management intervention among middle‐age adults with knee osteoarthritis
Authors: Kao Mei‐Hua , Tsai Yun‐Fang , Chang Ting‐Kuo , Wang Jong‐Shyan , Chen Chie‐Pein , Chang Yue‐Cune
Published: March 2016

Aim

The aim of this study was to explore the effects of a self‐management intervention for middle‐aged adults with knee osteoarthritis.

Background

Knee osteoarthritis is a common cause of lower limb disability in middle‐aged and older adults. Use of self‐management interventions that apply the self‐regulation theory have not been reported for patients with knee osteoarthritis.

Design

A quasi‐experimental design was applied.

Methods

Knee osteoarthritis patients were recruited from two medical centres in northern Taiwan by convenience sampling between July 2013–May 2014. We developed a self‐management intervention programme for knee osteoarthritis; participants began an individualized programme 4 weeks after recruitment. Effectiveness of the intervention was evaluated using the Knee Injury and Osteoarthritis Outcome Score, Health Care Questionnaire and the Short‐Form Health Survey. A generalized estimating equation compared assessment scores for 105 participants after the intervention (10 and 18 weeks) with scores at 4 weeks.

Results

Knee symptoms and physical function scores significantly improved and quality‐of‐life scores significantly increased while body mass index, unplanned medical consultations and doses of pain medication significantly decreased at 10 and 18 weeks compared with 4 weeks. After adjusting for the effect of time‐ and significant‐related factors, knee symptoms and physical function, body mass index and quality of life significantly improved at 10 and 18 weeks compared with 4 weeks.

Conclusions

The self‐management intervention based on self‐regulation theory, improved participants’ symptoms and functions of knee osteoarthritis, overall health and quality of life. Offering self‐management interventions in clinical practice can be beneficial for patients with knee osteoarthritis.
A phylogeographical survey of a highly dispersive spider reveals eastern Asia as a major glacial refugium for Palaearctic fauna
Authors: Krehenwinkel Henrik , Graze Maxene , Rödder Dennis , Tanaka Kazuhiro , Baba Yuki G. , Muster Christoph , Uhl Gabriele
Published: March 2016

Aim

The phylogeographical history of wide‐ranging Palaearctic species is not well understood. Here, we present a range‐wide phylogeographical study of the wasp spider, Argiope bruennichi (Scopoli, 1772), a highly dispersive and widely distributed Palaearctic species. We aim to identify glacial refugia and patterns of interglacial gene flow across the Palaearctic.

Location

Palaearctic region, including the Azores, Madeira, Europe, North Africa and Asia.

Methods

We conduct a range‐wide phylogeographical survey. Our study is based on nuclear and mitochondrial DNA markers, as well as morphological characters. We use species distribution models to predict the species’ current range as well as its historical distribution during and shortly after the Last Glacial Maximum (LGM).

Results

All analysed genetic markers and morphological characters support the divergence of a lineage in eastern Asia from the remainder of the Palaearctic. Within the Western Palaearctic, a less pronounced divergence into an Azorean and a European clade is found. Species distribution models predict a pronounced loss of suitable habitat for Western Palaearctic lineages during the LGM, whereas the range of East Asian populations remained largely unaffected.

Main conclusions

Our results highlight the existence of non‐European glacial refugia for Palaearctic species, particularly in East Asia. The current genetic structure is best explained by the recent recolonization of the Western Palaearctic from eastern Asia, or repeated interglacial contact of populations.
Geographical distribution patterns of Carcharocles megalodon over time reveal clues about extinction mechanisms
Authors: Pimiento Catalina , MacFadden Bruce J. , Clements Christopher F. , Varela Sara , Jaramillo Carlos , Velez‐Juarbe Jorge , Silliman Brian R.
Published: March 2016

Aim

Given its catastrophic consequences, the extinction of apex predators has long been of interest to modern ecology. Despite major declines, no present‐day species of marine apex predator has yet become extinct. Because of their vulnerability, understanding the mechanisms leading to their extinction in the past could provide insight into the natural factors that interact with human threats to drive their loss. We studied the geographical distribution patterns of the extinct macro‐predatory shark Carcharocles megalodon in order to elucidate its pathway to extinction.

Location

World‐wide from the Miocene to the Pliocene (c. 23–2.6 Ma).

Methods

A meta‐analysis of C. megalodon occurrence records was performed using the Paleobiology Database as a platform. The data were binned into geological time slices, and the circular home range around each data point was mapped in reconstructions made in GPlates. We then quantitatively assessed the species' geographical range and global abundance over time, and the relationship between distribution and climate.

Results

The pathway to extinction of C. megalodon probably started in the late Miocene with a decrease in its global abundance. This decrease was then followed by a decline in its geographical range during the Pliocene. Although the extinction of C. megalodon has been attributed to climate change, we found no evidence of direct effects of global temperature. Instead, we found that the collapse in geographical distribution coincided mainly with a drop in the diversity of filter‐feeding whales and the appearance of new competitors (large predatory whales and the great white shark).

Main conclusions

This research represents the first study of the distributional trends of an extinct, cosmopolitan apex predator in deep‐time. Our results suggest that biotic factors, and not direct temperature limitations, were probably the primary drivers of the extinction of the largest marine apex predators that ever lived.
Natural killer cells regulate Th1/Treg and Th17/Treg balance in chlamydial lung infection
Authors: Li Jing , Dong Xiaojing , Zhao Lei , Wang Xiao , Wang Yan , Yang Xi , Wang Hong , Zhao Weiming
Published: March 2016

Natural killer (NK) cell is an important component in innate immunity, playing a critical role in bridging innate and adaptive immunity by modulating the function of other immune cells including T cells. In this study, we focused on the role of NK cells in regulating Th1/Treg and Th17/Treg balance during chlamydial lung infection. We found that NK cell‐depleted mice showed decreased Th1 and Th17 cells, which was correlated with reduced interferon‐γ, interleukin (IL)‐12, IL‐17 and IL‐22 production as well as T‐bet and receptor‐related orphan receptor gamma t expression compared with mice treated with the isotype control antibody. In contrast, NK cell depletion significantly increased Treg in cell number and related transcription factor (Foxp3) expression. The opposite trends of changes of Th1/Th17 and Treg led to significant reduction in the Th1/Treg and Th17/Treg ratios. The data implicate that NK cells play an important role in host defence against chlamydial lung infection, mainly through maintaining Th1/Treg and Th17/Treg balance.
Potential future risk of errors in medication administration recording
Authors: Vicente Oliveros Noelia , Pérez Menendez‐Conde Covadonga , Gramage Caro Teresa , Álvarez Díaz Ana María , Vélez‐Díaz‐Pallarés Manuel , Montero Errasquín Beatriz , Nieto Gómez Gema , Rodríguez Cubilot Teresa , Martín‐Aragón Álvarez Sagrario , Bermejo Vicedo Teresa , Delgado Silveira Eva
Published: March 2016

Rationale, aims and objectives

The aim of this study is to adapt and assess the interrater reliability of a potential future risk matrix for medication errors in medication administration recording (ME‐MAR).

Methods

The study was carried out in a teaching hospital. It was conducted in two phases. In the first phase, a consensus method was used in order to adapt the potential future risk matrix published by the National Patient Safety and Otero et al. to the ME‐MAR. The consensus method consisted in a nominal group formed by four pharmacists. In the second phase, a multidisciplinary group of experts in patient safety assessed the reliability of the adapted matrix. Five raters evaluated 100 ME‐MAR. Its reliability was evaluated using the kappa statistic.

Results

In the first phase, two meetings were necessary until consensus was reached to adapt the potential future risk matrix to the ME‐MAR. For this purpose, the two following categories were defined: likelihood of ME‐MAR's recurrence and most likely consequences of ME‐MAR. The definition of each grade of likelihood of recurrence was based on the incidence of ME‐MAR from an unpublished study carried out in our hospital. In order to determine the most likely consequences of ME‐MAR, a two‐dimensional matrix was designed, with severity per type of ME‐MAR on one axis and the class of medication on the other. In the second phase, the reliability of the matrix was tested. The overall interrater agreement for the five raters was substantial at 0.68 (Confidence interval 95% 0.60–0.76).

Conclusion

The adapted matrix of potential future risk to ME‐MAR is reliable and can serve as a guide for future studies.
Genotyping of microsatellite markers to study genetic structure of the wild striped snakehead Channa striata in Malaysia
Authors: Tan M. P. , Jamsari A. F. J. , Siti Azizah M. N.
Published: March 2016

Genetic variability and differences in wild striped snakehead Channa striata from Malaysia were analysed by genotyping nine novel nuclear microsatellite loci. Analysis revealed moderate‐to‐high genetic diversity in most of the populations, indicative of large effective population sizes. The highly diversified populations are admixed populations and, therefore, can be recommended as potential candidates for selective breeding and conservation since they each contain most of the alleles found in their particular region. Three homogenous groups of the wild populations were identified, apparently separated by effective barriers, in accordance with contemporary drainage patterns. The highest population pairwise FST found between members of the same group reflects the ancient population connectivity; yet prolonged geographical isolation resulted in adaptation of alleles to local contemporary environmental change. A significant relationship between genetic distance and geographical isolation was observed (r = 0·644, P < 0·01). Anthropogenic perturbations indicated apparent genetic proximity between distant populations.
Kinetics of Texture Change of Bamboo Shoots During Pickling Process
Authors: Zhang Fusheng , Zheng Jiong , Zhong Jinfeng , Chen Guangjing , Kan Jianquan
Published: March 2016

Effects of pickling conditions including salt concentration, pickling temperature, blanching time and CaCl2 concentration on texture change kinetics of bamboo shoots were investigated during pickling process. The results showed that salt concentration, pickling temperature, blanching time and CaCl2 concentration can affect the hardness of pickled bamboo shoots significantly. The hardness changes of bamboo shoots during pickling conform to the first‐order kinetic model. According to the improved first‐order kinetic classical equation, a modified kinetic model for the texture changes of bamboo shoots during pickling was established. All samples were suitably fitted with the kinetic model (R² > 0.9836), indicating that texture changes of bamboo shoots under different pickling conditions can be described and predicted by the established model equation. These research results can provide references for texture quality control of pickled bamboo shoots and other vegetables.

Practical Applications

Texture is an important evaluation factor of pickled vegetables and a key determinant of consumers' satisfaction to products. Effect of pickling conditions on vegetable texture during pickling is significant to control texture quality. In this study, texture changes of bamboo shoots under different pickling conditions were described and predicted through a modified kinetic model of hardness changes. Research results could provide references for texture quality control of pickled bamboo shoots and other vegetables, as well as improvement of pickling technique.
Diverticular disease and additional comorbidities associated with increased risk of dementia
Authors: Peng Yen‐Chun , Lin Cheng‐Li , Yeh Hong‐Zen , Tung Chun‐Fang , Chang Chi‐Sen , Kao Chia‐Hung
Published: March 2016

Background and Aim

Colonic diverticular disease may cause a chronic systemic effect, but its role in the development of dementia remains unclear. The purpose of this study was to investigate the potential increased risk for dementia in colonic diverticular disease.

Methods

We conducted a population‐based cohort study using data from Taiwan's National Health Insurance Research Database. A total of 66 377 sex‐matched, age‐matched, and index year‐matched (1:4) pairs of patients with colonic diverticular disease and 265 508 patients without colonic diverticular disease, who served as controls, were selected from all potential participants aged 20 years or older in the database. Each subject was individually tracked from 2000 to 2011 to identify incident cases of dementia. Cox proportional hazards regression was employed to calculate the hazard ratios and 95% confidence intervals for the association between colonic diverticular disease and dementia.

Results

There were 1057 dementia cases in the diverticular disease cohort during the follow‐up period of 315 171 person‐years; the overall incidence rate of dementia differed from that of the control group (3.35 vs 2.43 per 1000 person‐years, P < 0.001). The adjusted hazard ratio for dementia was 1.24 (95% confidence interval 1.15–1.33) for diverticular disease patients after adjusting for age, sex, and comorbidities.

Conclusions

Colonic diverticular disease may be associated with increased risk for dementia.
Prevalence and associated features of depression in women with Rett syndrome
Authors: Hryniewiecka‐Jaworska A. , Foden E. , Kerr M. , Felce D. , Clarke A.
Published: March 2016

Background

Little is known about depression among women with Rett syndrome (RTT) despite recent advances in knowledge about RTT. In this study, we aimed to establish the prevalence of depression among women with RTT as identified by a screening telephone interview and to explore the clinical factors associated with this.

Methods

The study employed the cross‐sectional analysis of data from telephone interviews with carers of 56 women with RTT, using validated questionnaires for assessing mental health problems, challenging behaviour and RTT severity.

Results

Scores on the mental health assessment reached the affective/neurotic threshold in eight cases (14.3%). No significant differences were found between those reaching the threshold and those who did not in terms of severity of RTT phenotype, health problems or social circumstances. There was a significant association between screening identified depression and higher lethargy and social withdrawal.

Conclusions

Screening identified depression was found among a sizeable minority of women with RTT. Further investigation is needed to establish a clinically validated prevalence of depression among this group and to identify behavioural features that would lead to prompt psychiatric assessment.
Effects of local heat application before intravenous catheter insertion in chemotherapy patients
Authors: Biyik Bayram Sule , Caliskan Nurcan
Published: March 2016

Aims and objectives

To characterise the effects of local heat application on the ease of subsequent intravenous catheter insertion.

Background

Intravenous catheter insertion is a challenging procedure for both nurses and chemotherapy patients. The local application of heat to the area before intravenous catheter insertion may decrease these difficulties by increasing venous distension and visibility.

Design

This study was an open label experimental study involving intervention and control groups.

Methods

Patients receiving chemotherapy were divided into intervention (n = 40) and control (n = 40) groups. For patients in the intervention group, a digital moist heating pad was applied to the arm prepared for catheter insertion for 10 minutes in addition to routine care. No additional preparation procedure beyond routine care was performed for control patients. Data were collected using a data collection form and evaluated using chi square, Fisher's exact chi square, Student's t, Mann–Whitney U, Wilcoxon and Pearson correlation tests.

Results

Local application of heat decreased patients' pain (p = 0·011), increased the rate of successful catheter placement at first attempt (p = 0·004), decreased the catheterisation procedure time (p = 0·001) and decreased nurse‐perceived difficulty during catheter placement (p = 0·001).

Conclusions

Local application of heat before the catheterisation procedure is suggested for patients receiving chemotherapy, particularly in cases where visibility of the veins is poor and intravenous catheter insertion is difficult.

Relevance to clinical practice

Local application of heat results in vasodilation, and thus intravenous catheter insertion becomes easier. Our findings have important implications for nurses who care for chemotherapy patients. The inclusion of local heat application before catheterisation as a preparation step is suitable to be implemented by nurses in other hospitals and clinics where chemotherapy is provided.
Intentional rounding: facilitators, benefits and barriers
Authors: Flowers Kelli , Wright Kylie , Langdon Rachel , McIlwrath Maureen , Wainwright Craig , Johnson Maree
Published: March 2016

Aims and objectives

To describe the implementation, practice and sustainability of Intentional Rounding (IR) within two diverse settings (aged care and maternity).

Background

The profile of patients in hospitals has changed over time, generally being more severe, placing heavy demands on nurses' time. Routine non‐urgent care is often provided only when there is time. IR has been found to increase both patient and staff satisfaction, also resulting in improved patient outcomes such as reduced falls and call bell use. IR is also used as a time management tool for safe and reliable provision of routine care.

Methods

This descriptive qualitative research study comprised of three focus groups in a metropolitan hospital.

Results

Fifteen nurses participated in three focus groups. Seven main themes emerged from the thematic analysis of the verbatim transcripts: implementation and maintenance, how IR works, roles and responsibilities, context and environment, benefits, barriers and legal issues.

Conclusion

IR was quickly incorporated into normal practice, with clinicians being able to describe the main concepts and practices. IR was seen as a management tool, facilitating accountability and continuity of management support being essential for sustainability. Clinicians reported increases in patient and staff satisfaction, and the opportunity to provide patient education. While patient type and acuity, ward layout and staff experience affected the practice of IR, the principles of IR are robust enough to allow for differences in the ward specialty and patient type. However, care must be taken when implementing IR to reduce the risk of alienating experienced staff. Incorporation of IR charts into the patient health care record is recommended.

Relevance to clinical practice

Engaging all staff, encouraging ownership and stability of management are key factors in the successful implementation and maintenance of IR. IR is flexible and robust enough to accommodate different patient types and acuity.
Early skin‐to‐skin contact for healthy full‐term infants after vaginal and caesarean delivery: a qualitative study on clinician perspectives
Authors: Koopman Inez , Callaghan‐Koru Jennifer A. , Alaofin Oluwatope , Argani Cynthia H. , Farzin Azadeh
Published: March 2016

Aims and objectives

This study aims to provide insight into key factors from a clinician's perspective that influence uninterrupted early skin‐to‐skin contact after vaginal and caesarean delivery of healthy full‐term infants.

Background

Early skin‐to‐skin contact of healthy full‐term infants ideally begins immediately after birth and continues for the first hour or the first breastfeed as recommended by the Baby Friendly Hospital Initiative. However, adoption of early skin‐to‐skin contact is low in many settings and the barriers that hinder its universal use are not well understood.

Design

An exploratory qualitative research design using semi‐structured interviews.

Methods

Eleven clinicians were interviewed, including five registered nurses and one medical doctor from the obstetrics and gynaecology unit as well as four registered nurses and one medical doctor from the neonatal intensive care unit. Core topics that were discussed included perceptions on early skin‐to‐skin contact and facilitating factors and barriers to early skin‐to‐skin contact after vaginal and caesarean delivery. Interview sessions were recorded, transcribed and analysed using a thematic analysis approach. A coding framework was developed from which subthemes emerged. The overall themes were adopted from Lee et al.'s thematic framework to categorise factors into institutional, familial‐level and implementation factors.

Findings

Critical institutional factors included inadequate staffing and education of clinicians on early skin‐to‐skin contact. On a familial level, parental education and motivation were identified as important factors. Barriers to implementation included the absence of a clinical algorithm and unclear definitions for eligible mothers and infants.

Conclusions

Various facilitating factors and barriers to early skin‐to‐skin contact of healthy full‐term infants born via vaginal and caesarean delivery were identified.

Relevance to clinical practice

Addressing these factors can help to provide a better understanding of clinician perspectives on early skin‐to‐skin contact and help guide its implementation as standard of care for healthy full‐term infants.
Household Disorder, Network Ties, and Social Support in Later Life
Authors: York Cornwell Erin
Published: March 2016

Family relationships, social interactions, and exchanges of support often revolve around the household context, but scholars rarely consider the social relevance of this physical space. In this article the author considers social causes and consequences of household disorder in the dwellings of older adults. Drawing from research on neighborhood disorder and social connectedness in later life, she describes how network characteristics may contribute to household disorder and how household disorder may weaken relationships and reduce access to support. This is explored empirically by estimating cross‐lagged panel models with data from 2 waves of the National Social Life, Health, and Aging Project. The results reveal that household disorder reflects a lack of social support, and it leads to more kin‐centered networks and more strain within family relationships. The author concludes by urging greater attention to how the household context shapes—and is shaped by—the social interactions and processes that occur within it.
Modeling Trajectories of Adolescent‐Perceived Family Conflict: Effects of Marital Dissatisfaction and Parental Alcoholism
Authors: Rothenberg William A. , Hussong Andrea M. , Chassin Laurie
Published: March 2016

We evaluated the effects of marital dissatisfaction on adolescent‐perceived conflict in 435 families with and without a parental history of alcoholism. On average, family conflict decreased linearly as adolescents aged. Families with an alcoholic parent demonstrated higher adolescent‐reported family conflict and this effect was partially mediated by higher mother‐ and father‐reported marital dissatisfaction. Families with higher marital dissatisfaction had greater conflict when adolescents were young (based on fathers’ marital dissatisfaction) and as they aged (based on mother's marital dissatisfaction). Years in which mothers reported higher marital dissatisfaction than usual coincided with years in which adolescents reported greater family conflict. Results indicate that marital dissatisfaction has both within and between‐family effects on adolescent perceptions of conflict.
Consumer‐Led Development of Novel Sea‐Buckthorn Based Beverages
Authors: Geertsen Julie Leth , Allesen‐Holm Bodil H. , Giacalone Davide
Published: March 2016

In the context of a growing interest toward foods of local origin, this research explored consumer perceptions of novel sea‐buckthorn‐based beverages (SBBs), developed by combining sea‐buckthorn (hippophae rhamnoides L.) berries in combination with other locally sourced ingredients.

Specifically, the aims of the present study were to test how newly developed SBBs were perceived compared to a selected market reference, and to determine their acceptability with a representative sample of the Danish consumer population. Using a combination of consumer‐friendly product profiling methods, we investigated which product attributes were associated with different ingredient combinations. Promising prototypes were tested in a larger study where consumers (N = 200) reported hedonic response and appropriateness of use for the SBBs. Results showed that the developed SBBs were generally well liked, but were perceived as appropriate for fewer usages than the existing ones, suggesting that consumers may find it hard to envisage how to incorporate novel SBBs in their existing dietary habits. Consumer demographics and psychographics did not significantly affect product acceptance, indicating that sensory characteristics were the most important drivers of consumer preferences within this product category.

Practical Applications

This study offers new insights into consumers’ perception of novel food products of local origin. A key issue with such ingredients is that they have unique sensory properties which are unfamiliar to many consumers. We suggest evidence‐based directions for product development and identify potential barriers to adoption that food producers should be aware of. Methodologically, this study shows a stepwise approach to consumer‐driven product development that effectively differentiated between the products and identified most promising prototypes, and could, therefore, be beneficially applied to support product development efforts among small and medium‐sized local producers.
New treatments for hepatitis C virus (HCV): scope for preventing liver disease and HCV transmission in England
Authors: Harris R. J. , Martin N. K. , Rand E. , Mandal S. , Mutimer D. , Vickerman P. , Ramsay M. E. , De Angelis D. , Hickman M. , Harris H.E.
Published: March 2016

New direct‐acting antivirals have the potential to transform the hepatitis C (HCV) treatment landscape, with rates of sustained viral response in excess of 90%. As these new agents are expensive, an important question is whether to focus on minimizing the consequences of severe liver disease, or reducing transmission via ‘treatment as prevention’. A back‐calculation model was used to estimate the impact of treatment of mild, moderate and compensated cirrhosis on incident cases ofHCV‐related end‐stage liver disease/hepatocellular carcinoma (ESLD/HCC). In addition, a dynamic model was used to determine the impact on incidence and prevalence of chronic infection in people who inject drugs (PWID), the main risk group in England. Treating 3500 cirrhotics per year was predicted to reduceESLD/HCCincidence from 1100 (95% CrI 970–1240) cases per year in 2015 to 630 (95% CrI 530–770) in 2020, around half that currently expected, although treating moderate‐stage disease will also be needed to sustain this reduction. Treating mild‐stagePWIDwas required to make a substantial impact on transmission: with 2500 treated per year, chronic prevalence/annual incidence inPWIDwas reduced from 34%/4.8% in 2015 to 11%/1.4% in 2030. There was little overlap between the two goals: treating mild stage had virtually no impact onESLD/HCCwithin 15 years, but the long timescale of liver disease means relatively fewPWIDreach cirrhosis before cessation of injecting. Strategies focussing on treating advanced disease have the potential for dramatic reductions in severe morbidity, but virtually no preventative impact.
Lipid disorder and intrahepatic renin–angiotensin system activation synergistically contribute to non‐alcoholic fatty liver disease
Authors: Wu Yu , Ma Kun L. , Zhang Yang , Wen Yi , Wang Gui H. , Hu Ze B. , Liu Liang , Lu Jian , Chen Pei P. , Ruan Xiong Z. , Liu Bi C.
Published: March 2016

Background

This study aimed to investigate the possible synergistic effects of lipid disorder with renin–angiotensin system (RAS) activation in non‐alcoholic fatty liver disease (NAFLD).

Methods

Apolipoprotein E gene‐knockout mice, angiotensin II (Ang II) type 1 receptor (AT1) gene‐knockout mice and human hepatoblastoma cell line (HepG2) were used for experiments. Lipid accumulation was examined by Filipin staining and intracellular cholesterol quantitative assay. The gene and protein expression of molecules involved in RAS and low‐density lipoprotein receptor (LDLr) pathway was examined by real‐time PCR, immunofluorescent staining and Western blot.

Results

There was significantly increased expression of RAS components and extracellular matrix (ECM) in livers of high‐fat‐diet‐fed apolipoprotein E gene‐knockout mice compared with controls. Upregulation of RAS components was positively associated with increased plasma levels of lipid profile. The in vitro study further confirmed that cholesterol loading increased supernatant renin activity and Ang II level of HepG2 cells, accompanied by increased ECM production that was positively associated with increased expression of intracellular RAS components. Interestingly, Ang II treatment increased lipid accumulation in livers of C57BL/6 mice and HepG2 cells. Furthermore, Ang II treatment increased gene and protein expression of sterol regulatory element–binding protein (SREBP) cleavage activating protein (SCAP), SREBP‐2 and LDLr, which were mediated by enhanced SCAP/SREBP‐2 complex translocation from endoplasmic reticulum to Golgi. However, LDLr pathway was accordingly downregulated in livers of AT1 gene‐knockout C57BL/6 mice or in HepG2 cells treated by telmisartan.

Conclusion

These findings demonstrate that lipid disorder and intrahepatic RAS activation synergistically accelerate NAFLD progression.
Molecular characterization of XopAG effector AvrGf2 from Xanthomonas fuscans ssp. aurantifolii in grapefruit
Authors: Gochez Alberto M. , Shantharaj Deepak , Potnis Neha , Zhou Xiaofeng , Minsavage Gerald V. , White Frank F. , Wang Nian , Hurlbert Jason C. , Jones Jeffrey B.
Published: March 2016

Xanthomonas fuscans ssp. aurantifolii group C strains exhibit host specificity on different citrus species. The strains possess a type III effector, AvrGf2, belonging to the XopAG effector gene family, which restricts host range on citrus. We dissected the modular nature and mode of action of AvrGf2 in grapefruit resistance. XopAG effectors possess characteristic features, such as a chloroplast localization signal, a cyclophilin‐binding domain characteristic amino acid sequence motif (GPLL) and a C‐terminal domain‐containing CLNAxYD. Mutation of GPLL to AASL in AvrGf2 abolished the elicitation of the hypersensitive response (HR), whereas mutation of only the first amino acid to SPLL delayed the HR in grapefruit. Yeast two‐hybrid experiments showed strong interaction of AvrGf2 with grapefruit cyclophilin (GfCyp), whereas AvrGf2‐SPLL and AvrGf2‐AASL mutants showed weak and no interaction, respectively. Molecular modelling and in silico docking studies for the cyclophilin–AvrGf2 interaction predicted the binding of citrus cyclophilins (CsCyp, GfCyp) to hexameric peptides spanning the cyclophilin‐binding domain of AvrGf2 and AvrGf2 mutants (VAGPLL, VASPLL and VAAASL) with affinities equivalent to or better than a positive control peptide (YSPSA) previously demonstrated to bind CsCyp. In addition, the C‐terminal domain of XopAG family effectors contains a highly conserved motif, CLNAxYD, which was identified to be crucial for the induction of HR based on site‐directed mutagenesis (CLNAxYD to CASAxYD). Our results suggest a model in which grapefruit cyclophilin promotes a conformational change in AvrGf2, thereby triggering the resistance response.
miR‐21 contributes to renal protection by targeting prolyl hydroxylase domain protein 2 in delayed ischaemic preconditioning
Authors: Jiao Xiaoyan , Xu Xialian , Fang Yi , Zhang Hui , Liang Mingyu , Teng Jie , Ding Xiaoqiang
Published: March 2016

Aim

Upregulation of miR‐21 in renal ischaemic preconditioning (IPC) was associated with increased hypoxia inducible factor (HIF)‐1α expression. Hypoxic induction of HIF‐1α is mediated by inhibition of prolyl hydroxylase domain protein 2 (PHD2) .We hypothesized that miR‐21 regulated HIF‐1α by targeting PHD2 in the renal IPC.

Methods

Luciferase reporter assay examined if miR‐21 target the 3'‐untranslated region of PHD2. In vitro, human proximal tubular cell line (HK‐2) was incubated in hypoxia or hypoxia/ reoxygenation condition. Kidneys of Mice were respectively subjected to ischaemia/reperfusion injury (IRI) and IPC. Locked nucleic acid (LNA) modified anti‐miR‐21 was used to knockdown miR‐21. Serum creatinine and histological changes estimated the renal injury. Levels of HIF‐1α, PHD2, VEGF and miR‐21 were examined by western blot or real‐time PCR.

Result

miR‐21 targeting of PHD2 was confirmed by 3'‐untranslated region reporter assay. miR‐21 was significantly upregulated by hypoxia/reoxygenation in HK‐2 cell, while PHD2 protein level decreased significantly. LNA anti‐miR‐21 significantly repressed miR‐21 levels and increased the abundance of PHD2. In vivo, IPC upregulated miR‐21 expression 24 h after the second ischaemia, while PHD2 expression decreased significantly with upregulation of HIF‐1α protein and VEGF mRNA. MiR‐21 induced by delayed IPC was effectively inhibited by the LNA anti‐miR‐21. With downregulation of miR‐21, the protection of delayed IPC was attenuated and PHD2 protein was increased. Furthermore, upregulation of HIF‐1α and VEGF were abolished after the LNA anti‐miR‐21 treatment.

Conclusion

miR‐21 could protect kidney against IRI via HIF‐1α by inhibiting its target PHD2.The study suggested a new relationship between miR‐21 and HIF‐1α.
External validity of Concealed Information Test experiment: Comparison of respiration, skin conductance, and heart rate between experimental and field card tests
Authors: Zaitsu Wataru
Published: March 2016

The Concealed Information Test (CIT) is a memory detection method based on an examinee's physiological responses to crime‐relevant items (critical items) in comparison with crime‐irrelevant items (noncritical items). I examined the external validity of CIT laboratory experiments by comparing respiratory speed (RS), skin conductance response (SCR), and heart rate (HR) between a laboratory experiment (n = 30) and a field test (n = 30) in a card test. A linear mixed models analysis showed that the critical items in both CIT contexts elicited CIT effects: RS repression, SCR increase, and HR deceleration. Additionally, the critical items in the field elicited a larger RS suppression than those in the laboratory; however, SCR and HR on the critical items showed no statistical differences between the laboratory and field CITs. Moreover, the tonic HRs in the field tests were higher than in the CIT experiments, but there were no significant correlations between the tonic HR and each CIT effect in RS, SCR, and HR. These results suggested that CIT detection efficiency was not affected by arousal levels and may imply that the CIT effects observed with RS, SCR, and HR in the CIT laboratory experiments has adequate external validity and can be generalized to the CIT field.
Mechanisms and implications of the link between sleep apnoea and chronic kidney disease
Authors: Hepokoski Mark L. , Wali Arvin R. , Sarmiento Kathleen F.
Published: March 2016

See article, page 754
Effects of short‐rotationEucalyptusplantations on soil quality attributes in highly acidic soils of the central highlands of Ethiopia
Authors: Temesgen D. , Gonzálo J. , Turrión M.B.
Published: March 2016

In recent decades, conversion of agricultural land to short‐rotation (5–10 years)Eucalyptusplantations has become a common practice in the highlands of Ethiopia. Yet, we have a poor understanding of the effect of these land conversions on soil quality attributes under acidic soil conditions. Previous studies along the same line but based merely on physico‐chemical properties of soils were inconsistent and contradictory. We compared soil physical, chemical and biological properties under 5‐ and 10‐year‐oldEucalyptusplantations with adjacent grassland soils. Results revealed that soil bulk density of adjacent grassland was significantly smaller than in the twoEucalyptusplantations. Although land‐use change from grassland to short‐rotationEucalyptusdid not affect soil texture significantly, values of soilpH, organic carbon, total nitrogen, calcium and cation exchange capacity (CEC) values in adjacent grassland were greater at both 0–10 cm and 10–20 cm depths compared with 5‐ and 10‐year‐oldEucalyptusplantations. Available phosphorus, exchangeable potassium and magnesium were not significantly affected under the three land‐use systems. Generally, no differences were observed in available phosphorus, potassium, calcium and magnesium concentrations or inCECbetween the two sampling depths (0–10 cm and 10–20 cm). The microbial biomass carbon and microbial biomass nitrogen recorded in 5‐ and 10‐year‐oldEucalyptusplantations were comparable but significantly smaller than in adjacent grasslands. Kinetics parameters calculated using a first‐order equation (Ct = Co(1−e−kt)) showed potentially mineralizable carbon (Co) was significantly larger (P < 0.001) under grassland compared with 5‐ and 10‐year‐oldEucalyptusplantations. Conversion of grassland to 5‐year‐old and 10‐year‐oldEucalyptusreduced the values ofCoby 21 and 43%, respectively. However, soil physical and chemical properties were not adversely affected by age ofEucalyptusover a 5‐year period. It is concluded thatEucalyptusplantations degrade soil ecosystem functioning and environmental sustainability compared with grassland.