bluuebunny/crossref_metadata_2025 huggingface dataset:
Predicting richness and composition in mountain insect communities at high resolution: a new test of the SESAM framework
Authors: D'Amen Manuela , Pradervand Jean‐Nicolas , Guisan Antoine
Published: July 2015

Aim

The aim of this study was to test different modelling approaches, including a new framework, for predicting the spatial distribution of richness and composition of two insect groups.

Location

The western Swiss Alps.

Methods

We compared two community modelling approaches: the classical method of stacking binary prediction obtained from individual species distribution models (binary stacked species distribution models, bS‐SDMs), and various implementations of a recent framework (spatially explicit species assemblage modelling, SESAM) based on four steps that integrate the different drivers of the assembly process in a unique modelling procedure. We used: (1) five methods to create bS‐SDM predictions; (2) two approaches for predicting species richness, by summing individual SDM probabilities or by modelling the number of species (i.e. richness) directly; and (3) five different biotic rules based either on ranking probabilities from SDMs or on community co‐occurrence patterns. Combining these various options resulted in 47 implementations for each taxon.

Results

Species richness of the two taxonomic groups was predicted with good accuracy overall, and in most cases bS‐SDM did not produce a biased prediction exceeding the actual number of species in each unit. In the prediction of community composition bS‐SDM often also yielded the best evaluation score. In the case of poor performance of bS‐SDM (i.e. when bS‐SDM overestimated the prediction of richness) the SESAM framework improved predictions of species composition.

Main conclusions

Our results differed from previous findings using community‐level models. First, we show that overprediction of richness by bS‐SDM is not a general rule, thus highlighting the relevance of producing good individual SDMs to capture the ecological filters that are important for the assembly process. Second, we confirm the potential of SESAM when richness is overpredicted by bS‐SDM; limiting the number of species for each unit and applying biotic rules (here using the ranking of SDM probabilities) can improve predictions of species composition.
Non‐HIV‐related health care utilization, demographic, clinical and laboratory factors associated with time to initial retention in HIV care among HIV‐positive individuals linked to HIV care
Authors: Lourenço L , Nohpal A , Shopin D , Colley G , Nosyk B , Montaner JSG , Lima VD ,   the Seek and Treat for Optimal Prevention of HIV/AIDS (STOP HIV/AIDS) Study Group
Published: July 2015

Objectives

The aim of the study was to explore non‐HIV‐related health care service (NHRHS) utilization, demographic, clinical and laboratory factors associated with timely initial “retention” in HIV care among individuals “linked” to HIV care in British Columbia (BC), Canada.

Methods

We conducted a Weibull time‐to‐initial‐retention analysis among BC Seek and Treat for Optimal Prevention of HIV/AIDS (STOP HIV/AIDS) cohort participants linked in 2000–2010, who had ≥ 1 year of follow‐up. We defined “linked” as the first HIV‐related service accessed following HIV diagnosis and “retained” as having, within a calendar year, either: (i) at least two HIV‐related physician visits/diagnostic tests or (ii) at least two antiretroviral therapy (ART) dispensations, ≥ 3 months apart. Individuals were followed until they were retained, died, their last contact date, or until 31 December 2011, whichever occurred first.

Results

Of 5231 linked individuals (78% male; median age 39: (Q1−Q3: 32–46) years], 4691 (90%) were retained [median time to initial retention of 9 (Q1–Q3: 5–13) months] by the end of follow‐up and 540 (10%) were not. Eighty‐four per cent of not retained and 96% of retained individuals used at least one type of NHRHS during follow‐up. Individuals who saw a specialist for NHRHS during follow‐up had a shorter time to initial retention than those who did not [adjusted hazard ratio (aHR) 2.79; 95% confidence interval (CI): 2.47–3.16]. However, those who saw a general practitioner (GP) for NHRHS (aHR 0.79; 95% CI: 0.74–0.84) and those admitted to the hospital for NHRHS (aHR 0.60; 95% CI: 0.54–0.67), versus those who did/were not, respectively, had longer times to initial retention, as did female patients, people who inject drugs (PWID) and individuals < 40 years old.

Conclusions

Overall, 84% of not retained individuals used some type of NHRHS during follow‐up. Given that 71% of not retained individuals used GP NHRHS, our results suggest that GP‐targeted interventions may be effective in improving time to initial retention.
CREDIT RATIONING, RISK AVERSION, AND INDUSTRIAL EVOLUTION IN DEVELOPING COUNTRIES
Authors: Bond Eric W. , Tybout James , Utar Hale
Published: July 2015

Relative to their counterparts in high‐income regions, entrepreneurs in developing countries face less efficient financial markets, more volatile macroeconomic conditions, and higher entry costs. This article develops a dynamic empirical model that links these features of the business environment to cross‐firm productivity distributions, entrepreneurs’ welfare, and patterns of industrial evolution. Fit to panel data on Colombian apparel producers, the model yields estimates of a credit market imperfection index, the sunk costs of creating a new business, and various technology parameters. Model‐based counterfactual experiments suggest that improved intermediation could dramatically increase the return on assets for entrepreneurial households with modest wealth.
SEQUENTIAL OR SIMULTANEOUS ELECTIONS? A WELFARE ANALYSIS
Authors: Hummel Patrick , Knight Brian
Published: July 2015

Should all voters vote on the same day or should elections be staggered? Using a model of voting and social learning, we illustrate that sequential elections place too much weight on early states but also provide late voters with valuable information. Simultaneous elections equally weigh states but place too much weight on voter priors, providing an inappropriate advantage to front‐runners. Simultaneous elections are thus preferred if the front‐runner advantage is small, but sequential elections are preferred if the advantage is large. Our quantitative welfare analysis of presidential primaries suggests that simultaneous systems slightly outperform sequential systems.
FRAMING OF INCENTIVES AND EFFORT PROVISION
Authors: Armantier Olivier , Boly Amadou
Published: July 2015

A prospect theory model combining loss aversion and diminishing sensitivity predicts that the link between incentives framing and effort is ambiguous: small penalties yield higher effort, but isomorphic contracts with large penalties decrease effort. We conduct two experiments (a framed field and a conventional lab experiment) in which economically equivalent contracts are framed as menus of either (i) bonuses, (ii) penalties, or (iii) bonuses and penalties. The experimental results confirm the main intuition of the model as subjects performed best when bonuses and penalties are combined. A follow‐up lottery experiment confirms that both loss aversion and diminishing sensitivity influenced the performance.
p‐Coumaric acid in cereals: presence, antioxidant and antimicrobial effects
Authors: Boz Hüseyin
Published: July 2015

Coumaric acid is a hydroxy derivative of cinnamic acid and naturally occurs in three isomers (ortho‐, meta‐ and para‐); p‐coumaric acid is one of the most commonly occurring isomer in nature. p‐coumaric acid, classified as a phytochemical and nutraceutical, is found in various edible plants, such as carrots, tomatoes and cereals. p‐coumaric acid (4‐hydroxy‐cinnamic acid) occurs widely in the cell walls of graminaceous plants. It decreases low‐density lipoprotein (LDL) peroxidation, shows antioxidant and antimicrobial activities and plays an important role in human health. It is found in the endosperm of kernels at a limited level; however, the amount of p‐coumaric acid increases significantly in peripheral tissues. In terms of cereal types, it appears that pericarp fractions in barley, wheat, oat and corn are the fractions richest in p‐coumaric acid. It is both a good antioxidant and a good antimicrobial; therefore, it is natural alternative instead of synthetic additives, nowadays.
Assessment of Intrathecal Pressure in Chondrodystrophic Dogs With Acute Thoracolumbar Disk Disease
Authors: Kunz Rhona E. , Rohrbach Helene , Gorgas Daniela , Gendron Karine , Henke Diana , Forterre Franck
Published: July 2015

Objectives

To assess intrathecal pressure (ITP) in chondrodystrophic dogs with thoracolumbar disk extrusion.

Study design

Prospective cohort study.

Animals

Group 1: 11 chondrodystrophic dogs with thoracolumbar disk extrusion and present deep pain sensation. Group 2 (control): 3 healthy chondrodystrophic laboratory dogs without spinal disease.

Methods

Diagnosis was based on neurologic signs, magnetic resonance imaging (MRI) findings, and surgical confirmation. Blood pressure was maintained within physiologic range during anesthesia. A standardized surgical procedure was applied to minimize factors that could influence measurement readings. An extended hemilaminectomy was performed and ITP was measured with a fiber optic catheter. The catheter was inserted in the subarachnoid space 1 spinal segment caudal to the level of herniation and its tip was advanced to the site of compression.

Results

Significantly higher ITP occurred in chondrodystrophic dogs with acute thoracolumbar disk disease compared with controls. ITP was not associated with duration of clinical signs, neurologic status, outcome, degree of spinal cord compression, or signal intensity changes as assessed by MRI.

Conclusion

Acute thoracolumbar disk disease leads to elevated ITP in chondrodystrophic dogs, which may contribute to increased compression of spinal cord parenchyma.
The Impact of Composite Effect on Dielectric Constant and Tunability in Ferroelectric–Dielectric System
Authors: Lei Ming
Published: July 2015

A theoretical study was carried out to analyze the impact of composite effect on dielectric constant and tunability in the ferroelectric–dielectric system. Models of Ba0.5Sr0.5TiO3–Mg2TiO4, Ba0.45Sr0.55TiO3–MgO and Ba0.5Sr0.5TiO3–MgO–Mg2SiO4 system were constructed. The corresponding dielectric constant, tunability, and electric field distribution were obtained from the finite element analysis and the connections between these parameters were analyzed. The effects of the relative relationship between the dielectric constant of ferroelectric and dielectric on the whole dielectric properties were also analyzed by constructing a series of models with different dielectrics.
Wet Green‐State Joining of Alumina Ceramics Without Paste
Authors: Peng Xiang , Shimai Shunzo , Sun Yi , Zhou Guohong , Wang Shiwei
Published: July 2015

A new technique for the green‐state joining of alumina ceramics without paste has been developed. Wet alumina green body, gelcast by PIBM (a copolymer of isobutylene and maleic anhydride) gel system, is used as a parent green body. The joining process involves integrating two wet green bodies in a gelling state, followed by drying and sintering. For example, wet green bodies after aging 10 h were joined, and the joint region of the dried and sintered sample exhibited a homogeneous microstructure without defects or an interlayer. The flexural strength of the joined sample (468.5 ± 62.9 MPa) was nearly equivalent to that of a monolithic sample (470.6 ± 27.4 MPa). The joining mechanism was discussed on the basis of interaction among PIBM molecular chains. The proposed joining technique is simple and promising for producing advanced ceramics with large sizes and/or complicated shapes.
Factors associated with experiences and attitudes of healthcare professionals towards family‐witnessed resuscitation: a cross‐sectional study
Authors: Sak‐Dankosky Natalia , Andruszkiewicz Paweł , Sherwood Paula R. , Kvist Tarja
Published: July 2015

Aims

To examine factors associated with healthcare professionals' experiences and attitudes towards adult family‐witnessed resuscitation in the emergency and intensive care units.

Background

Family‐witnessed resuscitation offers the option for patients' families to be present during in‐hospital resuscitation. It is important to understand healthcare professionals' views about this practice to determine why, despite its benefits and general recommendation, this practice has not been widely implemented.

Design

A descriptive, correlational, cross‐sectional survey.

Methods

A total of 390 Finnish and Polish Registered Nurses and physicians from six university hospitals took part in the study. A structured questionnaire that examined nurses' and physicians' experiences and attitudes was used. Data, collected between July–December 2013, were analysed with descriptive statistics, logistic and multiple linear regression analyses.

Results

The results indicated that healthcare professionals are not well experienced in family‐witnessed resuscitation. The general attitude towards this practice is somewhat negative. Physicians seem more confident about overcoming process‐related barriers than nurses. Having previous positive experiences of family‐witnessed resuscitation was associated with a more positive attitude towards this practice. Consequently a previous negative experience was associated with more negative attitudes.

Conclusion

Family‐witnessed resuscitation awareness should be increased in daily clinical practice. It is important to find a way to improve experiences and attitudes of healthcare professionals related to this phenomenon. Furthermore, developing local guidelines and multidisciplinary training plans is needed to respond to the needs of patients and their families.
Nurses' views of patient participation in nursing care
Authors: Tobiano Georgia , Bucknall Tracey , Marshall Andrea , Guinane Jessica , Chaboyer Wendy
Published: July 2015

Aims

To explore nurses' views of patient participation in nursing care on medical wards.

Background

Nurses have frequent contact with patients, highlighting their potential role in enabling patient participation. However, some nurses' actions and attitudes act as barriers, failing to achieve core requirements of patient participation. Discovering nurses' views may assist in developing strategies to encourage patient participation in hospitals.

Design

Interpretive study.

Methods

Twenty nurses were recruited from four medical wards, located in two Australian hospitals. In‐depth semi‐structured interviews were conducted between November 2013–March 2014 and analysed using content analysis.

Findings

Five categories emerged from the nurses' views. The first category, acknowledging patients as partners, showed nurses respected patients as legitimate participants. In the second category, managing risk, nurses emphasized the need to monitor participation to ensure rules and patient safety were maintained. Enabling participation was the third category, which demonstrated nurses' strategies that enhanced patients' participation. The fourth category was hindering participation; encapsulating nurses' difficulty in engaging patients with certain characteristics. In the final category, realizing participation, nurses believed patients could be involved in physical activities or clinical communication.

Conclusion

Nurses have a crucial role in promoting patient participation. Through acknowledging and enabling participation, nurses may facilitate patient participation in a range of nursing activities. The nurse's role in enacting participation is complex, having to accommodate each patient's risks and characteristics, highlighting the need for good assessment skills. Education, policy and research strategies are essential to foster nurses' pivotal role in patient participation.
Condition‐dependent expression of carotenoid‐ and melanin‐based plumage colour of northern flicker nestlings revealed by manipulation of brood size
Authors: Musgrove Annessa B. , Wiebe Karen L.
Published: July 2015

Carotenoid‐based colouration in feathers is widely accepted to be a reliable signal of the health of an individual, but the condition‐dependence of melanin‐based plumage ornaments has been highly debated. Using broods that were manipulated in size, we tested whether nutritional stress during rearing affected the carotenoid pigmentation in secondary feathers and the size, shape, and symmetry of melanin spots on breast plumage of northern flickerColaptes auratusnestlings. Two measures of carotenoid colour (chroma and brightness) of secondary flight feathers did not vary according to brood size treatment, but in a larger dataset from the population, carotenoid chroma was positively associated with nestling mass. Nestlings from experimentally enlarged broods had smaller melanin spots than those from reduced broods, which is some of the first experimental evidence that melanin ornament size in growing nestlings is condition‐dependent. However, the shape and symmetry of the melanin breast spots was not associated with nestling mass. Sexual dimorphism was apparent in both types of pigmentation and future studies should investigate whether there are any trade‐offs for nestlings between investing in carotenoid colouration and melanisation and whether trade‐offs differ between the sexes.
Development of the Andalusian Registry of Patients Receiving Community Case Management, for the follow‐up of people with complex chronic diseases
Authors: Morales‐Asencio Jose M. , Kaknani‐Uttumchandani Shakira , Cuevas‐Fernández‐Gallego Magdalena , Palacios‐Gómez Leopoldo , Gutiérrez‐Sequera José L. , Silvano‐Arranz Agustina , Batres‐Sicilia Juan Pedro , Delgado‐Romero Ascensión , Cejudo‐Lopez Ángela , Trabado‐Herrera Manuel , García‐Lara Esteban L. , Martin‐Santos Francisco J. , Morilla‐Herrera Juan C.
Published: July 2015

Rationale, aims and objectives

Complex chronic diseases are a challenge for the current configuration of health services. Case management is a service frequently provided for people with chronic conditions, and despite its effectiveness in many outcomes, such as mortality or readmissions, uncertainty remains about the most effective form of team organization, structures and the nature of the interventions. Many processes and outcomes of case management for people with complex chronic conditions cannot be addressed with the information provided by electronic clinical records. Registries are frequently used to deal with this weakness. The aim of this study was to generate a registry‐based information system of patients receiving case management to identify their clinical characteristics, their context of care, events identified during their follow‐up, interventions developed by case managers and services used.

Methods

The study was divided into three phases, covering the detection of information needs, the design and its implementation in the health care system, using literature review and expert consensus methods to select variables that would be included in the registry.

Results

A total of 102 variables representing structure, processes and outcomes of case management were selected for their inclusion in the registry after the consensus phase. A web‐based registry with modular and layered architecture was designed. The framework follows a pattern based on the model‐view‐controller approach. In its first 6 months after the implementation, 102 case managers have introduced an average number of 6.49 patients each one.

Conclusions

The registry permits a complete and in‐depth analysis of the characteristics of the patients who receive case management, the interventions delivered and some major outcomes as mortality, readmissions or adverse events.
Cumulative Incidence of Functional Decline After Minor Injuries in Previously Independent Older Canadian Individuals in the Emergency Department
Authors: Sirois Marie‐Josée , Émond Marcel , Ouellet Marie‐Christine , Perry Jeffrey , Daoust Raoul , Morin Jacques , Dionne Clermont , Camden Stéphanie , Moore Lynne , Allain‐Boulé Nadine
Published: July 2015

Objectives

To estimate the cumulative incidence of functional decline in independent older adults 3 and 6 months after a minor injury treated in the emergency department (ED) and to identify predictors of this functional decline.

Design

Prospective cohort study.

Settings

Three Canadian teaching EDs.

Participants

Individuals aged 65 and older who were independent in basic activities of daily living before their injury and were evaluated in the ED for minor injuries (N = 335).

Measurements

Functional decline was defined as a loss of 2 or more out of 28 points on the self‐reported Older Americans Resources Services scale. Sociodemographic, mobility, and clinical risk factors for functional decline in non‐ED studies were measured at the ED visit and 3 and 6 months after the injury. Generalized linear mixed models were used to explore differences in functional decline between groups determined according to the different factors.

Results

The cumulative incidence of decline was 14.9% (95% confidence interval (CI) = 7.6–29.1%) at 3 months and 17.3% (95% CI = 9.7–30.9%) at 6 months. Predictors of functional decline were occasional use of a walking aid (relative risk (RR)=2.4, 95% CI = 1.4–4.2), needing help in instrumental activities of daily living (IADLs) before the injury (RR = 3.1, 95% CI=1.7–5.5), taking five or more daily medications (RR = 1.8, 95% CI = 1.0–3.2), and the emergency physicians' assessment of functional decline (RR = 2.8, 95% CI = 1.5–5.3).

Conclusion

Minor injuries in independent older adults treated in EDs are associated with a 15% cumulative incidence of functional decline 3 months after the injury that persisted 6 months later. Simple‐to‐measure factors such as occasional use of a walking aid, daily medication, need for help with IADLs, and physician assessment of decline may help identify independent older adults at risk of functional decline during their consultation. These results confirm the need to improve risk assessment and management of this population in EDs.
A Reconsideration of Minsky's Financial Instability Hypothesis
Authors: BHATTACHARYA SUDIPTO , GOODHART CHARLES A.E. , TSOMOCOS DIMITRIOS P. , VARDOULAKIS ALEXANDROS P.
Published: July 2015

The worst and longest depressions have tended to occur after periods of prolonged, and reasonably stable, prosperity. This results in part from agents rationally updating their expectations during good times and hence becoming more optimistic about future economic prospects. Investors then increase their leverage and shift their portfolios toward projects that would previously have been considered too risky. So, when a downturn does eventually occur, the financial crisis and the extent of default become more severe. Whereas a general appreciation of this syndrome dates back to Minsky (1992) and even beyond, to Irving Fisher (), we model it formally. In addition, endogenous default introduces a pecuniary externality since investors do not factor in the impact of their decision to take risk and default on the borrowing cost. We explore the relative advantages of alternative regulations in reducing financial fragility and suggest a novel criterion for improvement of aggregate welfare.
Household Response to Government Debt: Evidence from Life Insurance Holdings
Authors: CRAIG STEVEN G. , HOANG EDWARD C. , VOLLRATH DIETRICH
Published: July 2015

We use state‐level panel data on life insurance in force in the United States and find that a $1 increase in government debt, at either the state or federal level is associated with a $0.96 increase in the face value of the average life insurance holdings per capita for a household in the average state. This increase represents an intention to save that would almost completely offset the government debt in specific states of the world (i.e., if the insured dies). Because this state of the world is rare, the immediate increase in actual savings is only about $0.03, the cost of the additional insurance. We find, in addition, that this response occurs mainly on the intensive margin, meaning that the size of the average life insurance policy increases when government debt increases. Along the extensive margin, we find the number of policies in force falls slightly with federal debt, and rises slightly with state debt increases. The results show altruistic planning in response to changes in government debt that are consistent with Ricardian Equivalence and the long‐run neutrality of government debt.
Screening and Brief Interventions for Alcohol and Other Drug Use Among Pregnant Women Attending Midwife Obstetric Units in Cape Town, South Africa: A Qualitative Study of the Views of Health Care Professionals
Authors: Petersen Williams Petal , Petersen Zaino , Sorsdahl Katherine , Mathews Catherine , Everett‐Murphy Katherine , Parry Charles DH
Published: July 2015

Introduction

Despite the negative consequences of alcohol and other drug use during pregnancy, few interventions for pregnant women are implemented, and little is known about their feasibility and acceptability in primary health care settings in South Africa. As part of the formative phase of screening, brief intervention, and referral to treatment for substance use among women presenting for antenatal care, the present study explored health care workers’ attitudes and perceptions about screening, brief intervention, and referral to treatment among this population.

Methods

Forty‐three health care providers at 2 public sector midwife obstetric units in Cape Town, South Africa, were interviewed using an open‐ended, semistructured interview schedule designed to identify factors that hinder or support the implementation of screening, brief intervention, and referral to treatment for substance use in these settings. Transcribed interviews were analyzed using the framework approach.

Results

Health care providers agreed that there is a substantial need for screening, brief intervention, and referral to treatment for substance use among pregnant women and believe such services potentially could be integrated into routine care. Several women‐, staff‐, and clinic‐level barriers were identified that could hinder the successful implementation in antenatal services. These barriers included the nondisclosure of alcohol and other drug use, the intervention being considered as an add‐on service or additional work, negative staff attitudes toward implementation of an intervention, poor staff communication styles such as berating women for their behavior, lack of interest from staff, time constraints, staff shortages, overburdened workloads, and language barriers.

Discussion

The utility of screening, brief intervention, and referral to treatment for addressing substance use among pregnant women in public health midwife obstetric units was supported, but consideration will need to be given to addressing a variety of barriers that have been identified.
Which Aspects of Professional Commitment Can Effectively Retain Nurses in the Nursing Profession?
Authors: Chang Hao‐Yuan , Shyu Yea‐Ing Lotus , Wong May‐Kuen , Friesner Daniel , Chu Tsung‐Lan , Teng Ching‐I
Published: July 2015

Purpose

This study examined which aspects of professional commitment can effectively retain nurses in the nursing profession.

Design, Settings, and Participants

This study used a longitudinal design, simple random sampling, and two‐wave data collection to survey and follow up a representative sample of 579 nurses for 1 year in a major medical center in northern Taiwan.

Methods

Items measuring each aspect of professional commitment came from Meyer et al.’s scale. In the second wave, administrative data were culled to determine whether these nurses remain employed as nurses. Structural equation modeling is used to analyze the data.

Results

Analytical results indicate that continuance commitment predicts nurse retention in the nursing profession (path coefficient = 0.34, p < .01).

Conclusions

Institutional efforts to improve continuance commitment (e.g., improved salary structures and enhanced professional development opportunities) likely retain nurses in the nursing profession.

Clinical Relevance

The findings of this study indicate the importance of continuance intention in retaining nurses. Nursing managers who face staff retention issues may consider making efforts to improve nurse salary and employer‐sponsored benefits.
Hyperglycaemic hyperosmolar syndrome in children: Patient characteristics, diagnostic delays and associated complications
Authors: Price Amanda , Losek Joseph , Jackson Benjamin
Published: July 2015

Aims

The aim of this study was to describe the demographical and clinical characteristics, diagnostic difficulties, and morbidity and mortality in children with hyperglycaemic hyperosmolar syndrome (HHS).

Methods

Retrospective cross‐section descriptive study of children (<18 years of age) at an urban, tertiary, academic Children's Hospital diagnosed with HHS from January 2002 to December 2011.

Results

Six patients met inclusion criteria for the diagnosis of HHS. Age ranged from 6 to 16 years with 4 (67%) patients younger than 13 years. Four (67%) patients were women and 5 (83%) were African‐American. Body mass index (BMI)‐for‐age percentile was >97% in four (67%) patients. Three (60%) of five patients seen as outpatients were misdiagnosed, two cases were seen twice before an accurate diagnosis of HHS was made. There was one (17%) death. Complications included three patients with acute renal failure, one patient with seizures, and one patient with rhabdomyolysis and compartment syndrome leading to below the knee amputation. Malignant hyperthermia and ventricular arrhythmias occurred in the patient who expired. Three of the five patients who had autoantibody tests had positive results and were diagnosed with type 1 diabetes mellitus.

Conclusions

Characteristics of children with HSS are variable for age, gender and BMI‐for‐age percentile and not predominately limited to obese male adolescent African‐American. Delay in diagnosis is common and morbidity and mortality in paediatric HHS are significant. The subsequent diagnosis of patients presenting with HHS includes type 1 and 2 diabetes mellitus.
A Toll-Like Receptor 1/2 Agonist Augments Contractility in Rat Corpus Cavernosum
Authors: Stallmann-Jorgensen Inger , Ogbi Safia , Szasz Theodora , Webb R. Clinton
Published: July 2015

Introduction

Activation of the innate immune Toll-like receptor 2 (TLR2) initiates inflammation and has been implicated in vascular dysfunction. Increased contraction and decreased relaxation responses in the penile vasculature lead to erectile dysfunction, a condition associated with inflammation. However, whether TLR2 activation plays a role in penile vascular function has not been established.

Aim

We hypothesized that activation of the TLR 1/2 heterodimer (TLR1/2) augments contractile and impairs relaxation responses of corpus cavernosum and that these perturbations of vascular function are mediated by low nitric oxide (NO) availability and enhanced activity of the RhoA/Rho-kinase pathway.

Methods

Contraction and relaxation responses were measured in rat cavernosal strips using a myograph after incubation with a TLR1/2-activating ligand Pam3CSK4 (Pam3), the TLR1/2 inhibitor CuCPT 22 (CuCPT), and inhibitors of NO synthase (LNAME) and Rho-kinase (Y27632). TLR2 protein expression was assessed by immunohistochemistry.

Main Outcome Measures

Cumulative concentration response curves, sensitivity (pEC50), and maximal response (Emax) of cavernosal strips to vasodilatory and vasocontractile agonists were compared between treatments.

Results

Pam3-treated cavernosal strips exhibited greater pEC50 and higher Emax to phenylephrine (PE) than control tissues. Inhibition of NO synthase increased Emax to PE in Pam3-treated cavernosal strips. Pam3 treatment reduced relaxation to Y27632 compared with control tissues. Inhibition of TLR1/2 activation with CuCPT returned the augmented contraction to PE and the decreased relaxation to Y27632 of Pam3-treated cavernosal strips to control values.

Conclusions

The TLR1/2 heterodimer mediates augmented contraction and reduced relaxation in rat cavernosal strips. Thus, TLR1/2 activation antagonizes vascular responses crucial for normal erectile function and implicates immune activation in vasculogenic erectile dysfunction. Immune signaling via TLR2 may offer novel targets for treating inflammation-mediated vascular dysfunction in the penis.
Liver‐infiltrating CD8+ lymphocytes as prognostic factor for tumour recurrence in hepatitis C virus‐related hepatocellular carcinoma
Authors: Ramzan Muhammad , Sturm Nathalie , Decaens Thomas , Bioulac‐Sage Paulette , Bancel Brigitte , Merle Philippe , Tran Van Nhieu Jeanne , Slama Rémy , Letoublon Christian , Zarski Jean‐Pierre , Jouvin‐Marche Evelyne , Marche Patrice N. , Leroy Vincent
Published: July 2015

Background

Chronic liver inflammation and immune/inflammatory response promote hepatocellular carcinoma. The aim of this study was to characterize the immune status of HCV‐related cirrhosis in patients with hepatocellular carcinoma (HCV‐HCC) as compared to HCV patients without hepatocellular carcinoma.

Method

Immune markers (CD3, CD4, CD8, CD20, CD56, TCRγδ, FoxP3) and gene expression profiles (CD8α, CD8β, FoxP3, IL‐6, IFN‐γ, perforin, RANTES) were analysed in a test cohort by immunohistochemistry and quantitative RT‐PCR analysis on serial non‐tumorous and tumorous tissues.

Results

Immune micro‐environment was more inflammatory in HCV‐HCC than HCV cirrhotic livers. The number of CD3+, CD4+, CD8+ and CD20+ liver‐infiltrating lymphocytes was significantly higher, whereas the number of CD56+ cells was significantly lower in HCV‐HCC compared to HCV cirrhotic parenchyma. These differences were restricted to fibrous septa for CD4+ and CD20+ cells and to nodular parenchyma for CD8+ cells. Gene expressions of CD8α, FoxP3 and RANTES were also significantly higher in HCV‐HCC than in HCV cirrhosis. Interestingly, in a large cohort of 63 HCV‐HCC patients. The number of CD8+ cells ≥100/field was associated with significant higher tumour recurrence (P = 0.003) and lower overall survival (P = 0.05) at 5 years.

Conclusion

High densities of liver‐infiltrating lymphocytes in HCV‐HCC cirrhotic parenchyma prevail inflammatory conditions and could contribute to tumorigenesis and tumour recurrence. These results could contribute towards better clinical evaluation of patients susceptible for HCC recurrence after curative surgery.
Leveling L2 Texts Through Readability: Combining Multilevel Linguistic Features with the CEFR
Authors: SUNG YAO–TING , LIN WEI–CHUN , DYSON SCOTT BENJAMIN , CHANG KUO–EN , CHEN YU–CHIA
Published: July 2015

Selecting appropriate texts for L2 (second/foreign language) learners is an important approach to enhancing motivation and, by extension, learning. There is currently no tool for classifying foreign language texts according to a language proficiency framework, which makes it difficult for students and educators to determine the precise difficulty/complexity levels of an unclassified text. Taking the Chinese language as an example, this study aimed to create a readability assessment system, called the Chinese Readability Index Explorer for Chinese as a Foreign Language (CRIE–CFL), in order to level—that is, to sort by proficiency level—texts that will be used for instructional purposes. The framework of choice in this project is the Common European Framework of Reference (CEFR). A team of expert CFL teachers first classified 1,578 CFL texts into their appropriate CEFR levels. A set of 30 CFL readability features was then developed or drawn from previous research, and sorted according to importance using F‐scores. In addition, a support vector machine model was trained by sequentially integrating the features into the model to optimize accuracy. The empirical evaluation of CRIE–CFL revealed average exact‐ and adjacent‐level accuracies of 74.97% and 99.62%, respectively, for predicting the expert classification of a text. The functionalities of CRIE–CFL are introduced and discussed.
Meeting the Challenges of Curriculum Construction and Change: Revision and Validity Evaluation of a Placement Test
Authors: MOZGALINA ANASTASIA , RYSHINA–PANKOVA MARIANNA
Published: July 2015

Achievement of advanced literacy as a goal of foreign language (FL) study within the available amount of time requires that FL departments construct a well‐articulated program and optimize student learning at each stage of the curriculum. One essential element of such optimization is the development of assessment procedures to place students into courses that enable successful fostering of their abilities. Ideally, such assessment practices should incorporate aspects of textual literacy, including a well‐motivated link between meaning‐oriented textual semantics and the required lexicogrammatical features. This article reports on the revision and validity evaluation of a C‐test as one component of the placement test in the Georgetown University German program and as an instrument that includes accounting for textual literacy. We begin with the reasons for the test revision and report on the development and evaluation of the new C‐test texts, which enabled better alignment with the curriculum and demonstrate a fitting range of reliable distinctions among examinees of broadly differing abilities. The article concludes by highlighting the central role of contextually relevant assessment practices for the success of a program that aims to develop advanced literacy in a FL and the lessons learned throughout the evaluation process.
Esophagogastric junction contractility for clinical assessment in patients with GERD: a real added value?
Authors: Tolone S. , De Bortoli N. , Marabotto E. , de Cassan C. , Bodini G. , Roman S. , Furnari M. , Savarino V. , Docimo L. , Savarino E.
Published: July 2015

Background

The role of esophagogastric junction contractile integral (EGJ‐CI) as assessed by high‐resolution manometry (HRM) is unclear. We aimed to correlate the EGJ‐CI with impedance‐pH findings in gastro‐esophageal reflux disease (GERD) patients.

Methods

Consecutive patients with GERD symptoms were enrolled. All patients underwent upper endoscopy, HRM, and impedance‐pH testing. The EGJ‐CI was calculated using the distal contractile integral tool box during three consecutive respiratory cycles. The value was then divided by the duration of these cycles. A value below 13 was considered as a defective EGJ‐CI. We also assessed EGJ morphology, esophageal acid exposure time (AET), number of reflux episodes (NRE), and symptom association analysis (SAA). A positive impedance‐pH monitoring was considered in case of abnormal AET and/or NRE and/or positive SAA.

Key Results

Among 130 patients we enrolled, 91 had GERD (abnormal AET and/or elevated NRE and/or positive SAA) and 39 had functional heartburn (FH) (negative endoscopy, normal AET, normal NRE, and negative SAA). The GERD patients had a lower median value of EGJ‐CI (11 [3.1–20.7] vs 22 [9.9–41], p < 0.02) compared to FH patients. Patients with a defective EGJ‐CI had, more frequently, a positive impedance‐pH monitoring or esophageal mucosal lesions at endoscopy (p < 0.05 and p < 0.05, respectively) than patients with a normal EGJ‐CI. An EGJ‐CI cut‐off value of 5 mmHg cm yielded the optimal performance in identifying GERD at impedance‐pH (sensitivity 89%–specificity 63%).

Conclusions & Inferences

A defective EGJ‐CI at HRM is clearly associated with evidence of GERD at impedance‐pH monitoring. Evaluating EGJ‐CI may be useful to predict an abnormal impedance‐pH testing.
The GPR55 antagonist CID16020046 protects against intestinal inflammation
Authors: Stančić A. , Jandl K. , Hasenöhrl C. , Reichmann F. , Marsche G. , Schuligoi R. , Heinemann A. , Storr M. , Schicho R.
Published: July 2015

Background

G protein‐coupled receptor 55 (GPR55) is a lysophospholipid receptor responsive to certain cannabinoids. The role of GPR55 in inflammatory processes of the gut is largely unknown. Using the recently characterized GPR55 inhibitor CID16020046, we determined the role of GPR55 in experimental intestinal inflammation and explored possible mechanisms of action.

Methods

Colitis was induced by either 2.5% dextran sulfate sodium (DSS) supplemented in the drinking water of C57BL/6 mice or by a single intrarectal application of trinitrobenzene sulfonic acid (TNBS).

Key Results

Daily application of CID16020046 (20 mg/kg) significantly reduced inflammation scores and myeloperoxidase (MPO) activity. In the DSS colitis model, levels of tumor necrosis factor alpha (TNF‐α) and interleukin 1 beta (IL‐1β), and the expression of cyclooxygenase (Cox)‐2 and signal transducer and activator of transcription 3 (STAT‐3) were reduced in colon tissues while in TNBS‐induced colitis, levels of Cox‐2, IL‐1β and IL‐6 were significantly lowered. Evaluation of leukocyte recruitment by flow cytometry indicated reduced presence of lymphocytes and macrophages in the colon following GPR55 inhibition in DSS‐induced colitis. In J774A.1 mouse macrophages, inhibition of GPR55 revealed reduced migration of macrophages and decreased CD11b expression, suggesting that direct effects of CID16020046 on macrophages may have contributed to the improvement of colitis. GPR55−/− knockout mice showed reduced inflammation scores as compared to wild type mice in the DSS model suggesting a pro‐inflammatory role in intestinal inflammation.

Conclusions & Inferences

Pharmacological blockade of GPR55 reduces experimental intestinal inflammation by reducing leukocyte migration and activation, in particular that of macrophages. Therefore, CID16020046 represents a possible drug for the treatment of bowel inflammation.
Free Trade Agreements and US Foreign Policy
Authors: Hundt David
Published: July 2015

The United States has completed numerous free trade agreements (FTAs), but the pattern of these agreements defies conventional explanations. Arguments that are based on domestic interests and economic gains cannot explain the comparative under‐performance of US trade agreements. The pattern of US trade agreements is also inconsistent with explanations that focus on state power, which depict FTAs as a “reward” for loyal clients. This article finds a better explanation for the pattern of the United States' FTAs by considering the systemic level of analysis, and in particular the dynamics of the international economic order. It illustrates that strong competition for bilateral trade agreements has resulted in patterns of agreements that the United States cannot easily dominate. This is not to say that the United States has no capacity to finalize trade agreements: the United States remains the world's most influential nation‐state, but the constraints of the international system necessarily limit the degree to which FTAs can serve the interests of US foreign economic policy. The recent evolution of international trade politics, however, indicates that smaller states are comparatively less vulnerable to pressure from great powers, such as the United States.
Root aquaporins contribute to whole plant water fluxes under drought stress in rice (Oryza sativa L.)
Authors: Grondin Alexandre , Mauleon Ramil , Vadez Vincent , Henry Amelia
Published: July 2015

Aquaporin activity and root anatomy may affect root hydraulic properties under drought stress. To better understand the function of aquaporins in rice root water fluxes under drought, we studied the root hydraulic conductivity (Lpr) and root sap exudation rate (Sr) in the presence or absence of an aquaporin inhibitor (azide) under well‐watered conditions and following drought stress in six diverse rice varieties. Varieties varied in Lpr and Sr under both conditions. The contribution of aquaporins to Lpr was generally high (up to 79% under well‐watered conditions and 85% under drought stress) and differentially regulated under drought. Aquaporin contribution to Sr increased in most varieties after drought, suggesting a crucial role for aquaporins in osmotic water fluxes during drought and recovery. Furthermore, root plasma membrane aquaporin (PIP) expression and root anatomical properties were correlated with hydraulic traits. Three chromosome regions highly correlated with hydraulic traits of the OryzaSNP panel were identified, but did not co‐locate with known aquaporins. These results therefore highlight the importance of aquaporins in the rice root radial water pathway, but emphasize the complex range of additional mechanisms related to root water fluxes and drought response.
Fetal Growth, Obesity, and Atopic Disorders in Adolescence: a Retrospective Birth Cohort Study
Authors: Lin Meng‐Hung , Hsieh Chia‐Jung , Caffrey James L. , Lin Yu‐Sheng , Wang I‐Jen , Ho Wen‐Chao , Chen Pau‐Chung , Wu Trong‐Neng , Lin Ruey‐Shiung
Published: July 2015

Background

Developmental status at birth and subsequent obesity have been implicated in the development of childhood atopic dermatitis (AD) and allergic rhinitis (AR).

Methods

The current study analysed the cohort data of 74 688 junior high school students from a national retrospective birth cohort study in Taiwan. A random 10% sample was selected from singleton livebirths with complete data on the analytical variables of interest. Atopic disorders, including AD and AR, were assessed by questionnaires (International Study of Asthma and Allergies in Childhood). Logistic regression analyses were applied with adjustments for related risk factors.

Results

Among subjects mainly 13–15 years of age, the estimated prevalence was 7.6% for AD and 22.4% for AR. While the role of fetal growth in allergic disorders was less evident, the risk of developing AD and AR were both influenced by a combination of fetal growth status and adolescent body mass index (BMI). Compared with those with normal fetal growth and school‐aged BMI, the risk of developing AD increased 64% among adolescents with both restricted fetal growth and high BMI (odds ratio 1.64, 95% confidence interval 1.37, 1.97). The risk for this combination was higher than that for either restricted fetal growth or high BMI alone. Nevertheless, the overall interaction between BMI and fetal growth status on atopic disorders did not reach statistical significance.

Conclusions

Excessive weight gain could be an important risk factor related to developing atopic dermatitis and allergic rhinitis during adolescence, especially among infants born small for gestational age.
Early Voting and Presidential Nominations: A New Advantage for Front‐Runners?
Authors: Fullmer Elliott B.
Published: July 2015

Early voting has become an important feature of presidential elections. While research has generally focused on whether programs increase turnout, few have considered whether early voting alters the information environment in campaigns. Those who vote early may do so before important information becomes available in the final weeks of a campaign. I speculate that early voting should benefit early front‐runners in presidential nomination contests, as voters may cast early votes for these candidates before fully considering their less‐known opponents. Examining exit‐poll data from the 2008 Democratic primaries between Hillary Clinton and Barack Obama, I find that Clinton indeed benefited from early voting in several early primary states.
Presidential Confidence in Crisis: Blame, Media, and the BP Oil Spill
Authors: Johnston Travis M. , Goggin Stephen N.
Published: July 2015

Recent studies find that voters regularly punish presidents for seemingly unrelated events, despite a clear understanding of how these issues become tied to the president. We contend that the media plays an important role in creating this link. Testing this, we examined how the 2010 BP oil spill shaped evaluations of President Barack Obama, paying particular attention to news coverage to isolate the event's applicability to the president. We estimate the causal effect of these different frames by matching respondents from a prespill control group to two separate treatment phases, finding that presidential confidence decreases once the media begins attributing political blame, but not before.