bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing the readability, quality and accuracy of online health information for patients with low anterior resection syndrome following surgery for rectal cancer
Authors: Garfinkle R. , Wong‐Chong N. , Petrucci A. , Sylla P. , Wexner S. D. , Bhatnagar S. , Morin N. , Boutros M.
Published: January 2019

Aim

Management of low anterior resection syndrome (LARS) requires a high degree of patient engagement. This process may be facilitated by online health‐related information and education. The aim of this study was to systematically review current online health information on LARS.

Method

An online search of Google, Yahoo and Bing was performed using the search terms ‘low anterior/anterior resection syndrome’ and ‘bowel function/movements after rectal cancer surgery’. Websites were assessed for readability (eight standardized tests), suitability (using the Suitability Assessment of Materials instrument), quality (the DISCERN instrument), accuracy and content (using a LARS‐specific content checklist). Websites were categorized as academic, governmental, nonprofit or private.

Results

Of 117 unique websites, 25 met the inclusion criteria. The median readability level was 10.4 (9.2–11.7) and 11 (44.0%) websites were highly suitable. Using the DISCERN instrument, seven (28.0%) websites had clear aims, two (8.0%) divulged the sources used and four (16.0%) had high overall quality. Only eight (32.0%) websites defined LARS and ten (40.0%) listed all five major symptoms associated with the LARS score. There was variation in the number of websites that discussed dietary modifications (80.0%), self‐help strategies (72.0%), medication (68.0%), pelvic floor rehabilitation (60.0%) and neuromodulation (8.0%). The median accuracy of websites was 93.8% (88.2–96.7%). Governmental websites scored highest for overall suitability (P = 0.0079) and quality (P < 0.001).

Conclusions

Current online information on LARS is suboptimal. Websites are highly variable, important content is often lacking and material is too complex for patients.
The sentineling—Foraging trade‐off in dominant and subordinate Arabian babblers
Authors: Ostreiher Roni , Heifetz Aviad
Published: January 2019

Many cooperative breeders forage under predation risks, sentineling is a central activity, and groupmates have to balance between sentineling and foraging. The optimal balance between sentinel activity and foraging may differ among dominant and subordinate individuals, as dominants are more efficient foragers. Two theoretical models pertain to this balance and predict when individuals with different foraging abilities should switch between the two activities on the basis of their energetic state. In one of these models, individuals must attain a critical energetic level by dusk to pass the night, and in the second model fitness is monotonically increasing with the energetic state. We tested these models in the cooperatively breeding Arabian babbler,Turdoides squamiceps. We measured the length of sentinel bouts and the gaps between them both in natural conditions and following experimental feeding. Following feeding ad libitum, subordinates expanded their sentinel bouts significantly more than dominants in comparison with natural conditions. These findings are consistent with the first model, but not with the second. In the experiment, we measured the mass of mealworms consumed by each individual following a sentinel bout relative to its body mass. This ratio was larger for subordinates, indicating that they ended their sentinel bouts at a lower energetic state than dominants. This finding is consistent with the second model, but not with the first. Immediately after eating ad libitum,in 62% of the cases the first behavior performed by the babblers was a new sentinel bout, but in 17% it was a mutual interaction with a groupmate, indicating that social interactions also play a role in the trade‐off vis‐à‐vis sentinel activity.
Main stem and off‐channel habitat use by juvenile Chinook salmon in a sub‐Arctic riverscape
Authors: Huntsman Brock M. , Falke Jeffrey A.
Published: January 2019

Poor growth and survival in freshwater and marine environments have been implicated as responsible for Chinook salmon (Oncorhynchus tshawytscha) declines across Alaska.

Lateral connectivity of river main stems with off‐channel habitats may play an integral role in sustaining Alaskan salmonid populations because off‐channel habitats commonly provide greater growth opportunities than main stem habitats through greater macroinvertebrate productivity and warmer water temperatures. However, off‐channel habitats may impose greater mortality risks to juvenile salmonids, as these habitats are typically more susceptible to drying and are often occupied by potential predators.

We used a hierarchical Bayesian count model to describe juvenile Chinook salmon distributions throughout the Chena River, Alaska in main stem and off‐channel habitats and employed diet, prey availability, and bioenergetic analyses to explain these habitat selection decisions from data collected in the summer of 2015.

We found salmon to be most abundant in off‐channel habitats as summer temperature increased, which suggested that salmon dispersed to off‐channel habitats to take advantage of energetically favourable growth conditions as indicated by the higher prey biomass in benthic and diet samples collected within off‐channel habitats.

Our results could have significant implications for juvenile salmon under a warming Alaskan climate as access to productive off‐channel habitats may be important to offset increased energetic costs as temperature warms.
Importance of scale, land‐use, and stream network properties for riparian plant communities along an urban gradient
Authors: Kuglerová Lenka , Kielstra Brian W. , Moore R. Dan , Richardson John S.
Published: January 2019

Riparian forests along urban streams are affected by flashy hydrological regimes and adjacent upland land‐use, and their downstream dynamics are altered by forest fragmentation and by frequent river network truncation. This can lead to lower riparian habitat quality, decreased dispersal along the river network and increased recruitment of novel plant communities including non‐native species. Compared to forested landscapes, our understanding of riparian plant community diversity and composition along urban river networks is poor.

We investigated riparian plant communities and riparian habitat variables along seven river networks situated along an urban gradient in the Greater Toronto Area, Canada. Six land‐use metrics classifying the intensity of urbanisation on three spatial scales (sub‐catchment, upstream riparian buffer, site buffer) were tested to explain the variation in riparian plant communities along the river networks and to describe the differences in riparian habitat.

Riparian plant diversity peaked at sites which had between 40% and 70% of built‐up land cover within sub‐catchments; however, these communities contained a large number of non‐native species compared to the forested streams. While total species richness and native species richness were more related to river network factors (catchment area), non‐native richness was also affected by land‐use within a site. Community composition was more related to local land‐use than catchment area. Geographical distance between sites (both overland and hydrological) was increasingly more important for community heterogeneity along the urbanisation gradient. Riparian habitat worsened along the urbanisation gradient, with higher disturbance and soil pH and lower soil organic content and bryophyte cover in the more urban catchments. Riparian habitat variables were also related to the position along the river networks.

Our results provide important insights into how riparian plant communities and riparian habitat differ along a gradient of urbanisation. Compared to previous studies we investigated the patterns in riparian vegetation in the context of river networks, including a variety of land‐use metrics, and analysed data across different spatial scales. This revealed important trends in plant diversity, demonstrated that urban land‐use increases the occurrence of non‐native species, and showed that the land‐use at the local scale is a stronger determinant of plant assemblages compared to land‐use at broader scales. These novel findings can be applied to land management in order to mitigate the effects of urbanisation on riparian ecosystems and the functions they provide for adjacent streams and rivers.
Whales in warming water: Assessing breeding habitat diversity and adaptability in Oceania's changing climate
Authors: Derville Solène , Torres Leigh G. , Albertson Renee , Andrews Olive , Baker C. Scott , Carzon Pamela , Constantine Rochelle , Donoghue Michael , Dutheil Cyril , Gannier Alexandre , Oremus Marc , Poole Michael M. , Robbins Jooke , Garrigue Claire
Published: January 2019

In the context of a changing climate, understanding the environmental drivers of marine megafauna distribution is important for conservation success. The extent of humpback whale breeding habitats and the impact of temperature variation on their availability are both unknown. We used 19 years of dedicated survey data from seven countries and territories of Oceania (1,376 survey days), to investigate humpback whale breeding habitat diversity and adaptability to climate change. At a fine scale (1 km resolution), seabed topography was identified as an important influence on humpback whale distribution. The shallowest waters close to shore or in lagoons were favored, although humpback whales also showed flexible habitat use patterns with respect to shallow offshore features such as seamounts. At a coarse scale (1° resolution), humpback whale breeding habitats in Oceania spanned a thermal range of 22.3–27.8°C in August, with interannual variation up to 2.0°C. Within this range, both fine and coarse scale analyses of humpback whale distribution suggested local responses to temperature. Notably, the most detailed dataset was available from New Caledonia (774 survey days, 1996–2017), where encounter rates showed a negative relationship to sea surface temperature, but were not related to the El Niño Southern Oscillation or the Antarctic Oscillation from previous summer, a proxy for feeding conditions that may impact breeding patterns. Many breeding sites that are currently occupied are predicted to become unsuitably warm for this species (>28°C) by the end of the 21st century. Based on modeled ecological relationships, there are suitable habitats for relocation in archipelagos and seamounts of southern Oceania. Although distribution shifts might be restrained by philopatry, the apparent plasticity of humpback whale habitat use patterns and the extent of suitable habitats support an adaptive capacity to ocean warming in Oceania breeding grounds.
A multilevel perspective of the identity transition to motherhood
Authors: Hennekam Sophie , Syed Jawad , Ali Faiza , Dumazert Jean‐Pierre
Published: January 2019

This study examines the identity transition of women when they become mothers and return to work. Twenty‐two first‐time mothers were interviewed at two points in time: just after giving birth and on re‐entry into employment after maternity leave. The findings suggest that this transition is influenced by multiple factors on different levels which include individual factors, such as partner support and career aspirations, organizational factors such as family‐friendly work practices and role models, and societal factors such as social norms and attitudes towards the maternal body. The findings highlight the importance of context by stressing the interrelated nature of factors on the micro‐, meso‐ and macro‐level in order to better understand the identity transition to motherhood.
Changes in plaque and gingivitis levels after tooth bleaching: A systematic review
Authors: Sanz‐Sánchez Ignacio , Oteo‐Calatayud Jesús , Serrano Jorge , Martín Conchita , Herrera David
Published: January 2019

Objectives

The primary aim of this systematic review was to evaluate the effect of external tooth‐bleaching products on plaque indices and to compare it to a placebo or a negative control.

Methods

A protocol was developed aimed to answer the next focused question: What is the effect of tooth bleaching compared to no treatment or a placebo, in subjects without periodontitis aged ≥18 years in the levels of plaque and gingivitis? Two electronic databases were used as sources in the search for studies satisfying the inclusion criteria: (a) The National Library of Medicine (MEDLINE via PubMed); (b) Cochrane Central Register of Controlled Trials.

Results

Only randomized controlled trials were included. The initial search found 382 potential publications. Seven of them were finally included, and six were used in the meta‐analyses. The use of bleaching products showed higher reductions in plaque (n = 6; standardized mean difference [SMD] = 0.47; 95% confidence interval [CI] = 0.06, 0.88;P < 0.001) and gingivitis indices (n = 4; SMD = 0.47; 95% CI = 0.22, 0.73;P < 0.001), when compared to a control group (no treatment or placebo).

Conclusions

External tooth bleaching is associated with statistically significant short‐term reductions in plaque and gingivitis indices. However, no data were available to evaluate long‐term effects.
Infants’ Ability to Detect Emotional Incongruency: Deep or Shallow?
Authors: Crivello Cristina , Poulin‐Dubois Diane
Published: January 2019

Infants can detect individuals who demonstrate emotions that are incongruent with an event and are less likely to trust them. However, the nature of the mechanisms underlying this selectivity is currently subject to controversy. The objective of this study was to examine whether infants’ socio‐cognitive and associative learning skills are linked to their selective trust. A total of 102 14‐month‐olds were exposed to a person who demonstrated congruent or incongruent emotional referencing (e.g., happy when looking inside an empty box), and were tested on their willingness to follow the emoter's gaze. Knowledge inference and associative learning tasks were also administered. It was hypothesized that infants would be less likely to trust the incongruent emoter and that this selectivity would be related to their associative learning skills, and not their socio‐cognitive skills. The results revealed that infants were not only able to detect the incongruent emoter, but were subsequently less likely to follow her gaze toward an object invisible to them. More importantly, infants who demonstrated superior performance on the knowledge inference task, but not the associative learning task, were better able to detect the person's emotional incongruency. These findings provide additional support for the rich interpretation of infants’ selective trust.
Indirubin modulates CD4+ T‐cell homeostasis via PD1/PTEN/AKT signalling pathway in immune thrombocytopenia
Authors: Zhao Yajing , Han Panpan , Liu Lei , Wang Xiaojie , Xu Pengcheng , Wang Haoyi , Yu Tianshu , Sun Yunqi , Li Lizhen , Sun Tao , Liu Xinguang , Zhou Hai , Qiu Jihua , Wang Liang , Peng Jun , Xu Shuqian , Hou Ming
Published: January 2019

Immune thrombocytopenia (ITP) is an acquired autoimmune disease characterized by an immune mediated decrease in platelet number. Disturbance of CD4+ T‐cell homeostasis with simultaneous decrease of CD4+CD25+Foxp3+ regulatory T cells (Tregs) as well as unrestricted proliferation and activation of peripheral CD4+ effector T cells underpin the pathophysiology of ITP. Indirubin is an active ingredient of a traditional Chinese herb called Indigofera tinctoria L. which is clinically used for the treatment of ITP patients. Whether indirubin targets the Tregs/effector T cell‐axis to restore platelet number is unknown. In our in vitro studies, Indirubin could significantly enhance the number and function of Tregs and meanwhile dampen the activation of effector T cells in a dose‐dependent manner. Indirubin was observed to restore the expression of programmed cell‐death 1 (PD1) and phosphatase and tensin homolog (PTEN) on the CD4+ T cells of ITP patients, leading to the subsequent attenuation of the AKT/mTOR pathway. Furthermore, these observations were recapitulated in an active murine model of ITP with a prominent platelet response. Thus, our results identified a potentially novel mechanism of the therapeutic action of indirubin in the treatment of ITP through regulating the homeostasis of CD4+ T cells in a PD1/PTEN/AKT signalling pathway.
Neural induction of porcine‐induced pluripotent stem cells and further differentiation using glioblastoma‐cultured medium
Authors: Kim Eunhye , Kim Mirae , Hwang Seon‐Ung , Kim Jongpil , Lee Gabsang , Park Young Seok , Hyun Sang‐Hwan
Published: January 2019

Prior to transplantation, preclinical study of safety and efficacy of neural progenitor cells (NPCs) is needed. Therefore, it is important to generate an efficient in vitro platform for neural cell differentiation in large animal models such as pigs. In this study, porcine‐induced pluripotent stem cells (iPSCs) were seeded at high cell density to a neural induction medium containing the dual Sma‐ and Mad‐related protein (SMAD) inhibitors, a TGF‐β inhibitor and BMP4 inhibitor. The dSMADi‐derived NPCs showed NPC markers such as PLAG1, NESTIN and VIMENTIN and higher mRNA expression of Sox1 compared to the control. The mRNA expression of HOXB4 was found to significantly increase in the retinoic acid‐treated group. NPCs propagated in vitro and generated neurospheres that are capable of further differentiation in neurons and glial cells. Gliobalstoma‐cultured medium including injury‐related cytokines treated porcine iPSC‐NPCs survive well in vitro and showed more neuronal marker expression compared to standard control medium. Collectively, the present study developed an efficient method for production of neural commitment of porcine iPSCs into NPCs.
Neuropeptide W regulates proliferation and differentiation of ATDC5: Possible involvement of GPR7 activation, PKA and PKC‐dependent signalling cascades
Authors: Wang RiKang , Zheng Chaojun , Jiang Wenyu , Xie Xinshu , Liao Rifang , Zhou Guangqian
Published: January 2019

Various neuropeptides related to the energy equilibrium affect bone growth in humans and animals. Neuropeptides W (NPW) are identical in the internal ligands of the two G‐protein receptors (GPRs) included in subtypes 7 and 8. Neuropeptides W inhibits proliferation in the cultivated rat calvarial osteoblast‐like (ROB) cells. This study examines the expression of NPW and GPR7 in murine chondrocyte and their function. An immunohistochemical analysis showed that NPW and GPR7 were expressed in the proliferative chondrocytes of the growth plates in the hind limbs of mice. The NPW mRNA quickly elevated in the early differentiation (7‐14 days) of ATDC5 cells, while NPW and GPR7 mRNA were reduced during the late stage (14‐21 days) of differentiation. Neuropeptide W‐23 (NPW‐23) promoted the proliferation of ATDC5 cells, which was attenuated by inhibiting the GPR7, protein kinase A (PKA), protein kinase C (PKC) and ERK1/2 pathways. Neuropeptide W‐23 enhanced the early cell differentiation, as evaluated by collagen type II and the aggrecan gene expression, which was unaffected by inhibiting the ERK1/2 pathway, but significantly decreased by inhibiting the PKA, PKC and p38 MAPK pathways. In contrast, NPW‐23 was not involved in the terminal differentiation of the chondrocytes, as evaluated by the mineralization of the chondrocytes and the activity of the alkaline phosphatase. Neuropeptides W stimulated the PKA, PKC, p38 MAPK and ERK1/2 activities in a dose‐ and time‐dependent manner in the ATDC5 cells. These results show that NPW promotes the proliferation and early differentiation of murine chondrocyte via GPR7 activation, as well as PKA and PKC‐dependent signalling cascades, which may be involved in endochondral bone formation.
Melatonin ameliorates intervertebral disc degeneration via the potential mechanisms of mitophagy induction and apoptosis inhibition
Authors: Chen Yu , Wu Yanqing , Shi Hongxue , Wang Jianle , Zheng Zengming , Chen Jian , Chen Xibang , Zhang Zengjie , Xu Daoliang , Wang Xiangyang , Xiao Jian
Published: January 2019

Intervertebral disc degeneration (IDD) is a complicated disease in patients. The pathogenesis of IDD encompasses cellular oxidative stress, mitochondrion dysfunction and apoptosis. Melatonin eliminates oxygen free radicals, regulates mitochondrial homoeostasis and function, stimulates mitophagy and protects against cellular apoptosis. Therefore, we hypothesize that melatonin has beneficial effect on IDD by mitophagy stimulation and inhibition of apoptosis. The effects of melatonin on IDD were investigated in vitro and in vivo. For the former, melatonin diminished cellular apoptosis caused by tert‐butyl hydroperoxide in nucleus pulposus (NP) cells. Mitophagy, as well as its upstream regulator Parkin, was activated by melatonin in both a dose and time‐dependent manner. Mitophagy inhibition by cyclosporine A (CsA) partially eliminated the protective effects of melatonin against NP cell apoptosis, suggesting that mitophagy is involved in the protective effect of melatonin on IDD. In addition, melatonin was demonstrated to preserve the extracellular matrix (ECM) content of Collagen II, Aggrecan and Sox‐9, while inhibiting the expression of matrix degeneration enzymes, including MMP‐13 and ADAMTS‐5. In vivo, our results demonstrated that melatonin treatment ameliorated IDD in a puncture‐induced rat model. To conclude, our results suggested that melatonin protected NP cells against apoptosis via mitophagy induction and ameliorated disc degeneration, providing the potential therapy for IDD.
Incumbency advantage and its value
Authors: Biglaiser Gary , Calvano Emilio , Crémer Jacques
Published: January 2019

Markets with network effects are typically concentrated. The aim of this paper is to discuss some recent work on “incumbency advantage.” That is, the fact that firms already installed generate higher profits than entrants even if the latter offer identical or even better terms (in terms of price and quality) to consumers. In particular, we review recently known sources of the advantage and potential mitigating factors and point to a number of open issues.
Detection of herpes viruses in Ghanaian patients with periodontitis
Authors: Blankson Paa‐Kwesi , Blankson Harriet N. A. , Obeng‐Nkrumah Noah , Turkson Albert A. , Tormeti Daniel , Adamafio Mary , Awuah‐Mensah Georgina , Asmah Richard H.
Published: January 2019

Aim

The complexity of periodontitis in both etiology and progression has raised many questions, necessitating enormous research in recent years. The aim of the present study was to detect the presence of herpes viruses in Ghanaian patients diagnosed with periodontitis.

Methods

Thirty‐one patients were included in the study; 21 with periodontitis classified into localized chronic, generalized, and aggressive periodontitis, and 10 without the disease were used as controls. Subgingival samples were collected, followed by DNA extraction. Multiplex polymerase chain reaction was used to amplify viral DNA for the detection of herpes viruses. Data was analyzed using Stata 14.

Results

The mean age for patients with aggressive periodontitis was 32.2 years (standard deviation [SD]: 8.50), while those for localized chronic periodontitis and generalized chronic periodontitis were 40.6 years (SD: 7.83) and 46.3 years (SD: 12.12), respectively. Viruses were detected only among patients clinically diagnosed with aggressive periodontitis. Of the total number of aggressive periodontitis patients, herpes simplex virus 1 (HSV‐1) and Epstein‐Barr virus (HBV) were found in four (44%) and one (11%), respectively. The mean age for patients found to have HSV‐1 or EBV was 29 years (SD: 6.93).

Conclusion

We found HSV‐1 and EBV in the subgingival plaque samples of Ghanaian patients clinically diagnosed with aggressive periodontitis. While our finding requires further investigation, the role of HSV in periodontitis, if elucidated, could transform and inform the clinical management of the condition.
Nitric oxide, γ‐aminobutyric acid, and mannose pretreatment influence metabolic profiles in white clover under water stress
Authors: Li Zhou , Yong Bin , Cheng Bizhen , Wu Xing , Zhang Yan , Zhang Xinquan , Peng Yan
Published: January 2019

Nitric oxide (NO), γ‐aminobutyric acid (GABA), and mannose (MAS) could be important regulators of plant growth and adaptation to water stress. The application of sodium nitroprusside (SNP, a NO donor), GABA, and MAS improved plant growth under water‐sufficient conditions and effectively mitigated water stress damage to white clover. The metabonomic analysis showed that both SNP and GABA application resulted in a significant increase in myo‐inositol content; the accumulation of mannose was commonly regulated by SNP and MAS; GABA and MAS induced the accumulation of aspartic acid, quinic acid, trehalose, and glycerol under water deficit. In addition, citric acid was uniquely up‐regulated by SNP associated with tricarboxylic acid (TCA) cycle under water stress. GABA specially induced the accumulation of GABA, glycine, methionine, and aconitic acid related to GABA shunt, amino acids metabolism, and TCA cycle in response to water stress. MAS uniquely enhanced the accumulation of asparagine, galactose, and D‐pinitol in association with amino acids and sugars metabolism under water stress. SNP‐, GABA‐, and MAS‐induced changes of metabolic profiles and associated metabolic pathways could contribute to enhanced stress tolerance via involvement in the TCA cycle for energy supply, osmotic adjustment, antioxidant defense, and signal transduction for stress defense in white clover.
Novel microscopy‐based approaches to study the film formation mechanism and associated mechanical response in polymer lattices
Authors: TKACZYK MARZENA , DRAGNEVSKI KALIN I. , SIVIOUR CLIVE R. , EDWARDS GARY
Published: January 2019

In this paper, we present the results from novel microscopy‐based approaches aimed at providing further insight into the mechanism of film formation and associated mechanical response in polymer lattices. Firstly, a ‘simple’ methodology, combining the use of variable pressure scanning electron microscopy and a recently introduced enhanced coolstage (–50 to +50°C), was successfully developed and not only used to study dynamic processes, e.g. different stages of latex film formation, but also for high‐resolution imaging of ‘freeze‐dried’ structures. By using the enhanced freeze‐drying capability of the system, it was also possible to preserve the structure and features of the studied system with minimum shrinkage and distortion and in the case of polymer lattices at a desired stage of film formation. Moreover, specimens can then be readily imaged, without the need of conductive coatings and at much lower chamber gas pressures, thus minimizing the beam skirting effects and allowing higher resolutions to be achieved. The second and final part of our study consider the mechanical response of the studied latex dried under different conditions, with the particular emphasis on the effects of drying rate [% relative humidity (RH)]. Atomic force microscopy force distance curve measurements revealed that while the %RH did not have an effect on the structures formed, it did have an effect on the adhesive properties of the studied system. It is strongly believed that the methodologies developed and used here can be applied to other material systems, including biologicals and pharmaceuticals.
Bridging Aging and Intellectual/Developmental Disabilities in Research, Policy, and Practice
Authors: Heller Tamar
Published: January 2019

Bridging the fields of aging and intellectual/developmental disabilities (I/DD) in research, policy, and practice can improve the lives of people both in aging with I/DD and in older adults aging into disabilities. These two groups have both unique and common needs for health and long‐term services and supports. Examples of bridging include exchange of research, adaptation of interventions, and development of policy embracing ideas from both fields. Research exchange includes scoping reviews of health promotion and family caregiving interventions in aging and I/DD. Adaptations from aging include chronic disease self‐management, falls prevention programs, dementia caregiving, retirement planning, and end‐of‐life care. The Administration on Community Living programs in the United States are examples of policy initiatives that bridge aging and disabilities. Opportunities for bridging the fields of aging and I/DD exist, and there are numerous examples of productive practice. Moving forward, it is important to consider the influence of future developments, such as technology and universal design, on the bridging movement. Further research can benefit our understanding of how to improve the bridge between these fields to an even greater extent.
Clinical Governance Climate Within Disability Service Organizations from the Perspective of Allied Health Professionals
Authors: Vassos Maria , Nankervis Karen , Chan Jeffrey
Published: January 2019

Within the healthcare service sector across many Western countries, clinical governance frameworks have been adopted to ensure consistent and effective service provision. There is merit in adopting such frameworks within disability service organizations as a mechanism to enhance service quality. This study explored whether disability service organizations exhibit organizational climates conducive to supporting clinical governance from the perspective of allied health professionals (AHPs). A total of 88 AHPs completed the Clinical Governance Climate Questionnaire via an online questionnaire. AHPs reported that planned quality improvement initiatives tend to be crisis‐driven within their organizations, with immediate and pressing work pressures taking precedence. AHPs also report that clinical risk data are routinely collected within their organizations, with a lack of consensus around how this information is used to improve practice. In addition, dedicated time for professional development was not available to many of the AHPs, and many reported the presence of hierarchies. Correlation analyses implied that planned quality improvement initiatives appear to be the lynchpin to ensuring quality service provision within disability service organizations. Further research into the organizational climate issues identified in this study is needed—from the perspective of all staff working within disability service organizations—in an effort to inform the development of strategies to effectively implement clinical governance in disability services.
Neurofibromatosis type 1 (Nf1)‐mutant mice exhibit increased sleep fragmentation
Authors: Anastasaki Corina , Rensing Nicholas , Johnson Kevin J. , Wong Michael , Gutmann David H.
Published: January 2019

Neurofibromatosis type 1 (NF1) is a neurodevelopmental disorder in which affected children and adults are at a higher risk of sleep disorders. In an effort to identify potential sleep disturbances in a small animal model, we used a previously reported Nf1 conditional knockout (Nf1CKO) mouse strain. In contrast to Nf1 mutant flies, the distribution of vigilance states was intact in Nf1CKO mice. However, Nf1CKO mice exhibited increased non‐REM sleep (NREM)‐to‐wake and wake‐to‐NREM transitions. This sleep disruption was accompanied by decreased bout durations during awake and NREM sleep states under both light and dark conditions. Moreover, Nf1CKO mice have higher percentage delta power during awake and NREM sleep states under all light conditions. Taken together, Nf1CKO mice phenocopy some of the sleep disturbances observed in NF1 patients and provide a tractable platform to explore the molecular mechanisms governing sleep abnormalities in NF1.
Leaf and root nutrient concentrations and stoichiometry along aridity and soil fertility gradients
Authors: Liu Guofang , Ye Xuehua , Huang Zhenying , Dong Ming , Cornelissen Johannes H. C.
Published: January 2019

Questions

Leaf nitrogen (N), phosphorus (P) concentrations and N : P ratio have been extensively studied along environmental gradients, but whether and how leaves and roots show similar responses to climatic and fertility gradients is little studied. Also, the responses of leaf and root N and P in different plant functional types (PFT; legumes, grasses, forbs and shrubs) to environmental gradients are poorly known. We examined the following two hypotheses: (a) P concentration and N : P ratios in leaves or fine roots would not be modulated by soil N for legumes while they would be for non‐legume PFTs; (b) Species turnover would have stronger influence on the responses of N and P concentrations and N : P ratios of plant tissues along aridity and soil fertility gradients than intraspecific variation.

Study site

Ordos Plateau, China.

Methods

We collected samples of leaf and fine roots covering 95 species of 28 families across 17 sites affiliated to four vegetation types on the dry Ordos Plateau of North China and compared variations in N and P concentrations and N : P ratios in both leaves and fine roots among PFTs.

Results

We found that legumes had higher N concentrations in leaves and fine roots than the non‐legume PFTs. Leaf and fine root P and N : P ratios increased with increasing soil N for most non‐legume PFTs, but the relationships were decoupled for legumes. Species turnover had a stronger contribution to these relationships of N and P in leaves and fine roots along aridity and soil N gradients than intraspecific variation.

Conclusions

When modeling vegetation nutrient stocks and cycling, the predictive power could be improved by taking into account not only influences of soil fertility but also of climate on leaf and root tissue N and soil N on tissue P and N : P ratio, especially for non‐legume functional types.
mHealth interventions targeting pregnancy intakes in low and lower‐middle income countries: Systematic review
Authors: Saronga Naomi J. , Burrows Tracy , Collins Clare E. , Ashman Amy M. , Rollo Megan E.
Published: January 2019

Dietary intake during pregnancy plays a vital role in determining the health of both mother and baby. Maternal undernutrition affects a large proportion of women in low and lower middle income countries (LLMIC) likely influencing high maternal, infant, and child mortality in these countries. Mobile health (mHealth) interventions have been proposed as effective solutions to improve maternal and neonatal health. This paper reviews the literature to evaluate the effectiveness of mHealth interventions on improving dietary/nutrients intake of pregnant women in LLMIC. Eight electronic databases were searched from inception up to April 2018, including the MEDLINE, EMBASE, CINAHL, Cochrane, Web of Science, Scopus, Global Index Medicus, and Maternity and Infant Care. Using Covidence, two reviewers assessed articles for inclusion, assessed study quality and extracted data. Only studies published in English language were included. Data were summarised narratively. In total, 6,778 were identified of which four were included, with three randomised controlled trials and one prepost experimental study. Studies were conducted in India (n = 2), Indonesia (n = 1), and Kenya (n = 1). All articles evaluated the use of nutrient supplements; iron supplements (n = 1), vitamin supplements (composition not mentioned; n = 1), or calcium supplements (n = 1). This review suggests that mHealth interventions can be used to improve intake of micronutrient supplementation and nutritional status of pregnant women in LLMIC. Further studies are needed to address the limited evidence base related to mHealth nutrition interventions targeting dietary intakes of pregnant women in LLMIC.
A systematic review of 7 years of research on entrustable professional activities in graduate medical education, 2011–2018
Authors: O'Dowd Emily , Lydon Sinéad , O'Connor Paul , Madden Caoimhe , Byrne Dara
Published: January 2019

Purpose

This review aimed to synthesise some of the extant work on the use of entrustable professional activities (EPAs) for postgraduate physicians, to assess the quality of the work and provide direction for future research and practice.

Method

Systematic searches were conducted within five electronic databases (Medline, Scopus, Web of Science, PsycINFO and CINAHL) in September 2018. Reference lists, Google Scholar and Google were also searched. Methodological quality was assessed using the Quality Assessment Tool for Studies with Diverse Designs (QATSDD).

Results

In total, 49 studies were included, classified as Development of EPAs (n = 37; 76% of total included), Implementation and/or assessment of EPAs (n = 10; 20%), or both (n = 2; 4%). EPAs were described for numerous specialties, including internal medicine (n = 14; 36%), paediatrics (n = 8; 21%) and psychiatry (n = 4; 10%). Of the development studies, 92% utilised more than one method to generate EPAs. The two most commonly used methods were developing initial EPAs in a working group, (n = 27; 69%) and revising through deliberation (n = 21; 54%). Development papers were of variable quality (mean QATSDD score = 20, range 6–41). Implementation and assessment studies utilised methods that included observing trainee performance (n = 6; 50%) and enrolling trainees in competency‐based curricula, which included EPAs (n = 4; 33%). The methodological quality of these implementation studies varied (mean QATSDD score = 19.5, range = 6–32).

Conclusions

This review highlighted a need for: (i) consideration of best practice guidelines for EPA development; (ii) focus on the methodological quality of research on EPA development and of EPAs, and (iii) further work investigating the implementation of EPAs in the curriculum.
Flood frequency analysis for the Iranian interior deserts using the method ofL‐moments: A case study in the Loot River Basin
Authors: Mesbahzadeh Tayyebeh , Soleimani Sardoo Farshad , Kouhestani Shapour
Published: January 2019

Floods are one of the greatest natural disasters, especially in arid land ecosystems. These phenomena damage fragile ecosystems and human societies. If construction of various structures and the development of towns and villages are based on flood forecasting and information, the risk of damage from flooding can be reduced to a large extent. We analyzed the frequency of flooding in the Loot Basin, central Iran, using annual peak discharge series and the method of maximumL‐moment. We found that the distribution based on the H test was homogeneous and theZDISTstatistic selected a regional Log Pearson Type III (LPIII) distribution. The results also showed a high correlation coefficient between the return period and flood discharge, and it was possible to estimate the relationship between flood discharge and area parameters. These methods can be used for areas which lack observational data or statistics.

Recommendations for Resource Managers

Floods are one of the most destructive of natural phenomena, especially in arid and semiarid regions. It is important to be aware of the flood peaks in areas without statistics.

In arid and semiarid regions, there is always a lack of information. Frequency analysis methods are useful in these areas.

The method ofL‐moments is one of the most widely used methods for analyzing the frequency of floods. This method predicts the future behavior of data using statistical distributions.

In areas without observational data or statistics, such as the Loot River Basin, Iran, the method ofL‐moments can be used to predict floods by using the physical characteristics of the watersheds.
Guide to the statistical analysis plan
Authors: Yuan Ian , Topjian Alexis A. , Kurth Charles D. , Kirschen Matthew P. , Ward Christopher G. , Zhang Bingqing , Mensinger Janell L.
Published: January 2019

Biomedical research has been struck with the problem of study findings that are not reproducible. With the advent of large databases and powerful statistical software, it has become easier to find associations and form conclusions from data without forming an a‐priori hypothesis. This approach may yield associations without clinical relevance, false positive findings, or biased results due to “fishing” for the desired results. To improve reproducibility, transparency, and validity among clinical trials, the National Institute of Health recently updated its grant application requirements, which mandates registration of clinical trials and submission of the original statistical analysis plan (SAP) along with the research protocol. Many leading journals also require the SAP as part of the submission package. The goal of this article and the companion article detailing the SAP of an actual research study is to provide a practical guide on writing an effective SAP. We describe the what, why, when, where, and who of a SAP, and highlight the key contents of the SAP.
Feasibility and indicator outcomes using computerized clinical decision support in pediatric traumatic brain injury anesthesia care
Authors: Colletti Ashley A. , Kiatchai Taniga , Lyons Vivian H. , Nair Bala G. , Grant Rosemary M. , Vavilala Monica S.
Published: January 2019

Background

Traumatic brain injury anesthesia care is complex. The use of clinical decision support to improve pediatric trauma care has not been examined.

Aims

The aim of this study was to examine feasibility, reliability, and key performance indicators for traumatic brain injury anesthesia care using clinical decision support.

Methods

Clinical decision support was activated for patients under 19 years undergoing craniotomy for suspected traumatic brain injury. Anesthesia providers were prompted to adhere to process measures via on‐screen alerts and notified in real time of abnormal monitor data or laboratory results (unwanted key performance indicator events). Process measures pertained to arterial line placement and blood gas draws, neuromuscular blockade, hypotension, anemia, coagulopathy, hyperglycemia, and intracranial hypertension. Unwanted key performance indicators were: hypotension, hypoxia, hypocarbia, hypercarbia, hypothermia, hyperthermia, anesthetic agent overdose; hypoxemia, coagulopathy, anemia, and hyperglycemia. Anesthesia records, vital signs, and alert logs were reviewed for 39 anesthetic cases (19 without clinical decision support and 20 with clinical decision support).

Results

Data from 35 patients aged 11 months to 17 years and 77% males were examined. Clinical decision support reliably identified 39/46 eligible anesthetic cases, with 85% sensitivity and 100% specificity, and was highly sensitive, detecting 89% of monitor key performance indicator events and 100% of reported lab key performance indicator events. There were no false positive alerts. Median event duration was lower in the “with clinical decision support” group for 4/7 key performance indicators. Second insult duration was lower for duration of hypocarbia (by 44%), hypotension (29%), hypothermia (12%), and hyperthermia (15%).

Conclusion

Use of clinical decision support in pediatric traumatic brain injury anesthesia care is feasible, reliable, and may have the potential to improve key performance indicator outcomes. This observational study suggests the possibility of clinical decision support as a strategy to reduce second insults and improve traumatic brain injury guideline adherence during pediatric anesthesia care.
Genetic dissection of root architectural traits by QTL and genome‐wide association mapping in rapeseed (Brassica napus)
Authors: Kiran Aysha , Wakeel Abdul , Snowdon Rod , Friedt Wolfgang
Published: January 2019

Variation in root architecture is essential for the adaptation of plants to target environments. A non‐destructive gel‐based mini‐rhizotron system was used for root architecture trait phenotyping. This system has facilitated the visualization of root architectural traits in large genotype collection of rapeseed including 94 double haploid (DH) lines from “Express617” x “V8” and 439 inbred lines (ASSYST diversity set). A high‐density Express617‐V8 linkage map was used for quantitative trait loci (QTLs) identification in DH population based on standard composite interval mapping. 6K SNPs were analysed for association mapping of root traits in ASSYST diversity set. A large variation, broad segregation and medium–low heritability of root architectural traits, primary root length and growth rate, lateral root number, lateral root length and lateral root density, were observed. In the double haploid population, 11 QTL regions, and in the diversity set, 38 significant marker–trait associations were detected. Significant marker–trait associations proved that these are quantitatively inherited traits controlled by multiple genes which revealed to proceed for genetic improvement and selection of rapeseed lines with improved root system.
Virus‐specific and common transcriptomic responses of potato (Solanum tuberosum) against PVY, PVA and PLRV using microarray meta‐analysis
Authors: Osmani Zhila , Sabet Mohammad Sadegh , Shams‐Bakhsh Masoud , Moieni Ahmad , Vahabi Khabat
Published: January 2019

Potato as an essential root crop plays a fundamental role in sustenance security of the world. Viruses are among the most critical pathogens that can decrease the quality of products such as potato and their potential yield. Understanding plant responses to various stresses is an economically important subject in global food security, which is seriously threatened by climate changes. One of the effective methodologies to expand the resistance of potato against various stresses can be identified as the natural defence‐related genes. Microarray meta‐analysis was used for finding common patterns in microarray data sets. The results were filtered out by comparing the resistant and susceptible host data sets in combination with the data derived from biotic and abiotic stress experiments. A total of 42 candidate resistance genes were selected, which were specifically regulated during the potato–virus interaction. Also, 265 genes were recognized to respond to virus infection or other stresses. Integration of transcriptome data sets from various microarray studies gives new insight into the potato–stress interactions. Moreover, the selected genes can be used as candidates to enhance potato resistance against viruses.
Competence versus control: The governor's dilemma
Authors: Abbott Kenneth W. , Genschel Philipp , Snidal Duncan , Zangl Bernhard
Published: January 2019

Most governance is indirect, carried out through intermediaries. Principal–agent theory views indirect governance primarily as a problem of information: the agent has an informational advantage over the principal, which it can exploit to evade principal control. But indirect governance creates a more fundamental problem of power. Competent intermediaries with needed expertise, credibility, legitimacy, and/or operational capacity are inherently difficult to control because the policy benefits they can create (or the trouble they can cause) give them leverage. Conversely, tight governor control constrains intermediaries. The governor thus faces a dilemma: emphasizing control limits intermediary competence and risks policy failure; emphasizing intermediary competence risks control failure. This “governor's dilemma” helps to explain puzzling features of indirect governance: why it is not limited to principal–agent delegation but takes multiple forms; why governors choose forms that appear counterproductive in an informational perspective; and why arrangements are frequently unstable.
Resolving the unbiasedness and forward premium puzzles
Authors: Thornton Daniel L.
Published: January 2019

There are two unresolved puzzles in the foreign exchange literature. The unbiasedness puzzle – the finding of a marked difference in the conclusion about the forward rate unbiasedness hypothesis depending on whether the hypothesis is tested using the forward rate equation or forward premium equation, and the forward premium puzzle – the fact that more often than not the forward premium incorrectly predicts the direction of the subsequent change in the spot rate. This paper resolves both puzzles.