bluuebunny/crossref_metadata_2025 huggingface dataset:
Achieving the World Health Organization's vision for clinical pharmacology
Authors: Martin Jennifer H. , Henry David , Gray Jean , Day Richard , Bochner Felix , Ferro Albert , Pirmohamed Munir , Mörike Klaus , Schwab Matthias
Published: October 2015

Clinical pharmacology is a medical specialty whose practitioners teach, undertake research, frame policy, give information and advice about the actions and proper uses of medicines in humans and implement that knowledge in clinical practice. It involves a combination of several activities: drug discovery and development, training safe prescribers, providing objective and evidence‐based therapeutic information to ethics, regulatory and pricing bodies, supporting patient care in an increasingly subspecialized arena where co‐morbidities, polypharmacy, altered pharmacokinetics and drug interactions are common and developing and contributing to medicines policies for Governments. Clinical pharmacologists must advocate drug quality and they must also advocate for sustainability of the Discipline. However for this they need appropriate clinical service and training support. This Commentary discusses strategies to ensure the Discipline is supported by teaching, training and policy organizations, to communicate the full benefits of clinical pharmacology services, put a monetary value on clinical pharmacology services and to grow the clinical pharmacology workforce to support a growing clinical, academic and regulatory need.
Effect of Iron and Carbon Monoxide on Fibrinogenase‐like Degradation of Plasmatic Coagulation by Venoms of Six Agkistrodon Species
Authors: Nielsen Vance G. , Redford Daniel T. , Boyle Patrick K.
Published: October 2015

Annually, thousands suffer poisonous snakebite, often from defibrinogenating species. It has been demonstrated that iron and carbon monoxide change the ultrastructure of plasma thrombi and improve coagulation kinetics. Thus, this investigation sought to determine whether pre‐treatment of plasma with iron and carbon monoxide could attenuate venom‐mediated catalysis of fibrinogen obtained from Agkistrodon species with fibrinogenase activity. Human plasma was pre‐treated with ferric chloride (0–10 μM) and carbon monoxide‐releasing molecule‐2 (CORM‐2, 0–100 μM) prior to exposure to 0.5–11 μg/ml of six different Agkistrodon species’ venom. The amount of venom used for experimentation needed to decrease coagulation function of one or more kinetic parameters by at least 50% of normal values for (e.g. half the normal speed of clot formation). Coagulation kinetics were determined with thrombelastography. All six snake venoms degraded plasmatic coagulation kinetics to a significant extent, especially prolonging the onset to clot formation and diminishing the speed of clot growth. Pre‐treatment of plasma with iron and carbon monoxide attenuated these venom‐mediated coagulation kinetic changes in a species‐specific manner, with some venom effects markedly abrogated while others were only mildly decreased. Further in vitro investigation of other pit viper venoms that possess fibrinogenolytic activity is indicated to identify species amenable to or resistant to iron and carbon monoxide‐mediated attenuation of venom‐mediated catalysis of fibrinogen. Lastly, future pre‐clinical investigation with animal models (e.g. rabbit ear‐bleed model) is planned to determine whether iron and carbon monoxide can be used therapeutically after envenomation.
Consultation about Sexual Health Issues in the Year after Childbirth: A Cohort Study
Authors: McDonald Ellie , Woolhouse Hannah , Brown Stephanie J.
Published: October 2015

Background

Postnatal sexual health remains underresearched. The main aims of this study were to investigate the prevalence of postnatal sexual health issues, and the extent to which primary care practitioners routinely inquire about sexual health issues.

Method

1,507 first time mothers were recruited in early pregnancy and followed up at 3, 6, and 12 months postpartum. Sexual health issues were assessed at every follow‐up using a checklist.

Results

Eighty‐nine percent of women reported sexual health issues in the first 3 months postpartum. The most common sexual health issues at 3 months postpartum were: loss of interest in sex, pain during sex, vaginal tightness, and lack of lubrication. Fifty‐one percent continued to report loss of interest in sex at 12 months postpartum, and around 30 percent reported persisting pain. Although most women had contact with primary care practitioners during the first 3 months postpartum, only 24 percent recalled being asked about sexual health issues by general practitioners and 14 percent by maternal and child health nurses. Women who had a cesarean delivery had equivalent or higher odds of reporting persisting sexual health issues, but had lower odds of being asked directly about sexual problems (OR 0.58 [95% CI 0.4–0.9]).

Conclusions

Sexual health issues are extremely common after childbirth. There was no evidence that women who had a cesarean delivery experienced fewer sexual health problems. Despite frequent contact with health professionals, women rarely discussed sexual health issues unless health professionals asked them directly. Given the high prevalence of postpartum sexual health issues routine inquiry is warranted.
Nephron‐sparing surgery across a nation – outcomes from the British Association of Urological Surgeons 2012 national partial nephrectomy audit
Authors: Fernando Archie , Fowler Sarah , O'Brien Tim ,   the British Association of Urological Surgeons (BAUS)
Published: October 2015

Objective

To determine the scope and outcomes of nephron‐sparing surgery (NSS), i.e. partial nephrectomy, across the UK and in so doing set a realistic benchmark and identify fresh contemporary challenges in NSS.

Patients and Methods

In 2012 reporting of outcomes of all types of nephrectomy became mandatory in the UK. In all, 148 surgeons in 86 centres prospectively entered data on 6 042 nephrectomies undertaken in 2012. This study is a retrospective analysis of the NSS procedures in the dataset.

Results

A total of 1 044 NSS procedures were recorded and the median (range) surgical volume was 4 (1–39) per consultant and 8 (1–59) per centre. In all, 36 surgeons and 10 centres reported on only one NSS. The indications for NSS were: elective with a tumour of ≤4.5 cm in 59%, elective with a tumour of >4.5 cm in 10%, relative in 7%, imperative in 12%, Von Hippel–Lindau in 1%, and unknown in 11%. The median (range) tumour size was 3.4 (0.8–30) cm. The technique used was minimally invasive surgery in 42%, open in 58%, with conversions in 4%. The histology results were: malignant in 80%, benign in 18%, and unknown in 2%. In patients aged <40 years 36% (36/101) had benign histology vs 17% (151/874) of those aged ≥40 years (P < 0.01). In patients with tumours of <2.5 cm 29% (69/238) had benign histology vs 14% (57/410) with tumours of 2.5–4 cm vs 8% (16/194) with tumours of ≥4 cm (P = 0.02). In patients aged <40 years with of tumours of <2.5 cm 44% (15/34) were benign. The 30‐day mortality was 0.1% (1/1 044). There were major complications (Clavien–Dindo grade of ≥IIIa) in 5% (53/1 044). There was an increased risk of complications after extended elective NSS of 19% (19/101) vs elective at 12% (76/621) (relative risk [RR] 1.54; P < 0.01). Margins were recorded in 68% (709/1 044) of the patients, with positive margins identified in 7% (51/709). Positive surgical margins after NSS for pathological T3 (pT3) tumours were found in 47.8% (11/23) vs 6.1% (32/523) for pT1a, tumours (RR 5.61; P < 0.01). In all, 14% (894/6 042) of the patients underwent surgery for T1a tumours: 55% (488/894) by NSS, 42% (377/894) by radical nephrectomy (RN), and in 3% (29/894) the procedure used was unknown. Major complications after occurred in 4.9% (24/488) of NSS vs 1.3% (5/377) of RN (P < 0.01). Limitations included poor reporting of renal function data and no data on tumour complexity.

Conclusions

In its first year, mandatory national reporting has provided several challenging contemporary insights into NSS.
The impact of re‐transurethral resection on clinical outcomes in a large multicentre cohort of patients with T1 high‐grade/Grade 3 bladder cancer treated with bacille Calmette–Guérin
Authors: Gontero Paolo , Sylvester Richard , Pisano Francesca , Joniau Steven , Oderda Marco , Serretta Vincenzo , Larré Stéphane , Di Stasi Savino , Van Rhijn Bas , Witjes Alfred J. , Grotenhuis Anne J. , Colombo Renzo , Briganti Alberto , Babjuk Marek , Soukup Viktor , Malmström Per‐Uno , Irani Jacques , Malats Nuria , Baniel Jack , Mano Roy , Cai Tommaso , Cha Eugene K. , Ardelt Peter , Vakarakis John , Bartoletti Riccardo , Dalbagni Guido , Shariat Shahrokh F. , Xylinas Evanguelos , Karnes Robert J. , Palou Joan
Published: October 2015

Objectives

To determine if a re‐transurethral resection (TUR), in the presence or absence of muscle at the first TUR in patients with T1‐high grade (HG)/Grade 3 (G3) bladder cancer, makes a difference in recurrence, progression, cancer specific (CSS) and overall survival (OS).

Patients and methods

In a large retrospective multicentre cohort of 2451 patients with T1‐HG/G3 initially treated with bacille Calmette–Guérin, 935 (38%) had a re‐TUR. According to the presence or absence of muscle in the specimen of the primary TUR, patients were divided in four groups: group 1 (no muscle, no re‐TUR), group 2 (no muscle, re‐TUR), group 3 (muscle, no re‐TUR) and group 4 (muscle, re‐TUR). Clinical outcomes were compared across the four groups.

Results

Re‐TUR had a positive impact on recurrence, progression, CSS and OS only if muscle was not present in the primary TUR specimen. Adjusting for the most important prognostic factors, re‐TUR in the absence of muscle had a borderline significant effect on time to recurrence [hazard ratio (HR) 0.67, P = 0.08], progression (HR 0.46, P = 0.06), CSS (HR 0.31, P = 0.07) and OS (HR 0.48, P = 0.05). Re‐TUR in the presence of muscle in the primary TUR specimen did not improve the outcome for any of the endpoints.

Conclusions

Our retrospective analysis suggests that re‐TUR may not be necessary in patients with T1‐HG/G3, if muscle is present in the specimen of the primary TUR.
Design and baseline characteristics of a population‐based study of eye disease in southern Chinese people: the Dongguan Eye Study
Authors: Meng Qianli , Cui Ying , Zhang Min , Zhang Lixin , Zhang Liang , Zhang Jinxin , Kuang Jian , Liu Qingyang , Zheng Yang , Luo Zhongling , Liu Huikun , Zhu Guoping , Cai Jingjing , Zhang Guanrong , Wen Xingxuan , Guo Haike
Published: October 2015

Background

To describe the study design, methodology and baseline characteristics of the Dongguan Eye Study.

Design

Population‐based, cross‐sectional study

Participants

A total of 8952 rural‐dwelling residents aged 40 years or older in Hengli, Dongguan.

Methods

The Dongguan Eye Study was conducted from September 2011 to February 2012. The interview covered demographic data, socio‐economic status and health‐ and vision‐related quality of life. Physical measurements included height, weight, waist and hip circumference, heart rate and blood pressure. Laboratory tests included fasting blood glucose, haemoglobin A1c, oral glucose tolerance, serum total cholesterol, triglycerides, high‐density lipoprotein‐cholesterol, low‐density lipoprotein‐cholesterol, serum creatinine, blood urea nitrogen and uric acid. Ophthalmic examinations included visual acuity and autorefraction testing, intraocular pressure measurement, slit‐lamp examination, ocular biometry, gonioscopy, fundus photography, retinal nerve fibre layer imaging and visual field testing.

Main Outcome Measures

Prevalence and risk factors for visual impairment, blindness, eye diseases and their associations with systemic medical indicators or health‐related lifestyles, as well as epidemiological data on diabetic subjects. Methodology, response rates and baseline characteristics are presented.

Results

Of the 11 357 individuals eligible for the Dongguan Eye Study, 8952 (78.82%) subjects participated. All participants were self‐identified Han Chinese. The average age was 54.0 years, 59.9% were female, 48.4% were farmers and 77.2% had elementary or junior middle school educational levels. The average body mass index and waist–hip ratio were 24.6 ± 3.9 kg/m2 and 0.9 ± 0.2.

Conclusions

Data from the Dongguan Eye Study provide information concerning the prevalence, risk factors and impacts of eye diseases in rural residents undergoing urbanization in southern China.
Early evolution of the hyperdiverse rove beetle tribe Staphylinini (Coleoptera: Staphylinidae: Staphylininae) and a revision of its higher classification
Authors: Brunke Adam J. , Chatzimanolis Stylianos , Schillhammer Harald , Solodovnikov Alexey
Published: October 2015

The rove beetle tribe Staphylinini (Staphylinidae: Staphylininae) is a monophyletic lineage of over 5500 relatively large and charismatic species, yet its higher classification remains deeply rooted in historical concepts. Despite recent progress toward inferring phylogenetic relationships within this group using morphological and molecular datasets, relationships among taxa that were united under a polyphyletic “Quediina” remain largely unknown. To infer these relationships, we analysed a six‐gene dataset (4370 bp) using parsimony and model‐based analyses and the results were placed in the context of morphology. While all genes contributed synapomorphies for major lineages or relationships between them, carbamoyl synthetase (CAD), topoisomerase I (TP) and wingless (Wg) were the most informative. TP was generally most informative at the level of subtribe, Wg above this level and CAD throughout the tree. The monophyly of Staphylinini was strongly supported and analyses support seven clades that correspond to higher taxonomic levels, four of which are formally described as subtribes here: Acylophorina stat. rev., Cyrtoquediina new subtribe, Erichsoniina new subtribe and Indoquediina new subtribe. The majority of Staphylinini taxa were recovered within a well‐supported “northern hemisphere clade” that is weakly represented in the southern hemisphere. The composition and morphological diagnosis of the “Staphylinini propria” clade are revised, and the pronotum shape historically associated with this group is shown to have evolved multiple times elsewhere in Staphylinini. The genus Stevensia is moved from Staphylinina to Acylophorina based on morphological evidence. Cyrtoquedius stat. nov., previously a subgenus of Quedius, is raised to the genus level. The following 32 new combinations (from Quedius) are proposed: Cyrtoquedius anthracinus (Solsky); C. arrogans (Sharp); C. basiventris (Sharp); C. bolivianus (Sharp); C. bruchi (Bernhauer); C. clypealis (Sharp); C. concolor (Sharp); C. flavicaudus (Sharp); C. flavinasis (Bernhauer); C. frenatus (Erichson); C. graciliventris (Sharp); C. jacobi (Scheerpeltz); C. jocosus (Sharp); C. labiatus (Erichson); C. laeviventris (Bernhauer); C. mexicanus (Sharp); C. ochropygus (Bernhauer); C. ogloblini (Bernhauer); C. ornatocollis (Bierig); C. protensus (Sharp); C. rufinasus (Sharp); C. verecundus (Sharp); C. verres (Smetana); Indoquedius borneensis (Cameron); I. dispersepunctatus (Scheerpeltz); I. javanus (Cameron); I. malaisei (Scheerpeltz); I. micantiventris (Scheerpeltz); I. parallelicollis (Scheerpeltz); I. philippinus (Cameron); I. recticollis (Scheerpeltz); and I. sanguinipennis (Scheerpeltz). Cyrtoquedius verres is recorded from the state of Georgia (USA) for the first time, which, together with its transfer from Quedius, extends the distribution of the Cyrtoquediina significantly northward into the Nearctic.
INFORMAL LABOR MARKETS AND ON‐THE‐JOB TRAINING: EVIDENCE FROM WAGE DATA
Authors: Cano‐Urbina Javier
Published: October 2015

This study examines whether informal sector jobs are a source of training for young less‐educated workers. Controlling for worker and job characteristics, it is found that, in the early years of workers' careers in Mexico, wage growth in the informal sector is higher than in the formal sector. This result is consistent with general human capital investment on‐the‐job if the informal labor market is more competitive than the formal labor market due to frictions generated by labor regulations. (JEL O17, J24, J310)
Reconstructing changes in the genotype, phenotype, and climatic niche of an introduced species
Authors: Atwater Daniel Z. , Sezen U. Uzay , Goff Valorie , Kong Wenqian , Paterson Andrew H. , Barney Jacob N.
Published: October 2015

An introduced species must contend with enormous environmental variation in its introduced range. In this study, we use niche models and ordination analyses to reconstruct changes in genotype, phenotype, and climatic niche of Johnsongrass Sorghum halepense, which is regarded as one of the world's most threatening invasive plants. In the United States, Johnsongrass has rapidly evolved within‐ and among‐population genetic diversity; our results show that genetic differentiation in expanding Johnsongrass populations has resulted in phenotypic variation that is consistent with habitat and climatic variation encountered during its expansion. Moreover, Johnsongrass expanded from agricultural to non‐agricultural habitat, and now, despite occupying overlapping ranges, extant agricultural and non‐agricultural populations are genetically and phenotypically distinct and manifest different plastic responses when encountering environmental variation. Non‐agricultural accessions are broadly distributed in climatic and geographic space and their fitness traits demonstrate plastic responses to common garden conditions that are consistent with local specialization. In contrast, agricultural accessions demonstrate ‘general purpose’ plastic responses and have more restricted climatic niches and geographic distributions. They also grow much larger than non‐agricultural accessions. If these differences are adaptive, our results suggest that adaptation to local habitat variation plays a crucial role in the ecology of this invader. Further, its success relates to its ability to succeed on dual fronts, by responding simultaneously to habitat and climate variability and by capitalizing on differential responses to these factors during its range expansion.
Changing Perspectives: The Professional Relevance of Higher Education on the Way Towards the Highly‐Educated Society
Authors: Teichler Ulrich
Published: October 2015

Higher education has been one of the major thematic areas of theEuropeanJournal ofEducationover the years, and the relationships between higher education the world of work have been one of the 10 major themes in this area. The multitude of related articles shows substantial changes of the situation and the related discourse. The employment and work situation of graduates underwent changes in the course of expansion, the respective political climate had its ups and downs, and the knowledge base on the impact of study conditions and provisions of graduate employment and work improved over time. This notwithstanding, we note a constant return to the persistent questions as to whether we have too few or too many graduates. In recent years, higher education has been increasingly exposed to greater instrumental expectations. The paradigms of ‘knowledge society’ and ‘knowledge economy’ reinforce a call for higher education to serve more directly the ‘employability’ of graduates. As views vary strikingly regarding issues such as specialisation vs. general competences, preparation for predictable tasks vs. preparing for an unexpected future, etc., higher education could keep a diversity of options in the best ways to ensure professional relevance.
Glimpsing the Future in the Past: VET in Europe
Authors: Gordon Jean
Published: October 2015

What do we expect from Vocational Education and Training (VET) systems? Is it different from 25 years ago? This article argues that the focus has increasingly been placed on strategies for lifelong and life‐wide learning that seek to reinforce continuity among the subsystems of learning, but that VET systems are, nevertheless, still expected to address many and sometimes conflicting agendas, needs and priorities. The last 25 years or so have been critical for the development of VET in Europe. Making VET more attractive and increasing its parity of esteem in relation to general secondary education have been major, recurring themes in European countries, as part of, at least conceptually, more comprehensive approaches to lifelong and life‐wide learning. From 1989 to 2003, the European Journal of Education (EJE) published a special issue on ‘Trends in Vocational Education and Training’ every two years and has continued to publish on VETrelated topics. This article revisits the major themes and challenges as they were observed and discussed by the authors who wrote in those special issues and in later articles. Many were directly involved in advisory positions to governments; held key decision‐making responsibilities; undertook studies and consultancy and brought technical assistance across several countries. Their articles are moments of reflection nourished by experience on the ground. This article explores how the European Journal of Education has contributed to European reflection on VET systems, policies and preoccupations in recent decades – what can we learn that is useful for shaping and formulating our present ideas about new policy from our colleagues writing about the same or similar issues 20 years ago? A key theme concerns the role of the Europe Community (and subsequently EU) as a change agent supporting bottom‐up exchange and top‐down stimulus for reform through an increasing integration of education and training in the socio‐economic strategy of the EU.
A robust and representative lower bound on object processing speed in humans
Authors: Bieniek Magdalena M. , Bennett Patrick J. , Sekuler Allison B. , Rousselet Guillaume A.
Published: October 2015

How early does the brain decode object categories? Addressing this question is critical to constrain the type of neuronal architecture supporting object categorization. In this context, much effort has been devoted to estimating face processing speed. With onsets estimated from 50 to 150 ms, the timing of the first face‐sensitive responses in humans remains controversial. This controversy is due partially to the susceptibility of dynamic brain measurements to filtering distortions and analysis issues. Here, using distributions of single‐trial event‐related potentials (ERPs), causal filtering, statistical analyses at all electrodes and time points, and effective correction for multiple comparisons, we present evidence that the earliest categorical differences start around 90 ms following stimulus presentation. These results were obtained from a representative group of 120 participants, aged 18–81, who categorized images of faces and noise textures. The results were reliable across testing days, as determined by test–retest assessment in 74 of the participants. Furthermore, a control experiment showed similar ERP onsets for contrasts involving images of houses or white noise. Face onsets did not change with age, suggesting that face sensitivity occurs within 100 ms across the adult lifespan. Finally, the simplicity of the face–texture contrast, and the dominant midline distribution of the effects, suggest the face responses were evoked by relatively simple image properties and are not face specific. Our results provide a new lower benchmark for the earliest neuronal responses to complex objects in the human visual system.
Absence of direction‐specific cross‐modal visual–auditory adaptation in motion‐onset event‐related potentials
Authors: Grzeschik Ramona , Lewald Jörg , Verhey Jesko L. , Hoffmann Michael B. , Getzmann Stephan
Published: October 2015

Adaptation to visual or auditory motion affects within‐modality motion processing as reflected by visual or auditory free‐field motion‐onset evoked potentials (VEPs, AEPs). Here, a visual–auditory motion adaptation paradigm was used to investigate the effect of visual motion adaptation on VEPs and AEPs to leftward motion‐onset test stimuli. Effects of visual adaptation to (i) scattered light flashes, and motion in the (ii) same or in the (iii) opposite direction of the test stimulus were compared. For the motion‐onset VEPs, i.e. the intra‐modal adaptation conditions, direction‐specific adaptation was observed – the change‐N2 (cN2) and change‐P2 (cP2) amplitudes were significantly smaller after motion adaptation in the same than in the opposite direction. For the motion‐onset AEPs, i.e. the cross‐modal adaptation condition, there was an effect of motion history only in the change‐P1 (cP1), and this effect was not direction‐specific – cP1 was smaller after scatter than after motion adaptation to either direction. No effects were found for later components of motion‐onset AEPs. While the VEP results provided clear evidence for the existence of a direction‐specific effect of motion adaptation within the visual modality, the AEP findings suggested merely a motion‐related, but not a direction‐specific effect. In conclusion, the adaptation of veridical auditory motion detectors by visual motion is not reflected by the AEPs of the present study.
Determination of the critical absolute blood volume for intradialytic morbid events
Authors: Kron Susanne , Schneditz Daniel , Leimbach Til , Czerny Jutta , Aign Sabine , Kron Joachim
Published: October 2015

The reduction of blood volume below a critical threshold is assumed to trigger intradialytic morbid events (IME). Recently, we presented a simple method to determine the absolute blood volume during routine hemodialysis (HD) carried out without blood sampling and without injection of dyes or radiolabeled markers. Such information could be used to detect excessive volume reduction during HD and to prevent IME. Therefore, we performed a pilot study in IME‐prone patients to identify the absolute blood volume at which they developed clinical symptoms. A volume of 240 mL of ultrapure dialysate was automatically infused into the extracorporeal circulation using the bolus function of a commercial online hemodiafiltration machine incorporating a blood volume monitor (BVM). The increase in relative blood volume (RBV) caused by the infusion was measured and used to determine the absolute blood volume at that time. The blood volume per kilogram body mass at the time of symptomatic IME was also determined. All IME‐prone patients of a single‐dialysis center were included in the study. Ten out of 12 patients became symptomatic at a specific blood volume between 65 and 56 mL/kg (mean 62 mL/kg) whereas RBV showed a wide scatter (82–97%). A specific blood volume of 65 mL/kg seems to represent the threshold for IME by this method. The technique could be completely automated without altering the hardware of the dialysis device. Present feedback systems for automated blood volume‐controlled ultrafiltration could be adapted to maintain absolute blood volume above this critical volume to safely prevent volume‐dependent IME.
A Survey of Headache Medicine Specialists on Career Satisfaction and Burnout
Authors: Evans Randolph W. , Ghosh Kamalika
Published: October 2015

Background

Physicians report increasing rates of career dissatisfaction and professional burnout, which may be related to the practice environment and subspecialty. There has never been a survey of professional burnout among headache medicine specialists.

Objectives

The aim of the present survey was to learn more about how headache medicine physicians are affected by these issues.

Methods

An email survey was sent to 749 physician members of the American Headache Society with questions or statements about demographics, professional quality of life and satisfaction, future practice plans, and professional burnout using the Maslach Burnout Inventory.

Results

In a sample of 127 headache medicine specialists, 66 (57.4%) physicians reported symptoms of professional burnout reflected by high Emotional Exhaustion and/or high Depersonalization. There is widespread dissatisfaction with work schedules, government regulations, implementation of the Affordable Care Act, insurance company policies, malpractice concerns, patient telephone calls, and compensation. Sixty‐two percent of respondents concur that headache medicine is becoming more complicated without patient benefit, 14% concur that headache medicine specialists are fairly compensated, and 59% would go into headache medicine again if they were fourth year medical students. In the next 1 to 3 years, 21.3% plan to cut back on hours, 14.2% plan to cut back on patients seen, and 12.6% plan to switch to a cash practice. Medicine and healthcare are changing in such a way that 33.9% concur that they will accelerate their retirement plans.

Conclusions

Headache medicine specialists have one of the highest rates of burnout compared to other physician specialists, which is twice the rate of working adults. Physicians’ age and practice environment and experience are related with their career satisfaction and professional burnout. Some attributes of career satisfaction can decrease burnout by reducing emotional exhaustion and depersonalization and by enhancing personal accomplishment. There is widespread dissatisfaction with the practice environment. These findings may portend decreasing access to headache medicine specialists in the future if specialists cut back on hours and patients seen, accelerate their retirement plans, and fewer neurologists are attracted to headache medicine.
Deformation and fracture of K3 rotary nickel–titanium endodontic instruments after clinical use
Authors: Shen S. M. , Deng M. , Wang P. P. , Chen X. M. , Zheng L. W. , Li H. L.
Published: October 2015

Aim

The aim was to evaluate the incidence and type of defects that occurred with K3 rotary nickel–titanium instruments during routine clinical use.

Methodology

A total of 2397 K3 (G‐PACKS, SybronEndo, West Collins, Orange, CA, USA) instruments were collected from a graduate endodontic clinic over 21 months. All the instruments were limited to a maximum use of 30 canal preparations. The collected instruments were measured by a digital caliper to determine whether any fractures had occurred and then were visually inspected for deformation and fracture under a stereomicroscope. The surfaces of fractured instruments were further evaluated under a scanning electron microscope. Data were analysed using chi‐square test and Kruskal–Wallis test.

Results

The incidence of instrument defect was 5.63%, consisting of 3.59% fractures and 2.05% deformations. The defect rates of 0.04 and 0.06 files were statistically higher than the other taper groups (P < 0.003) except for 0.08 files (P > 0.05). For the fractured instruments, 63.95% failed from flexural fatigue, whilst 36.05% failed from torsion.

Conclusion

Flexural fracture was the major mode of fracture for instruments with larger taper. A routine check for instrument integrity particularly for 0.04 and 0.06 files at high magnification is recommended after each clinical use.
High Reactive MgO‐Y2O3 Nanopowders via Microwave Combustion Method and Sintering Behavior
Authors: Sun Haibin , Zhang Yujun , Li Teng , Gong Hongyu , Li Qisong
Published: October 2015

To decrease the sintering temperature of MgO‐Y2O3 composites to avoid undesired grain coarsening, high reactive MgO‐Y2O3 nanopowders were synthesized via microwave combustion method. The degree of combustion was enhanced effectively by adding an extra oxidant ammonium nitrate. The as‐synthesized MgO‐Y2O3 nanopowders, ~18 nm in size, showed high specific surface area of 64.55 m2/g and low agglomeration. Relative density of 98% was obtained when sintered at a low sintering temperature of 1350°C. The high reactivity can be attributed to the lower activation energy Q (131.13 kJ/mol), compared with samples without extra oxidant (192.97 kJ/mol).
Two‐Dimensional Nb‐Based M4C3 Solid Solutions (MXenes)
Authors: Yang Jian , Naguib Michael , Ghidiu Michael , Pan Li‐Mei , Gu Jian , Nanda Jagjit , Halim Joseph , Gogotsi Yury , Barsoum Michel W.
Published: October 2015

Herein, two new two‐dimensional Nb4C3‐based solid solutions (MXenes), (Nb0.8,Ti0.2)4C3Tx and (Nb0.8,Zr0.2)4C3Tx (where T is a surface termination) were synthesized—as confirmed by X‐ray diffraction—from their corresponding MAX phase precursors (Nb0.8,Ti0.2)4AlC3 and (Nb0.8,Zr0.2)4AlC3. This is the first report on a Zr‐containing MXene. Intercalation of Li ions into these two compositions, and Nb4C3Tx was studied to determine the potential of those materials for energy storage applications. Lithiation and delithiation peaks at 2.26 and 2.35 V, respectively, appeared in the case of Nb4C3Tx, but were not present in Nb2CTx. After 20 cycles at a rate of C/4, the specific capacities of (Nb0.8,Ti0.2)4C3Tx and (Nb0.8,Zr0.2)4C3Tx were 158 and 132 mAh/g, respectively, both slightly lower than the capacity of Nb4C3Tx.
Screening for infertility‐related stress at the time of initial infertility consultation: psychometric properties of a brief measure
Authors: Casu Giulia , Gremigni Paola
Published: October 2015

Aim

To develop and psychometrically test a brief self‐report to assess the amount of infertility‐related stress; to investigate how infertility‐related stress was associated to socio‐demographics, causes of infertility and emotional distress.

Background

Infertility exerts a stress effect on both personal and interpersonal areas. Due to the burden of multiple assessments in fertility clinics, there is the need for very brief and easy to administer measures of the stressful impact of infertility on the intrapersonal and interpersonal life domains.

Design

The study had a psychometric, cross‐sectional design.

Method

Between January ‐ December 2013, a total of 597 Italian infertile patients (58·6% women), recruited at the time of initial infertility consultation, completed the Infertility‐Related Stress Scale. A subsample of 200 participants (50% women) also completed self‐reports of anxiety and depression. A subsample of 40 patients completed again the Infertility‐Related Stress Scale at a 4‐week follow‐up visit.

Results

Confirmatory factor analyses supported the proposed two‐factor model of infertility stress affecting intrapersonal and interpersonal life domains. Both dimensions showed good reliability and were associated in expected ways with emotional distress. Patients with above‐threshold levels of anxiety and depression showed higher infertility stress in both domains and particularly in the intrapersonal area. Infertility stress was significantly higher in women than in men in the intrapersonal domain.

Conclusion

The Infertility‐Related Stress Scale showed evidence of validity and reliability. This new, brief self‐report can assist fertility clinic staff in identifying those patients who need support to overcome the stressful impact of infertility on intrapersonal and interpersonal domains.
Relational job characteristics and nurses’ affective organizational commitment: the mediating role of work engagement
Authors: Santos Alda , Chambel Maria José , Castanheira Filipa
Published: October 2015

Aim

To study work engagement as a mediator of the associations between relational job characteristics and nurses’ affective commitment to the hospital.

Background

Earlier research has shown that work engagement mediates the relationship between job resources and affective organizational commitment. However, relational job characteristics, which may be job resources, have not been studied or examined in relation to work engagement and affective organizational commitment in the nursing profession.

Design

This study uses a correlational survey design and an online survey for data collection.

Method

Data for this correlational study were collected by survey over months (2013) from a sample of 335 hospital nurses. Measures included Portuguese translations of the Relational Job Characteristics’ Psychological Effects Scale, the Utrecht Work Engagement Scale and the Affective Organizational Commitment Scale.

Results

Data analysis supports a full mediation model where relational job characteristics explained affective commitment to the hospital through nurses’ work engagement.

Conclusions

Relational job characteristics contribute to nurses’ work engagement, which in turn contributes to affective organizational commitment.
Annual Research Review: Building a science of personalized intervention for youth mental health
Authors: Ng Mei Yi , Weisz John R.
Published: October 2015

Background

Within the past decade, health care service and research priorities have shifted from evidence‐based medicine to personalized medicine. In mental health care, a similar shift to personalized intervention may boost the effectiveness and clinical utility of empirically supported therapies (ESTs). The emerging science of personalized intervention will need to encompass evidence‐based methods for determining which problems to target and in which order, selecting treatments and deciding whether and how to combine them, and informing ongoing clinical decision‐making through monitoring of treatment response throughout episodes of care. We review efforts to develop these methods, drawing primarily from psychotherapy research with youths. Then we propose strategies for building a science of personalized intervention in youth mental health.

Findings

The growing evidence base for personalizing interventions includes research on therapies adapted for specific subgroups; treatments targeting youths’ environments; modular therapies; sequential, multiple assignment, randomized trials; measurement feedback systems; meta‐analyses comparing treatments for specific patient characteristics; data‐mining decision trees; and individualized metrics.

Conclusion

The science of personalized intervention presents questions that can be addressed in several ways. First, to evaluate and organize personalized interventions, we propose modifying the system used to evaluate and organize ESTs. Second, to help personalizing research keep pace with practice needs, we propose exploiting existing randomized trial data to inform personalizing approaches, prioritizing the personalizing approaches likely to have the greatest impact, conducting more idiographic research, and studying tailoring strategies in usual care. Third, to encourage clinicians’ use of personalized intervention research to inform their practice, we propose expanding outlets for research summaries and case studies, developing heuristic frameworks that incorporate personalizing approaches into practice, and integrating personalizing approaches into service delivery systems. Finally, to build a richer understanding of how and why treatments work for particular individuals, we propose accelerating research to identify mediators within and across RCTs, to isolate mechanisms of change, and to inform the shift from diagnoses to psychopathological processes. This ambitious agenda for personalized intervention science, although challenging, could markedly alter the nature of mental health care and the benefit provided to youths and families.
Which factors are associated with the use of systemic antihistamines in patients with chronic hand eczema? Results from the CARPE registry
Authors: Apfelbacher C. , Weiß M. , Molin S. , Bauer A. , Mahler V. , Schmitt J. , Elsner P. , Diepgen T.L. , Weisshaar E.
Published: October 2015

Background

Antihistamines (AH) are often used to treat chronic skin diseases related to allergy and/or pruritus. Data on the use of AH in patients with chronic hand eczema (CHE) is scarce.

Objective

The objective of this study was to investigate prevalence and determinants of AH use in patients with CHE.

Methods

Data were drawn from the German CARPE registry. The relationship of clinical, demographic and treatment‐related variables with AH use in the past 12 months was analysed by means of logistic regression. Odds ratios (OR) with corresponding 95% confidence intervals (CIs) were computed.

Results

A total of 1255 patients with CHE were eligible for analysis (54.1% female; mean age: 47.1 years, standard deviation (SD) 13.6 years). Mean subjective disease severity was 5.0 (SD 2.5). 25% of the sample reported to have used AH in the past 12 months. Significant positive associations with AH use were identified for moderate (OR = 3.05, 95% CI 1.81–5.15) or severe (OR = 4.27, 95% CI 2.40–7.59) pruritus, a history of systemic treatment (e.g. alitretinoin) (OR = 2.85, 95% CI: 2.06–3.96), UV phototherapy (OR = 1.78, 95% CI 1.28–2.46), flexural eczema (OR = 1.89, 95% CI 1.32–2.71), allergic rhinitis/conjunctivitis (OR = 2.41, 95% CI 1.71–3.39) and female gender (OR = 1.58, 95% CI 1.16–2.14) in multivariate analyses (N = 1184). Significant inverse associations were found for an eczema localization besides the hands (OR = 0.66, 95% CI 0.46–0.94) and for patients being recruited in hospital (vs. dermatological practice; OR = 0.47, 95% CI 0.33–0.67).

Conclusions

This study suggests that AH use is frequent in patients with CHE and mainly related to female gender, disease severity, pruritus, comorbid atopic disease and treatment centre.
Expression of Concern: The effects of vitamin D plus calcium supplementation on metabolic profiles, biomarkers of inflammation, oxidative stress and pregnancy outcomes in pregnant women at risk for pre‐eclampsia
Authors: Samimi M. , Kashi M. , Foroozanfard F. , Karamali M. , Bahmani F. , Asemi Z. , Hamidian Y. , Talari H. R. , Esmaillzadeh A.
Published: October 2015

Background

The present study was designed to examine the effects of vitamin D plus calcium administration on metabolic profiles and pregnancy outcomes among women at risk for pre‐eclampsia.

Methods

In a prospective, double‐blind, placebo‐controlled trial, 60 women at risk for pre‐eclampsia were randomised to take either 50 000 IU vitamin D3 every 2 weeks plus 1000 mg day−1 calcium supplements (as calcium carbonate) (n = 30) or to receive placebos at the same times (n = 30) from 20 to 32 weeks of gestation. Fasting blood samples were taken at baseline and 12 weeks after intervention to determine related variables. Newborn anthropometric measurements were determined.

Results

Taking combined cholecalciferol and calcium supplements, compared to placebo, led to significant reductions in fasting plasma glucose (FPG) [mean (SD)] [−5.7 (5.5) versus −0.6 (12.6) mg dL−1, P = 0.04], serum insulin concentrations [−2.8 (6.0) versus +7.7 (9.8) μIU mL−1, P < 0.001], homeostasis model of assessment‐insulin resistance [−0.8 (1.3) versus +1.6 (2.2), P < 0.001], homeostatic model assessment‐beta cell function [−8.2 (25.8) versus +32.6 (41.3, P < 0.001] and a significant rise in quantitative insulin sensitivity check index score [+0.02 (0.02) versus −0.02 (0.02, P < 0.001]. Additionally, pregnant women who received cholecalciferol plus calcium supplements had increased serum high‐density lipoprotein (HDL)‐cholesterol [+4.6 (8.3) versus −2.9 (7.7) mg dL−1, P = 0.001] and plasma total glutathione (GSH) concentrations [+23.4 (124.0) versus −94.8 (130.2) μm, P = 0.001] compared to placebo. However, after adjustment for the baseline levels, maternal age and baseline body mass index, the effects on FPG levels (P = 0.13) and systolic blood pressure (P = 0.13) disappeared.

Conclusions

Vitamin D plus calcium administration for 12 weeks had beneficial effects on glycaemic status, HDL‐cholesterol, GSH and blood pressure among women at risk for pre‐eclampsia.
Jasmonic acid carboxyl methyltransferase regulates development and herbivory‐induced defense response in rice
Authors: Qi Jinfeng , Li Jiancai , Han Xiu , Li Ran , Wu Jianqiang , Yu Haixin , Hu Lingfei , Xiao Yutao , Lu Jing , Lou Yonggen
Published: October 2015

Jasmonic acid (JA) and related metabolites play a key role in plant defense and growth. JA carboxyl methyltransferase (JMT) may be involved in plant defense and development by methylating JA to methyl jasmonate (MeJA) and thus influencing the concentrations of JA and related metabolites. However, no JMT gene has been well characterized in monocotyledon defense and development at the molecular level. After we cloned a rice JMT gene, OsJMT1, whose encoding protein was localized in the cytosol, we found that the recombinant OsJMT1 protein catalyzed JA to MeJA. OsJMT1 is up‐regulated in response to infestation with the brown planthopper (BPH; Nilaparvata lugens). Plants in which OsJMT1 had been overexpressed (oe‐JMT plants) showed reduced height and yield. These oe‐JMT plants also exhibited increased MeJA levels but reduced levels of herbivore‐induced JA and jasmonoyl‐isoleucine (JA‐Ile). The oe‐JMT plants were more attractive to BPH female adults but showed increased resistance to BPH nymphs, probably owing to the different responses of BPH female adults and nymphs to the changes in levels of H2O2 and MeJA in oe‐JMT plants. These results indicate that OsJMT1, by altering levels of JA and related metabolites, plays a role in regulating plant development and herbivore‐induced defense responses in rice.
Hemipteran and dipteran pests: Effectors and plant host immune regulators
Authors: Kaloshian Isgouhi , Walling Linda L.
Published: October 2015

Hemipteran and dipteran insects have behavioral, cellular and chemical strategies for evading or coping with the host plant defenses making these insects particularly destructive pests worldwide. A critical component of a host plant's defense to herbivory is innate immunity. Here we review the status of our understanding of the receptors that contribute to perception of hemipteran and dipteran pests and highlight the gaps in our knowledge in these early events in immune signaling. We also highlight recent advances in identification of the effectors that activate pattern‐triggered immunity and those involved in effector‐triggered immunity.
Nurse Staffing and Quality of Care of Nursing Home Residents in Korea
Authors: Shin Juh Hyun , Hyun Ta Kyung
Published: October 2015

Purpose

To investigate the relationship between nurse staffing and quality of care in nursing homes in Korea.

Methods

This study used a cross‐sectional design to describe the relationship between nurse staffing and 15 quality‐of‐care outcomes. Independent variables were hours per resident day (HPRD), skill mix, and turnover of each nursing staff, developed with the definitions of the Centers for Medicare & Medicaid Services and the American Health Care Association. Dependent variables were prevalence of residents who experienced more than one fall in the recent 3 months, aggressive behaviors, depression, cognitive decline, pressure sores, incontinence, prescribed antibiotics because of urinary tract infection, weight loss, dehydration, tube feeding, bed rest, increased activities of daily living, decreased range of motion, use of antidepressants, and use of restraints. Outcome variables were quality indicators from the U.S. Centers for Medicare & Medicaid and 2013 nursing home evaluation manual by the Korean National Health Insurance Service.

Findings

The effects of registered nurse (RN) HPRD was supported in fall prevention, decreased tube feeding, decreased numbers of residents with deteriorated range of motion, and decreased aggressive behavior. Higher turnover of RNs related to more residents with dehydration, bed rest, and use of antipsychotic medication.

Conclusions

Study results supported RNs’ unique contribution to resident outcomes in comparison to alternative nurse staffing in fall prevention, decreased use of tube feeding, better range of motion for residents, and decreased aggressive behaviors in nursing homes in Korea. More research is required to confirm the effects of nurse staffing on residents’ outcomes in Korea.

Clinical Relevance

We found consistency in the effects of RN staffing on resident outcomes acceptable. By assessing nurse staffing levels and compositions of nursing staffs, this study contributes to more effective long‐term care insurance by reflecting on appropriate policies, and ultimately contributes to the stable settlement of the long‐term care insurance system for elders.