bluuebunny/crossref_metadata_2025 huggingface dataset:
Caring for transgender patients with epilepsy
Authors: Johnson Emily L. , Kaplan Peter W.
Published: August 2017

Objective

Approximately 25 million individuals older than age 15 identify as transgender, representing about 0.3–0.9% of the world's population. The aim of this paper is to identify and describe important medical and social considerations facing transgender persons with epilepsy.

Methods

We performed literature searches on the following terms: transgender AND epilepsy, transgender AND neurology, gender dysphoria AND epilepsy, gender dysphoria AND neurology. We also performed literature searches for common feminizing or masculinizing treatment regimens, and searched for interactions of those treatment regimens with antiepileptic drugs (AEDs) and with seizures.

Results

There are multiple bidirectional interactions between AEDs and the commonly used treatments for aligning external sex characteristics with identified gender. The scope of the transgender population with epilepsy remains to be elucidated.

Significance

Transgender patients with epilepsy face significant social and medical challenges. Interactions between medical gender‐affirming treatments and AEDs are common, and management must depend on knowledge of these interactions to provide appropriate treatment.
Radiographic, computed tomographic, gross pathological and histological findings with suspected apical infection in 32 equine maxillary cheek teeth (2012–2015)
Authors: Liuti T. , Smith S. , Dixon P. M.
Published: August 2017

Background

Equine maxillary cheek teeth apical infections are a significant disorder because of frequent spread of infection to the supporting bones. The accuracy of computed tomographic imaging (CT) of this disorder has not been fully assessed.

Objectives

To compare the radiographic and CT findings in horses diagnosed with maxillary cheek teeth apical infections with pathological findings in the extracted teeth to assess the accuracy of these imaging techniques.

Study design

Observational clinical study.

Methods

Thirty‐two maxillary cheek teeth (in 29 horses) diagnosed with apical infections by clinical, radiographic and principally by CT examinations, were extracted orally. The extracted teeth were subjected to further CT, gross pathological and histological examinations. Four normal teeth extracted from a cadaver served as controls.

Results

Pulpar and apical changes highly indicative of maxillary cheek teeth apical infection were present in all 32 teeth on CT, but in just 17/32 teeth (53%) radiographically. Gross pulpar/apical abnormalities and histological pulpar/periapical changes were present in 31/32 (97%) extracted teeth. On CT, one tooth contained small gas pockets in the apical aspect of one pulp and adjacent periodontal space, however no pathological changes were found following its extraction.

Main limitations

The study is descriptive and is confined to a small number of cases.

Conclusion

This study showed a 97% agreement between CT diagnosis of maxillary cheek teeth apical infection and the presence of pathological changes in the extracted teeth, confirming the diagnostic accuracy of CT compared with radiography for this disorder.
Systematic conservation planning in floodplain fisheries: To what extent are fishers’ needs captured in prioritisation models?
Authors: Chiaravalloti R. M.
Published: August 2017

Systematic conservation planning (SCP) is a promising tool underpinned by the idea that multistakeholders’ needs should be considered in any conservation action. However, there is almost no research verifying whether those proposed solutions indeed capture local people's needs. In this article, a SCP exercise was developed in the Pantanal wetland, Brazil, to propose a possible new negotiated solution for environmental protection areas and fisheries zone. To test the validity of the SCP‐delivered solutions, physical maps showing them were presented and discussed with local people. None of the proposed possible SCP scenarios was accepted locally as workable. The fixed solutions proposed by SCP do not map onto the spatial–temporal flexibility of floodplain fisheries. Current, SCP approaches seem far from being able to incorporate the livelihood uncertainties of floodplain fisheries into mathematical models in a way that encompasses people's needs and, therefore remains only a theoretical tool for sustainability.
Modelling pasture production and soil temperature, water and carbon fluxes in Mediterranean grassland systems with the Pasture Simulation model
Authors: Pulina A. , Lai R. , Salis L. , Seddaiu G. , Roggero P. P. , Bellocchi G.
Published: August 2017

Grasslands play important roles in agricultural production and provide a range of ecosystem services. Modelling can be a valuable adjunct to experimental research in order to improve the knowledge and assess the impact of management practices in grassland systems. In this study, the PaSim model was assessed for its ability to simulate plant biomass production, soil temperature, water content, and total and heterotrophic soil respiration in Mediterranean grasslands. The study site was the extensively managed sheep grazing system at the Berchidda‐Monti Observatory (Sardinia, Italy), from which two data sets were derived for model calibration and validation respectively. A new model parameterization was derived for Mediterranean conditions from a set of eco‐physiological parameters. With the exception of heterotrophic respiration (Rh), for which modelling efficiency (EF) values were negative, the model outputs were in agreement with observations (e.g., EF ranging from ~0.2 for total soil respiration to ~0.7 for soil temperature). These results support the effectiveness of PaSim to simulate C cycle components in Mediterranean grasslands. The study also highlights the need of further model development to provide better representation of the seasonal dynamics of Mediterranean annual species‐rich grasslands and associated peculiar Rh features, for which the modelling is only implicitly being undertaken by the current PaSim release.
Effects of UV radiation on the process of wilting and application of additives at ensiling on the fermentation quality of Siberian wildrye silage on the Qinghai‐Tibetan plateau
Authors: Li Ping , Tang Haiyang , Feng Tao , Zhang Yu , Qu Hui , Bai Shiqie , Shen Yixin
Published: August 2017

Effects of lactic acid bacteria (LAB) and formic acid (FA) on silage quality of ultraviolet (UV)‐radiated Siberian wildrye (Elymus sibiricus L.) were studied on the Qinghai‐Tibetan plateau. Siberian wildrye seeds were sown in early April, 2012 and harvested in 2013, 2014 and 2016. Fresh forage was radiated for 0, 4 and 8 h under ambient/laboratory UV radiation conditions during the wilting process, and then mixed with LAB inoculant (105 cfu g−1 fresh matter [FM]) and FA (3 mL kg−1 FM), respectively, no additives treatment as control. After additive treatments, chopped Siberian wildrye plants were packed in 30 cm × 40 cm polythene bags and stored in a dark room at ambient temperature (<15°C) for 90 days. Silages of UV‐radiated Siberian wildrye had higher (P < 0.05) pH and ammonia‐nitrogen (N) content, lower (P < 0.05) acetic and propionic acid content and in vitro ruminal dry matter digestibility. Compared with control, treatments with additives (especially for inoculant LAB) enhanced pH decline, increased (P > 0.05) acetic acid content, decreased (P < 0.05) butyric acid and ammonia‐N content of silages of UV‐radiated Siberian wildrye. It was concluded that the application of FA and inoculant LAB at ensiling could reduce the negative effects of extended UV radiation on the process of wilting.
Cdk1‐interacting protein Cip1 is regulated by the S phase checkpoint in response to genotoxic stress
Authors: Zhang Ze , Ren Ping , Vashisht Ajay A. , Wohlschlegel James A. , Quintana David G. , Zeng Fanli
Published: August 2017

In eukaryotic cells, a surveillance mechanism, the S phase checkpoint, detects and responds to insults that challenge chromosomal replication, arresting cell cycle progression and triggering appropriate events to prevent genomic instability. In the budding yeast Saccharomyces cerevisiae, Mec1/ATM/ATR, and its downstream kinase, Rad53/Chk2, mediate the response to genotoxic stress. In this study, we place Cip1, a recently identified Cdk1 inhibitor (CKI), under the regulation of Mec1 and Rad53 in response to genotoxic stress. Cip1 accumulates dramatically in a Mec1‐ and Rad53‐dependent manner upon replication stress. This increase requires the activity of MBF, but not the transcriptional activator kinase Dun1. At the protein level, stabilization of replication stress‐induced Cip1 requires continued de novo protein synthesis. In addition, Cip1 is phosphorylated at an S/TQ motif in a Mec1‐dependent manner. Deletion of Cip1 affects proliferation in hydroxyurea‐containing plates. Significantly, the sensitivity is increased when the dosage of the G1 cyclin CLN2 is increased, compatible to a role of Cip1 as a G1‐cyclin‐dependent kinase inhibitor. In all, our results place Cip1 under the S phase checkpoint response to genotoxic stress. Furthermore, Cip1 plays a significant role to preserve viability in response to insults that threaten chromosome replication.
Effect on Helicobacter pylori eradication therapy against gastric cancer in Japan
Authors: Tsuda Momoko , Asaka Masahiro , Kato Mototsugu , Matsushima Rumiko , Fujimori Kenji , Akino Kozo , Kikuchi Shogo , Lin Yingsong , Sakamoto Naoya
Published: August 2017

Background

In Japan, there have been approximately 50 000 deaths from gastric cancer annually for over 40 years with little variation. It has been reported that most gastric cancers in Japan are caused by Helicobacter pylori infection. H. pylori eradication therapy was approved for patients with chronic gastritis by the Japanese national health insurance scheme in February 2013 for patients with an endoscopic diagnosis of chronic gastritis is positive for H. pylori. We examined the effect on gastric cancer death rate 4 years after expansion of health insurance coverage.

Aim

We conducted an epidemiological study and analyzed trends in prescription for H. pylori eradication therapy. We used the electronic medical claims database from Hokkaido, Japan to evaluate the impact of expansion of national health insurance coverage for H. pylori eradication therapy on deaths from gastric cancer.

Methods

Data on deaths from gastric cancer were obtained from the Japanese Ministry of Health, Labour and Welfare and the Cancer Statistics in Japan (2015). Analysis of electronic claims records was performed using the National Database, mainly focusing on Hokkaido. Prescriptions for H. pylori eradication therapy and the number of patients treated for gastric cancer were also extracted from the Hokkaido database.

Results

Approximately 1.5 million prescriptions for H. pylori eradication therapy were written annually. Gastric cancer deaths fell each year: 48 427 in 2013, 47 903 in 2014, 46 659 in 2015, and 45 509 in 2016, showing a significant decrease after expansion of insurance coverage for H. pylori eradication therapy (P<.0001).

Conclusions

Prescriptions for H. pylori eradication therapy increased markedly after approval of the gastritis indication by the national health insurance scheme and was associated with a significant decrease in gastric cancer deaths.
Limited effectiveness with a 10‐day bismuth‐containing quadruple therapy (Pylera®) in third‐line recue treatment for Helicobacter pylori infection. A real‐life multicenter study
Authors: Rodríguez de Santiago Enrique , Martín de Argila de Prados Carlos , Marcos Prieto Hector Miguel , Jorge Turrión Miguel Ãngel , Barreiro Alonso Eva , Flores de Miguel Alvaro , de la Coba Ortiz Cristobal , Rodríguez Escaja Carlos , Pérez Álvarez Gustavo , Ferre Aracil Carlos , Aguilera Castro Lara , García García de Paredes Ana , Rodríguez Pérez Antonio , Albillos Martínez Agustin
Published: August 2017

Background

Helicobacter pylori antibiotic resistance is an increasing problem worldwide. Pylera® may be an option as salvage therapy.

Aim

To assess the effectiveness, safety, and tolerance of Pylera® as a third‐line in clinical practice.

Materials and Methods

This was a multicenter, observational, prospective database study in four Spanish hospitals. Consecutive H. pylori‐infected individuals treated with Pylera® and a proton‐pump inhibitor (PPI) were invited to participate if they had failed to respond to PPI‐clarithromycin‐amoxicillin as first‐line and to levofloxacin‐amoxicillin‐PPI as second‐line therapy. Eradication was tested 4‐8 weeks after Pylera® using a C13‐urea breath test. Treatment‐related adverse effects (TRAEs) were assessed through a questionnaire and by reviewing databases. A questionnaire on patient satisfaction was completed in the last visit.

Results

Of 103 subjects fulfilling the selection criteria, 101 were included in the intention‐to‐treat (ITT) analysis and 97 in the per‐protocol (PP) analysis. A 10 day course was prescribed in all patients. Esomeprazole 40 mg b.i.d. was the most used PPI regimen (ITT=94.1%). Ninety‐seven individuals (ITT=96.04%) completed more than 90% of the treatment. Overall eradication rates were ITT=80.2% (95% confidence interval [CI]: 72.3%‐88.1%) and PP=84.4% (95% CI: 76.8%‐91.8%). One or more TRAEs were experienced by 67.3% (95% CI: 57.7%‐75.7%), all mild or moderate. TRAEs and the number of pills were the main complaints.

Conclusion

In an area of high antibiotic resistance to H. pylori, 10‐day Pylera® plus double‐dose PPI emerged as an alternative as third‐line therapy, although not achieving optimal eradication rates. TRAEs were common but were neither severe nor did they condition compliance.
Geochemical characteristics of zircons in the Ashizuri A‐type granitoids: An additional granite topology tool for detrital zircon studies
Authors: Sawaki Yusuke , Suzuki Kazue , Asanuma Hisashi , Okabayashi Satoki , Hattori Kentaro , Saito Takuya , Hirata Takafumi
Published: August 2017

Zircon is resistant to alteration over a wide range of geological environments, and isotopic ratios within the mineral provide constraints on ages and their parental magmas. Trace element compositions in zircon are also expected to reflect those of their parent magmas, and have a potential as essential indicators for their host rocks. Because most detrital zircons that accumulate at river mouths are derived primarily from granitoids, the classification of zircon within granitoids is potentially meaningful. This study employs the conventional classification scheme of granites (I‐, S‐, M‐, and A‐types). To clarify geochemical characteristics of zircons in A‐type granites, trace element compositions of zircons extracted from the A‐type Ashizuri granitoids were examined. Zircons from the Ashizuri granitoids commonly show enrichments of heavy rare earth elements and positive Ce anomalies, indicating that these zircons were igneous in origin. In addition, zircons in these A‐type granites are characterized by enrichments of Nb, Y, Ta, Th, and U and strong negative Eu anomalies, which exhibit good positive correlations with those in their whole rocks. This fact indicates that these signatures in zircons reflect well those in their parental bodies and are useful in identifying zircons derived from A‐type granite. Based on compilations of available data, zircons from A‐type granites can be clearly discriminated from other‐types of granites within Nb/Sr–Eu anomaly, U/Sr–Eu anomaly, Nb/Sr–U/Sr, and Nb/Sr–Ta/Sr cross‐plots. All indices used in these diagrams were selected based on the geochemical features of both zircon and whole rock of A‐type granites. Application of these discrimination diagrams to detrital zircons will likely provide further insights. For example, some Hadean detrital zircons plot in similar fields to A‐type granites, implying the existence of A‐type magmatism in the Earth's earliest history.
Effects of both Sr and Mg substitution on compositions of biphasic calcium phosphate derived from hydrothermal method
Authors: Xu Yiming , Geng Zhen , Gao Zhonghui , Zhuo Xianglong , Li Bing , Cui Zhenduo , Zhu Shengli , Liang Yanqin , Li Zhaoyang , Yang Xianjin
Published: August 2017

Biphasic calcium phosphate (BCP) ceramics have received much attention in the field of biomaterials. Regulation of phase compositions ofBCPis extremely important for improving their bioactivity. In this study, the effects of Sr‐ and Mg‐addition on the phase composition and morphology ofBCPceramics, prepared by a conventional hydrothermal way, were investigated deeply. The results indicated that the addition of Sr and Mg both facilitated the generation of β‐tricalcium phosphate (β‐TCP), and the relationships between the addition and the relative content of β‐TCPunder differentpH8.5 and 10.5 were similar. The relative content of β‐TCPphase increased linearly with the Sr addition. Meantime, the relative content of β‐TCPchanged quadratically with the Mg addition and reached its peak when the Mg addition was up to 30%. Besides, the fraction of β‐TCPphase of samples synthesized atpH8.5 was higher than that of samples synthesized atpH10.5 when the substitution was same. The morphology did not change significantly in Sr‐substituted samples while an enhancement in density was observed with Mg addition in Mg‐substituted samples. These results and findings provide more comprehensive knowledge about controlling the phase compositions ofBCPby changing the initial substitution of Mg and Sr.
Fatigue of three advanced SiC/SiC ceramic matrix composites at 1200°C in air and in steam
Authors: Ruggles‐Wrenn Marina , Boucher Nicholas , Przybyla Craig
Published: August 2017

High‐temperature mechanical properties and tension‐tension fatigue behavior of three advanced SiC/SiC composites are discussed. The effects of steam on high‐temperature fatigue performance of the ceramic‐matrix composites are evaluated. The three composites consist of a SiC matrix reinforced with laminated, woven SiC (Hi‐Nicalon™) fibers. Composite 1 was processed by chemical vapor infiltration (CVI) of SiC into the Hi‐Nicalon™ fiber preforms coated with boron nitride (BN) fiber coating. Composite 2 had an oxidation inhibited matrix consisting of alternating layers of silicon carbide and boron carbide and was also processed by CVI. Fiber preforms had pyrolytic carbon fiber coating with boron carbon overlay applied. Composite 3 had a melt‐infiltrated (MI) matrix consolidated by combining CVI‐SiC with SiC particulate slurry and molten silicon infiltration. Fiber preforms had a CVI BN fiber coating applied. Tensile stress‐strain behavior of the three composites was investigated and the tensile properties measured at 1200°C. Tension‐tension fatigue behavior was studied for fatigue stresses ranging from 80 to 160 MPa in air and from 60 to 140 MPa in steam. Fatigue run‐out was defined as 2 × 105 cycles. Presence of steam significantly degraded the fatigue performance of the CVI SiC/SiC composite 1 and of the MI SiC/SiC composite 3, but had little influence on the fatigue performance of the SiC/SiC composite 2 with the oxidation inhibited matrix. The retained tensile properties of all specimens that achieved fatigue run‐out were characterized. Composite microstructure, as well as damage and failure mechanisms were investigated.
Determining the effects of annealing time on the glass transition temperature of Pueraria lobata (Willd.) Ohwi starch
Authors: Zhu Xiaoyan , Du Xianfeng , Chen Xu , Hu Jingwei , Zhou Xiuhong , Guo Li
Published: August 2017

To probe the effects of annealing time on the glass transition temperature (Tg) and digestibility of Pueraria lobata (Willd.) Ohwi starch, the starch crystal structure and moisture distribution through the components of P. lobata (Willd.) Ohwi starch were investigated. Annealing times of 0, 1, 3, 6, 12 and 24 h were employed to determine the effect of starch Tg using differential scanning calorimetry (DSC) with the support of 1H low‐field NMR, polarised light microscopy and 13C CP/MAS NMR. The Tg values of the starch increased with longer annealing times. The 1H low‐field NMR results showed that the T2 relaxation time decreased and starch–water interactions increased as the annealing time increased. Compared with native starch, annealed starch had higher contents of slowly digested starch (SDS) and resistant starch (RS). The starch crystal structure was not destroyed after annealing, but the relative crystallinity percentage increased slightly.
Stability of antioxidant peptides from duck meat after post‐mortem ageing
Authors: Liu Dongmei , Chen Xing , Huang Jichao , Zhou Xinghu , Huang Ming , Zhou Guanghong
Published: August 2017

The stability of antioxidant peptides from aged duck meat during processing and simulated gastrointestinal digestion was investigated. The antioxidant peptides preserved a high stability in the presence of diverse NaCl or upon various time heating. The antioxidant activities were strengthened by the addition of 4–8% glucose or by heating at 100 °C, whereas they were lost under alkaline conditions. During in vitro digestion, the antioxidant activities increased with pepsin treatment but then decreased following trypsin digestion. Pepsin hydrolysed peptides into short fragments and results in the increased exposure of internal hydrophobic amino acids. With further treatment by trypsin, peptides can be hydrolysed completely and more free amino acids were released, leading to the decline in surface hydrophobicity. These variations might be responsible for the change in antioxidant activity during in vitro digestion. The antioxidant peptides from aged duck with high stability can be used as functional food ingredients to improve human health.
Fabrication of core–shell structured macrocapsules by electro‐coextrusion with agar–hydrocolloid mixtures for precooked food applications: textural and release characteristics
Authors: Ngamnikom Peerapong , Phawaphuthanon Natthiya , Kim Moojoong , Boonsupthip Waraporn , Shin Il‐Shik , Chung Donghwa
Published: August 2017

Textural and release characteristics of three types of core–shell macrocapsules, fabricated by electro‐coextrusion with agar only, an agar/fish gelatin (80:20) mixture or an agar/κ‐carrageenan (80:20) mixture at a total hydrocolloid concentration of 2% (w/v) and different applied voltages (0–8 kV), were investigated. The capsule diameter (1.1–1.6 mm) and shell thickness (15.1–38.4 μm) decreased with increasing applied voltage. Mixing agar with fish gelatin or κ‐carrageenan reduced slightly the capsule hardness and breaking energy; however, the capsule integrity was solid enough for safe handling. The release of core (olive oil containing a dye) in boiling water followed first‐order kinetics and was retarded significantly when κ‐carrageenan was mixed with agar but accelerated with fish gelatin addition (only 2.5–3.4 min for the release of 80% of the core). The agar/fish gelatin macrocapsules can be applied in precooked foods, because they are mechanically stable and can rapidly release the core upon contact with hot water.
Evaluation of a muscle pump‐activating device for non‐healing venous leg ulcers
Authors: Harris Connie , Duong Rochelle , Vanderheyden Gwen , Byrnes Beth , Cattryse Renee , Orr Ava , Keast David
Published: August 2017

This evaluation involves an innovative muscle pump‐activating device (geko™) as an adjunctive therapy with best practices for non‐healing venous leg ulcers (VLUs). Stimulating the common peroneal nerve (at the fibular head), the geko™ device creates a response that acts as foot and calf muscle pumps, increasing venous, arterial and microcirculatory flow. The aim was to evaluate and determine if the geko™ is effective in this population and if it should be added to the medical supply formulary. In all, 12 patients with 18 recalcitrant VLUs (defined as less than 30% reduction in wound size in 30 days with best practices) in two community settings in Ontario consented to the evaluation and were treated with the geko™ for up to 20 weeks.

A total of 44% of wounds healed, and 39% decreased in size. One patient non‐adherent with the geko™ and best practices had deterioration in his or her wounds. With the patients as their own control, the mean weekly healing rate with the geko™ was 9·35% (±SD 0·10) compared to 0·06% (±SD 0·10) prior to baseline, which was statistically significant (P < 0·01). Three patients not in optimal therapy increased compression due to decreased pain, further enabling healing. This study was not a randomised investigation, although the patients acted as their own controls. A pragmatic evaluation reflects the reality of the community sector; in spite of best practices or evidence‐based care, therapy is not uniformly applied, with some participants unable to tolerate or indeed comply with optimal compression therapy. Rash occurred under the devices in 7 of 12 (58%) patients. One patient stopped the device due to rash, while another had to take breaks from using the device. Subsequently, the manufacturer (FirstKind Ltd) has developed a new device and protocol specific to the requirements of wound therapy to minimise this response.

This small case series demonstrated the highly significant effectiveness of the geko™ device in these hard‐to‐heal VLUs. Further evaluations to determine dose and patient selection criteria are underway.
A PEGylated fibrin hydrogel‐based antimicrobial wound dressing controls infection without impeding wound healing
Authors: Gil Joel , Natesan Shanmugasundaram , Li Jie , Valdes Jose , Harding Andrew , Solis Michael , Davis Stephen C. , Christy Robert J.
Published: August 2017

Combat injuries are associated with a high incidence of infection, and there is a continuing need for improved approaches to control infection and promote wound healing. Due to the possible local and systemic adverse effects of standard 1% cream formulation (Silvadene), we had previously developed a polyethylene glycol (PEGylated) fibrin hydrogel (FPEG)‐based wound dressing for the controlled delivery of silver sulfadiazine (SSD) entrapped in chitosan microspheres (CSM). In this study, we have evaluated the antimicrobial and wound healing efficacy of SSD‐CSM‐FPEG using a full‐thickness porcine wound infected with Pseudomonas aeruginosa. Infected wounds treated with a one‐time application of the SSD‐CSM‐FPEG wound dressing demonstrated significantly reduced bacterial bioburden over time (99·99% of reduction by day 11; P < 0·05) compared with all the other treatment groups. The epithelial thickness and granulation of the wound bed was significantly better on day 7 (150·9 ± 13·12 µm), when compared with other treatment groups. Overall, our findings demonstrate that the SSD‐CSM‐FPEG wound dressing effectively controls P. aeruginosa infection and promotes wound healing by providing a favourable environment that induces neovascularisation. Collectively, sustained release of SSD using fibrin hydrogel exhibited enhanced benefits when compared with the currently available SSD treatment, and this may have significant implications in the bacterial reduction of infected wounds in military and civilian populations.
Sintering behavior of Ba/Sr celsian precursor obtained from zeolite‐A by ion‐exchange method
Authors: Biesuz Mattia , Spiridigliozzi Luca , Marocco Antonello , Dell'Agli Gianfranco , Sglavo Vincenzo M. , Pansini Michele
Published: August 2017

(Ba, Sr)‐exchanged zeolite A with composition Ba0.74Sr0.22Na0.04Al2Si2O8 was prepared by cation exchange; a mild thermal treatment converts into an amorphous phase. Successive crystallization and sintering behavior was studied by XRD, DTA, and thermodilatometric analysis. The results point out the activation of viscous flow sintering mechanisms between 900°C and 1050°C. The densification process starts when the amorphous phase reaches its glass transition temperature (897°C) and finishes when the material crystallizes forming hexacelsian. The application of an external pressure in such temperature range allows to achieve an almost complete densification, the material transforming at 1300°C into dense monoclinic celsian much below the typical processing temperature.
Infant sleep problems: The sleep characteristics of the “Don't Know” response
Authors: Tsai Shao‐Yu , Lee Chien‐Chang , Chen Li‐Chiou , Tung Yi‐Ching
Published: August 2017

Aims

To examine the sleep characteristics of infants with parentally reported sleep problems, with parentally reported no sleep problems and with parentally reported uncertain sleep conditions.

Background

Infant sleep problems are recognized as a major health issue worldwide. However, in our daily clinical practices, it is not uncommon for parents not to know whether their infant sleep is problematic.

Design and Methods

A prospective study conducted between 2012 ‐ 2015 where 219 parents completed questionnaires and infants wore an actigraph monitor for 7 days. Multinomial logistic regression models were used to evaluate the actigraphic and parentally reported infant sleep behaviours between the groups.

Results

Thirty‐two (14.61%) parents did not know whether their infant sleep was problematic and 118 (53.88%) parents considered their infant sleep a problem. Compared with infants without sleep problems, infants with uncertain sleep conditions had significantly increased odds of having shortened longest sleep duration according to parental report. A significant association was found for infants without sleep problems compared with those with sleep problems who had significantly more wake after sleep onset as measured by actigraphy, as well as reduced longest sleep duration according to parental report.

Conclusion

Infants with uncertain sleep conditions have the same problematic sleep behaviours resembling those of children with reported sleep problems. Healthcare professionals should actively disseminate sleep knowledge to help parents interpret infant sleep behaviours and consider possible intervention strategies for improving parental sleep‐related knowledge and infant sleep.
Adaptive coping strategies of affected family members of a relative with substance misuse: A qualitative study
Authors: McCann Terence V. , Lubman Dan I.
Published: August 2017

Aim

To explore the coping strategies used by affected family members of a relative with substance misuse.

Background

Families play an important role in supporting a relative with substance misuse. However, the experience often has an adverse effect on their general well‐being, the extent of which depends largely on their coping strategies.

Design

An interpretative phenomenological analysis study. Data were collected between January ‐ December 2015.

Method

Semistructured, audio‐recorded qualitative interviews were conducted with 31 affected family members.

Results

Three main themes and related subthemes were abstracted from the data illustrating how participants coped with their relative's substance misuse: (1) Seeking timely access to evidence‐based information; (2) Enhancing personal coping strategies and (3) Accessing informal and formal support.

Conclusion

Greater investment is needed in support services for affected family members, particularly in regional and rural areas. A wide range of accessible evidence‐based information and informal and formal support, including telephone and online support, is needed to assist them to cope in this crucial support‐giving role. Affected family members need to adopt a flexible set of coping strategies while supporting a relative with substance misuse. Family and friends, alcohol and other drug services, mental health nurses and other clinicians have a critical role providing emotional, instrumental and educational support to affected family members to enhance their adaptive coping strategies.
A qualitative study of decision‐making on PhaseIIIrandomized clinical trial participation in paediatric oncology: Adolescents’ and parents’ perspectives and preferences
Authors: Ingersgaard Marianne Vie , Tulstrup Morten , Schmiegelow Kjeld , Larsen Hanne Bækgaard
Published: August 2017

Aim

To explore parents’ and adolescents’ motives for accepting/declining participation in theALL2008 trials and adolescents’ involvement in the decision‐making process.

Background

Children and adolescents with acute lymphoblastic leukaemia treated on the Nordic Society of Paediatric Haematology and OncologyALL2008 protocol were eligible for two randomizations testing 6‐mercaptopurine treatment intensifications to improve efficacy and Asparaginase de‐escalation to reduce toxicity. We recently reported that while adolescents favoured treatment reduction, parents of young children favoured treatment intensification.

Design

A qualitative, exploratory study.

Methods

A maximum variation sampling strategy was used. Five adolescents aged 12–17 years, six parents of adolescents and five parents of children aged 1–12 years were interviewed in the period March–May 2015. Data were analysed using content analysis.

Findings

Adolescents and parents emphasized the importance of adolescents’ active participation in decisions regarding enrolment into clinical trials. A majority of adolescents were either final or collaborative decision‐makers. Parents stated that in case of disagreement, they would overrule the adolescents’ decision. There were no differences between motivations of preferences held by parents of children or adolescents, respectively. Decisions were based on subjective values attributed to cure contra toxicity and individual preferences for either standard or experimental treatment. The possibility of a negative outcome induced fear of decisional regret and distress by the parents, yet they invested considerable trust in the physician's expertise.

Conclusion

Our findings highlight the importance of adolescents’ active involvement in consent conferences. Research on management of disagreements between adolescents and parents in trial decisions is needed.
Integrative review of the social determinants of health in older adults with multimorbidity
Authors: Northwood Melissa , Ploeg Jenny , Markle‐Reid Maureen , Sherifali Diana
Published: August 2017

Aim

To examine how the social determinants of health have been considered in conceptualizations of multimorbidity in older adults in the literature and to identify implications for nursing practice, research and healthcare planning and policy.

Background

The common conceptualization of multimorbidity is the presence of multiple chronic conditions where one is not more central than others.

Design

The integrative review methodology of Whittemore and Knafl was employed. The World Health Organization Social Determinants of Health framework was used to determine how the social determinants of health have been considered in conceptualizations of multimorbidity.

Data sources

A search of electronic databases (2000–2015) generated 22 relevant articles, including quantitative and qualitative studies and grey literature reports.

Review methods

A systematic process was used to appraise the quality of the documents, conduct qualitative data analysis procedures of data extraction, coding and theme development, and synthesize conclusions.

Results

Current conceptualizations of multimorbidity provide limited consideration of the complex interplay of multimorbidity with the broader social determinants of health. Gender, education, behaviours and the health system were the most commonly cited determinants. Ethnicity, socioeconomic status/social class and material circumstances received little attention. Most of the dimensions of socioeconomic political context were not discussed.

Conclusion

The predominant conceptualization of multimorbidity focuses on the biomedical dimensions of multimorbidity. Consequently, nursing practice, research and policy informed by this literature could inadvertently sustain the mismatch between the needs of older adults with multimorbidity and the services they receive. Future research to inform a new conceptualization is necessary.
Positive and negative intergroup contact predict Black and White Americans' judgments about police violence against Black Americans
Authors: Hayward Lydia E. , Hornsey Matthew J. , Tropp Linda R. , Barlow Fiona Kate
Published: August 2017

We examined whether past positive and negative interracial contact predict people's views of interracial police violence. White (N = 207) and Black (N = 116) Americans reported on their past intergroup experiences before viewing information about one of two true events involving the death of a Black man at the hands of a White police officer. For White Americans, negative contact predicted a reluctance to blame the officer and a willingness to believe that people's responses to the events involved “playing the race card.” For Black Americans, positive contact predicted marginally less officer blame and lower beliefs that the victim was racially profiled. This suggests the potential for a vicious cycle, whereby past contact experiences color perceptions of intergroup conflict in the present.
Dietary behaviors in relation to prevalence of irritable bowel syndrome in adolescent girls
Authors: Khayyatzadeh Sayyed Saeid , Kazemi‐Bajestani Seyyed Mohammad Reza , Mirmousavi Seyed Jamal , Heshmati Masoud , Khoshmohabbat Somaieh , Ferns Gordon A , Ghayour‐Mobarhan Majid
Published: August 2017

Backgrounds and Aims

There is limited evidence regarding the relationship between dietary behaviors and irritable bowel syndrome (IBS). This study aimed to explore the association between diet‐related practices and prevalence of IBS.

Methods

The study was conducted among 988 adolescent girls living in Iran. Dietary behaviors were pre‐defined and assessed in nine domains using a pre‐tested questionnaire. To investigate the association between diet‐related practices and the presence of IBS, this study used logistic regression analysis in crude and adjusted models.

Results

The prevalence of IBS was 16.9% in this population. Compared with individuals who did not consume fluid with their meal, those who always consumed fluid with meals had a greater chance of IBS (odds ratio [OR]: 2.91; P: 0.01). This study found a direct relationship between a greater intake of spicy food and IBS prevalence (OR: 5.28; P: 0.02). The individuals who ate fried foods every day also had a greater risk of IBS compared with those who did not consume fried foods (OR: 1.65; P: 0.01). The subjects who had lost ≥ 5 teeth had 2.23 times greater odds for IBS than the individual who had lost ≤ 1 tooth (OR: 2.23; P: 0.01) was a significant inverse relationship between the chewing sufficiency and the risk of IBS (OR: 4.04; P: 0.02). These associations remained significant after controlling for potential confounder.

Conclusions

Intra‐meal fluid intake, chewing insufficiency, higher tooth loss, and the consumption of spicy and fried food were associated with increased risk of IBS. Prospective studies are needed to confirm these findings.
Salvianolic acids enhance cerebral angiogenesis and neurological recovery by activating JAK2/STAT3 signaling pathway after ischemic stroke in mice
Authors: Li Yaoru , Zhang Xiangjian , Cui Lili , Chen Rong , Zhang Ye , Zhang Cong , Zhu Xingyuan , He Tingting , Shen Zuyuan , Dong Lipeng , Zhao Jingru , Wen Ya , Zheng Xiufen , Li Pan
Published: August 2017

Post‐stroke angiogenesis facilitates neurovascular remodeling process and promotes neurological recovery. Proangiogenic effects of Salvianolic acids (Sals) have been reported in various ischemic disorders. However, the underlying mechanisms are still poorly understood. Previous studies of our laboratory have demonstrated that activating Janus kinase 2/signal transducer and activator of transcription 3 (JAK2/STAT3) signaling pathway is involved in the protection against cerebral ischemia/reperfusion injury. In this study, we investigated the impacts of Sals on angiogenesis and long‐term neurological recovery after ischemic stroke as well as the potential mechanisms. Male mice subjected to permanent distal middle cerebral artery occlusion were administrated with Sals, 5‐bromo‐2′‐deoxyuridine, and JAK2 inhibitor AG490 once daily from day 1 to day 14 after distal middle cerebral artery occlusion. Compared with the control group, Sals treatment significantly improved neurological recovery at day 14 and 28 after ischemic stroke. Sals enhanced post‐stroke angiogenesis, pericytes and astrocytic endfeet covered ratio in the peri‐infarct area. The JAK2/STAT3 signaling pathway was activated by Sals in the angiogenesis process, and inhibition of JAK2/STAT3 signaling blocked the effects of Sals on post‐stroke angiogenesis and neurological recovery as well as abolished the mediation of proangiogenic factors. In summary, these data suggest that Sals administration enhances cerebral angiogenesis and promotes neurological recovery after ischemic stroke, mediated by the activation of JAK2/STAT3 signaling pathway.

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Less is more: Caloric regulation of neurogenesis and adult brain function
Authors: Morgan A. H. , Andrews Z. B. , Davies J. S.
Published: August 2017

Calorie intake is essential for regulating normal physiological processes and is fundamental to maintaining life. Indeed, both extremes of calorie intake result in increased morbidity and mortality. In this review, we discuss the effect of calorie intake on adult brain function, with an emphasis on the beneficial effects of mild calorie restriction. Recent findings relating to the regenerative and protective effects of the gastrointestinal hormone, ghrelin, suggest that it may underlie the beneficial effects of calorie restriction. We discuss the putative cellular mechanisms underlying the action of ghrelin and their possible role in supporting healthy brain ageing.
Original article: Platelet‐rich plasma with microneedling in androgenetic alopecia along with dermoscopic pre‐ and post‐treatment evaluation
Authors: Jha Abhijeet Kumar , Udayan Uday Kumar , Roy Prasoon Kumar , Amar Amar Kant Jha , Chaudhary R K P
Published: August 2017

Background

Platelet‐rich plasma has shown beneficial effects in the treatment of androgenic alopecia with its growth factor properties in accelerating the dermal papilla. Dermoscopy is a noninvasive method that allows the in vivo evaluation of microstructures not visible to the naked eye.

Objective

To ascertain the role of platelet‐rich plasma (PRP) with microneedling, and to compare the pre‐ and post‐treatment dermoscopic features in androgenetic alopecia. (AGA).

Method

Patients with mild to moderate AGA, aged 18‐45 years with Hamilton‐Norwood score 1‐5 were included in both study and control group. Dermoscopy was performed using Dermlite II hybrid m; 3Gen dermoscope at 10× magnification in polarized mode, and photographs were taken. Those not responding or those not having any new hair growth to conventional therapy for at least 1 year were included. The study group were given autologous platelet‐rich plasma injections with microneedling over a period of 3 months at 3 weekly interval. Baseline and post‐treatment photographs were taken.

Result

Hair growth started after the first session. The patients’ satisfaction was more than 75% in 18 patients, on patients’ subjective hair growth assessment scale. In post‐PRP‐treated patients of AGA, increase in the number of vellus and total hairs, increased hair shaft diameter, and reduction in yellow dots were appreciated after 3 sessions. Hair pull test was negative after treatment in 14 patients (70%).

Conclusion

This study reinforces the importance of dermoscopy in not only aiding in the diagnosis, but also in evaluation of pre‐ and post‐treatment response of AGA.
Clinicians’ perceptions and recognition of practice improvement strategies to prevent harms to older people in acute care hospitals
Authors: McGrath Michele , Botti Mari , Redley Bernice
Published: August 2017

Aims and objectives

Explore clinicians’ perceptions of practice improvement strategies used to prevent harms to older people during acute hospitalisation.

Background

Older people are vulnerable to many interrelated preventable harms during acute care hospitalisation. Improvement strategies recommend standardisation of practices to assist healthcare staff to mitigate risk; however, older people continue to suffer preventable harms in acute hospitals.

Methods

A qualitative exploratory descriptive design was used to collect data using focus groups and individual interviews from a purposive sample of 33 participants. Participants represented a wide range of clinicians from four diverse healthcare organisations. Qualitative content analysis used a framework informed by common preventable harms derived from key literature and policy documents.

Results

Participants’ perceptions of practice improvement strategies varied depending on their role within their organisational hierarchy. Recognition of preventable harms was guided by standard risk assessment and management tools used in their organisations. Preventable harms relating to skin integrity and falls were universally recognised across all sites and roles. Alternatively, there was variability in participant recognition of preventable harms related to nutrition, continence, medications and cognition; pain was consistently overlooked as a contributor to preventable harms.

Conclusions

Hospital staff perceived standard clinical risk assessment and management tools as the main practice improvement strategy to prevent harms. These tools prompted staff recognition of preventable harms to older people during acute hospitalisation. Variability in the recognition of some preventable harms was attributed to variable use of standard assessment tools. Pain was unlikely to be recognised as contributing to preventable harms.

Relevance to clinical practice

Clinical Risk Management tools may assist clinicians in recognising and responding to preventable harms to older people during hospitalisation. These tools provide critical resources for consistent and timely assessment and evaluation of risk for preventable harms.
Aboriginal parent support: A partnership approach
Authors: Munns Ailsa , Toye Christine , Hegney Desley , Kickett Marion , Marriott Rhonda , Walker Roz
Published: August 2017

Aims and objectives

This study was positioned within a larger action research study relating to a peer‐led Aboriginal home visiting parent support program in an urban Western Australian setting. The aims for this study component were to identify program elements, exploring participants’ perceptions of the program's suitability, feasibility, acceptability and effectiveness to inform program model recommendations and add to the body of knowledge on effective Aboriginal peer‐led program models.

Background

The ability of Aboriginal parents to develop positive family environments is crucial, with parent support needing to be reflexive to local needs and sociocultural influences. Culturally appropriate service provision needs meaningful and acceptable strategies.

Design

This study was situated within a critical paradigm supporting Participatory Action Research methodology, using Action Learning Sets as the participant engagement and data collection setting.

Methods

Within ten Action Learning Sets, focus group interviews were carried out with Aboriginal peer support workers, a non‐Aboriginal parent support worker, an Aboriginal program coordinator, an Aboriginal education support officer and non‐Aboriginal program managers (n = 8), and individual interviews with parents (n = 2) and community agencies (n = 4). Data were analysed using thematic analysis.

Results

Five themes were derived from peer support worker and community agency cohorts: peer support worker home visiting skills; responding to impacts of social determinants of health; client support and engagement; interagency collaboration; and issues addressing program sustainability. Parent responses augmented these themes.

Conclusions

Participants identified five key elements relating to peer‐led home visiting support for Aboriginal parents. These are uniquely placed to inform ongoing program development as there is little additional evidence in wider national and international contexts.

Relevance to clinical practice

Engagement with communities and peer support workers to develop culturally relevant partnerships with Aboriginal families is integral to contemporary child health practice. Ongoing nurse support is needed for peer support worker role development.

Indigenous Australian peoples are people who identify as Aboriginal or Torres Strait Islander. Respectfully, throughout this paper, they will be described as Aboriginal.