bluuebunny/crossref_metadata_2025 huggingface dataset:
Eye movement disorders are an early manifestation of CACNA1A mutations in children
Authors: Tantsis Esther M , Gill Deepak , Griffiths Lyn , Gupta Sachin , Lawson John , Maksemous Neven , Ouvrier Robert , Riant Florence , Smith Robert , Troedson Christopher , Webster Richard , Menezes Manoj P
Published: January 2016

Aim

The alpha‐1 isoform of the calcium channel gene is expressed abundantly in neuronal tissue, especially within the cerebellum. Mutations in this gene may manifest with hemiplegic migraine, spinocerebellar ataxia type 6 (SCA6) and episodic ataxia type 2 (EA2) in adults. There are reports of children with CACAN1A mutations presenting with paroxysmal tonic upgaze, abnormal saccades and congenital nystagmus as well as severe forms of hemiplegic migraine. The aim of this study was to review the clinical presentation and subsequent course of all children with a CACNA1A mutation who presented to a tertiary children's hospital.

Method

We reviewed retrospectively nine children with a proven CACNA1A mutation who presented to the Children's Hospital at Westmead between 2005–2015. The initial and subsequent clinical presentation, radiological features and molecular genetic profile of each child was reviewed.

Results

Nine children presented to out institute over a 10 year period; six were female and three male. The median age of presentation was 1.2 years. Eye movement disorders were the presenting feature in eight children. Three of these children later presented with severe hemiplegic migraine episodes often requiring ICU care. Affected children also had developmental delay and developed classical hemiplegic migraine, episodic ataxia and seizures. Calcium channel blockers were used with some efficacy in preventing severe HM episodes.

Interpretation

Eye movement disorders are an early manifestation of CACNA1A mutations in children. Improved recognition of the CACNA1A phenotype in childhood is important for early diagnosis, counselling and appropriate emergency management. There is some early evidence that calcium channel blockers may be an effective prophylactic agent for the severe hemiplegic migraine episodes.
First report on the nationwide incidence and prevalence of Type 1 diabetes among children in Turkey
Authors: Yeşilkaya E. , Cinaz P. , Andıran N. , Bideci A. , Hatun Ş. , Sarı E. , Türker T. , Akgül Ö. , Saldır M. , Kılıçaslan H. , Açıkel C. , Craig M. E.
Published: January 2016

Aim

To report, for the first time, the incidence and prevalence of childhood Type 1 diabetes in Turkey using a nationwide registry.

Methods

Information on birth date, city of birth, diagnosis date and gender of all patients with Type 1 diabetes aged < 18 years were obtained from the Turkish Social Security Institute for the period from January 2011 to December 2013.

Results

There were 17 175 prevalent cases of Type 1 diabetes over the 3‐year period. The prevalence of Type 1 diabetes was 0.75/1 000 (95% CI 0.74–0.76) and was higher in girls than in boys (0.79 vs 0.72 /1 000; P < 0.01). There were 2465 incident cases in 2013. The incidence was slightly higher among girls (50.6%) than boys (49.4%); the girl:boy case ratio was 1.02. The incidence was 10.4/100 000 for boys and 11.3/100 000 for girls. The age‐standardized incidence rate was 10.8 per 100 000 (95% CI 10.1–11.5) according to the WHO standard population, estimated using the direct method. The mean patient age at diagnosis was 10.6 ± 4.6 years. The highest proportion of cases (40.6%) was diagnosed in children aged 10–14 years.

Conclusions

This is the first study to report the incidence and prevalence of Type 1 diabetes in children in Turkey. The incidence of Type 1 diabetes reflects the geographical location of Turkey, bridging Asia and Europe, with the incidence being higher than in Asia but lower than in Europe.
Increased follistatin associated with decreased gait speed among old adults
Authors: Liaw Fang‐Yih , Kao Tung‐Wei , Fang Wen‐Hui , Han Der‐Sheng , Chi Yu‐Chiao , Yang Wei‐Shiung
Published: January 2016

Background

Low gait speed is associated with inflammation and muscle strength. Follistatin, a glycosylated plasma protein, is involved in inflammatory diseases, bone metabolism, muscle strength and cognition. However, research regarding the relationship between follistatin and gait speed in elderly individuals is limited. In this study, we aimed to examine the association between follistatin and gait speed in older adults.

Methods

This cross‐sectional, observational study included 205 ambulatory individuals aged ≥ 65 years. The baseline measures included 15‐foot walking time, a structured questionnaire, grip strength and biomarkers, including follistatin and myostatin levels. Multiple linear regression was used to determine the change in gait speed for each 1 pg/mL increase in serum follistatin level. An extended model approach with a quartile‐based analysis of serum follistatin levels was conducted.

Results

In the linear regression model, the β coefficient, representing the change in gait speed for each 1 pg/mL increase in serum follistatin level, was −0·308 (P < 0·001). After additional adjustment for relevant covariates, the β coefficient changed slightly, although the negative correlation remained (all P ≤ 0·001). After controlling for multiple covariates, participants in the highest serum follistatin level quartile had a significantly lower gait speed than those in the lowest quartile (all P for trend < 0·001).

Conclusions

A higher follistatin level was independently associated with lower gait speed in community‐dwelling elderly individuals; this suggests that serum follistatin level may be an indicator of mobility in elderly persons and may more particularly represent lower extremity function.
Additive Theories of Rationality: A Critique
Authors: Boyle Matthew
Published: January 2016

Additive theories of rationality, as I use the term, are theories that hold that an account of our capacity to reflect on perceptually‐given reasons for belief and desire‐based reasons for action can begin with an account of what it is to perceive and desire, in terms that do not presuppose any connection to the capacity to reflect on reasons, and then can add an account of the capacity for rational reflection, conceived as an independent capacity to ‘monitor’ and ‘regulate’ our believing‐on‐the‐basis‐of‐perception and our acting‐on‐the‐basis‐of‐desire. I show that a number of recent discussions of human rationality are committed to an additive approach, and I raise two difficulties for this approach, each analogous to a classic problem for Cartesian dualism. Theinteraction problemconcerns how capacities conceived as intrinsically independent of the power of reason can interact with this power in what is intuitively the right way. Theunity problemconcerns how an additive theorist can explain a rational subject's entitlement to conceive of the animal whose perceptual and desiderative life he or she oversees as ‘I’ rather than ‘it’. I argue that these difficulties motivate a general skepticism about the additive approach, and I sketch an alternative, ‘transformative’ framework in which to think about the cognitive and practical capacities of a rational animal.
The Trilemma of European Economic and Monetary Integration, and Its Consequences
Authors: Snell Jukka
Published: January 2016

The article analyses trade‐offs between sovereignty, mass politics and economic and monetary union (EMU), employing Rodrik's paradox of globalisation. The logic of EMU is incompatible with sovereignty and mass politics—only two of the three can coexist. It is argued that three different answers to the trilemma can be observed in the EU practice. In the initial EMU, integration was limited to safeguard mass politics and sovereignty. Member States were free to set economic policies in response to domestic mass politics. This proved unsustainable. During the crisis, democracy was sacrificed to bolster integration, while sovereignty was maintained. Rules on fiscal discipline and macroeconomic imbalances constrain mass politics, and non‐democratic institutions have acquired more prominent roles. Finally, long‐term plans for a genuine EMU envisage the strengthening of integration and moving the locus of democracy to the EU level, while weakening sovereignty. The analysis carries implications. If national courts insist on sovereignty and democracy, the likely consequence is an unworkable EMU, damaging the output legitimacy of the EU. The model adopted in the crisis reinforces the elite nature of the EU, undermines democracy at the national level and may bolster political extremism. This leaves the task of building the preconditions for democracy at the European level.
Long‐term effects of single and combined introductions of antibiotics and bacteriophages on populations of Pseudomonas aeruginosa
Authors: Torres‐Barceló Clara , Franzon Blaise , Vasse Marie , Hochberg Michael E.
Published: January 2016

With escalating resistance to antibiotics, there is an urgent need to develop alternative therapies against bacterial pathogens and pests. One of the most promising is the employment of bacteriophages (phages), which may be highly specific and evolve to counter antiphage resistance. Despite an increased understanding of how phages interact with bacteria, we know very little about how their interactions may be modified in antibiotic environments and, reciprocally, how phage may affect the evolution of antibiotic resistance. We experimentally evaluated the impacts of single and combined applications of antibiotics (different doses and different types) and phages on in vitro evolving populations of the opportunistic pathogen Pseudomonas aeruginosa PAO1. We also assessed the effects of past treatments on bacterial virulence in vivo, employing larvae of Galleria mellonella to survey the treatment consequences for the pathogen. We find a strong synergistic effect of combining antibiotics and phages on bacterial population density and in limiting their recovery rate. Our long‐term study establishes that antibiotic dose is important, but that effects are relatively insensitive to antibiotic type. From an applied perspective, our results indicate that phages can contribute to managing antibiotic resistance levels, with limited consequences for the evolution of bacterial virulence.
Determination of dynamic rotation factor for DWTT specimens by strain analysis and hardness measurement
Authors: Fang J. , Zhang J.W. , Zhou Y.D.
Published: January 2016

As to accurately ascertain the value of dynamic rotation factor r*, strain analysis‐based measurement was performed on the bent low‐blow specimens by means of two approaches. (i) Surface strain analysis on the ligament indicates a critical transition zone from the necking to swelling, where the total strain reaches the minimum as undeformed material. (ii) Hardness measurement on the thickness‐reduction specimen also reflects a typical V‐shape distribution of interior plasticity along the ligament as observed from the surface, suggesting the location of true rotation centre relative to the neutral strain axis where the hardness is nearly invariable without any work hardening. As a result, the obtained value of r* maintains nearly 0.45 for (B × 4B) size drop‐weight tear test‐type specimens after their crack initiation and propagation, well consistent with the values calculated from the slip‐line field theory.
Touchable topography: 3D printing elevation data and structural models to overcome the issue of scale
Authors: Hasiuk Franciszek , Harding Chris
Published: January 2016

The fundamental problem of geology is scale. Geological length scales range from angstroms for atoms to thousands of kilometres for planets. Geological processes are often very slow (and geological events so very infrequent). Since the beginning of our discipline, it has been the business of geologists to integrate observations at a variety of length and time scales to answer questions about Earth's history and to make predictions about its future. While this may sound like one of the most academic of pursuits, multi‐billion dollar decisions are routinely made by governments and the largest multi‐national corporations on the basis of geological studies that, for example, model groundwater or petroleum occurrence.
A fellow Swede is the reference for humanity
Authors: Eriksson Mats E.
Published: January 2016

There is (or should be) an archived specimen, a reference copy if you like, for all living and fossil species that have been described scientifically. These physical specimens, so‐called name‐bearing type specimens, are housed at museums or academic institutes around the world for researchers to study and perhaps compare with their own material. But what about our own species, Homo sapiens?
Comorbidity of Headache and Depression After Mild Traumatic Brain Injury
Authors: Lucas Sylvia , Smith Brendon M. , Temkin Nancy , Bell Kathleen R. , Dikmen Sureyya , Hoffman Jeanne M.
Published: January 2016

Objective

To examine headache and depression over time in individuals who sustained mild traumatic brain injury (mTBI). Prevalence of headache and depression early after mTBI and at 1 year postinjury as well as the relationship between the two are evaluated.

Background

Headache is the most common physical symptom and depression is among the most common psychiatric diagnosis after traumatic brain injury regardless of severity. Headache and depression have been found to be two independent factors related to poor outcome after mTBI, yet there appears to be a paucity of research exploring the comorbidity of these two conditions after injury.

Method/Design

Longitudinal survey design over 1 year of 212 participants with mTBI who were admitted to a Level 1 trauma center for observation or other system injuries. Depression was based on a score ≥10 on the Patient Health Questionnaire‐9. Headache was based on participant report of new or worse‐than‐preinjury headache since hospitalization (baseline) or within the previous 3 months at 1 year postinjury.

Results

The prevalence of headache and depression at baseline was 64% (135/212) and 15% (31/212), respectively. The prevalence of headache and depression at 1 year was 68% (127/187) and 27% (50/187), respectively. The co‐occurrence of headache and depression increased from 11% (23/212) at baseline to 25% (46/187) at 1 year. At 1 year, the risk ratio of individuals who had headache to be depressed was 5.43 (95% CI 2.05–14.40) compared to those without headache (P < .001). The corresponding risk ratio at baseline was 1.64 (95% CI .77–3.49; P = .23).

Conclusions

While prevalence of headache is consistently high over the first year after injury, rate of depression increased over the first year for those who were followed. Given the high rate of comorbidity, those with headache may develop depression over time. Evaluation for possible depression in those with headache after mTBI should be conducted to address both conditions over the year following injury.
Differential expression of E‐cadherin and catenins in ovarian sex cord stromal tumours
Authors: Stavrinou Stavroula , Clark Ashleigh , Irving Julie , Lee Cheng‐Han , Oliva Esther , Young Robert , Sriraksa Ruethairat , Magdy Nesreen , Van Noorden Susan , McCluggage W Glenn , El‐Bahrawy Mona
Published: January 2016

Aims

Sex cord stromal tumours (SCSTs) of the ovary encompass several histological tumour subtypes that are defined by characteristic histological features. Some can show morphological overlap with other subtypes of SCSTs, as well as with non‐SCSTs. The E‐cadherin/catenin complex constitutes the adherens junction, which is well developed in epithelial tissue, but the constituent molecules are also expressed in several non‐epithelial tumours. The aim of this study was to determine whether the expression patterns of E‐cadherin and catenins in ovarian SCSTs can be of diagnostic utility.

Methods and results

We studied the expression of E‐cadherin, α‐, β‐ and γ‐catenin in 55 tumours using immunohistochemistry. We found that all tumour subtypes showed nuclear expression of E‐cadherin, while only microcystic stromal tumours (MCSTs) displayed a distinct profile, with nuclear localization of all three catenins in almost all cases.

Conclusions

We conclude that the E‐cadherin expression profile in SCSTs can assist in distinguishing between SCSTs and non‐SCSTs in which there is no nuclear expression of E‐cadherin. The nuclear localization of catenins may be of potential use in distinguishing MCST from other subtypes of SCST.
Uniqueness of stationary equilibrium payoffs in the Baron–Ferejohn model with risk‐averse players
Authors: Eraslan Hülya
Published: January 2016

I study a multilateral sequential bargaining model among risk‐averse players in which the players may differ in their probability of being selected as the proposer and the rate at which they discount future payoffs. For games in which agreement requires less than unanimous consent, I characterize the set of stationary subgame perfect equilibrium payoffs. With this characterization, I establish the uniqueness of the equilibrium payoffs. For the case where the players have the same discount factor, I show that the payoff to a player is non‐decreasing in his probability of being selected as the proposer. For the case where the players have the same probability of being selected as the proposer, I show that the payoff to a player is non‐decreasing in his discount factor. This generalizes earlier work by allowing the players to be risk averse.
Goethe's secret reserve price
Authors: Zheng Charles Z.
Published: January 2016

The story in which Goethe sold a manuscript through a secret reserve price is revisited. Goethe's choice of secrecy can be explained as an attempt to mitigate the lemons problem through concealing his private information about the manuscript. The standard mechanisms that make the price public are unsafe for the seller as the buyer may adopt non‐trusting posterior beliefs. A safe inscrutable mechanism is constructed here that generates more expected profits for some seller types than any such standard mechanism. A contrast between this mechanism and the one devised by Goethe explains why his mechanism was corrupted during its execution.
Sunspot fluctuations in two‐sector models: New results with additively separable preferences
Authors: Dufourt Frédéric , Nishimura Kazuo , Venditti Alain
Published: January 2016

We analyze the emergence of local indeterminacy and sunspot‐driven fluctuations in the standard two‐sector model with additively separable preferences as a function of various structural parameters influencing the degree of increasing returns to scale, the amount of intertemporal substitution in consumption, and the elasticity of the aggregate labor supply curve. On the theoretical side, we prove the existence of both a flip and a Hopf bifurcation locus in the corresponding parameter space. We also show that local indeterminacy can be obtained under any labor supply elasticity or under an arbitrarily low elasticity of intertemporal substitution in consumption. On the empirical side, we find that indeterminacy and sunspot fluctuations are robust features of two‐sector models, prevailing for most empirically plausible calibrations for these parameters.
Medicine: in need of culture change
Authors: Ward S. , Outram S.
Published: January 2016

Compared with other health professionals and the general population, doctors and medical students reported higher rates of psychological distress, burnout, diagnosed mental illness, suicidal ideation and attempted suicide. Where possible, the problematic and unnecessarily stressful aspects of working as a doctor must be improved. Collectively, we must change the often toxic culture of medicine into a culture that promotes a nurturing and supportive approach to teaching and supervision. The goal should be to develop medical practices that facilitate well‐being and quality of life, where sustainable medical careers can develop and better serve the community.
Coronary computed tomography angiography and its increasing application in day to day cardiology practice
Authors: Markham R. , Murdoch D. , Walters D. L. , Hamilton‐Craig C.
Published: January 2016

Coronary artery disease (CAD) is the leading single cause of death in Australia affecting around 1.4 million people. Coronary computed tomography angiography has an established role in the assessment of patients with low to intermediate pretest probability for CAD who have chest pain and is typically used with the aim to rule out significant coronary artery stenosis. Use was initially limited because of concerns over radiation exposure, a Medicare rebate restricted to specialist referrals and an absence of data supporting its use as an alternative to functional testing in patients with chest pain. Recent advances in scanner technology and image sequencing, along with data from randomised control trials, have addressed these issues and indicate that coronary computed tomography angiography will play a greater role in the assessment of CAD in the coming years.
Endogenous TWEAK is critical for regulating the function of mouse uterine natural killer cells in an immunological model of pregnancy loss
Authors: Qi Xuefeng , Lei Mingzhu , Qin Lijuan , Xie Mengjie , Zhao Dandan , Wang Jingyu
Published: January 2016

Uterine natural killer (uNK) cells are the most abundant lymphocyte population in the feto–maternal interface during early gestation, and uNK cells play a significant role in the establishment and maintenance of pregnancy‐related vascularization, as well as in tolerance to the fetus. Tumour necrosis factor‐like weak inducer of apoptosis (TWEAK) and its receptor, fibroblast growth factor‐inducible molecule (Fn14), are involved in preventing local cytotoxicity and counterbalancing the cytotoxic function of uNK cells. Here, we studied the regulation of TWEAK/Fn14‐mediated innate immunity in the uterus using a lipopolysaccharide (LPS)‐induced model of abortion in pregnant mice. Specifically, we detected the expression of TWEAK and Fn14 in the uterus and in uNK cells following LPS treatment. Our results revealed that TWEAK and Fn14 are expressed by uNK cells in pregnant mice; in particular, it appears that the cytokine TWEAK is primarily derived from uNK cells. Interestingly, the down‐regulation of TWEAK in uNK cells and the up‐regulation of the Fn14 receptor in the uterus in LPS‐treated mice may contribute to the disruption of decidual homeostasis by altering uNK cell cytotoxicity – ultimately leading to fetal rejection. In conclusion, the present study strongly suggests that the TWEAK–Fn14 axis in uNK cells is involved in maintaining the tolerance necessary for successful pregnancy.
Banking Union in Historical Perspective: The Initiative of the European Commission in the 1960s–1970s
Authors: Mourlon‐Druol Emmanuel
Published: January 2016

This article shows that planning for the organization of EU banking regulation and supervision did not just appear on the agenda in recent years with discussions over the creation of the eurozone banking union. It unveils a hitherto neglected initiative of the European Commission in the 1960s and early 1970s. Drawing on extensive archival work, this article explains that this initiative, however, rested on a number of different assumptions, and emerged in a much different context. It first explains that the Commission's initial project was not crisis‐driven; that it articulated the link between monetary integration and banking regulation; and finally that it did not set out to move the supervisory framework to the supranational level, unlike present‐day developments.
Retention costs of periodontally compromised molars in a German population
Authors: Schwendicke Falk , Plaumann Anna , Stolpe Michael , Dörfer Christof E. , Graetz Christian
Published: January 2016

Aim

This study assessed the long‐term costs per retention year for periodontally affected molars.

Methods

A cohort of 379 compliant subjects was retrospectively evaluated. Periodontal, restorative, endodontic, prosthetic and surgical treatment costs were estimated based on fee items of the private German health insurance. Costs/year were calculated and the impact of tooth‐ and subject‐related factors on this cost‐effectiveness ratio assessed using generalized linear‐mixed modelling.

Results

2306 molars received non‐regenerative initial and supportive therapy and were followed until extraction or censoring (in mean (SD): 16.5 [6.8] years). Per year, 0.07 (SD: 0.12) deep scalings, 0.04 (0.11) open flap debridements, 0.01 (0.04) resective therapies and 2.49 (0.12) SPTs had been provided. Few teeth received non‐periodontal treatments. Costs/year decreased significantly with each tooth a patient had at baseline (mean difference: −0.01, 95% CI: −0.02/−0.01 Euro/year), and increased with each mm of probing‐pocket depth (0.04 [0.03/0.06] Euro/year), in upper (0.07 [0.11/0.31] Euro/year) or mobile molars (up to 0.33 [0.18/0.48] Euro/year), those with bone loss (up to 0.11 [0.04/0.17] Euro/year), endodontic treatment (0.24 [0.15/0.33] Euro/year), peri‐apical lesions (0.24 [0.11/0.38]) and prosthetic treatment (0.54 [0.49/0.59] Euro/year).

Conclusions

Annual costs for retaining periodontally affected molars were limited, and associated mainly with tooth‐level factors.
Suitability of native North American Rutaceae to serve as host plants for the Asian citrus psyllid (Hemiptera: Liviidae)
Authors: Sétamou M. , da Graça J. V. , Sandoval J. L.
Published: January 2016

The Asian citrus psyllid, Diaphorina citri Kuwayama, a vector of citrus huanglongbing, is now present in all citrus‐producing states in the USA and Mexico. In addition to citrus, the insect can reproduce on several other plant species in the Rutaceae family; orange jasmine (Murraya spp.) and curry leaf (Bergera koenigii) are among its preferred hosts. There are several indigenous Rutaceae species in North America, and some are popular ornamentals. A study was therefore initiated to determine the suitability of some of these plants for feeding and development of the psyllid in choice and no‐choice experiments. D. citri was found to reproduce successfully on Choisya ternata, C. arizonica and Helietta parvifolia in no‐choice tests, but preferentially selected orange jasmine and curry leaf for feeding and reproduction, in choice tests. On Amyris madrensis, A. texana and Zanthoxylum fagara, adult psyllids laid eggs which hatched, but no successful nymphal development was recorded beyond the first instars. No oviposition was recorded on Esenbeckia berlandieri, Ptelea trifoliata and Casimiroa tetrameria, although adult psyllids were able to survive on these species for several days. Results showed that C. ternata, C. arizonica and H. parvifolia can serve host plants of D. citri and this constitutes the first report of these plants serving as host for D. citri. The findings of the present study suggest that native rutaceous host plants can serve as host plants and thus affect D. citri population dynamics and the epidemiology of Huanglongbing, the deadly citrus greening disease whose pathogen is vectored by D. citri. Thus, area‐wide management of this pest also should target these riparian habitats where these host plants are present with D. citri biological control agents for sustainable management of this pest.
Nebela jiuhuensis nov. sp. (Amoebozoa; Arcellinida; Hyalospheniidae): A New Member of the Nebela saccifera ‐ equicalceus ‐ ansata Group Described from Sphagnum Peatlands in South‐Central China
Authors: Qin Yangmin , Man Baiying , Kosakyan Anush , Lara Enrique , Gu Yansheng , Wang Hongmei , Mitchell Edward A. D.
Published: January 2016

Hyalospheniids are among the most common and conspicuous testate amoebae in high‐latitude peatlands and forest humus. These testate amoebae were widely studied as bioindicators and are increasingly used as models in microbial biogeography. However, data on their diversity and ecology are still very unevenly distributed geographically: notably, data are lacking for low‐latitude peatlands. We describe here a new species, Nebela jiuhuensis, from peatlands near the Middle Yangtze River reach of south‐central China with characteristic morphology. The test (shell) has hollow horn‐like lateral extensions also found in N. saccifera, N. equicalceus (=N. hippocrepis), and N. ansata, three large species restricted mostly to Sphagnum peatlands of Eastern North America. Mitochondrial cytochrome oxidase (COI) data confirm that N. jiuhuensis is closely related to the morphologically very similar North American species N. saccifera and more distantly to N. ansata within the N. penardiana group. These species are all found in wet mosses growing in poor fens. Earlier reports of morphologically similar specimens found in South Korea peatlands suggest that N. jiuhuensis may be distributed in comparable peatlands in Eastern Asia (China and Korea). The discovery of such a conspicuous new species in Chinese peatlands suggests that many new testate amoebae species are yet to be discovered, including potential regional endemics. Furthermore, human activities (e.g., drainage, agriculture, and pollution) have reduced the known habitat of N. jiuhuensis, which can thus be considered as locally endangered. We, therefore, suggest that this very conspicuous micro‐organism with a probably limited geographical distribution and specific habitat requirement should be considered as a flagship species for microbial biogeography as well as local environmental conservation and management.
Long‐term epidemiological study of disseminated neoplasia of cockles in Galicia (NW Spain): temporal patterns at individual and population levels, influence of environmental and cockle‐based factors and lethality
Authors: Díaz S , Iglesias D , Villalba A , Carballal M J
Published: January 2016

The dynamics of disseminated neoplasia (DN) affecting cockles Cerastoderma edule (L.) in Galicia was addressed at individual and population levels. Early stage of DN was characterized by isolated neoplastic cells occurring in branchial vessels or in the connective tissue of gills, mantle, gonad or digestive gland. As disease progressed, the neoplastic cells appeared loose in foci and became widely distributed throughout the organs. In advanced stages, the connective tissue of most organs was infiltrated by neoplastic cells, which displaced normal cells, leading to the loss of the normal tissue/organ architecture. Host defence reaction was occasionally observed. A field survey performed for 7 years, in two cockle beds located in different Galician Rías, showed that DN is a hyperendemic disease usually present all year‐round at high prevalence in adult cockles but with annual prevalence minima in spring likely due to the death of heavily affected cockles, concurrently with gonad ripeness–spawning. DN was detected in the cockles ranging from 10 to 39 mm in size; the highest DN prevalence and severity corresponded to the cockles of intermediate size/age (22–29 mm/0.7–1 year old). Sex did not appear to influence DN occurrence. An inhibitory effect of DN on cockle gametogenesis was detected.
First detection of koi herpesvirus from koi, Cyprinus carpio L. experiencing mass mortalities in Iran: clinical, histopathological and molecular study
Authors: Rahmati‐Holasoo H , Zargar A , Ahmadivand S , Shokrpoor S , Ezhari S , Ebrahimzadeh Mousavi H A
Published: January 2016

Koi herpesvirus (KHV) is the aetiological agent of an emerging disease (KHVD) associated with mass mortalities in koi and common carp and reported from at least 30 countries. We report the first detection of KHV from koi in Iran using clinical, histopathological and molecular studies. KHV‐infected fish showed reduced swimming activity, sunken eyes and increased mucus production on skin and fins. On post‐mortem examination, gill necrosis was observed in the majority of fish. Histopathologically, the gill showed diffuse necrosis of the branchial epithelial cells. Margination of chromatin was detected in gills, kidney, heart, spleen, intestine and brain. In addition, sequence analyses of the TK gene, ORF 136 and marker I and II, demonstrates that Iranian KHV isolates were identical and classified as variant A1 of TUSMT1 (J strain) and displayed the I++II+ allele of this Asian genotype.
Ribosomal RNA – a tail wagging the dog?
Authors: Stehle Jörg H. , Rawashdeh Oliver
Published: January 2016

image

It is an intriguing hypothesis that the complex organization of neuronal dynamics important for a memory engram is largely underpinned by the regulation of nucleolar functioning. This Editorial highlights a study by Capitano and coworkers in this issue of the Journal of Neurochemistry, in which the authors tackle this hypothesis with a behavioral approach. The study investigates the role of axo‐dendritic mRNAs within learning‐induced plasticity and in vivo modulation of rRNA transcription in response to spatial learning. The authors confirm with their in vivo approach what is known from many earlier in vitro experiments: efficient learning and memory requires a proper homeostasis of hippocampal neurons in general, which, however, depends crucially on proper integrity of the nucleolus.

Read the highlighted article ‘RNA polymerase I transcription is modulated by spatial learning in different brain regions’ on page 706.
High‐Cholesterol Diet Disrupts the Levels of Hormones Derived from Anterior Pituitary Basophilic Cells
Authors: Yang J. , Zhang X. , Liu Z. , Yuan Z. , Song Y. , Shao S. , Zhou X. , Yan H. , Guan Q. , Gao L. , Zhang H. , Zhao J.
Published: January 2016

Emerging evidence shows that elevated cholesterol levels are detrimental to health. However, it is unclear whether there is an association between cholesterol and the pituitary. We investigated the effects of a high‐cholesterol diet on pituitary hormones using in vivo animal studies and an epidemiological study. In the animal experiments, rats were fed a high‐cholesterol or control diet for 28 weeks. In rats fed the high‐cholesterol diet, serum levels of thyroid‐stimulating hormone (TSH; also known as thyrotrophin), luteinising hormone (LH) and follicle‐stimulating hormone (FSH) produced by the basophilic cells of the anterior pituitary were elevated in a time‐dependent manner. Among these hormones, TSH was the first to undergo a significant change, whereas adrenocorticotrophic hormone (ACTH), another hormone produced by basophilic cells, was not changed significantly. As the duration of cholesterol feeding increased, cholesterol deposition increased gradually in the pituitary. Histologically, basophilic cells, and especially thyrotrophs and gonadotrophs, showed an obvious increase in cell area, as well as a potential increase in their proportion of total pituitary cells. Expression of the β‐subunit of TSH, FSH and LH, which controls hormone specificity and activity, exhibited a corresponding increase. In the epidemiological study, we found a similar elevation of serum TSH, LH and FSH and a decrease in ACTH in patients with hypercholesterolaemia. Significant positive correlations existed between serum total cholesterol and TSH, FSH or LH, even after adjusting for confounding factors. Taken together, the results of the present study suggest that the high‐cholesterol diet affected the levels of hormones derived from anterior pituitary basophilic cells. This phenomenon might contribute to the pituitary functional disturbances described in hypercholesterolaemia.
Processes in healthcare teams that include nurse practitioners: what do patients and families perceive to be effective?
Authors: Kilpatrick Kelley , Jabbour Mira , Fortin Chantal
Published: January 2016

Aims and objectives

To explore patient and family perceptions of team effectiveness of teams those include nurse practitioners in acute and primary care.

Background

Nurse practitioners provide safe and effective care. Patients are satisfied with the care provided by nurse practitioners. Research examining patient and family perceptions of team effectiveness following the implementation of nurse practitioners in teams is lacking.

Design

A descriptive qualitative design was used.

Methods

We used purposeful sampling to identify participants in four clinical specialties. We collected data from March 2014–January 2015 using semi‐structured interviews and demographic questionnaires. Content analysis was used. Descriptive statistics were generated.

Results

Participants (n = 49) believed that the teams were more effective after the implementation of a nurse practitioner and this was important to them. They described processes that teams with nurse practitioners used to effectively provide care. These processes included improved communication, involvement in decision‐making, cohesion, care coordination, problem‐solving, and a focus on the needs of patients and families. Participants highlighted the importance of interpersonal team dynamics. A human approach, trust, being open to discussion, listening to patient and family concerns and respect were particularly valued by participants. Different processes emerged as priorities when data were examined by speciality. However, communication, trust and taking the time to provide care were the most important processes.

Conclusion

The study provides new insights into the views of patients and families and micro‐level processes in teams with nurse practitioners. The relative importance of each process varied according to the patient's health condition. Patients and providers identified similar team processes. Future research is needed to identify how team processes influence care outcomes.

Relevance to clinical practice

The findings can support patients, clinicians and decision‐makers to determine the processes to focus on to promote effective team functioning, and involve patients and families as team members.
Profiles of delirium and the clinical outcomes of patients who underwent coronary artery bypass grafting: a prospective study from China
Authors: Zhang Weiying , Hu Wenlin , Shen Meifang , Ye Xiaofei , Huang Yan , Sun Yan
Published: January 2016

Aims and objectives

To explore the profiles of delirium in coronary artery bypass grafting patients and identify related patient outcomes.

Background

Delirium was assessed previously as a binary result, i.e. present or absent, but little attention was paid to the profiles of delirium, e.g. the subtype, severity, duration and the first episode, and little was known about clinical outcomes.

Design

A prospective study.

Methods

Ninety‐five delirious patients who underwent coronary artery bypass grafting were included. Delirium episodes were categorised as hypoactive, hyperactive or mixed type and as mild, moderate or severe. Duration in days and the first episode of delirium in day after surgery were recorded. Patient outcomes were recorded prospectively to determine the effects of delirium profiles.

Results

Mixed‐type delirium was most common (44·21%), followed by hyperactive delirium (26·32%) and hypoactive delirium (29·47%). Patients with hypoactive delirium had a longer duration of ventilator use. Severity of delirium measurements revealed 28·42% mild, 51·58% moderate and 20·00% severe. Patients with severe delirium had a longer duration of ventilation use, longer lengths of intensive care unit stay and hospital stay compared to mild and moderate delirium. Delirium duration lasted from 1–5 days. Differences were observed in the length of intensive care unit stay and hospital days across groups of different delirium duration. A total of 73·68% of delirium developed on the first and second postoperative days. The later the first episode of delirium occurred, the longer the duration of delirium was, which also yielded longer lengths of intensive care unit stay.

Conclusion

Hypoactive delirium, severe delirium and delirium of later onset and longer duration were associated with adverse outcomes.

Relevance to clinical practice

Hospital staff should pay attention to hypoactive delirium, take measures properly to decrease the severity and duration of delirium to improve the results of delirious patients.
How do nurses and ward managers perceive that evidence‐based sources are obtained to inform relevant nursing interventions? – an exploratory study
Authors: Jansson Inger , Forsberg Anna
Published: January 2016

Aims and objectives

To explore how nurses and managers perceive that evidence‐based sources are obtained to inform relevant nursing interventions.

Background

Implementation of evidence‐based practice requires a systematic search and evaluation of research, clinical expertise and consideration of the patients’ preferences and values. Much has been written over the past decade about how this should be done and nurses’ mandatory education has provided them with the necessary tools to work in this way. In spite of this, nurses do not provide evidence‐based practice on a regular basis. Many of the barriers against evidence‐based practice are dependent on contextual factors. Therefore, it can be of interest to study both managers and nurses.

Design

This qualitative study has an explorative and retrospective design.

Method

Interviews were conducted with 15 participants, including eight nurses, four ward managers, two operation managers and one care developer. Directed content analysis was used.

Result

Nurses and managers had different approaches towards the use of scientific knowledge. Nurses’ use of clinical experience and learning from each other was common. Nurses’ work as facilitators was structured by managers. Not involving the patient in the care was common among the nurses.

Conclusion

The parts of evidence‐based practice that are supported by the managers are also used by the nurses. When use of research is not controlled by the managers, the nurses do not search for scientific research. Neither is the patients’ involvement in decision‐making obvious.

Relevance to clinical practice

A change in nurses’ attitudes to scientific knowledge and perception of patient participation is needed. For this to happen, nurses need managers with a strong interest in evidence‐based practice that support successful implementation of research in everyday clinical practise.
Evaluation of two instruments of perceived symptom intensity in palliative care patients in an outpatient clinic
Authors: Sætra Pia , Fossum Mariann , Svensson Elisabeth , Cohen Marlene Z
Published: January 2016

Aims and objectives

To evaluate the test–retest stability in assessments of perceived symptom intensity on the Edmonton Symptom Assessment System‐revised and the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Core 15 Palliative. The possible interchangeability between the instruments and the patients’ experiences of completing the instruments were also studied.

Background

The two instruments assess the same symptoms, but the symptom intensity is assessed on 11‐point numerical scales on the Edmonton Symptom Assessment System‐revised and on four‐point verbal descriptive scales on the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Core 15 Palliative. Both instruments are commonly used; however, uncertainty exists about which instrument should be recommended and about the interchangeability of the instruments.

Design

This study used a test–retest design with inter‐scale comparisons.

Methods

Data from 54 patients with cancer who were receiving palliative care in an oncology outpatient clinic were self‐reported by the patients in the clinic, at home and when patients returned to the clinic.

Results

The assessments on the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Core 15 Palliative verbal rating scales showed a higher level of test–retest stability than the assessments on the Edmonton Symptom Assessment System‐revised numerical scoring scales, indicating higher reliability. The correspondence between the verbal categories and the numerical scores of symptom intensity were low because different verbal categories were used by patients who assessed the same numerical score.

Conclusions

The test–retest stability in the assessments was higher on the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Core 15 Palliative and the results show that assessments on the two instruments could not be used interchangeably. Therefore, the symptom instrument chosen must be specified and unchanged within a patient to improve efficacy in clinical practice.

Relevance to clinical practice

The Edmonton Symptom Assessment System‐revised or the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Core 15 Palliative can be used for initial assessments of patients, but should not be compared or used interchangeably. It is vitally important to have individual follow‐up for all patients who score an instrument.
Agreement of infrared temporal artery thermometry with other thermometry methods in adults: systematic review
Authors: Kiekkas Panagiotis , Stefanopoulos Nikolaos , Bakalis Nick , Kefaliakos Antonios , Karanikolas Menelaos
Published: January 2016

Aims and objectives

To critically review and synthesise the evidence on the agreement of temporal artery thermometry with invasive and noninvasive thermometry methods in hospitalised adults.

Background

Noninvasive thermometry methods aim at combining patient comfort and ease of use with satisfactory accuracy of temperature measurements. Infrared temporal artery thermometry is based on the detection of heat radiated from this artery in the forehead and temporal region.

Design

Systematic literature review.

Methods

A literature search was conducted in Pubmed,CINAHL, Cochrane Library, Web of Science and Embase. Data were extracted from twenty method‐comparison studies published between 2002–2015. Methodological quality of selected studies was evaluated.

Results

Temperature measurements of temporal artery were compared with pulmonary artery, urinary bladder, oesophageal or nasopharyngeal ones in eight studies for the whole temperature range. Accuracy and precision of temporal artery thermometry exceeded recommended levels of 0·3°C in three and six studies respectively. Likewise, in nine studies that compared temporal artery temperature measurements with oral and ear‐based ones, satisfactory agreement and variability was reported in five and none of them respectively. With regard to fever and hypothermia, although specificity of temporal artery thermometers for detecting these disorders was satisfactory, their sensitivity was low.

Conclusions

Existing evidence does not support that temporal artery thermometry can replace common invasive and noninvasive thermometry methods in adult patients.

Relevance to clinical practice

Health care professionals are recommended to avoid the use of infrared temporal artery temporal artery thermometry in adults, or be cautious about the accuracy and precision of its readings, until improved devices are developed.