bluuebunny/crossref_metadata_2025 huggingface dataset:
Ausstattung und Betrieb eines Heißlabores − Ein Handbuch zur Qualitätssicherung der Kit-basierten Zubereitung radioaktiver Arzneimittel (nach §13 Abs. 2b AMG)
Authors: Walte Almut , Brandau Wolfgang , Meyer Geerd-J.
Published: December 2018

Die hier vorgestellte Übersicht beinhaltet primär ein „Handbuch zur Qualitätssicherung der Kit-basierten Zubereitung radioaktiver Arzneimittel (nach § 13 Abs. 2b AMG)“.

Dieses Handbuch kann und darf als „eins-zu-eins-Grundlage“ für die Praxis- bzw. Heißlabor-eigene Dokumentation rund um diese Radiopharmaka genutzt werden. Die enthaltenen Anforderungen sind im pharmazeutischen Sinne Minimalanforderungen, die aus Sicht der Autoren für jede Einrichtung und insbesondere für den niedergelassenen Nuklearmediziner umsetzbar sein sollten und dabei trotzdem dem Stand von Wissenschaft und Technik gerecht werden.

Thematisch werden der Strahlenschutz, die Qualifikation des Personals, die Anforderungen an Räume, Ausrüstung und Ausgangsstoffe, die Hygieneanforderungen und -überwachung, die Zubereitung und Prüfung als auch allgemeine qualitätssichernde Maßnahmen abgedeckt.
Herstellung von PET-Radiopharmaka in der Klinik – Aktuelle Rahmenbedingungen und Qualitätssicherung
Authors: Kienzle Gabriele , Reischl Gerald
Published: December 2018

Radiopharmaka, die mit Positronen-Emittern markiert sind, werden zumindest in Deutschland meist in Kliniken vor Ort hergestellt, die Nuklide stammen vom hauseigenen Zyklotron. Nur wenige dieser Radiopharmaka sind zugelassen und kommerziell erhältlich (wichtigstes Beispiel: 2-Deoxy-2-[18F]fluor-D-glucose, FDG). Syntheseprozesse sind komplexer und aufwendiger als Herstellungen aus zugelassenen Kits und Nukliden aus zugelassenen Generatoren. Auch die Anforderungen an die Qualitätskontrolle sind deutlich höher. Erfolgt die Herstellung unter einer offiziellen Herstellungserlaubnis, sind die Regeln der „Guten Herstellungspraxis“ (Good-Manufacturing-Praxis, GMP) anzuwenden. Auch die in Deutschland verbreitete Radiopharmaka-Herstellung unter Verantwortung eines Arztes (Arzneimittelgesetz, AMG § 13 2b) hat Qualitätsstandards zu genügen. GMP ist ein Qualitätssicherungs-System, das alle Aspekte der Herstellung betrachtet, um eine Gefährdung von Patienten durch das Arzneimittel zu minimieren. Für Räumlichkeiten, Ausrüstung, Personal, Produktion, Qualitätskontrolle, Umgang mit Produktmängeln, Inspektionen und Dokumentation sind formale Kriterien zu beachten. Qualifizierung und Validierung spielen dabei eine fundamentale Rolle. Die Herstellung hat in Räumen der Reinraumklasse C zu erfolgen, Abfüllung und Aufteilung in Klasse A. Hohe Investitionen und hoher Herstellungsaufwand rechtfertigen sich jedoch durch die stetig wachsende Bedeutung der Positronen-Emissions-Tomografie (PET) als bildgebender Diagnostik im Rahmen der Individualisierung therapeutischer Verfahren.
Assoziationen zwischen der Rumpfkraft und judospezifischen Anriss-Leistungen von Judoka
Authors: Helm Norman , Prieske Olaf , Muehlbauer Thomas , Krüger Tom , Retzlaff Matthias , Granacher Urs
Published: December 2018

Hintergrund Eine gut ausgeprägte Rumpfstabilität ist eine wichtige Voraussetzung für die Mobilität der oberen und unteren Extremitäten während des sportlichen Bewegungsvollzugs. Vor diesem Hintergrund könnte die Rumpfkraft ein leistungsdeterminierender Faktor bei der Ausführung judospezifischer Bewegungen darstellen. Das Ziel der vorliegenden Studie war es, statistische Zusammenhänge zwischen der Rumpfkraft und kinetischen Parametern bei Anriss-Bewegungen von Judoka zu untersuchen.

Methode An der Untersuchung nahmen 21 leistungsorientierte Judoka mit einem mittleren Alter von 22 ± 4 Jahre und einem Trainingsumfang von 15 ± 4 Stunden pro Woche teil. Das maximale isokinetische Drehmoment (PIT) der Rumpfflexoren (PITFlex), -extensoren (PITEx) und -rotatoren (PITRot) wurde unter Verwendung eines isokinetischen Dynamometers (IsoMed 2000) erfasst. Zusätzlich wurden kinetische Parameter (mechanische Arbeit [W], dynamisch-realisierte Maximalkraft [Fmax]) bei Anriss-Bewegung im Stand und bei Anriss- mit Eindrehbewegung (d. h. Morote-seoi-nage) mithilfe eines judospezifischen Mess- und Informationssystems (JERGo©) erhoben.

Ergebnisse Die statistische Analyse zeigte signifikante Korrelationen (0,62 ≤ r
P ≤ 0,72) zwischen den maximalen isokinetischen Drehmomenten (PITFlex, PITEx, PITRot) und der Anriss-Bewegung im Stand (W). Zudem konnten signifikante Zusammenhänge (0,59 ≤ r
P ≤ 0,65) zwischen den isokinetischen Tests (PITEx, PITRot) und Fmax auf der Hubarmseite bei der Anriss-Bewegung im Stand gefunden werden. Für die Anriss- mit Eindrehbewegung ergaben sich signifikante Korrelationen (0,47 ≤ r
P ≤ 0,88) zwischen den isokinetischen Tests (PITFlex, PITEx, PITRot) und Leistungskennwerten der judospezifischen Bewegung (W und Fmax), unabhängig von der untersuchten Armseite. Es wurden vergleichbare Korrelationskoeffizienten zwischen PIT der Rumpfflexoren, -extensoren und -rotatoren und judospezifischen Leistungskennwerten festgestellt. Weiterhin identifizierte die Regressionsanalyse den Kennwert PIT bei Rumpfextension als besten Prädiktor für die mechanische Arbeit bei Anriss-Bewegung im Stand (46,9 %). Bei der Anriss- mit Eindrehbewegung konnte PIT der Rumpfrotatoren auf die Hubarmseite als bester Prädiktor für die mechanische Arbeit (69,4 %) ermittelt werden.

Schlussfolgerung Die Ergebnisse zeigen, dass die Rumpfkraft, insbesondere bei der Rumpfrotationsbewegung, mit Variablen der judospezifischen Leistungskennwerte bei der Anriss- mit Eindrehbewegung assoziiert ist. Dies impliziert, dass vor allem durch rumpfrotationskräftigende Übungen Einfluss auf die Anriss- mit Eindrehbewegung (d. h. Morote-seoi-nage) genommen werden könnte.
Mit vereinter Kraft?
Authors: Oberhauser Anette
Published: December 2018

Kooperationen zwischen Heilpraktikern und Zahnärzten sind möglich in Form von Empfehlungsstrukturen, Anstellungsverhältnissen oder einer reinen Organisationsgemeinschaft. Streng anatomisch gesehen dürfte der Heilpraktiker Zahnherde nicht einmal befunden. Jedoch wird dies bislang behördlich nicht sanktioniert und es gibt noch keine Rechtsprechung dazu. Befunde zu Zahnstellung und Bissverhalten unterstehen dem Zahnarztvorbehalt. Das Kiefergelenk darf der Heilpraktiker behandeln.
Freunde, Feinde, Doppelagenten
Authors: Rauth Lisa
Published: December 2018

Das Mikrobiom des Mundes setzt sich aus mindestens 700 Bakterienarten zusammen, die Entzündungsaktivitäten im Kärper direkt beeinflussen. Der häufige Konsum von Zucker, Fleisch und verarbeiteter Nahrung kann zu einer oralen Dysbiose führen, die mäglicherweise unter anderem Parodontitis sowie artikuläre, kardiovaskuläre und rheumatische Erkrankungen verursacht. Eine zuckerfreie, gemüse- und ballaststoffreiche Ernährung, Mundhygiene und spezifische Probiotika zählen zu den wichtigsten Maβnahmen für eine gesunde orale Mikrobiota.
Mandible Growth of Wistar Rats: Effects of Malnutrition during Lactation in Adulthood Mandibular Size
Authors: Degani Jr Hugo , Babinski Monique , Ramos Cristiane , Degani Viviane , Pires Lucas , Babinski Marcio
Published: December 2018

Introduction Malnutrition is a world health issue; thus, it is imperative to know its effects during lactation. The aim of this study was to evaluate the effects of maternal protein restriction during lactation on the horizontal and vertical bone growth of the mandible, according to predetermined parameters.

Material and Methods At parturition, Wistar rat dams were randomly assigned to the following groups: (1) control, which had free access to a standard laboratory diet containing 23% of protein; (2) protein energy-restricted, which had free access to an isoenergetic, protein-restricted diet containing 8% of protein; and (3) energy-restricted group, which received limited access to commercial diet containing 23% of protein. After 21 days, all pups received free access to a standard laboratory diet containing 23% of protein until their adulthood. Afterwards, the animals were euthanized under thiopental anesthesia and their mandibles were excised. The dimensions of the excised pup mandibles were measured directly with a digital caliper.

Results The protein-restricted and the energy-restricted groups presented minor adulthood mandibular length in all parameters analyzed.

Conclusion Our results provide original information regarding the mandibular growth and indicate that the maternal nutritional state during lactation can affect the development of mandibular growth. Moreover, our results indicated that the growth dysfunction could not be restored after normalization of the diet.
Neurosciences in Buddhist India
Authors: Kumar Arushi , Kumar Raj
Published: December 2018

Neurosciences in Buddhist era was mainly based on power of mind and thoughts. It emphasized mainly about the power of mind, control of thoughts, purification, and modifications of erroneous thought process, which should result in truthful and correct practices and subsequent actions by human beings to remain happy. Buddhism believes that most diseases of human body are secondary to mind and that these can be healed by controlling the erroneous thoughts and practices of Dhamma. Though the treatment for neurologic disorders such as headache, stress, and anxiety was primitive, it was mainly based on purification of mind and righteous pathway of Dhamma followed by medicines, modification in dietary and other living habits, etc. Enough evidence (including operated case-based commentary) shows that cranial surgery was also performed following appropriate diagnosis. The concept of diagnosis, preoperative evaluation, explanation to the patient, operative procedure, perioperative care, and follow-up was also present in that era.
Perspective: Current challenges and solutions of Doppler optical coherence tomography and angiography for neuroimaging
Authors: Zhu Jiang , He Xingdao , Chen Zhongping
Published: December 2018

The nervous system, based on a complex network of nerves and cells, carries messages by transmitting signals to and from different parts of the body. The supply of blood flow in the nervous system is critical to maintain physiological functions. Optical coherence tomography (OCT) has the ability to noninvasively image the microvascular networks and accurately quantify the blood flow in vivo with high spatial and temporal resolutions in three dimensions. It has been used to measure changes in blood supplies and assess physiological functions before and after occurrences of diseases, drug administration, and external stimulation in the nervous system, especially in the brain. In this paper, we discuss current challenges of Doppler OCT and angiography in the data processing algorithms and imaging systems for neuroscience research. The advancements and feasible solutions for current challenges are proposed.
Molten core optical fiber fabrication: A versatile, simple and practical approach for producing long lengths of novel material fibers
Authors: Zhang Zhengzheng
Published: December 2018

The history, materials, challenges and promises of the molten core method, a flexible and versatile method for fabricating long-length novel optical fibers.
How Local Health Districts can prepare for the effects of climate change: an adaptation model applied to metropolitan Sydney
Authors: Rychetnik Lucie , Sainsbury Peter , Stewart Greg
Published: December 2018

Climate change adaptation can be defined as a form of risk management (i.e. assessing climate change-related risks and responding appropriately so that the risks can be pre-emptively minimised and managed as they arise). Adapting to climate change by hospital and community health services will entail responding to changing health needs of the local population, and to the likely effects of climate change on health service resources, workforce and infrastructure. In this paper we apply a model that health services can use to predict and respond to climate change risks and illustrate this with reference to Sydney’s Local Health Districts (LHDs). We outline the climate change predictions for the Sydney metropolitan area, discuss the resulting vulnerabilities for LHDs and consider the potential of LHDs to respond. Three ‘core business’ categories are examined: (1) ambulance, emergency and acute health care; (2) routine health care; and (3) population and preventative health services. We consider the key climate change risks and vulnerabilities of the LHDs’ workforce, facilities and finances, and some important transboundary issues. Many Australian health services have existing robust disaster plans and management networks. These could be expanded to incorporate local climate and health adaptation plans.

What is known about the topic?
There is an inextricable relationship between climate change and human health, with important implications for the delivery of health services. Climate change will affect health service demand, and the resources, workforce and infrastructure of health services.

What does this paper add?
This paper outlines how local health services can use existing data sources and models for assessing their climate change-related risks and vulnerabilities to predict, prepare for and respond to those risks. This is illustrated with reference to Sydney’s LHDs.

What are the implications for practitioners?
Adaptation to climate change by health services is an important component of risk management. Local health services need to prepare for the effects of climate change by assessing the risks and developing and implementing climate and health adaptation plans.
Post-release breeding of translocated sharp-tailed grouse and an absence of artificial insemination effects
Authors: Mathews Steven R. , Coates Peter S. , Fike Jennifer A. , Schneider Helena , Fischer Dominik , Oyler-McCance Sara J. , Lierz Michael , Delehanty David J.
Published: December 2018

Context
Translocation has become a widely used method to restore wildlife populations following extirpation. For some species, such as lekking grouse, which breed at traditional mating grounds, reproduction is linked to culturally established geographic locations. Cultural centres are lost upon extirpation, making restoration into otherwise rehabilitated habitats especially challenging. The process by which species with culturally dependent reproduction sometimes become re-established is poorly understood and merits investigation to improve conservation strategies.
Historically, population restoration of North American lekking grouse (Tympanuchus spp. and Centrocercus spp.) via translocation has yielded poor results, in part because translocation sites lack leks, culturally determined breeding locations for which breeding adults form a high degree of philopatry. Columbian sharp-tailed grouse (Tympanuchus phasianellus columbianus; CSTG) occurs in <10% of its historic range, but the existence of rehabilitated historic habitat provides for the potential of population restoration via translocation.

Aims
We reintroduced CSTG to vacant habitat in north-central Nevada, USA, from 2013 to 2017, with concordant goals of promoting females to nest and males to lek. We tested the utility of performing artificial insemination (AI) on females before translocation and we conducted paternity analyses to understand male reproduction.

Methods
We monitored females for the effects of AI on nest initiation, nest survival and egg fertility. We used post-hatch extra-embryonic membranes and other tissues to evaluate paternity of chicks produced at the restoration site.

Key results
Artificial insemination had no effect on female survival or nest initiation, and did not fertilise any eggs within nine sampled clutches (n=102 eggs). Most paternity was attributable to male residents that had survived for ≥1 year at the restoration site before the arrival of translocated females.

Conclusions
Artificial insemination neither aided nor harmed female reproduction. A small number of translocated, resident adult males sired reproduction following female release.

Implications
The presence of resident males at restoration sites may be more likely to result in post-translocation reproduction than is pre-translocation AI. Restoring CSTG to vacant habitat should focus on translocating females into suitable nesting habitat while simultaneously ensuring that reproductively capable males are available within or adjacent to the nesting habitat.
The impact of Hajj satisfaction on Islamic religious commitment: a theoretical framework.
Authors: Utomo S. B. , Scott N. , Jin Xin Jin Xin
Published: December 2018

This chapter aims to discusses the impact of the Hajj experience on Islamic religious commitment in Indonesia. To do so the chapter adopts the investment model of commitment (IMC) used in the psychology literature to provide a theoretical framework for studying Hajj experiences. IMC claims that relationship commitment has three antecedents: satisfaction level, quality of alternatives and investment size. The quality of alternatives was excluded in this study as there is no alternative in undertaking Hajj.
Food security: a plant pathology perspective.
Authors: Hollier C. A.
Published: December 2018

Food Security has four dimensions: food availability, food access, economic access to food and food utilization. There is a fifth dimension, sometimes referred to as stability of food. Embedded within each of these four dimensions are sub-dimensions. Historically, production was the focus of concern, but today there is more interest in imports and stockpiles because almost every country in the world today relies on trade and imports with food security. No country is totally self-sufficient in food in today's environment. Plant diseases play a major role in the production of food. Their influence on food security is expressed by the epidemics they cause, the reduction in production and post-harvest deterioration reducing available food for a hungry world.
The COP9 signalosome influences the epigenetic landscape of Arabidopsis thaliana
Authors: Tuller Tamir , Diament Alon , Yahalom Avital , Zemach Assaf , Atar Shimshi , Chamovitz Daniel A
Published: December 2018

Motivation

The COP9 signalosome is a highly conserved multi-protein complex consisting of eight subunits, which influences key developmental pathways through its regulation of protein stability and transcription. In Arabidopsis thaliana, mutations in the COP9 signalosome exhibit a number of diverse pleiotropic phenotypes. Total or partial loss of COP9 signalosome function in Arabidopsis leads to misregulation of a number of genes involved in DNA methylation, suggesting that part of the pleiotropic phenotype is due to global effects on DNA methylation.

Results

We determined and analyzed the methylomes and transcriptomes of both partial- and total-loss-of-function Arabidopsis mutants of the COP9 signalosome. Our results support the hypothesis that the COP9 signalosome has a global genome-wide effect on methylation and that this effect is at least partially encoded in the DNA. Our analyses suggest that COP9 signalosome-dependent methylation is related to gene expression regulation in various ways. Differentially methylated regions tend to be closer in the 3D conformation of the genome to differentially expressed genes. These results suggest that the COP9 signalosome has a more comprehensive effect on gene expression than thought before, and this is partially related to regulation of methylation. The high level of COP9 signalosome conservation among eukaryotes may also suggest that COP9 signalosome regulates methylation not only in plants but also in other eukaryotes, including humans.

Supplementary information

Supplementary data are available at Bioinformatics online.
Prognostic implications of small left atria on hospitalized patients
Authors: Rozenbaum Zach , Topilsky Yan , Aviram Galit , Entin-Meer Michal , Granot Yoav , Pereg David , Berliner Shlomo , Steinvil Arie , Biner Simon
Published: December 2018

Aims

To demonstrate the association between small left atria (LA) and outcome in a relatively large heterogeneous population of hospitalized patients.

Methods and results

In a single-centre retrospective study, all inpatients that underwent an echocardiographic assessment between 2011 and 2016 and had an available left atrial volume index (LAVI) measurement were included. The cohort consisted of 17 343 inpatients who had an available LAVI measurement, 288 with small LA (LAVI <16 mL/m2), 7531 patients had LAVI within normal limits (16–34 mL/m2) divided into low normal (16–24.9 mL/m2; n = 2636) and high normal (25–34 mL/m2; n = 4895), 4720 patients had large LAVI (34.1–45 mL/m2) and 4804 had very large LAVI (>45 mL/m2). Median follow-up time was 2.4 years. After adjustments for age, gender, and baseline characteristics with a P-value <0.2 in univariable analyses (body mass index, haemoglobin, ischaemic heart disease, valvulopathy, atrial fibrillation, diabetes mellitus, hypertension, hyperlipidaemia, smoking, renal dysfunction, lung disease, and malignancy) small LA was associated with a higher risk for in-hospital mortality (odds ratio 2.9, 95% confidence interval (CI) 1.4–5.7; P = 0.002] and all-cause mortality [hazard ratio (HR) 2.1, 95% CI 1.6–2.8; P < 0.001] compared with high normal LA. For every mL/m2 decrease below high normal LA size the risk for in-hospital and long-term all-cause mortality increased by 10% (HR 1.1, 95% CI 1.02–1.18; P = 0.005) and 8% (HR 1.08, 95% CI 1.05–1.12; P < 0.001), respectively.

Conclusion

Small LA are independently associated poorer short- and long-term mortality. LA volume should be referred to as J-shaped in terms of mortality.

Helsinki committee approval number

0170-17-TLV.
Don’t Forget to Say “Thank You”: Toward a Modern History of Gratitude
Authors: Clay Ruthann , Stearns Peter N
Published: December 2018

Gratitude is much discussed these days as an area of research in the positive psychology movement. But the quality has not been given much historical attention—despite the surge of historical attention to other types of emotional response. This article lays out the evidence for extensive reliance on gratitude in the nineteenth-century United States and its measurable decline in the twentieth century—at least until the recent revival. From childrearing materials to comments on etiquette, both references and conventions shifted measurably. The essay goes on to establish the context for these changes, relating gratitude to developments in gender relations and, particularly, to a heightened sense of self and, arguably, of self-entitlement. Current efforts to promote gratitude operate against the contemporary historical dynamic, and the resulting tensions deserve attention from historians and psychologists alike.
An Examination of an Interviewer-Respondent Matching Protocol in a Longitudinal CATI Study
Authors: West Brady T , Elliott Michael R , Mneimneh Zeina , Wagner James , Peytchev Andy , Trappmann Mark
Published: December 2018

This article presents results from an experimental study in Germany designed to test the effectiveness of a novel protocol for matching participants in a national panel survey with interviewers employing computer-assisted telephone interviewing (CATI) on selected sociodemographic features, including sex, age, and education. We specifically focus on the ability of the protocol to engender close matches between respondents and interviewers in terms of these features, using both theory and empirical evidence to suggest that this type of matching will improve cooperation rates in surveys employing CATI. We also focus on indicators of “success” at first contact (defined as a successful interview or establishment of an appointment for an interview) as a function of whether the matching protocol was in use on a given day and whether specific types of matches generated higher rates of success overall. We find strong evidence of the protocol effectively establishing close matches, and we also observe that matches based on education proved especially effective for rates of “success” in a panel survey that focused primarily on labor market topics. We conclude with thoughts on practical implementation of this approach in other settings and suggested directions for future work in this area.
Clinical Effectiveness of an At-Home Auditory Training Program: A Randomized Controlled Trial
Authors: Humes Larry E. , Skinner Kimberly G. , Kinney Dana L. , Rogers Sara E. , Main Anna K. , Quigley Tera M.
Published: December 2018

Objectives:

To investigate the effectiveness of an at-home frequent-word auditory training procedure for use with older adults with impaired hearing wearing their own hearing aids.

Design:

Prospective, double-blind placebo-controlled randomized trial with three parallel branches: an intervention group who received the at-home auditory training; an active control group who listened to audiobooks using a similar platform at home (placebo intervention); and a passive control group who wore hearing aids and returned for outcomes, but received no intervention. Outcome measures were obtained after a 5-week period. A mixed research design was used with a between-subjects factor of group and a repeated-measures factor of time (pre- and post-treatment) to evaluate the effects of the at-home auditory training program. The intervention was completed in participants’ own homes. Baseline and outcomes measures were assessed at a university research laboratory. The participants were adults, aged 54 to 80 years, with the mild-to-moderate hearing loss. Of the 51 identified eligible participants, 45 enrolled as a volunteer sample and 43 of these completed the study. Frequent-word auditory training regimen completed intervention at home over a period of 5 weeks. The active control group listened to audiobooks (placebo intervention) and the passive control group completed no intervention. The primary outcome measure is a Connected Speech test benefit. The secondary outcome measure is a 66-item self-report profile of hearing aid performance.

Results:

Participants who received the at-home training intervention demonstrated significant improvements on aided recognition for trained materials, but no generalization of these benefits to nontrained materials was seen. This was despite reasonably good compliance with the at-home training regimen and careful verification of hearing aid function throughout the trial. Based on follow-up post-trial evaluation, the benefits observed for trained materials in the intervention group were sustained for a period of at least 8.5 months. No improvement was seen for supplemental outcome measures of hearing aid satisfaction, hearing handicap, or tolerance of background noise while listening to speech.

Conclusions:

The at-home auditory training procedure utilizing frequently occurring words was effective for the trained materials used in the procedure. No generalization was seen to nontrained materials or to perceived benefit from hearing aids.
Validation of the Knowledge and Self-management Nursing Outcomes Classification for Adults With Diabetes
Authors: Oh Hyunkyoung , Moorhead Sue
Published: December 2018

People with diabetes have to self-manage their health conditions to promote, maintain, and restore their health. The Nursing Outcomes Classification provides two outcomes for people with diabetes to evaluate their knowledge and self-management behaviors. The purpose of this study was to validate these two Nursing Outcomes Classification outcomes for adults with diabetes. A descriptive exploratory design using the Delphi technique was used. Two groups of experts were invited for validation of the outcomes. Descriptive statistics were used to determine definition adequacy, clinical usefulness, and content similarity. The Outcome Content Validity method was used to evaluate each outcome and the indicators. A total of 16 nurse experts participated in this study. The definition adequacy of the two Nursing Outcomes Classification outcomes was rated higher than 4.0 out of 5. Clinical usefulness was rated higher than 4.0 out of 5. The range of content validity of the two Nursing Outcomes Classification outcomes was from 0.89 to 0.92 (perfect score is 1.0). The invited experts reported that the content of this outcome pair was very similar. By using validated Nursing Outcomes Classification outcomes, nurses who take care of patients with diabetes can evaluate patient outcomes effectively and determine the effect of nursing interventions accurately.
Wavefront-Guided Photorefractive Keratectomy in the Treatment of High Astigmatism Following Keratoplasty
Authors: Sorkin Nir , Kreimei Mohammad , Einan-Lifshitz Adi , Mednick Zale , Belkin Avner , Chan Clara C. , Slomovic Allan R. , Rootman David S.
Published: December 2018

Purpose:

To report the outcome of wavefront-guided photorefractive keratectomy (WG-PRK) in the treatment of high astigmatism following keratoplasty.

Methods:

A retrospective, interventional analysis including patients with high astigmatism following either penetrating keratoplasty or deep anterior lamellar keratoplasty, who underwent WG-PRK.

Results:

Thirteen eyes (7 right eyes) of 12 patients (10 male) aged 35.1 ± 5.9 years were included. Preoperative astigmatism ranged between 3.00 and 5.00 D. Average follow-up time was 14.0 ± 6.2 months. Uncorrected distance visual acuity (UDVA) improved from 0.97 ± 0.58 logarithm of the minimum angle of resolution (logMAR) (Snellen equivalent ∼20/187) preoperatively to 0.13 ± 0.15 logMAR (Snellen equivalent ∼20/27) at 6 months and 0.14 ± 0.16 logMAR (Snellen equivalent ∼20/28) at the final follow-up (P = 0.001 and P = 0.002, respectively). UDVA ≥20/40 increased from 1 eye (7.7%) preoperatively to 13 eyes (100%) at 6 months and 12 eyes (92.3%) at the final follow-up (P < 0.001 for both). UDVA ≥20/25 increased from 1 eye (7.7%) preoperatively to 6 eyes (46.2%) at 6 months and at the final follow-up (P = 0.027 for both). Mean astigmatism improved from −3.98 ± 0.75 D to −1.27 ± 0.82 D and −1.40 ± 1.04 at 6 months and at the last follow-up, respectively (P = 0.001 for both). Preoperative astigmatism was ≥3.00 D in all eyes and was reduced to ≤2.50 D in all eyes at 6 months postoperatively, with 7 eyes (63.6%) having ≤1.00 D of astigmatism at both 6 months and the final follow-up.

Conclusions:

WG-PRK was safe and effective in the treatment of high and regular postkeratoplasty astigmatism.
Baseline Impedance Measured During High-resolution Esophageal Impedance Manometry in Patients With Rumination Syndrome is as Abnormal as in Patients With GERD
Authors: Halland Magnus , Ravi Karthik , Nelson Holly A , Katzka David A. , Talley Nicholas J , Crowell Michael D.
Published: December 2018

Goals and Background:

Baseline impedance measured during high-resolution impedance manometry (HRIM) can distinguish patients with gastroesophageal reflux disease (GERD) from controls, presumably due to differences in esophageal acid exposure. The characteristics of regurgitation and reflux in rumination syndrome and GERD are very different, and thus we investigated whether baseline esophageal impedance would differ in these 2 patient groups compared with controls.

Study:

We compared 20 patients with rumination syndrome with 20 patients who had GERD and 40 controls. Baseline impedance was measured over 15 seconds during the landmark period of HRIM in all 18 impedance sensors on a HRIM catheter.

Results:

The mean distal baseline impedance measured in ohms during HRIM was 1336 Ω [95% confidence interval (CI)=799, 1873) in patients with GERD, 1536 Ω in rumination syndrome (95% CI=1012, 2061), and 3379 Ω in controls (95% CI=2999, 3759) (P<0.0001). Proximal impedance was significantly lower in the GERD and rumination groups compared with controls; rumination syndrome (2026; 95% CI=1493, 2559 Ω), GERD (2572; 95% CI=2027, 3118 Ω), and controls (3412; 95% CI=3026, 3798 Ω) (P<0.001).

Conclusions:

Baseline impedance measured during HRIM in patients with rumination syndrome is significantly lower than controls and appears similar to patients with GERD both in the proximal and distal esophagus. These findings suggest that the postprandial regurgitation in rumination syndrome alters both the distal and proximal esophageal mucosal barrier.
Self-Injurious Behavior in a Patient With Dementia
Authors: Gardizi Elmar , MacKillop Emily , Gaind Gagan
Published: December 2018

Self-injurious behavior (SIB) has frequently been associated with psychiatric illness and neurological lesions as means of reducing tension or diverting from pain. However, these explanations did not capture the complexity of SIB in the case of Mr. X, a 62-year-old patient who ingested his fingers in his sleep where cognitive testing was valuable in informing diagnosis. Mr. X's SIB was severe enough that he had chewed beyond the middle phalanx for most of his fingers. Clinical symptoms included daytime sleepiness, hypnogogic hallucinations, and bradykinesia. His cognitive profile revealed declines in his intellectual functioning as well as visuospatial and executive deficits in the context of preserved attention, language, and memory. His cognitive and clinical presentation suggested that Mr. X had a neurodegenerative disorder, which may have contributed to his SIB. We believed that the most probable diagnosis may have been rapid eye movement behavioral sleep disorder in the context of Lewy bodies dementia.
Nonimmunologic Donor-Recipient Pairing, HLA Matching, and Graft Loss in Deceased Donor Kidney Transplantation
Authors: Vinson Amanda Jean , Kiberd Bryce A. , Davis Roger B. , Tennankore Karthik K.
Published: December 2018

Background

In kidney transplantation, nonimmunologic donor-recipient (D-R) pairing is generally not given the same consideration as immunologic matching. The aim of this study was to determine how nonimmunologic D-R pairing relates to independent donor and recipient factors, and to immunologic HLA match for predicting graft loss.

Methods

Seven D-R pairings (race, sex, age, weight, height, cytomegalovirus serostatus, and HLA match) were assessed for their association with the composite outcome of death or kidney graft loss using a Cox regression-based forward stepwise selection model. The best model for predicting graft loss (including nonimmunologic D-R pairings, independent D-R factors, and/or HLA match status) was determined using the Akaike Information Criterion.

Results

Twenty three thousand two hundred sixty two (29.9%) people in the derivation data set and 9892 (29.7%) in the validation data set developed the composite outcome of death or graft loss. A model that included both independent and D-R pairing variables best predicted graft loss. The c-indices for the derivation and validation models were 0.626 and 0.629, respectively. Size mismatch (MM) between donor and recipient (>30 kg [D < R} and >15 cm [D < R]) was associated with poor patient and graft survival even with 0 HLA MM, and conversely, an optimal D-R size pairing mitigated the risk of graft loss seen with 6 HLA MM.

Conclusions

D-R pairing is valuable in predicting patient and graft outcomes after kidney transplant. D-R size matching could offset the benefit and harm seen with 0 and 6 HLA MM, respectively. This is a novel finding.
Advertisement. Proposals for printing by subscription, thie third and last volume of the General History of Plants; by John Ray F. R. S. In folio.
Authors: Ray John
Published: December 2018

There having been greater progress made in the history of plants, these twenty or thirty years last past, and more new species discovered and brought to light, than in any age before
Sex-dependent differences in pain and sleep in a porcine model of Neurofibromatosis type 1
Authors: Khanna Rajesh , Moutal Aubin , White Katherine A. , Chefdeville Aude , Negrao de Assis Pedro , Cai Song , Swier Vicki J. , Bellampalli Shreya S. , Giunta Marissa D. , Darbro Benjamin W. , Quelle Dawn E. , Sieren Jessica C. , Wallace Margaret R. , Rogers Christopher S. , Meyerholz David K. , Weimer Jill M.
Published: December 2018

Neurofibromatosis Type 1 (NF1) is an autosomal dominant genetic disorder resulting from germline mutations in the NF1 gene, which encodes neurofibromin. Patients experience a variety of symptoms, but pain in the context of NF1 remains largely underrecognized. Here, we characterize nociceptive signaling and pain behaviors in a miniswine harboring a disruptive NF1 mutation (exon 42 deletion). We explore these phenotypes in relationship to collapsin response mediator protein 2 (CRMP2), a known interactor of neurofibromin. Mechanistically, we found two previously unknown phosphorylated residues of CRMP2 in NF1+/ex42del pig dorsal root ganglia (DRGs) and replicated increased voltage-gated calcium channel currents in NF1+/ex42del pig DRGs previously described in rodent models of NF1. We present the first characterization of pain-related behaviors in a pig model of NF1, identifying unchanged agitation scores, lower tactile thresholds (allodynia), and decreased response latencies to thermal laser stimulation (hyperalgesia) in the NF1 mutant animals; NF1+/ex42del pigs demonstrated sexually dimorphic behaviors. NF1+/ex42del pigs showed reduced sleep quality and increased resting, two health-related quality of life symptoms found to be comorbid in people with NF1 pain. Finally, we show decreased depolarization-evoked calcium influx in both wildtype and NF1+/ex42del pig DRGs treated with CRMP2 phosphorylation inhibitor (5)-lacosamide. Our data supports use of NF1+/ex42del pigs as an ideal model for studying NF1-associated pain and are a better model for understanding the pathophysiology of NF1 compared to rodents. Moreover, our findings demonstrate that interfering with CRMP2 phosphorylation might be a promising therapeutic strategy for NF1-related pain management.
Supporting decision making: Modeling and forecasting measles in a London borough
Authors: Edlund Stefan , Lovett Derryn , Kaufman James , Yagci Sokat Kezban , van Wijgerden Johan , Poots Alan J.
Published: December 2018

To investigate the feasibility of using freeware to model and forecast disease on a local scale, we report the results of modeling measles using a spatial patch model centered around 73 clinics in the North West London Borough of Ealing. MMR1 and MM2 immunization data was extracted for three cohorts, age 1-3, 4-6 and 7-19 and patient population was estimated using general practice profile records. We designed the measles model using the open source Spatiotemporal Epidemio-logical Modeler (STEM), extending a compartmental disease model to include both maternal immunity and delays in antibody response after immunization. Individuals above age 19 are not included in the modeling. Next, we generate an approximate 20-year model of vaccination coverage for Ea-ling. In England, children are immunized between age 1 and 2, then again at around age 5; hence immunization events are modeled for the age 1-3 and age 4-6 cohorts. Parameter values were based on measles research literature; transmission coeffi-cients were estimated using the Polymod contact data and also fitted to 2011-2012 case reporting data for Ealing. To examine possible effects of policy change, we create two scenarios A and B. In A, we increase vaccination coverage by 10% for all clinics; in B, we focus only on the bottom 10% of the poorest performing clinics (8 clinics total) and equivalently improve their coverage. Scenario A reduces measles from an initial level of 60 cases per year (2011) to 26 cases per year in 2017 (a 58% reduction), compared to the status quo which declines to 45 cases per year. Scenario B reduces measles by 44%, or to 34 cases per year in 2017. We conclude that local scale modeling is possible, and that the transparency of anal-ysis provided by an open source application lends credence to the output of the models.
Theory of concentric β-barrel structures: models of amyloid beta 42 oligomers, annular protofibrils, and transmembrane channels
Authors: Durell Stewart R. , Kayed Rakez , Guy H. Robert
Published: December 2018

Amyloid beta (Aβ) peptides are a major contributor to Alzheimer’s disease. Previously, our group proposed molecular models of Aβ42 hexamers with two concentric antiparallel β-barrels that act as seeds from which dodecamers, octadecamers, both smooth and beaded annular protofibrils, and transmembrane channels form. Since then, numerous aspects of our models have been supported by experimental findings. Here we develop a more extensive range of models to be consistent with dimensions of assemblies observed in electron microscopy images of annular protofibrils and transmembrane assemblies. These models have the following features: Dodecamers with 2-concentric β-barrels are the major components of beaded annular protofibrils (bAPFs). These beads merge to form smooth annular protofibrils (sAPFs) that have three or four concentric β-barrels. Channels form from two to nine hexamers. Antiparallel C-terminus S3 segments form an outer transmembrane β-barrel. Half of the monomers of vertically asymmetric 12mer to 36mer channels form parallel transmembrane S2 β-barrels, and S1-S2 (N-terminus and middle) segments of the other half of the monomers form aqueous domains on the cis side of the membrane. Unit cells of 42-54mers have two more transmembrane S2 segments, with four concentric β-barrels in the transmembrane region and two concentric β-barrels on the cis side of the membrane.
Synthesis of new Ln4(Al2O6F2)O2 (Ln = Sm, Eu, Gd) phases with a cuspidine-related structure
Authors: Morán-Ruiz Aroa , Wain-Martin Aritza , Orera Alodia , Sanjuán María Luisa , Larrañaga Aitor , Slater Peter R. , Arriortua Maribel
Published: December 2018

The first fluorination of the cuspidine-related phases of Ln4(Al2O7□)O2 (where Ln = Sm, Eu, Gd) is reported. A low-temperature reaction with poly(vinylidene difluoride) lead to the fluorine being substituted in place of oxygen and inserted into the vacant position between the dialuminate groups. X-ray photoelectron spectroscopy shows the presence of the F 1s photoelectron together with an increase in Al 2p and rare-earth 4d binding energies supporting F incorporation. Energy-dispersive X-ray spectroscopy analyses are consistent with the formula Ln4(Al2O6F2)O2, confirming that substitution of one oxygen by two fluoride atoms has been achieved. Rietveld refinements show an expansion in the cell upon fluorination and confirm that the incorporation of fluoride in the Ln4(Al2O7□)O2 structure results in changes in Al coordination from four to five. Thus, the isolated tetrahedral dialuminate Al2O7 groups are converted to chains of distorted square-based pyramids. These structural results are also discussed based on Raman spectra.
Intentional interprofessional leadership in maternal and child health
Authors: McGrath Eileen Romer , Bacso Devon R. , Andrews Jennifer G. , Rice Sydney A.
Published: December 2018

Purpose

This paper aims to describe an interprofessional leadership training program curriculum implemented by a new maternal and child health leadership training program, its collaboration with a well-established leadership consortium, the measures taken to evaluate this training and implications for other leadership programs.

Design/methodology/approach

The intentional leadership program weaves together the complementary core threads to create strong sets of skills in the areas of personal leadership, leading and influencing others and creating effective interprofessional partnerships with others around women and children’s health.

Findings

The strong emphasis on the incorporation of leadership competencies coupled with evidence-based leadership training strengthens students’ clinical skills, enhances workforce development and increases interdisciplinary health care practices.

Research limitations/implications

The findings presented in this paper are limited to self-reported changes in understanding components of leadership skills for self, others and the wider community and attitudes and beliefs related to interdisciplinary training and interprofessional team decision-making.

Social implications

The in-depth focus on one’s self, teams and on the wider community enhances each individual’s grasp of how people and organizations approach women and children’s health challenges and strengthens their ability to negotiate among the diverse disciplines and cultures.

Originality/value

This paper details the intentional incorporation of leadership skill development throughout an academic program and brings to focus the importance of thoughtful leadership development to prepare participants to anticipate, manage and take advantage of changes in knowledge and health care delivery systems.
The potential for greater use of meta-analysis in archival auditing research
Authors: Hay David
Published: December 2018

Purpose

The purpose of this paper is to discuss the increasing potential demand for meta-analysis studies in auditing. The paper includes a review of a new technique and meta-regression analysis, and explains its advantages in comparison to meta-analysis techniques used in prior auditing research. It also discusses opportunities for applying meta-analysis to auditing topics and potential pitfalls.

Design/methodology/approach

The paper provides a review and commentary on meta-analysis techniques used in auditing research, especially for meta-analyses of empirical archival studies that use regression models.

Findings

There is now considerable potential for meta-analysis to have an impact on auditing policy and regulation. Researchers using meta-analysis should make use of the most current techniques (e.g. meta-regression), which are more reliable and allow researchers to explore more issues about the research.

Originality/value

The paper informs auditing researchers about methods to advance their research and increase its usefulness.
A prospective, randomized trial of intravenous hydroxocobalamin versus noradrenaline or saline for treatment of lipopolysaccharide‐induced hypotension in a swine model
Authors: Bebarta Vikhyat S. , Garrett Normalynn , Maddry Joseph K. , Arana Allyson , Boudreau Susan , Castaneda Maria , Dixon Patricia , Tanen David A.
Published: December 2018

Early, non‐clinical studies support the use of hydroxocobalamin to treat sepsis‐induced hypotension, but there is no translational, large animal model. The objective of this study was to compare survival in a sepsis model where large swine had endotoxaemia induced with lipopolysaccharide (LPS) and were treated with intravenous hydroxocobalamin (HOC), noradrenaline (NA), or saline. Thirty swine (45–55 kg) were anaesthetized, intubated, and instrumented with continuous femoral and pulmonary artery pressure monitoring. Hypotension, predefined as 50% of baseline, was induced with LPS. Animals then received HOC, NA, or saline and monitored for 3 hours. The main outcome was survival to the conclusion of the study. Using a power of 80% and an alpha of 0.05, 10 animals were used per group. Secondary outcomes included: mean arterial pressure (MAP), systemic vascular resistance (SVR) and cardiac output (CO) along with several markers of sepsis. No differences were detected between groups at baseline or after hypotension. The survival distributions of the three groups were significantly different with more HOC animals surviving (10/10) compared with NA (8/10) or Saline (5/10) (log‐rank P < 0.03). MAP was found to be higher in both the HOC and NA groups and HOC achieved the highest SVR. In this large animal, translational study of an endotoxaemic model of sepsis, hydroxocobalamin improved survival when compared with saline.