bluuebunny/crossref_metadata_2025 huggingface dataset:
Temporal changes in left ventricular longitudinal strain in general population: Clinical correlates and impact on cardiac remodeling
Authors: Kuznetsova Tatiana , Nijs Ellen , Cauwenberghs Nicholas , Knez Judita , Thijs Lutgarde , Haddad Francois , Yang Wen‐Yi , Kerkhof Peter L. , Voigt Jens‐Uwe , Staessen Jan A.
Published: January 2019

Background

Recent studies in patients and general population have reported the role of left ventricular (LV) longitudinal strain (LS) as an independent predictor of outcome. However, there are few data on changes in LS over time. We therefore investigated in a general population clinical correlates of temporal changes in LS. We also explored the potential correlation between temporal changes in LV volumes and LS.

Methods and Results

We measured LV end‐systolic (ESV) and end‐diastolic (EDV) volumes by conventional echocardiography and LS by 2D speckle tracking in 627 participants (mean age 50.6 years, 51.4% women; 41.3% hypertensives) at baseline and after 4.7 years. For statistical analysis, we used the absolute values of LS. In stepwise regression, the magnitude of the decrease in all LV LS indexes over time was greater in men than in women (P < 0.0001). Higher baseline mean arterial pressure (MAP), a larger longitudinal increase in MAP, and stopping diuretic treatment during follow‐up were related to larger decreases in LS indexes. In multivariable‐adjusted analysis, we observed an inverse correlation between baseline ESV and LV LS (P ≤ 0.0017). Similarly, lower baseline LS and a larger decrease in LS over time were correlated with a lesser longitudinal decrease in ESV (P ≤ 0.0004).

Conclusions

A significant decrease in LS over time was associated with male sex, higher baseline MAP, ∆MAP, and alteration in antihypertensive treatment. We suggested an interaction between a longitudinal decrease in LV deformation and adverse cardiac remodeling, while underscoring the importance of deformation analysis based on LS assessment in patients at risk.
Orotracheal intubation in the horse – Is bigger better?
Authors: Burns P. M.
Published: January 2019

Access to the respiratory tract of an anaesthetised animal is a vital line of life. An endotracheal tube ensures a secure airway that will allow the delivery of anaesthesia and facilitates mechanical ventilation. The case report by Miller and Auckburally (2020) described in this issue highlights the potential complications associated with endotracheal intubation. Intubation using a 30 mm ID endotracheal tube in the average sized horse (500 kg) has been documented to have a high rate of tracheal injury. The manufacturing specifications of endotracheal tubes may contribute to the incidence of tracheal injury. Further research is needed to help minimise the morbidity and potential mortality associated with this anaesthetic procedure.
Single cell analyses reveal specific distribution of anti‐bacterial molecule Perforin‐2 in human skin and its modulation by wounding and Staphylococcus aureus infection
Authors: Strbo Natasa , Pastar Irena , Romero Laura , Chen Vivien , Vujanac Milos , Sawaya Andrew P. , Jozic Ivan , Ferreira Andrea D. F. , Wong Lulu L. , Head Cheyanne , Stojadinovic Olivera , Garcia Denisse , O'Neill Katelyn , Drakulich Stefan , Taller Seth , Kirsner Robert S. , Tomic‐Canic Marjana
Published: January 2019

Perforin‐2 (P‐2) is a recently described antimicrobial protein with unique properties to kill intracellular bacteria. We investigated P‐2 expression pattern and cellular distribution in human skin and its importance in restoration of barrier function during wound healing process and infection with the common wound pathogen Staphylococcus aureus. We describe a novel approach for the measurement of P‐2 mRNA within individual skin cells using an amplified fluorescence in situ hybridization (FISH) technique. The unique aspect of this approach is simultaneous detection of P‐2 mRNA in combination with immune‐phenotyping for cell surface proteins using fluorochrome‐conjugated antibodies. We detected P‐2 transcript in both hematopoietic (CD45+) and non‐hematopoietic (CD45−) cutaneous cell populations, confirming the P‐2 expression in both professional and non‐professional phagocytes. Furthermore, we found an induction of P‐2 during wound healing. P‐2 overexpression resulted in a reduction of intracellular S. aureus, while infection of human wounds by this pathogen resulted in P‐2 suppression, revealing a novel mechanism by which S. aureus may escape cutaneous immunity to cause persistent wound infections.
Global relative species loss due to first‐generation biofuel production for the transport sector
Authors: Elshout Pieter M. F. , van Zelm Rosalie , van der Velde Marijn , Steinmann Zoran , Huijbregts Mark A. J.
Published: January 2019

The global demand for biofuels in the transport sector may lead to significant biodiversity impacts via multiple human pressures. Biodiversity assessments of biofuels, however, seldom simultaneously address several impact pathways, which can lead to biased comparisons with fossil fuels. The goal of the present study was to quantify the direct influence of habitat loss, water consumption and greenhouse gas (GHG) emissions on potential global species richness loss due to the current production of first‐generation biodiesel from soybean and rapeseed and bioethanol from sugarcane and corn. We found that the global relative species loss due to biofuel production exceeded that of fossil petrol and diesel production in more than 90% of the locations considered. Habitat loss was the dominating stressor with Chinese corn, Brazilian soybean and Brazilian sugarcane having a particularly large biodiversity impact. Spatial variation within countries was high, with 90th percentiles differing by a factor of 9 to 22 between locations. We conclude that displacing fossil fuels with first‐generation biofuels will likely negatively affect global biodiversity, no matter which feedstock is used or where it is produced. Environmental policy may therefore focus on the introduction of other renewable options in the transport sector.
A community‐wide quality improvement initiative to improve hypertension control and reduce disparities
Authors: Fortuna Robert J. , Rocco Thomas A. , Freeman Jeffrey , Devine Mathew , Bisognano John , Williams Geoffrey C. , Nagel Angela , Beckman Howard
Published: January 2019

Initiatives to improve hypertension control within academic medical centers and closed health systems have been extensively studied, but large community‐wide quality improvement (QI) initiatives have been both less common and less successful in the United States. The authors examined a community‐wide QI initiative across 226 843 patients from 198 practices in nine counties across upstate New York to improve hypertension control and reduce disparities. The QI initiative focused on (a) providing population and practice‐level comparative data, (b) community engagement, especially in underserved communities, and (c) practice‐level quality improvement assistance, but was not designed to examine causality of specific components. Across the nine counties, hypertension control rates improved from 61.9% in 2011 to 69.5% in 2016. Improvements were greatest among whites (73.7%‐81.5%) and more modest among black patients (58.8%‐64.7%). The authors noted a considerable improvement in BP within the group of patients with the highest risk (defined as a BP ≥ 160/100) and a decrease in disparities within this group. The quality collaborative identified five key lessons to help guide future community initiatives: (a) anticipate a plateauing of response; (b) distinguish the needs of disparate populations and create subpopulation‐specific strategies to address and reduce disparities; (c) recognize the variation across low SES practices; (d) remain open to the refinement of outcome measures; and (e) continually seek best practices and barriers to success. Overall, a large community‐wide QI initiative, involving multiple different stakeholders, was associated with improvements in BP control and modest reductions in some targeted disparities.
Ursolic acid prevents doxorubicin‐induced cardiac toxicity in mice through eNOS activation and inhibition of eNOS uncoupling
Authors: Mu Haiman , Liu Haiwen , Zhang Jiayi , Huang Jianhua , Zhu Chen , Lu Yue , Shi Yueping , Wang Yi
Published: January 2019

In addition to the known antitumour effects of ursolic acid (UA), increasing evidence indicates that this molecule plays a role in cardiac protection. In this study, the effects of ursolic acid on the heart in mice treated with doxorubicin (DOX) were assessed. The results showed that ursolic acid improved left ventrical fractional shortening (LVFS) and left ventrical ejection fraction (LVEF) of the heart, increased nitrogen oxide (NO) levels, inhibited reactive oxygen species (ROS) production and decreased cardiac apoptosis in mice treated with doxorubicin. Mechanistically, ursolic acid increased AKT and endothelial nitric‐oxide synthase (eNOS) phosphorylation levels, and enhanced eNOS expression, while inhibiting doxorubicin induced eNOS uncoupling through NADPH oxidase 4 (NOX4) down‐regulation. These effects of ursolic acid resulted in heart protection from doxorubicin‐induced injury. Therefore, ursolic acid may be considered a potential therapeutic agent for doxorubicin‐associated cardiac toxicity in clinical practice.
Platform market competition with endogenous side decisions
Authors: Choi Jay Pil , Zennyo Yusuke
Published: January 2019

This paper develops a framework to analyze platform competition in two‐sided markets in which agents endogenously decide on which side of a platform to join. We characterize the equilibrium pricing structure and perform a comparative statics analysis on how the distribution of agents’ preferences affects the platforms’ profits. We also show that the market equilibrium under profit‐maximizing platforms leads to the first best social surplus, which illustrates the importance of the price mechanism to induce more balanced participation across the two sides. This framework can be applied to analyze market competition for “rental” or “sharing” platforms. In addition, we extend our analysis to consider an initial investment stage, which makes participants the owner of some durable goods to rent out.
Interdisciplinary full‐mouth rehabilitation for redefining esthetics, function, and orofacial harmony
Authors: Edelhoff Daniel , Probst Florian , Ehrenfeld Michael , Prandtner Otto , Schweiger Josef , Liebermann Anja
Published: January 2019

Objective

In severe congenital or acquired orofacial anomalies, both dental esthetics and function are usually compromised. In particular, the esthetic ideas of the final desired appearance may differ from patient to patient, as the human esthetic sensibility differs significantly. Especially in complex cases, digital technology today offers outstanding improvements and simplifications in craniomaxillofacial surgical and prosthetic treatments, leading to a wide range of planning and pretreatment options.

Clinical Considerations

This case report describes a patient‐oriented interdisciplinary craniomaxillofacial surgical and prosthetic treatment with noninvasive tooth‐colored splints, a Le Fort I osteotomy, and a full‐mouth rehabilitation to meet the patient's demand for better function as well as orofacial esthetics and harmony.

Conclusions

By means of the digitally planned Le Fort I intervention and completion of the prosthetic rehabilitation, it was possible to optimize esthetics and facial harmony.

Clinical Significance

In complex cases, digital technology today offers outstanding improvements and simplifications in craniomaxillofacial surgery and prosthetic treatments, leading to a wide range of planning and pretreatment options. Computer‐aided design/computer‐aided manufacturing technology enables the fabrication of tooth‐colored flexible polycarbonate splints that offer a noninvasive, removable, functional, and esthetic solution. In intricate cases involving craniomaxillofacial anomalies, often together with necessary orofacial surgeries or prosthetic treatments due to moderate to severe tooth wear, such digital preprosthetic treatment and planning options represent an important enhancement with more predictable results.
Developmental pathways for shaping spike inflorescence architecture in barley and wheat
Authors: Koppolu Ravi , Schnurbusch Thorsten
Published: January 2019

Grass species display a wide array of inflorescences ranging from highly branched compound/panicle inflorescences to unbranched spike inflorescences. The unbranched spike is a characteristic feature of the species of tribe Triticeae, including economically important crops, such as wheat and barley. In this review, we describe two important developmental genetic mechanisms regulating spike inflorescence architecture in barley and wheat. These include genetic regulation of (i) row‐type pathway specific to Hordeum species and (ii) unbranched spike development in barley and wheat. For a comparative understanding, we describe the branched inflorescence phenotypes of rice and maize along with unbranched Triticeae inflorescences. In the end, we propose a simplified model describing a probable mechanism leading to unbranched spike formation in Triticeae species.
Plant peroxisomes at the crossroad of NO and H2O2 metabolism
Authors: Corpas Francisco J. , del Río Luis A. , Palma José M.
Published: January 2019

Plant peroxisomes are subcellular compartments involved in many biochemical pathways during the life cycle of a plant but also in the mechanism of response against adverse environmental conditions. These organelles have an active nitro‐oxidative metabolism under physiological conditions but this could be exacerbated under stress situations. Furthermore, peroxisomes have the capacity to proliferate and also undergo biochemical adaptations depending on the surrounding cellular status. An important characteristic of peroxisomes is that they have a dynamic metabolism of reactive nitrogen and oxygen species (RNS and ROS) which generates two key molecules, nitric oxide (NO) and hydrogen peroxide (H2O2). These molecules can exert signaling functions by means of post‐translational modifications that affect the functionality of target molecules like proteins, peptides or fatty acids. This review provides an overview of the endogenous metabolism of ROS and RNS in peroxisomes with special emphasis on polyamine and uric acid metabolism as well as the possibility that these organelles could be a source of signal molecules involved in the functional interconnection with other subcellular compartments.
Feasibility of a dance and exercise with music programme on adults with intellectual disability
Authors: Martínez‐Aldao D. , Martínez‐Lemos I. , Bouzas‐Rico S. , Ayán‐Pérez C.
Published: January 2019

Background

Research regarding the feasibility and effects of dancing and exercise with musical support programmes on the physical fitness of adults with intellectual disability (ID) is scarce. The purpose of this study was to provide scientific evidence regarding the feasibility of a training programme consisting of dancing and exercise with music designed for adults with ID, as well as to assess its impact on their body composition and cardiovascular and muscular fitness.

Methods

A total of 30 adults (mean age 36.37 ± 11.24 years) with mild (n = 13), moderate (n = 16) or severe (n = 1) ID took part in a 10‐week dancing and exercise with music programme. Recruitment and completion rate, adherence to the programme, participation and adverse effects were registered as measures of feasibility. The body mass index, cardiovascular endurance (6‐min walk test) and muscular strength (standing long jump test) of the participants were assessed in order to determine the effects of the programme on their fitness level.

Results

A 92.5% recruitment rate and a 90% completion rate were achieved. Adherence to the programme stood at 76.6%, and no adverse effects were registered. The comparison between the values obtained in the initial and final evaluations indicated the existence of positive changes in all the fitness dimensions measured.

Conclusion

A training programme combining dancing and exercise with music proved to be feasible when performed by adults with ID. These kind of programmes can have a positive effect on the fitness level of this specific group.
Spirituality in Therapeutic Spaces: Perceptions of Spatiality, Trace, and past Rituals Manifesting Present Occupation
Authors: Liddicoat Stephanie
Published: January 2019

Spaces for therapy and counseling are spaces whose physical characteristics transform into metaphysically changed feelings of transcendental reality and meaningful, spiritual overtones. For individuals who self–harm, therapeutic processes and associated interior spaces can be contemplative spaces, where they might develop interconnectedness with oneself and a sense of self–actualization. Therapeutic spaces can address high levels of anxiety and mitigate potential dissociation, which is when the individual is removed from a sense of aliveness, a sense of presence and immersion in the realm of sensory experience. This paper examined the perceptions of spatiality of individuals who self–harm and the interior encounters for which they were exposed. The data collection involved a series of semistructured interviews with mental health service users who self–harm, their careers, therapists/counselors, architects, and design experts/researchers. Also included was an examination of existing built therapeutic spaces. A series of findings revealed relationships between perceptions of spatiality and the spiritual dimensions of therapeutic environments. Based upon qualitative data, how individuals who self–harm experience particular connections between physical and psychological spaces, and how their interior space encounter is overlaid with inhabitation of past service users are presented. A discussion of sensory encounter and dissociation and the relationship between trace and spatial perception leads to a series of research–derived design recommendations to be used to develop supportive, therapeutic spaces delivering mental health services.
Taxation, redistribution, and observability in social dilemmas
Authors: Brent Daniel A. , Gangadharan Lata , Mihut Anca , Villeval Marie Claire
Published: January 2019

In the presence of social dilemmas, cooperation is more difficult to achieve when populations are heterogeneous because of conflicting interests within groups. We examine cooperation in the context of a nonlinear common pool resource game, in which individuals have unequal extraction capacities and have to decide on their extraction of resources from the common pool. We introduce monetary and nonmonetary mechanisms in this environment. The two monetary mechanisms are tax extraction and redistribution of the tax revenue. These include a Pigovian per‐unit tax mechanism and an increasing block tax that only taxes units extracted above the social optimum. Another mechanism varies the observability of individual decisions. We find that the two tax and redistribution mechanisms reduce extraction, increase efficiency, and decrease inequality within groups. In contrast, observability impacts only the baseline condition by encouraging free‐riding instead of creating moral pressure to cooperate.
CBT for late‐life insomnia and the accuracy of sleep and wake perceptions: Results from a randomized‐controlled trial
Authors: Dzierzewski Joseph M. , Martin Jennifer L. , Fung Constance H. , Song Yeonsu , Fiorentino Lavinia , Jouldjian Stella , Rodriguez Juan Carlos , Mitchell Michael , Josephson Karen , Alessi Cathy A.
Published: January 2019

Subjective and objective estimates of sleep are often discordant among individuals with insomnia who typically under‐report sleep time and over‐report wake time at night. This study examined the impact and durability of cognitive‐behavioural therapy for insomnia on improving the accuracy of sleep and wake perceptions in older adults, and tested whether changes in sleep quality were related to changes in the accuracy of sleep/wake perceptions. One‐hundred and fifty‐nine older veterans (97% male, mean age 72.2 years) who met diagnostic criteria for insomnia disorder were randomized to: (1) cognitive‐behavioural therapy for insomnia (n = 106); or (2) attention control (n = 53). Assessments were conducted at baseline, post‐treatment, 6‐months and 12‐months follow‐up. Sleep measures included objective (via wrist actigraphy) and subjective (via self‐report diary) total sleep time and total wake time, along with Pittsburgh Sleep Quality Index score. Discrepancy was computed as the difference between objective and subjective estimates of wake and sleep. Minutes of discrepancy were compared between groups across time, as were the relationships between Pittsburgh Sleep Quality Index scores and subsequent changes in discrepancy. Compared with controls, participants randomized to cognitive‐behavioural therapy for insomnia became more accurate (i.e. minutes discrepancy was reduced) in their perceptions of sleep/wake at post‐treatment, 6‐months and 12‐months follow‐up (p < .05). Improved Pittsburgh Sleep Quality Index scores at each study assessment preceded and predicted reduced discrepancy at the next study assessment (p < .05). Cognitive‐behavioural therapy for insomnia reduces sleep/wake discrepancy among older adults with insomnia. The reductions may be driven by improvements in sleep quality. Improving sleep quality appears to be a viable path to improving sleep perception and may contribute to the underlying effectiveness of cognitive‐behavioural therapy for insomnia.
Short sleep—poor sleep? A polysomnographic study in a large population‐based sample of women
Authors: Åkerstedt Torbjörn , Schwarz Johanna , Gruber Georg , Theorell‐Haglöw Jenny , Lindberg Eva
Published: January 2019

There is a lack of studies on the association between total sleep time (TST) and other polysomnographical parameters. A key question is whether a short sleep is an expression of habitual short sleep, or whether it reflects temporary impairment. The purpose of the present study was to investigate the association between TST and amount of sleep stages and sleep continuity measures, in a large population‐based sample of women (n = 385), sleeping at home in a normal daily life setting. The results show that sleep efficiency, N1 (min), N2 (min), REM (min), REM% and proportion of long sleep segments, increased with increasing TST, whereas the number of awakenings/hr, the number of arousals/hr, N1% and REM intensity decreased. In addition, longer sleep was more associated with TST being perceived as of “usual” duration and with better subjective sleep quality. TST was not associated with habitual reported sleep duration. It was concluded that short TST of a recorded sleep in a real‐life context may be an indicator of poor objective sleep quality for that particular sleep episode. Because individuals clearly perceived this reduction, it appears that self‐reports of poor sleep quality often may be seen as indicators of poor sleep quality. It is also concluded that PSG‐recorded sleep duration does not reflect habitual reported sleep duration in the present real‐life context.
Feeding of juvenile cobia,Rachycentron canadum: Evaluation of practical feeds, comparison of commercial fishmeal replacers, and estimation of essential amino acid requirements
Authors: Raggi Thiago , Tacon Albert G. J. , Lemos Daniel
Published: January 2019

Three studies were conducted with juvenile cobia,Rachycentron canadum: (Study 1) a 10‐week feeding trial within floating net cages to test the nutritional efficacy of different dietary feeding regimes (trash‐fish control diet, a semimoist diet, an in‐house dry formulated diet, and a commercial cobia feed); (Study 2) a 10‐week feeding trial within an indoor water‐recirculating tank‐based system to test the nutritional efficiency of different potential dietary fishmeal replacers (poultry byproduct meal, soy protein concentrate, feather meal), a diet without taurine supplementation, and a commercial cobia feed; and (Study 3) estimation of the essential amino acid (EAA) requirements of cobia based on EAA whole‐body composition in fast‐growing cobia fed a trash‐fish‐based diet. Fish performance in terms of growth and feed efficiency was the greatest within the outdoor net‐cage feeding trial, with fish fed the control trash‐fish‐based diet exhibiting the best performance. Although fish growth was poorer within the indoor feeding trials, fish performance was similar for most diets, with apparent crude protein digestibility coefficients of over 75% being obtained in all experimental diets in both feeding trials. The estimated EAA requirements of cobia obtained during this study were similar to those reported for other similar marine carnivorous fish species.
Imagining informal empire: Nineteenth‐century British literature and Latin America
Authors: Knox Marisa Palacios
Published: January 2019

This essay examines the emerging field of literary scholarship on Great Britain's “informal empire” in nineteenth‐century Latin America following independence from the Spanish and Portuguese empires. While “informal empire” was originally theorized as a concept within the field of economic history to describe the means by which Great Britain exercised political influence in sovereign states of Latin America through finance and commerce, it has also become a useful framework with which to analyze the literature of the period and its varied depictions of Latin America in multiple, overlapping forms: travel writing, science writing, poems, and novels. Just as some historians argue that informal empire is essentially the continuation of formal empire, some literary scholars read Romantic and Victorian literature about Latin America as another form of imperialist dominance. Most recent criticism, however, has highlighted the ambiguities, paradoxes, and ironies of nineteenth‐century British literature of informal empire, which seems to dwell on failure as much as fantasy, and the inaccessible past as much as the present and future.
Determinants of growth in HIV‐exposed and HIV‐uninfected infants in the Kabeho Study
Authors: Lane Charlotte E. , Bobrow Emily A. , Ndatimana Diuedonne , Ndayisaba Gilles F. , Adair Linda S.
Published: January 2019

HIV‐exposed and HIV‐uninfected (HEU) infants may be at increased risk of poor health and growth outcomes. We characterized infant growth trajectories in a cohort of HEU infants to identify factors associated with healthy growth. HIV‐positive women participating in prevention of mother‐to‐child HIV transmission programmes in Kigali, Rwanda, were followed until their infants were 2 years old. Infant anthropometrics were regularly collected. Latent class analysis was used to categorize infant growth trajectories. Multiple logistic regression was used to estimate the odds of infants belonging to each growth trajectory class. On average, this population of HEU infants had moderate linear growth faltering, but only modest faltering in weight, resulting in mean weight‐for‐length z‐score (WLZ) above the World Health Organization (WHO) median. Mean WLZ was 0.53, and mean length‐for‐age z‐score (LAZ) was −1.14 over the first 2 years of life. We identified four unique WLZ trajectories and seven trajectories in LAZ. Low neonatal weight‐for‐age and a high rate of illness increased the likelihood that infants were in the lightest WLZ class. Shorter mothers were more likely to have infants with linear growth faltering. Female infants who were older at the end of exclusive breastfeeding were more likely to be in the second tallest LAZ class. In conclusion, the current WHO recommendations of Option B+ and extended breastfeeding may induce higher WLZ and lower LAZ early in infancy. However, there is considerable heterogeneity in growth patterns that is obscured by simply analysing average growth trends, necessitating the analysis of growth in subpopulations.
Altered globotriaosylceramide accumulation and mucosal neuronal fiber density in the colon of the Fabry disease mouse model
Authors: Masotti Martina , Delprete Cecilia , Dothel Giovanni , Donadio Vincenzo , Rimondini Roberto , Politei Juan Manuel , Liguori Rocco , Caprini Marco
Published: January 2019

Background

Fabry disease (FD) is a hereditary X‐linked metabolic storage disorder characterized by deficient or absent lysosomal α‐galactosidase A (α‐Gal A) activity. This deficiency causes progressive accumulation of glycosphingolipids, primarily globotriaosylceramide (Gb3), in nearly all organ systems. Gastrointestinal (GI) symptoms can be very debilitating and are among the most frequent and earliest of the disease. As the pathophysiology of these symptoms is poorly understood, we carried out a morphological and molecular characterization of the GI tract in α‐Gal A knockout mice colon in order to reveal the underlying mechanisms.

Methods

Here, we performed the first morphological and biomolecular characterization of the colon wall structure in the GI tract of the α‐Gal A knock‐out mouse (α‐Gal A −/0), a murine model of FD.

Key Results

Our data show a greater thickness of the gastrointestinal wall in α‐Gal A (−/0) mice due to enlarged myenteric plexus' ganglia. This change is paralleled by a marked Gb3 accumulation in the gastrointestinal wall and a decreased and scattered pattern of mucosal nerve fibers.

Conclusions and Inferences

The observed alterations are likely to be a leading cause of gut motor dysfunctions experienced by FD patients and imply that the α‐Gal A (−/0) male mouse represents a reliable model for translational studies on enteropathic pain and GI symptoms in FD.
Prevention of physical restraint use among nursing home residents in Australia: The top three recommendations from experts and stakeholders
Authors: Bellenger Emma N. , Ibrahim Joseph E. , Kennedy Briohny , Bugeja Lyndal
Published: January 2019

Objective

To develop and prioritise recommendations to prevent the use of physical restraints among nursing home residents.

Methods

This study comprised two expert and stakeholder consultation forums using a modified nominal group technique and a follow‐up electronic survey to rank the final set of recommendations.

Results

There were 15 recommendations formulated to prevent the use of physical restraint among nursing home residents. The three recommendations ranked as most important were that: a single definition be mandated for describing “physical restraint”; use of physical restraint acts as a trigger for mandatory referral to a specialist aged care team; and nursing home staff profile and competencies are appropriate to meet the complex needs of residents with dementia and obviate the need to apply physical restraint.

Conclusions

Future studies should investigate the feasibility of implementing these recommendations and whether the proposed interventions reduce the use of physical restraint.

Implications

Implementation of recommendations to prevent the use of physical restraint may assist nursing home staff, providers and policy makers to deliver improved care that is more aligned with contemporary views of human rights.
Single injection ultrasound‐guided rectus sheath blocks for children: Distribution of injected anesthetic
Authors: Visoiu Mihaela , Hauber John , Scholz Stefan
Published: January 2019

Background

Single injection ultrasound‐guided rectus sheath blocks are used for postoperative analgesia after midline abdominal incisions, but the ultrasonographic spread of medication posterior to the rectus muscle has not been investigated.

Aims

The primary goal of this study was to determine the ultrasound‐measured medication spread superiorly and inferiorly after single injection ultrasound‐guided rectus sheath blocks and to calculate the incidence of cases with spread up to the subcostal margin and below of umbilicus. The secondary goals were to correlate the spread with the volume of medication administered and with the patient's age, weight, height, sex, and body mass index.

Methods

Pediatric patients who underwent single injection ultrasound‐guided rectus sheath blocks and underwent data collection of ultrasonographic information on medication spread along the plane of the posterior rectus sheath were identified retrospectively from an acute pain service database at UPMC Children's Hospital of Pittsburgh.

Results

Sixty‐eight children, 10.2 ± 4.2 (mean ± SD) years old, 41.7 ± 17.9 kg, 140 ± 24.6 cm, had complete data collection. Mean injected volume of ropivacaine was 8.3 ± 2.8 mL (right) and 8.2 ± 2.8 mL (left). The average spread was measured as 3.9 ± 1.4 cm (right) and 3.4 ± 1.3 cm (left) cranial to the umbilicus, and 1.5 ± 1.6 cm (right) and 1.6 ± 1.4 cm (left) caudal to the umbilicus. Complete spread up to the level of the subcostal margin was observed in 52.9% (n = 36; right) and 36.8% (n = 25; left) of cases. The spread correlated closely with the volume of injected ropivacaine (right: 0.556, P < 0.001; left: 0.541, P < 0.001). The spread below umbilicus was 70.6% (n = 48, right) and 80.9% (n = 55, left). There was a positive strong correlation (P < 0.001) between total medication spread and age (right: 0.608; left: 0.538), weight (right: 0.600; left: 0.540), and height (right: 0.593; left: 0.526).

Conclusion

After single injection ultrasound‐guided rectus sheath blocks, incomplete cephalocaudal medication spread can be expected within the posterior rectus sheath.
Moderate‐severe primary graft dysfunction after pediatric heart transplantation
Authors: Mowers Katie L. , Simpson Kathleen E. , Gazit Avihu Z. , Eghtesady Pirooz , Canter Charles E. , Castleberry Chesney D.
Published: January 2019

Background

PGD is a complication after heart transplantation (OHT) and a significant cause of mortality, particularly in infant recipients. Lack of standardized definition of PGD in the pediatric population makes the prevalence and magnitude of impact unclear.

Methods

ISHLT PGD consensus guidelines, which include inotrope scores and need for MCS, were applied retrospectively to 208 pediatric OHT recipients from a single institution from 1/2005‐5/2016. PGD was defined as: moderate PGD—inotrope score >10 on postoperative day 1 (24‐48 hours), and severe PGD—MCS within 24 hours (in the absence of detectable rejection).

Results

PGD occurred in 34 patients (16.3%); 14 of which had severe PGD (6.7%). Multivariate risk factors for PGD included CPB time (OR 10.3/10 min, 95% 10.05, 10.2, P = 0.03), Fontan palliation (OR 1.9, 95% 1.2, 3.97), and PCM (OR 5.65, 95% 1.52, 22.4); but not age, weight, ischemic time, or donor characteristics. Upon sub‐analysis excluding patients with PCM, increased CPB was a significant multivariate risk factor (OR 10.09, 95% 9.89, 10.12, P = 0.003). Patients with PGD had decreased discharge survival compared to those without PGD (85% vs 96%, P < 0.01). Severe PGD was associated with the poorest 1‐year survival (57% vs 91% without PGD, P = 0.04).

Conclusion

Patients with prolonged CPB are potentially at risk for developing PGD. Neither infant recipients nor donor characteristics were associated with an increased risk of PGD in the current era.
Competition, Conflict, and Conformity: Foreign Policy Making in the First Year of the Trump Presidency
Authors: da Vinha Luis
Published: January 2019

Donald Trump won the presidency by presenting himself to the electorate as someone who “could get things done” and by promising to upend policy making in Washington. However, the first year of the Trump presidency has been characterized as disorganized and chaotic. The president’s policy detachment and his penchant for improvisation and proclivity for heeding nontraditional sources of information have contributed to this generalized perception. This article assesses Trump’s management style and identifies the main dynamics involved in the administration’s foreign policy–making process in its first year in office by analyzing how the advisory system functioned in the decisions to withdraw from the Paris Agreement on climate change, decertify the Joint Comprehensive Plan of Action, and recognize Jerusalem as the capital of Israel.
Striking coincidences: How realists should reason about them
Authors: Hopster Jeroen
Published: January 2019

Many metaethicists assume that our normative judgments are both by and large true, and the product of causal forces. In other words, many metaethicists assume that the set of normative judgments that causal forces have led us to make largely coincides with the set of true normative judgments. How should we explain this coincidence? This is what Sharon Street (2006) calls the practical/theoretical puzzle. Some metaethicists can easily solve this puzzle, but not all of them can, Street argues; she takes the puzzle to constitute a specific challenge for normative realism. In this article I elucidate Street’s puzzle and outline possible solutions to it, framed in terms of a general strategy for reasoning about coincidences. I argue that the success of Street’s challenge crucially depends on how we set the ‘reference class’ of normative judgments that we could have endorsed, assuming realism. I conclude that while the practical/theoretical puzzle falls short of posing a general challenge for normative realism, it can be successful as a selective challenge for specific realist views.
Genesis of the Xiuwenghala Gold Deposit in the Beishan Orogen, Northwest China: Evidence from Geology, Fluid Inclusion, and H–O–S–Pb Isotopes
Authors: Wang Qisong , Zhang Jing , Shu Sunping , Lai Chunkit , Xu Bowen , Sun Haiwei
Published: January 2019

The Xiuwenghala gold deposit is located in the Beishan Orogen of the southern Central Asian Orogenic Belt. The vein/lenticular gold orebodies are controlled by Northeast‐trending faults and are hosted mainly in the brecciated/altered tuff and rhyolite porphyry of the Lower Carboniferous Baishan Formation. Metallic minerals include mainly pyrite and minor chalcopyrite, arsenopyrite, galena, and sphalerite, whilst nonmetallic minerals include quartz, chalcedony, sericite, chlorite, and calcite. Hydrothermal alterations consist of silicic, sericite, chlorite, and carbonate. Alteration/mineralization processes comprise three stages: pre‐ore silicic alteration (Stage I), syn‐ore quartz‐chalcedony‐polymetallic sulfide mineralization (Stage II), and post‐ore quartz‐calcite veining (Stage III). Fluid inclusions (FIs) in quartz and calcite are dominated by L‐type with minor V‐type and lack any daughter mineral‐bearing or CO2‐rich/‐bearing inclusions. From Stages I to III, the FIs homogenized at 240–260°C, 220–250°C, and 150–190°C, with corresponding salinities of 2.9–10.9, 3.2–11.1, and 2.9–11.9 wt.% NaCl eqv., respectively. The mineralization depth at Xiuwenghala is estimated to be relatively shallow (<1 km). FI results indicate that the ore‐forming fluids belong to a low to medium‐temperature, low‐salinity, and low‐density NaCl‐H2O system. The values decrease from Stage I to III (3.7‰, 1.7–2.4‰, and −1.7 to 0.9‰, respectively), and a similar trend is found for their values (−104 to −90‰, −126 to −86‰, and −130 to −106‰, respectively). This indicates that the fluid source gradually evolved from magmatic to meteoric. δ34S values of the hydrothermal pyrites (−3.0 to 0.0‰; avg. −1.1‰) resemble those of typical magmatic/mantle‐derived sulfides. Pyrite Pb isotopic compositions (206Pb/204Pb = 18.409–18.767, 207Pb/204Pb = 15.600–15.715, 208Pb/204Pb = 38.173–38.654) are similar to those of the (sub)volcanic ore host, indicating that the origin of ore‐forming material was mainly the upper crustal (sub)volcanic rocks. Integrating evidence from geology, FIs, and H–O–S–Pb isotopes, we suggest that Xiuwenghala is best classified as a low‐sulfidation epithermal gold deposit.
Sudden stops in a currency union – some lessons from the euro area
Authors: Kraus Lena , Beier Jürgen , Herz Bernhard
Published: January 2019

During the Great Financial Crisis several euro area Member States with current account deficits were subject to sharp reversals of private capital flows. We examine how the specific policy rules of the euro area's payments system TARGET2 affects the macroeconomic adjustments to sudden stops. We find that – in the short run – public capital flows in form of TARGET2 help euro area‐deficit countries to stabilize output, consumption, and investment after a sudden stop of private capital inflows. In the long run, however, euro area countries suffer under a prolonged economic recovery and accumulated large public debt as well as higher welfare losses relative to euro peggers.
Income Inequality, Ethnic Diversity, and State Minimum Wages
Authors: Foster John , Gonzalez Luis J. , Lopes Carlos
Published: January 2019

Objectives

The objective of the current study is to examine the determinants of wage floors set by state governments in the United States, with a particular focus on the effects of income inequality and ethnic diversity.

Method

We estimate the effects of income inequality, ethnic diversity, and their interaction on real state minimum wages using a state‐level panel of Census demographic data from 1981 to 2010. We also control for state‐level demographics and additional state‐level information, such as measures of voter and government liberalism, along with time and state fixed effects.

Results

We find that the impact of income inequality is mediated by ethnic diversity. When states are highly ethnically homogeneous, increases in income inequality are associated with higher state minimum wages. When states are highly ethnically heterogeneous, increases in income inequality are associated with lower state minimum wages. The impact of income inequality lacks statistical significance when levels of ethnic diversity are either average or somewhat below average.

Conclusions

Overall, our results suggest that the negative impact on state minimum wages in heterogeneous states could stem from rising income inequality, which increases the social distance between whites and other ethnic groups and weakens mass support for wage policies that are believed by the public to be beneficial to the poor.
Safety of blood donation by individuals over age 70 and their contribution to the blood supply in five developed countries: a BEST Collaborative group study
Authors: Goldman Mindy , Germain Marc , Grégoire Yves , Vassallo Ralph R. , Kamel Hany , Bravo Marjorie , Irving David O. , Di Angelantonio Emanuele , Steele Whitney R. , O'Brien Sheila F. ,   for the Biomedical Excellence for Safer Transfusion Collaborative (BEST) Investigators
Published: January 2019

BACKGROUND

Some countries impose an upper age limit on whole blood and double RBC donation while others do not. We evaluated the safety of blood donation in older individuals (≥71 years), and their contribution to the blood supply of five countries.

STUDY DESIGN AND METHODS

Twelve blood center members of the Biomedical Excellence for Safer Transfusion (BEST) Collaborative from four countries with no upper age limit for whole blood and double RBC donation (Canada, New Zealand, England, and the United States) or an upper age limit of 80 (Australia) provided 2016 data on donors and donations, deferral rates, and vasovagal reactions by donor age and sex. Donors under age 24 were included in the number of total donors and donations, but not in deferral and reaction rate comparisons.

RESULTS

Older donors accounted for 1.0% (New Zealand) to 4.3% (United States) of donors, and 1.5% (New Zealand) to 5.6% (United States) of donations; most were between ages 71 and 76. The deferral rate was higher in older compared to 24‐ to 70‐year‐old males, but very similar between older and younger females. In contrast, vasovagal reaction rates were either lower (male donors) or similar (female donor for reactions with loss of consciousness) in older compared to 24‐ to 70‐year‐old donors.

CONCLUSIONS

Exclusion solely based on older age appears to be unwarranted based on safety concerns such as donor reactions. Healthy older individuals can continue to safely donate and make a significant contribution to the blood supply past arbitrary age limits.
Improving safety in blood transfusion using failure mode and effect analysis
Authors: Mora Asunción , Ayala Luis , Bielza Rafael , Ataúlfo González F. , Villegas Ana
Published: January 2019

BACKGROUND

One of the medical areas where errors can have more serious consequences is the process of blood transfusion. We used failure mode and effect analysis (FMEA) for evaluating potential failures and improving transfusion safety in a medium‐size urban hospital with a highly complex transfusion service.

STUDY DESIGN AND METHODS

Each failure mode was evaluated using the likelihood of occurrence, severity of the effect, and probability of detection. The obtained results allowed each failure to be prioritized and decisions to be made in an organized manner to determine solutions. We define measures and indicators that allow the comparison of their results in a longer time period than most of the previous studies.

RESULTS

The most important failures were those regarding 1) transmitting information about the transfusion request, 2) patient identification, 3) sample identification, 4) cross‐matching ordered tests, 5) transfusing blood components, 6) completing and sending the transfusion control document, and 7) reporting of transfusion reactions. The application of the FMEA methodology allowed implementation of safety measures and monitoring of the measures using indicators, including the mandatory records of the hemovigilance system. There was a 56% improvement in the risk prioritization numbers in the second stage of the FMEA.

CONCLUSION

FMEA allows for identification of factors that reduce safety in this hospital, analysis of the causes and consequences of these errors, design of corrective measures, and establishment of indicators to monitor their application. The FMEA methodology can help other institutions to identify their own specific vulnerabilities.
Outcomes of horses treated with removal of a laryngoplasty prosthesis
Authors: Fitzharris Laura E. , Lane J. Geoffrey , Allen Kate J.
Published: January 2019

Objective

To determine the proportion of horses treated by laryngoplasty prosthesis removal (LPR) for complications associated with prosthetic laryngoplasty (LP), the reason for LPR, and the outcome of horses undergoing LPR to manage iatrogenic coughing/dysphagia.

Study design

Retrospective study.

Sample population

Client‐owned horses treated with LP (n = 1202) and LPR (n = 58).

Methods

Clinical case records were reviewed to determine the number of horses treated with LP and LPR by the same surgeon. Historical, clinical, endoscopic, and surgical data were extracted for those horses undergoing LPR. Long‐term outcome was assessed by questionnaire.

Results

The proportion of horses treated with LP and subsequently treated with LPR by the same surgeon was 3.5% (42/1202). Coughing/dysphagia was the reason for LPR in 90% (52/58) of horses. Sufficient follow‐up to determine outcome in horses undergoing LPR for coughing/dysphagia was available in 32 horses. Arytenoid abduction grade at the time of LPR did not influence clinical response (P = .416). Presenting clinical signs resolved after LPR in 21 of 32 (66%) horses, and 24 of 32 (75%) horses returned to exercise.

Conclusion

Coughing/dysphagia was the most common reason for LPR. Clinical signs improved in most horses after LPR.

Clinical significance

Laryngoplasty prosthesis removal can be a useful treatment option for horses affected with unmanageable coughing/dysphagia caused by LP.