bluuebunny/crossref_metadata_2025 huggingface dataset:
Concentrated insulins: History and critical reappraisal
Authors: Heinemann Lutz , Beals John M. , Malone James , Anderson James , Jacobson Jennie G. , Sinha Vikram , Corrigan Sheila M.
Published: September 2018

The earliest marketed insulins were crude acidic formulations with concentrations of ≤10 units/mL. Since the early 1920s, insulins have improved continually, via bioengineering, process, and chemical modifications. Today, most insulin formulations have a concentration of 100 units/mL (U100). However, more concentrated insulin formulations (200, 300, and 500 units/mL; U200, U300, and U500, respectively) are also available. There is a tendency to assume that concentrated insulins are similar, both to each other and to their U100 counterparts, but this is not always the case: two concentrated insulins, namely insulin degludec U200 and insulin lispro U200, are bioequivalent to their U100 counterparts, whereas regular human insulin U500 and insulin glargine U300 are not. The advent of these concentrated insulins offers greater opportunities to provide tailored therapy for patients; it also introduces potential confusion, and highlights the need for prescriber and patient education. Precise and accurate dedicated insulin delivery devices are also necessary for the safe use of these concentrated insulins. Although some clinicians only use concentrated insulin with obese and severely insulin‐resistant patients, other patients would also benefit from the reduced injection volume associated with concentrated insulins, or the modified time‐action profile of some concentrated insulins. The aim of this review is to enhance understanding of the historic development and the safe and effective use of concentrated insulins in clinical practice.
Impact of prolonged and early bevacizumab treatment on the overall survival of EGFR‐mutant and EGFR‐wild type nonsquamous non‐small cell lung cancer
Authors: Huang Yu‐Chen , Shen Shih‐Min , Liu Chien‐Ying , Pavlidis Stelios , Wang Chih‐Liang , Ko How‐Wen , Chung Fu‐Tsai , Lin Tin‐Yu , Feng Po‐Hao , Lee Kang‐Yun , Guo Yi‐Ke , Yang Cheng‐Ta , Kuo Chih‐Hsi Scott
Published: September 2018

Background

VEGF plays a key role in tumor angiogenesis and immunosuppression. VEGF‐blocking has proven beneficial for EGFR mutant and wild‐type nonsquamous non‐small cell lung cancer (nonsq‐NSCLC); however, the number of cycles and treatment line yielding the optimal benefit are unknown.

Methods

We retrospectively analyzed the data of 115 patients with advanced/metastatic nonsq‐NSCLC administered at least one cycle of bevacizumab. The number of bevacizumab cycles was treated as a time‐dependent covariate. Predictors of overall survival (OS) were investigated.

Results

Bevacizumab was used as first‐line treatment in 47 (40.9%) patients, with a median of five cycles (range: 1–31). Eastern Cooperative Oncology Group performance status ≥ 2 (hazard ratio [HR] 4.78, 95% confidence interval [CI] 2.68–8.51; P < 0.001), wild‐type EGFR (HR 2.61, 95% CI 1.45–4.70; P = 0.001), and bleeding during bevacizumab treatment (HR 3.63, 95% CI 1.77–7.45; P < 0.001) were predictive of poor OS; the number of bevacizumab cycles and first‐line administration were not. In the wild‐type EGFR subgroup, the number of bevacizumab cycles (≥ 5 vs. 1–4) was associated with a significant OS benefit (HR 0.28, 95% CI 0.08–0.98; P = 0.044); first‐line administration also showed an OS benefit (HR 0.48, 95% CI 0.20–1.17; P = 0.105). A significant association between the number of cycles and EGFR status was identified (P = 0.046).

Conclusion

OS benefit is negatively affected by bleeding events in bevacizumab‐treated patients. Prolonged and early introduction of bevacizumab may provide an OS benefit for patients with wild‐type EGFR nonsq‐NSCLC.
Treating Lyme carditis high‐degree AV block using a temporary–permanent pacemaker
Authors: Wang Chang , Chacko Sanoj , Abdollah Hoshiar , Baranchuk Adrian
Published: September 2018

A 28‐year‐old previously healthy male presented with nonprodromal syncope and a 4‐day history of chest pain, shortness of breath, and malaise. His ECG showed rapidly progressive high‐degree AV block. His Suspicious Index in Lyme Carditis (SILC) score was 8, indicating high risk for Lyme carditis. Lyme serology revealed to be positive (anti‐Lyme IgM). During the second day of hospitalization, the patient deteriorated his AV conduction, and a temporary–permanent pacemaker was implanted allowing ambulating in hospital the very same day. Temporary–permanent pacemakers for the management of transient high‐degree heart block associated with Lyme carditis were only occasionally used in the past.
Association of spontaneous labor onset with neonatal outcomes in pregnancies with fetal gastroschisis: A retrospective cohort analysis
Authors: Osmundo Junior Gilmar de Souza , Mohamed Samirah Hosney Mahmoud , Nishie Estela Naomi , Tannuri Ana Cristina Aoun , Gibelli Maria Augusta Bento Cicaroni , Francisco Rossana Pulcineli Vieira , Brizot Maria de Lourdes
Published: September 2018

Introduction

The present study aims to investigate the association of spontaneous labor onset with neonatal outcomes in pregnancies with fetal gastroschisis. The secondary goal was to evaluate the association between ultrasound markers and labor onset in pregnancies with fetal gastroschisis.

Material and methods

A retrospective analysis was performed for 207 pregnancies with fetal gastroschisis between 2005 and 2017. Patients were followed according to a strict protocol involving ultrasound scans and routine evaluations of fetal biophysical profile parameters and intra‐ and extra‐abdominal bowel diameters. Labor, delivery and neonatal records were reviewed. The neonatal outcomes were complex gastroschisis, staged surgical closure of the abdominal defect, short bowel syndrome, time on mechanical ventilation, time to full enteral feeding and necrotizing enterocolitis.

Results

Spontaneous labor onset was associated with complex gastroschisis (30.7% vs 6.8%,P = 0.002) and short bowel syndrome (13.2% vs none,P = 0.013) in cases with spontaneous preterm delivery compared with the indicated preterm deliveries. Spontaneous labor onset was associated with a longer time on mechanical ventilation for term and preterm newborns. Associations were not observed between ultrasound markers and spontaneous labor onset.

Conclusions

Spontaneous labor onset in pregnancies with fetal gastroschisis was associated with adverse neonatal outcomes, particularly in those born preterm.
Zero Diffusive Sodium Balance in Hemodialysis Provided by an Algorithm‐Based Electrolyte Balancing Controller: A Proof of Principle Clinical Study
Authors: Kuhlmann Uwe , Maierhofer Andreas , Canaud Bernard , Hoyer Joachim , Gross Malte
Published: September 2018

Restoring and controlling fluid volume homeostasis is still a challenge in contemporary end‐stage kidney disease patients treated by intermittent hemodialysis (HD) or hemodiafiltration (HDF). This primary target is achieved by ultrafiltration (dry weight probing) and control of intradialytic sodium transfer (dialysate‐plasma Na gradient). The latter task is mostly ignored in clinical practice by applying a dialysate sodium prescription uniform for all patients of the dialysis center but unaligned to individual plasma sodium levels. Depending on the patient’s natremia, a positive gradient gives rise to intradialytic diffusive sodium load and postdialytic thirst. On the contrary, a negative gradient may cause unwanted diffusive sodium removal and intradialytic symptoms. To overcome these challenges, a new conductivity‐based electrolyte balancing algorithm embedded in a hemodialysis machine with the aim to achieve “zero diffusive sodium balance” in HD and online HDF treatments was tested in the form of a prospective clinical trial. The study comprised two phases: a first phase with a conventional fixed‐sodium dialysate (standard care phase), followed by a phase with the electrolyte balancing control (EBC) module activated (controlled care phase). The results show a reduction in the variability of the intradialytic plasma sodium concentration shift, but it is overlain by a small but statistically significant increase in the mean plasma sodium levels. However, no clinical manifestations were observed. This sodium load can be explained by the design of the algorithm based on dialysate conductivity instead of sodium concentration. Furthermore, the increase in plasma sodium can be corrected by taking into account the potassium shift during the treatment. This study showed that the EBC module incorporated in the HD machine is able to automatically individualize the dialysate sodium to the patient’s plasma sodium without measuring or calculating predialytic plasma levels from previous laboratory tests. This tool has the potential to facilitate fluid management, to control diffusive sodium flux, and to improve intradialytic tolerance in daily clinical practice.
The Influence of Rotary Blood Pump Speed Modulation on the Risk of Intraventricular Thrombosis
Authors: Liao Sam , Wu Eric L. , Neidlin Michael , Li Zhiyong , Simpson Benjamin , Gregory Shaun D.
Published: September 2018

Rotary left ventricular assist devices (LVADs) are commonly operated at a constant speed, attenuating blood flow pulsatility. Speed modulation of rotary LVADs has been demonstrated to improve vascular pulsatility and pump washout. The effect of LVAD speed modulation on intraventricular flow dynamics is not well understood, which may have an influence on thromboembolic events. This study aimed to numerically evaluate intraventricular flow characteristics with a speed modulated LVAD. A severely dilated anatomical left ventricle was supported by a HeartWare HVAD in a three‐dimensional multiscale computational fluid dynamics model. Three LVAD operating scenarios were evaluated: constant speed and sinusoidal co‐ and counter‐pulsation. In all operating scenarios, the mean pump speed was set to restore the cardiac output to 5.0 L/min. Co‐ and counter‐pulsation was speed modulated with an amplitude of 750 rpm. The risk of thrombosis was evaluated based on blood residence time, ventricular washout, kinetic energy densities, and a pulsatility index map. Blood residence time for co‐pulsation was on average 1.8 and 3.7% lower than constant speed and counter‐pulsation mode, respectively. After introducing fresh blood to displace preexisting blood for 10 cardiac cycles, co‐pulsation had 1.5% less old blood in comparison to counter‐pulsation. Apical energy densities were 84 and 27% higher for co‐pulsation in comparison to counter‐pulsation and constant speed mode, respectively. Co‐pulsation had an increased pulsatility index around the left ventricular outflow tract and mid‐ventricle. Improved flow dynamics with co‐pulsation was caused by increased E‐wave velocities which minimized blood stasis. In the studied scenario and from the perspective of intraventricular flow dynamics, co‐pulsation of rotary LVADs could minimize the risk of intraventricular thrombosis.
Evaluation of screening for coeliac disease in children with juvenile idiopathic arthritis
Authors: Öman Anders , Hansson Tony , Carlsson Martin , Berntson Lillemor
Published: September 2018

Aim

To study the prevalence of coeliac disease (CD) in children with Juvenile idiopathic arthritis (JIA), by screening a population‐based cohort of children with JIA using autoantibodies against tissue transglutaminase (anti‐TG2).

Methods

All children diagnosed with JIA in three Swedish counties, with disease onset between 2007 and 2014, were included prospectively. Serum levels of IgA anti‐TG2 antibodies, IgG anti‐TG2 antibodies, and total IgA were analysed. Children with positive levels of IgA anti‐TG2 antibodies and children with IgA deficiency in combination with positive levels of IgG anti‐TG2 antibodies were referred to the paediatric gastroenterology unit for gastroscopy and small intestine biopsy.

Results

A total of 216 children were included, and analysis of IgA and IgG anti‐TG2 antibodies was performed in 213 children. Three children were diagnosed with CD prior to the diagnosis of JIA, and three additional children were found through screening, resulting in a CD point prevalence of 2.8% (95% CI 0.6–5.0%).

Conclusion

We found a point prevalence of CD close to previous described prevalence in the general population of Swedish children. Therefore, general screening for CD in children with JIA is not supported by our data. However, this study shows that asymptomatic CD in children with JIA may be found by screening.
Medical and dental applications of nanomedicines
Authors: Kavoosi Fraidoon , Modaresi Farzan , Sanaei Masumeh , Rezaei Zahra
Published: September 2018

Nanoparticles are tiny materials with nanosized components less than 100 nm in at least one dimension with physicochemical properties, which make them very attractive for medical application. These compounds have been evaluated as potential medicines for several decades. Nanotechnology has provided advances in the various fields of health sciences such as diagnosis, prevention and treatment by application of the agents named nanomedicines, including proteins, polymers, micelles, dendrimers, liposomes, emulsions, nanocapsules and nanoparticles. These materials can act as a scaffold, gene/drug delivery, tumor suppressor, conjugated with surgical implant, etc. They can also use as a nanocomposite, artificial tooth and dental caries preventing agent in the dentistry science. This current review tries to summarize recent applications of nanomedicine in the medical and dental fields.
Robotic surgery in pediatric urology: Current status
Authors: Mizuno Kentaro , Kojima Yoshiyuki , Nishio Hidenori , Hoshi Seiji , Sato Yuichi , Hayashi Yutaro
Published: September 2018

Robot‐assisted laparoscopic surgery (RALS) has been increasingly embraced in the fields of adult and pediatric urology, especially in North America and Europe. The advantages of a stable magnified 3‐D view, tremor filtering, and motion scaling allow for precise intracorporeal exposure and suturing. Because most surgeries are performed as reconstructive rather than excision procedures, the robotic platform is particularly feasible for the field of pediatric urology. In this review, we summarize the recent viewpoints on RALS, such as pyeloplasty, ureteral reimplantation, bladder neck reconstruction, bladder neck sling, appendicovesicostomy, bladder diverticulectomy, and treatments for ureterocele or ectopic ureters, and we also critically summarize the current status of the literature. Based on our initial experience, RALS is technically feasible for pediatric patients and may be achieved with comparable surgical outcomes. RALS is also associated with reduced morbidity compared to open surgery to conventional laparoscopic surgery. This evolution will offer an alternative in the treatment pediatric patients, along with improved care and patient quality of life. Further large case series and randomized controlled trials that investigate the robotic platform's technological improvements will help to expand indications of RALS in the field of pediatric urology.
A Corporate Social Responsibility Analysis of Payday Lending
Authors: Schwartz Mark S. , Robinson Chris
Published: September 2018

In this article, we use a corporate social responsibility (CSR) framework to analyze the payday loan industry by critically examining its practices from an economic, legal, and ethical perspective. Payday loans are essentially a very high cost, unsecured, short‐term personal loan. Given the inherent nature of the product being offered, the industry appears on the face of it to be in a position to potentially exploit vulnerable consumers in pursuit of profits. With this concern in mind, our analysis investigates the following three issues: Can the payday loan industry currently be considered to be acting in a socially responsible manner? If the industry cannot be considered to be socially responsible, should it be further regulated? If the industry should be further regulated, how should it be regulated? To address these issues, we first provide a brief historical overview of payday loans. Second, we describe the important characteristics of payday loans and how the industry operates. Third, we draw on various sources of evidence to demonstrate that the payday loan industry, while fulfilling its basic economic obligations, falls outside of both the legal and ethical domains of the Three Domain Model of CSR. Based on our analysis, our conclusion is that the payday loan industry requires additional government legal regulation, particularly with respect to allowable fees, and we conclude that there is a strong ethical case for banning payday loans altogether.
Exploring and Comparing Cognitive Moral Reasoning of Millennials and Across Multiple Generations
Authors: Weber James , Elm Dawn R.
Published: September 2018

This research builds on previous investigations seeking to understand how individuals reason about moral problems. Our research includes a preliminary investigation about Millennials and a cross‐generational analysis using secondary research data to understand this emerging generation's moral reasoning and assess trends in moral reasoning over time. This study addresses content‐bias in moral reasoning by using a new instrument with business‐based dilemmas, the Moral Recognition Interview, based on the well‐established moral reasoning framework of Lawrence Kohlberg. Results show that the Millennials in this study exhibit differences in moral reasoning based on gender, intelligence, work experience, and academic major, however not necessarily in an expected manner. Differences in moral reasoning were found when the context or “story pull” of the ethical dilemmas presented is considered. In addition, a comparison to other studies shows that business student Millennials tend to reason at lower levels of cognitive moral reasoning than non‐business college students, as well as college students in the 1960s–1970s (Baby Boomers) and in the 1980s–1990s (Generation Xers).
Multinational Enterprises, Employee Safety and the Socially Responsible Supply Chain: The Case of Bangladesh and the Apparel Industry
Authors: Hemphill Thomas A. , White George O.
Published: September 2018

This article address the issue of employee safety and the social responsibility of multinational apparel retailers who contract with Bangladesh manufacturers in their global supply chain. Both the Alliance for Bangladesh Worker Safety and the Accord on Fire and Building Safety in Bangladesh have been identified as the two primary facilitators for global apparel industry efforts to actively address this serious human rights issue; thus, they have the potential to help drive the success of the industry's corporate citizenship efforts to successfully manage the issue of fire and building safety in Bangladesh. The article further explores these relationships within the context of the “global corporate citizenship” concept, and develops a rationale for the limits of a socially responsible supply chain. In the context of global corporate citizenship, the article describes the existing state of these two industry organizations remediation efforts to ensure a stable supply chain in Bangladesh, and offers an analysis of existing industry nonmarket strategy approaches to improving contractor's factory fire and building safety environments for their employees. Lastly, a comprehensive set of nonmarket strategies for multinational apparel retailers is recommended when addressing their global corporate citizenship commitments to a safe working environment for Bangladesh garment manufacturing employees.
Strategies for implementing placental transfusion at birth: A systematic review
Authors: Anton Oana , Jordan Harriet , Rabe Heike
Published: September 2018

Background

Enhanced placental transfusion reduces adverse neonatal outcomes, including death. Despite being endorsed by the World Health Organization in 2012, the method has not been adopted widely in practice.

Methods

We performed a systematic literature search and included quality improvement projects on placental transfusion at birth and studies on barriers to implementation. We extracted information on population, methods of implementation, obstacles to implementation, and strategies to overcome them.

Results

We screened 99 studies out of which 18 were included in the review. The preferred methods of implementation were protocol development (86% of studies) reinforced by targeted education (64% of studies) and multidisciplinary team involvement (43% of studies). Barriers to implementation were mentioned in 12 studies and divided into four categories: general factors such as lack of staff awareness (5 studies) and professional resistance to change (5 studies); obstetrician‐specific concerns, including the impact during cesarean (3 studies) and the risk of postpartum hemorrhage (3 studies); pediatrician‐specific concerns, including the need for resuscitation (5 studies), risk of jaundice (3 studies), and polycythemia (2 studies); and logistical difficulties. The main strategies to facilitate placental transfusion at birth included effective multidisciplinary team collaboration, protocol development, targeted education, and constructive feedback sessions.

Conclusions

Placental transfusion implementation requires a multidisciplinary approach, with obstetricians, midwives, nurses, and pediatricians central to adoption of the practice. Understanding the obstacles to implementation informs strategies to increase placental transfusion adoption of practice worldwide. We suggest a stepwise approach to implementation and enhancement of placental transfusion into practice.
Single tooth implants in the esthetic zone following a two‐stage all flapless approach: A retrospective analysis
Authors: Hingsammer Lukas , Pommer Bernhard , Fürhauser Rudolf , Mailath‐Pokorny Georg , Haas Robert , Busenlechner Dieter
Published: September 2018

Background

Due to chronic inflammation or trauma facial bone is frequently missing after tooth loss in the esthetic zone. As a consequence, procedures to augment or at least to preserve bone are frequently necessary prior to implant placement.

Purpose

The aim of this retrospective case series is to demonstrate the applicability of a staged all‐flapless concept to establish satisfactory implant restorations following situations of partial missing facial bone in the esthetic zone.

Materials and Methods

Radiological/clinical data of 25 patients were analyzed and an esthetic evaluation of 24 patients was performed. The staged concept included ridge preservation at time of tooth extraction and delayed guided implant placement. Marginal bone loss was measured radiologically and esthetic evaluation was performed based on standardized photographs using the Pink Esthetic Score as well as the Papilla Index.

Results

Implant success rate revealed 100%. The mean radiological peri‐implant marginal bone loss measured 1.16 mm (SD: 0.16). Regarding the esthetic outcome 71% of patients were evaluated with a Pink Esthetic Score higher or equal to 10 constituting satisfactory esthetics (median pink esthetic score: 10). The mean follow‐up time for clinical and radiographic analysis was 1.3 years (SD: 0.6 years) and 1.2 years (SD: 0.6) for esthetic evaluation.

Conclusion

Although marginal bone loss cannot be avoided, the staged concept of flapless ridge preservation and subsequent delayed flapless guided implant placement carries the potential to improve esthetics of single‐tooth implants in the anterior maxilla.
Skin exposure to epoxy chemicals in construction coating, assessed by observation, interviews, and measurements
Authors: Suuronen Katri , Bäck Beatrice , Aalto‐Korte Kristiina , Pesonen Maria , Jungewelter Soile , Henriks‐Eckerman Maj‐Len , Mäkelä Erja
Published: September 2018

Background

Epoxy resin systems (ERSs) are among the leading causes of occupational allergic contact dermatitis.

Objectives

To identify riskful exposures and sources of skin exposure, and to quantify skin exposure to diglycidyl ether of bisphenol A (DGEBA) epoxy monomer, in construction coating work.

Methods

Skin exposure to epoxy chemicals was studied in 5 coating companies through (a) interviews and visual observation, (b) quantifying DGEBA on 12 workers’ skin by tape‐stripping, (c) measuring DGEBA on 23 surfaces by wipe‐sampling, and (d) quantifying DGEBA in new sewage pipe. Acetone extracts of the tapes, wipes and sawdust from a newly hardened sewage pipe were analysed by gas chromatography/mass spectrometry.

Results

Identified riskful exposures were, for example, mixing ERSs, handling coating pots, and working above shoulder level. Epoxy stains on, for example, tools, equipment and clothing were seen in all workplaces. Protective gloves were of varying quality, and were not always suitable for chemicals. The amount of DGEBA on the workers’ skin varied considerably. All screened tool handles were contaminated. Two‐day‐old epoxy sewage pipe contained 3.2% DGEBA.

Conclusions

Construction coating entails skin contact with ERSs directly and via contaminated surfaces, personal protective equipment, and recently hardened epoxy materials. Observation is a useful method for assessing skin exposure in coating work.
Effects of acute insulin‐induced hypoglycaemia on endothelial microparticles in adults with and without type 2 diabetes
Authors: Al‐Qaissi Ahmed , Papageorgiou Maria , Deshmukh Harshal , Madden Leigh A. , Rigby Alan , Kilpatrick Eric S. , Atkin Stephen L. , Sathyapalan Thozhukat
Published: September 2018

Aims

To assess whether endothelial microparticles (EMPs), novel surrogate markers of endothelial injury and dysfunction, are differentially produced in response to acute insulin‐induced hypoglycaemia in adults with and without type 2 diabetes.

Materials and methods

A prospective, parallel study was conducted in individuals with type 2 diabetes (n = 23) and controls (n = 22). Hypoglycaemia (<2.2 mmoL/L: <40 mg/dL) was achieved by intravenous infusion of soluble insulin. Blood samples were collected at baseline and at 0, 30, 60, 120, 240 minutes and 24 hours after hypoglycaemia and analysed for CD31+ (platelet endothelial cell adhesion molecule‐1), CD54+ (intercellular adhesion molecule 1), CD62‐E+ (E‐selectin), CD105+ (endoglin), CD106+ (vascular cell adhesion molecule 1) and CD142+ (tissue factor) EMPs by flow cytometry. The peak elevations (% rise from 0 minutes after hypoglycaemia) in EMP within 240 minutes after insulin‐induced hypoglycaemia were modelled using a regression model, with adjustment for relevant covariates. All EMPs were expressed as percentage from 0 minutes hypoglycaemia for each time point and total areas under the curve (AUC0min–24h) were calculated.

Results

Following insulin‐induced hypoglycaemia, levels of circulating EMPs were maximal at 240 minutes (P < 0.001) and returned to baseline values within 24 hours for both groups. The peak elevations (% rise from 0 minutes following hypoglycaemia) seen in CD31+, CD54+, CD62‐E+, CD105+ and CD142+ EMPs within 240 minutes were associated with diabetes status after adjustments for all relevant covariates. Individuals with type 2 diabetes showed increased CD31+ EMPs AUC0min–24h (P = 0.014) and CD105+ EMPs AUC0min–24h (P = 0.006) compared with controls, but there were no differences for CD54+ (P = 0.91), CD62‐E+ (P = 0.14), CD106+ (P = 0.36) or CD142+ (P = 0.77) EMPs AUC0min–24h.

Conclusions

The associations between peak elevations within 240 minutes after insulin‐induced hypoglycaemia for CD31+, CD54+, CD62‐E+, CD105+ and CD142+ and diabetes status indicate that the assessment of a panel of EMPs within this timeframe would identify a hypoglycaemic event in this population. The greater overall responses over time (AUCs) for apoptosis‐induced CD31+ and CD105+ EMPs suggest that hypoglycaemia exerts greater endothelial stress in type 2 diabetes.
Military casualties and exchange rates during the First World War: did the Eastern Front matter?
Authors: Duarte Pablo , Freidinger Marcel , Hoffmann Andreas
Published: September 2018

Although the First World War was ultimately decided in the west, historians have emphasized the importance of the often ‘forgotten’ Eastern Front in understanding its complex evolution. This article examines the perception of contemporary foreign exchange traders concerning the relative importance of the Eastern Front over time. Using a newly compiled dataset on prisoners of war and on soldiers killed and wounded, we show that traders were concerned with casualties on both fronts, recognizing the significance of the two‐front war in the early war years. From the autumn of 1916 onwards, traders seemed to believe the key to winning the war lay in the west only.
Diversity and trophic structure of insects associated with grains of three maize landraces in San Agustín Loxicha, Oaxaca, Mexico
Authors: Callejas‐Chavero Alicia , Cornejo‐Romero Amelia , Serrato‐Díaz Alejandra , Rendón‐Aguilar Beatriz
Published: September 2018

Diversity and trophic structure of grain insect communities were examined in Olotillo, Nal‐Tel and Comiteco maize landraces cultivated within a milpa agroecosystem by Zapotec ethnic groups in Mexico. Higher insect diversity was expected in Olotillo, whose cultivation comprises a wide variety of agroecosystems, and low insect abundance in Nal‐Tel with small grains and thick testa. Forty Olotillo cobs were collected at low, medium and high elevations, and 40 each of Nal‐Tel at low elevation and Comiteco at high elevation. Cobs were monitored for 30 days under controlled laboratory conditions until all insects emerged. Thickness of testa of 400 grains from each landrace was measured. Community composition and trophic structure were described and standard diversity indices were estimated. A total of 9,708 insects, corresponding to five orders, 24 families and 36 species, were recorded, with six species not previously reported in this region. Insect guilds were composed of 70% phytophages, 22% parasitoids and 8% predators. Species richness was S = 27, 16 and 8 in Olotillo, Comiteco and Nal‐Tel, respectively. Nal‐Tel and Olotillo had the highest diversity index values (H′ = 1.32 and 1.2, respectively) and no significant differences; Comiteco had the lowest value (H′ = 0.65) and differed significantly from the other landraces. Comiteco and Olotillo, which have large grains and thin testa, showed higher insect abundance than Nal‐Tel, which has small grains and thick testa and showed lower abundance. Results support our hypotheses and highlight the role of traditional crop management in insect agrobiodiversity maintenance and conservation.
Is Guam a regional source, destination, or stepping‐stone for larvae of three fisheries species?
Authors: Kendall Matthew S. , Poti Matthew , Winship Arliss
Published: September 2018

The pelagic larval duration (PLD) period of fish can influence dispersal, recruitment, and population connectivity, thereby potentially informing best strategies for fisheries management. Computer models were used to simulate the dispersal of larvae of three species, representing a range of PLDs, from the Pacific island of Guam and neighboring islands for a 9‐year period (2004–2012) to gain insight into the best management strategies for these species. The species included two springtime spawners with shorter and longer PLDs, scribbled rabbitfish (Siganus spinus; 33 days) and yellowfin goatfish (Mulloidichthys flavolineatus; ~90 days maximum), and a fall spawner with a similarly long PLD, bluespine unicornfish (Naso unicornis; ~94 days maximum). An ocean circulation model coupled with a particle dispersal model provided simulated numbers of larvae settling at each island in relation to the island where they were spawned. Graph analysis was used to examine generational connections between islands. For S. spinus, self‐seeding was the dominant means of replenishment at Guam. Local management actions to maintain adequate spawning stock may be a primary control on long‐term sustainability for that fishery. In contrast, N. unicornis and M. flavolineatus populations at Guam were reliant on outside sources for 92%–98% of larval supply. For them, identifying and negotiating the preservation of upstream spawning potential in the Marshall Islands and Federated States of Micronesia will be needed. Guam played a relatively minor role in generational connectivity across the region. Shortest paths spanning the region often did not pass through Guam, or there were equally short paths through other islands.
Atrial fibrillation and medication treatment among centenarians: Are all very old patients treated the same?
Authors: Kreutz Reinhold , Schmidt Insa M , Dräger Dagmar , Brüggen Franca , Hörter Stefan , Zwillich Christine , Kuhlmey Adelheid , Gellert Paul
Published: September 2018

Aim

Evidence on antithrombotic therapy use in centenarians diagnosed with atrial fibrillation (AF) is sparse. Our objective was to investigate a possible underprescribing in centenarians relative to younger cohorts of the oldest‐old. We assumed lower AF rates; and, within AF patients, lower use of anticoagulants in those who died as centenarians (aged ≥100 years) than in those who died aged in their 80s (≥80 years) or 90s (≥90 years).

Methods

The present study was a quarterly structured cohort study over the 6 years before death using administrative data from German institutionalized and non‐institutionalized insured patients (whole sample n = 1398 and subsample of AF patients n = 401 subclassified according to age‐of‐death groups [≥80, ≥90, ≥100 years]). AF, medication, stroke risk (Congestive heart failure; Hypertension; 2 × Age ≥75 years; Diabetes mellitus; 2 × Stroke; Vascular disease; Age 65–74 years; Sex [female] (CHA2DS2‐VASc)) and risk of major bleeding (Hypertension; Abnormal renal and liver function; Stroke; Bleeding; Labile International Normalized Ratio [omitted in the present analysis]; Elderly; Drugs or alcohol (HAS‐BLED)) were calculated. Generalized estimation equations were used to model the trajectories.

Results

Half a year before death (T1), AF rates were higher in patients aged ≥80 years (31.8%) and ≥90 years (30.6%) compared with patients aged ≥100 years (22.4%), whereas there were no significant differences between age groups 6 years before death (T0). Of all AF patients with AF at T1, 26.7% received anticoagulants; 11.2% vitamin K antagonists; 15.7% non‐vitamin K antagonist oral anticoagulants; and 17.5% platelet inhibitors; yet 58.1% received none of these drugs. Centenarians received significantly fewer anticoagulants compared with the other age groups. Prescriptions of anticoagulants were not associated with CHA2DS2‐VASc with and without adjustment for HAS‐BLED.

Conclusions

The present findings highlight the need for more appropriate use of anticoagulation therapy in older patients, as well as for new treatment guidelines taking the heterogeneity of very old patients into account. Geriatr Gerontol Int 2018; 18: 1634–1640.
Prevalence of diabetes among homeless men in Nagoya, Japan: A survey study
Authors: Yamamoto Mayumi , Watanabe Takahiro , Uehara Ryosuke , Horita Ryo , Sado Tadahiro , Nishio Akihiro
Published: September 2018

Aims/Introduction

The diabetes status of homeless people has not been elucidated because of the limited access to this population. We carried out a survey of the prevalence of diabetes and prediabetes among homeless men in Nagoya, Japan, and assessed the associations between diabetes prevalence and sociodemographic characteristics.

Materials and Methods

Interviews relating to individuals’ sociodemographic background, mental illness and cognitive ability, and blood sampling were carried out for 106 homeless men (mean age 54.2 ± 12.7 years). Diabetes, prediabetes and normoglycemia were diagnosed according to the individual's hemoglobin A1c level: ≥6.5%, 6.4–6.0% and ≤5.9%, respectively. Mental illness and cognitive disability were diagnosed using the Mini‐International Neuropsychiatric Interview and Wechsler Adult Intelligence Scale‐III, respectively. Associations between the prevalence of diabetes/prediabetes and mental illness/cognitive disability or sociodemographic background were analyzed using the χ2‐test.

Results

Seven (6.6%) and 12 (11.3%) participants were diagnosed as having diabetes and prediabetes, respectively, which was a similar trend to that of general populations in Japan National Health and Nutrition Survey data. There was a significant difference in the prediabetes prevalence between groups with and without a history of having social support; however, no significant associations were found between the diabetes/prediabetes prevalence and mental illness/cognitive ability or participants’ sociodemographic background.

Conclusions

The incidence of diabetes in Japanese homeless men was similar to that in the general population, and the prediabetes incidence was lower in the group with social support than in that without. Early intervention for preventing diabetes and social support that focuses on diabetes management is important for homeless people.
Cost analysis of a brief intervention for the prevention of falls after discharge from an emergency department
Authors: Harper Kristie J. , Arendts Glenn , Geelhoed Elizabeth A. , Barton Annette D. , Celenza Antonio
Published: September 2018

Rationale, aims and objectives

There is considerable uncertainty around the cost‐effectiveness of interventions for preventing secondary falls in older people presenting to emergency departments (ED). The objective was to complete an economic evaluation of a brief educational ED intervention aimed at preventing falls in older people post discharge.

Methods

A net cost analysis was completed from the health system perspective, using data from a controlled clinical trial, where an education intervention was compared to standard care. Patients aged 65 and older presenting to the ED with any diagnosis were enrolled. The costs, using Australian dollars (A$) at 2015 values, included resources required for the intervention and any health care cost incurred in the 6‐month follow‐up period (time horizon). Cost data were sourced through institutional billing records and liaison with the patient and their general practitioner. Mean costs and differences were analysed through nonparametric bootstrapping.

Results

The total costs in the control group (n = 201) were A$1 576 496 compared to A$1 292 130 in the intervention group (n = 211). The mean net cost per patient was A$7749 and A$6187 (P = 0.68) respectively resulting in a mean difference of A$1580 per patient in the intervention group (95% CI: A$−2806 to A$6150). Patients who presented to the ED with a fall diagnosis were reviewed through subgroup analysis. Total costs for patients who presented with a fall in the control group (n = 69) were A$708 995 compared to A$512 874 in the intervention group (n = 97). The mean net cost per patient was A$10 326 and A$5343 respectively (P = 0.33) with an overall saving of A$4624 per patient in the intervention group (95% CI: A$−2868 to A$15 426).

Conclusions

A brief intervention had no net cost benefit across the whole study population, but is more cost effective in older people presenting to the ED with a fall.
Effects of the organizational culture type, job satisfaction, and job stress on nurses’ happiness: A cross‐sectional study of the long‐term care hospitals of South Korea
Authors: Hwang Eunhee
Published: September 2018

Aim

It was aimed to explore the effects of the long‐term‐care (LTC) hospital–nurse organizational culture type, job satisfaction, and job stress on nurses’ happiness.

Methods

Included were 226 participants who were randomly selected among the nurses who were working in 17 LTC hospitals with ≥100 beds, located in five cities in South Korea. A multiple regression analysis was carried out in order to examine the factors affecting the happiness of the nurses.

Results

The happiness of the LTC hospital nurses was not high. Regarding the factors affecting their happiness, a higher feeling of happiness was evident when the estimation of their subjective health status was healthier, when they were in an organization with hierarchy‐oriented culture properties, when they expressed a higher job satisfaction regarding autonomy, and when the number of task requests was lower. Among these factors, autonomy‐based job satisfaction exerts the greatest effect.

Conclusion

Based on these results, the development of personal health improvement programs for nurses’ happiness should be required. In addition, hospitals need to be stably operated and managed to ensure organizational safety and the nurse managers should encourage the nurses to carry out their tasks with autonomy.
Smoking habit modulates peri‐implant microbiome: A case‐control study
Authors: Pimentel Suzana P. , Fontes Melline , Ribeiro Fernanda V. , Corrêa Mônica G. , Nishii Denise , Cirano Fabiano R. , Casati Marcio Z. , Casarin Renato C. V.
Published: September 2018

Background and Objective

Smoking is a recognized risk factor for peri‐implant disease and leads to microbiological changes in mucositis and peri‐implantitis. However, there is no knowledge about the impact of smoking in healthy peri‐implant tissue. The aim of the study was to evaluate the microbiome in a peri‐implant environment in smokers with healthy peri‐implant conditions.

Methods

Peri‐implant biofilm was collected around single clinically healthy, screwed‐retained, teeth‐surrounded implants in 12 non‐smoker (NSMK) and 12 smoker (SMK) non‐periodontitis subjects (no bleeding and probing depth <4 mm). Bacterial DNA was isolated and 16S ribosomal RNA gene libraries were sequenced using pyrosequencing, targeting the V3‐V4 region. Datasets were processed using the Quantitative Insights into Microbial Ecology, Greengenes and the Human Oral Microbiome Database databases.

Results

An evident difference in the SMK peri‐implant microbiome was observed compared to the NSMK microbiome, with a large abundance of species, even with a healthy peri‐implant. The SMK core‐microbiome showed an abundance of Fusobacterium, Tannerella and Mogibacterium, while the NSMK core revealed an abundance of Actinomyces, Capnocytophaga and Streptococcus, genera that are usually related to periodontal health. The microbiome inter‐relationship was shown to be more inter‐generic in SMK then in NSMK, indicating different microbiome cohesion.

Conclusion

Smoking negatively affected the peri‐implant microbiome, leading to a disease‐associated state, even in clinically healthy individuals.
Activity of two hyaluronan preparations on primary human oral fibroblasts
Authors: Asparuhova Maria B. , Kiryak Deniz , Eliezer Meizi , Mihov Deyan , Sculean Anton
Published: September 2018

Background and Objective

The potential benefit of using hyaluronan (HA) in reconstructive periodontal surgery is still a matter of debate. The aim of the present study was to evaluate the effects of two HA formulations on human oral fibroblasts involved in soft tissue wound healing/regeneration.

Material and Methods

Metabolic, proliferative and migratory abilities of primary human palatal and gingival fibroblasts were examined upon HA treatment. To uncover the mechanisms whereby HA influences cellular behavior, wound healing‐related gene expression and activation of signaling kinases were analyzed by qRT‐PCR and immunoblotting, respectively.

Results

The investigated HA formulations maintained the viability of oral fibroblasts and increased their proliferative and migratory abilities. They enhanced expression of genes encoding type III collagen and transforming growth factor‐β3, characteristic of scarless wound healing. The HAs upregulated the expression of genes encoding pro‐proliferative, pro‐migratory, and pro‐inflammatory factors, with only a moderate effect on the latter in gingival fibroblasts. In palatal but not gingival fibroblasts, an indirect effect of HA on the expression of matrix metalloproteinases 2 and 3 was detected, potentially exerted through induction of pro‐inflammatory cytokines. Finally, our data pointed on Akt, Erk1/2 and p38 as the signaling molecules whereby the HAs exert their effects on oral fibroblasts.

Conclusion

Both investigated HA formulations are biocompatible and enhance the proliferative, migratory and wound healing properties of cell types involved in soft tissue wound healing following regenerative periodontal surgery. Our data further suggest that in gingival tissues, the HAs are not likely to impair the healing process by prolonging inflammation or causing excessive MMP expression at the repair site.
Two pKM101‐encoded proteins, the pilus‐tip protein TraC and Pep, assemble on the Escherichia coli cell surface as adhesins required for efficient conjugative DNA transfer
Authors: González‐Rivera Christian , Khara Pratick , Awad Dominik , Patel Roosheel , Li Yang Grace , Bogisch Maxim , Christie Peter J.
Published: September 2018

Mobile genetic elements (MGEs) encode type IV secretion systems (T4SSs) known as conjugation machines for their transmission between bacterial cells. Conjugation machines are composed of an envelope‐spanning translocation channel, and those functioning in Gram‐negative species additionally elaborate an extracellular pilus to initiate donor‐recipient cell contacts. We report that pKM101, a self‐transmissible MGE functioning in the Enterobacteriaceae, has evolved a second target cell attachment mechanism. Two pKM101‐encoded proteins, the pilus‐tip adhesin TraC and a protein termed Pep, are exported to the cell surface where they interact and also form higher order complexes appearing as distinct foci or patches around the cell envelope. Surface‐displayed TraC and Pep are required for an efficient conjugative transfer, ‘extracellular complementation’ potentially involving intercellular protein transfer, and activation of a Pseudomonas aeruginosa type VI secretion system. Both proteins are also required for bacteriophage PRD1 infection. TraC and Pep are exported across the outer membrane by a mechanism potentially involving the β‐barrel assembly machinery. The pKM101 T4SS, thus, deploys alternative routing pathways for the delivery of TraC to the pilus tip or both TraC and Pep to the cell surface. We propose that T4SS‐encoded, pilus‐independent attachment mechanisms maximize the probability of MGE propagation and might be widespread among this translocation superfamily.
Secularization of immigration policy vs. religion's influence on integration: Israel's non‐Jewish Jews' immigration in a comparative perspective
Authors: Fisher Netanel
Published: September 2018

This article deals with the complex relationship between religion and immigration in Western countries, with an emphasis on Israel. The main argument it presents is that the legal procedures of immigration, i.e. laws relating to the acquisition of civil status, have undergone dramatic secularization, while religion's influence is expressed in the social and cultural aspects of the integration of immigrants belonging to religious minorities. This division reinforces the classical theory of secularization, as the formal boundaries of nations are not subject to religious affiliations, but it also supports the theories of competition and complementation between religion and secularism in the social sphere. The tension in the Israeli case between the immigration, naturalization and integration of non‐Jewish Jews, who are part of the extended Jewish population that is not defined by religious parameters, confirms this thesis. The immigration of hundreds of thousands of non‐Jewish Jews' under the Law of Return based on ethno‐national‐secular parameters is an ultimate expression of the secularization of Jewish nationality. On the other hand, the state's encouragement of non‐Jewish immigrants to convert to Judaism so that they can better assimilate into Jewish society signifies the importance of religion in the social integration aspect.