bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of ethanol, molasses and Lactobacillus plantarum on fermentation characteristics and aerobic stability of total mixed ration silages
Authors: Yuan X. J. , Wang J. , Guo G. , Wen A. Y. , Desta S. T. , Shao T.
Published: August 2015

This study was conducted to evaluate the effects of Lactobacillus plantarum, molasses and/or ethanol on fermentation quality and aerobic stability of total mixed ration (TMR) silage, which is widely used in dairy cow diets at mid‐to‐late lactation in Tibet. TMR was treated with ethanol (E), molasses (M), Lactobacillus plantarum(L), ethanol+molasses (EM), ethanol+Lactobacillus plantarum (EL) plus control. After 45 d of ensiling, inoculant significantly (P < 0·05) increased lactic acid (LA) concentration and decreased pH, ammonia nitrogen (AN) concentration, and aerobic bacterial and yeast counts, compared to control. After the first 3 d of aerobic exposure, LA for silages without ethanol started to decrease, while LA for E silages almost remained unchanged till the end of the aerobic exposure period. The pH in TMR silages without ethanol gradually increased, while that for E and EL remained about 4·60 and 4·00, respectively, and EL showed the lowest pH among six silages over the course of aerobic exposure. Aerobic bacterial counts in control, M and EM silages were significantly higher (P < 0·05) than those in E, L and EL, and yeast counts in E and EL silages were significantly lower (P < 0·05) than those in other silages after 9 d of aerobic exposure. The results suggest that inoculation with L. plantarum was more effective in altering fermentation characteristics than adding molasses, while ethanol showed a potential to protect TMR silages from pH increase and delayed the growth of aerobic bacteria and yeast either alone or in combination with L. plantarum.
Deriving seasonally optimal nitrogen fertilization rates for a ryegrass pasture based on agricultural production systems simulator modelling with a refined AgPasture model
Authors: Vogeler I. , Cichota R.
Published: August 2015

Productive pasture systems require a regular supply of mineral nitrogen (N) to replace the N removed through the export of animal products and other loss pathways such as leaching and emissions. High spatial and temporal variability of both N supply by the soil and demand by the plant means that synchronizing these is challenging, and early indicators are lacking. Optimum fertilization rates for an irrigated ryegrass pasture in Canterbury, New Zealand, were determined in a simulation study with twenty fertilization rates using the Agricultural Production Systems Simulator with a refined version of APSIM's pasture module (AgPasture). Improvements in AgPasture included ideal N concentrations for tissues of different ages (growing, mature, senescent and dead) and allowing N remobilization to occur from all tissue stages. The critical N concentration curve (the minimum N concentration required to achieve maximum aerial biomass) was tested as an early indicator for guiding N fertilization, which maximizes plant growth while avoiding unnecessary environmental impacts. Highest pasture yields were achieved with application rates of 20, 30, 140 and 160 kg N ha−1 for winter, autumn, summer and spring. These rates also minimized simulated N losses. Pasture N contents corresponding to the standing dry matter of the pastures were similar to the critical N curve in summer and spring, but lower critical N concentrations were obtained for autumn and winter. Before the critical N reference curve can be used to guide fertilization for pastures, further experimental studies, model testing and parameterization are required. It is also possible that season‐specific critical N curves need to be established for pastures.
CD34 immunohistochemistry in bone marrow biopsies for early response assessment in acute myeloid leukemia
Authors: Jain S. , Mahapatra M. , Pati H. P.
Published: August 2015

Introduction

Acute myeloid leukemia is a heterogenous disease with respect to prognosis. Early response assessment has an established role as predictor of remission rate, and overall and disease‐free survival. Assessment of blast percentage on bone marrow aspirate smears at this stage has its own limitations.

Materials and method

In this study, a total of 100 AML cases that were positive for CD34 at the time of diagnosis were included in the study. Blast percentage obtained in bone marrow aspirate smears by morphology was compared with that obtained in bone marrow biopsy using CD34 immunohistochemistry.

Results

Bone marrow aspirate and biopsy were discordant in 19% of the cases. In 15% of the cases, bone marrow aspirate blast count was ≤5% and bone marrow biopsy blast percentage was >5%.

Conclusion

Early response assessment plays an important role in management of acute myeloid leukemia. In patients with CD34‐positive blasts, the CD34 IHC can improve the detection of residual blasts on Day 14 bone marrow biopsy in comparison with morphological assessment of blast percentage in bone marrow aspirate.
Utility of the hypertriglyceridemic waist phenotype in the cardiometabolic risk assessment of youth stratified by body mass index
Authors: Buchan D. S. , Boddy L. M. , Despres J.‐P. , Grace F. M. , Sculthorpe N. , Mahoney C. , Baker J. S.
Published: August 2015

Background

It is unclear whether the hypertriglyceridemic waist phenotype (HTWP) can be used to identify those at most risk of cardiometabolic disorders.

Objectives

The utility of the HTWP as a useful predictor of cardiometabolic risk in youth stratified by body mass index was assessed.

Methods

Three hundred and eighty‐seven children (12–17.5 years) were used within this cross‐sectional study. Participants were classified as normal weight or overweight/obese according to the International Obesity Task Force criteria. The HTWP phenotype was defined as having a waist circumference ≥90th percentile for age and gender with concomitant triglyceride concentrations ≥1.24 mmol L−1. Cardiometabolic risk profiles were compared using MANCOVA.

Results

Normal weight participants with the HTWP had significantly higher levels of C‐reactive protein 2.6 ± 0.4 vs. 1.6 ± 0.3 mg L−1 (P < 0.05) and cardiometabolic risk scores (1.3 ± 0.3 vs. −0.7 ± 0.2 and 2.1 ± 0.4 vs. −0.5 ± 0.2; both P < 0.05) compared with those of a normal weight without the HTWP. Overweight/obese participants with the HTWP had significantly higher C‐reactive protein levels (3.5 ± 0.6 vs. 2.6 ± 0.5; P < 0.05) as well as both cardiometabolic risk scores (1.6 ± 0.6 vs. 0.9 ± 0.2 and 2.2 ± 0.6 vs. 0.8 ± 0.2; both P < 0.001) when compared with overweight/obese participants without the HTWP.

Conclusions

The HTWP may serve as a simple and clinically useful approach to identify youth at increased cardiometabolic risk.
Near Surface Changes Due to 700 keV Si+ Irradiation of Titanium Silicon Carbide
Authors: Qi Qiang , Liu Chaozhuo Z. , King Bruce V. , O'Connor Daryl J. , Kisi Erich H. , Wang Kung , Shi Liqun Q.
Published: August 2015

The radiation damage response of Ti3SiC2 heated from 120°C to 850°C during 700 keV Si+ irradiation has been investigated. The samples were analyzed using glancing incidence X‐ray diffraction, Rutherford backscattering spectrometry, Raman spectroscopy, and scanning electron microscopy. For the sample at 120°C, irradiation results in a buildup of a heterogeneous surface and the formation of TiCx. Irradiation at 200°C results in maximum microstrain, a maximum in the c lattice parameter, and the appearance of a β phase in addition to the normal α phase of Ti3SiC2. A minimum in the observed damage level near the surface was seen for irradiation at a sample temperature of 300°C but the damaged phase increases at higher temperatures. Differences between the present work and a previous C irradiation study have been ascribed to the enhanced Si defect transport at low temperatures.
Sliding Wear Behavior of ZTA with Different Yttria Stabilizer Content
Authors: Bartolomé José F. , Smirnov Anton , Sommer Frank , Landfried Richard , Gadow Rainer
Published: August 2015

In this study, tribological investigations were carried out on ZTA ceramics with 17 vol% Y‐TZP and different stabilizer contents (1, 1.5, and 2 mol% yttria) to analyze the influence of zirconia transformation on wear properties. Samples were tested in a linearly reciprocating ball on flat setup with different applied loads. Raising the fracture toughness by transformation toughening, microcracking, and residual stresses improves the wear resistance only at transition load but increases the wear at high loads. Higher yttria content of 2 mol% and lower zirconia grain size and thus low transformability, decreases fracture toughness but increases the wear resistance at high loads. Therefore the adjustment of stabilizer content on zirconia volume fraction in ZTA plays a decisive role in tribological applications.
Nurses' perceptions of transgressive behaviour in care relationships: a qualitative study
Authors: Vandecasteele Tina , Debyser Bart , Van Hecke Ann , De Backer Tineke , Beeckman Dimitri , Verhaeghe Sofie
Published: August 2015

Aim

To acquire insight into the onset and meaning of transgressive behaviour from the perspective of nurses.

Background

Patient aggression towards healthcare providers occurs frequently. Nurses in particular are at risk of encountering aggressive or transgressive behaviour due to the nature, duration and intensity of relationships with patients. This study analysed nurse perspectives with regard to the onset and meaning of transgressive patient behaviour in a general hospital setting.

Design

Qualitative research according to the grounded theory method.

Methods

Data were collected in 2011 through individual interviews with 18 nurses who were selected using purposive and theoretical sampling.

Findings

Findings revealed that various nurse‐patient interactions can result in episodes of transgressive behaviour, depending on the interplay of determining and regulating factors which have been identified at the patient, nurse and ward level. Experiences of transgressive behaviour are influenced by degree of control nurses experience over the provision of care; the degree of patient acceptance of organizational and ward rules, the degree of gratitude and recognition expressed by the patient and the extent of patient regard for the nurse as a person. Factors affecting transgressive experiences were a trusting relationship between patient and nurse; the extent to which patient perspectives are understood; methods of managing transgressive behaviour; and the influence of the team, head nurse and ward culture and habits.

Conclusions

The results of this study can support the development of nurses' coping ability and self‐confidence to mitigate or prevent experiences of transgressive behaviour.
Left Ventricular Lead Placement Targeted at the Latest Activated Site Guided by Electrophysiological Mapping in Coronary Sinus Branches Improves Response to Cardiac Resynchronization Therapy
Authors: LIANG YANCHUN , YU HAIBO , ZHOU WEIWEI , XU GUOQING , SUN YI , LIU RONG , WANG ZULU , HAN YALING
Published: August 2015

Optimization of LV Lead Site by EP Mapping

Introduction

Electrophysiological mapping (EPM) in coronary sinus (CS) branches is feasible for guiding LV lead placement to the optimal, latest activated site at cardiac resynchronization therapy (CRT) procedures. However, whether this procedure optimizes the response to CRT has not been demonstrated. This study was to evaluate effects of targeting LV lead at the latest activated site guided by EPM during CRT.

Methods

Seventy‐six consecutive patients with advanced heart failure who were referred for CRT were divided into mapping (MG) and control groups (CG). In MG, the LV lead, also used as a mapping bipolar electrode, was placed at the latest activated site determined by EPM in CS branches. In CG, conventional CRT procedure was performed. Patients were followed for 6 months after CRT.

Results

Baseline characteristics were comparable between the 2 groups. In MG (n = 29), EPM was successfully performed in 85 of 91 CS branches during CRT. A LV lead was successfully placed at the latest activated site guided by EPM in 27 (93.1%) patients. Compared with CG (n = 47), MG had a significantly higher rate (86.2% vs. 63.8%, P = 0.039) of response (>15% reduction in LV end‐systolic volume) to CRT, a higher percentage of patients with clinical improvement of ≥2 NYHA functional classes (72.4% vs. 44.7%, P = 0.032), and a shorter QRS duration (P = 0.004).

Conclusions

LV lead placed at the latest activated site guided by EPM resulted in a significantly greater CRT response, and a shorter QRS duration.
Association of baseline plasma des‐acyl ghrelin level with the response to rikkunshito in patients with functional dyspepsia
Authors: Togawa Koji , Matsuzaki Juntaro , Kobayakawa Masao , Fukushima Yasushi , Suzaki Fumio , Kasugai Kunio , Nishizawa Toshihiro , Naito Yuji , Hayakawa Toshihiko , Kamiya Takeshi , Andoh Takashi , Yoshida Hideo , Tokura Yoshifumi , Nagata Hiroshi , Mori Mikiji , Kato Kimihiko , Hosoda Hiroshi , Takebayashi Toru , Miura Soichiro , Uemura Naomi , Joh Takashi , Hibi Toshifumi , Suzuki Hidekazu
Published: August 2015

Background and Aim:

We recently conducted a randomized placebo‐controlled trial on the efficacy and safety of rikkunshito, a standardized Japanese herbal medicine, for the treatment of functional dyspepsia (FD). The present post‐hoc study aimed to evaluate the differences in clinical characteristics between responders and non‐responders among FD patients who received rikkunshito for 8 weeks.

Methods:

Rikkunshito responders were defined by using a global patient assessment. Candidate predictors included age, gender, smoking, alcohol consumption, body mass index, comorbidity, Helicobacter pylori infection, plasma levels of acyl ghrelin and des‐acyl ghrelin, severity of dyspeptic symptoms, FD subgroup, previous medication, and the type of recruiting institution (clinic or hospital). We calculated hazard ratios (HRs) by using Cox regression analysis with the factors that were indicated to be associated with responders.

Results:

We assigned 83 and 42 patients to responder and non‐responder categories, respectively. Lack of alcohol consumption (HR, 2.04; 95% confidence interval, 1.08–3.88) and low plasma des‐acyl ghrelin levels (< 177 fmol/mL; HR, 2.42; 95% confidence interval, 1.24–4.73) were significantly associated with the efficacy of rikkunshito. Lack of alcohol consumption was associated with the efficacy of rikkunshito especially among H. pylori‐infected participants. On the other hand, the low plasma des‐acyl ghrelin was associated with the efficacy of rikkunshito especially among H. pylori‐negative participants.

Conclusions:

A low baseline level of plasma des‐acyl ghrelin was associated with an increased treatment efficacy of rikkunshito against FD. Lack of alcohol consumption was also clinically useful for predicting the response to rikkunshito.
Validation of a food frequency questionnaire to determine vitamin D intakes using the method of triads
Authors: Weir R. R. , Carson E. L. , Mulhern M. S. , Laird E. , Healy M. , Pourshahidi L. K.
Published: August 2015

Background

Dietary sources of vitamin D (both natural and fortified) are increasingly contributing to consumers’ vitamin D intake and status. Therefore, the present study aimed to validate a vitamin D food frequency questionnaire (FFQ) for the assessment of habitual vitamin D intake.

Methods

A total of 49 apparently healthy consenting adults (aged 18–64 years) from the local community were sampled at the end of winter. Dietary intakes were recorded using a 4‐day weighed food record (4d‐WFR) and a 17‐item FFQ based on foods known to contribute to dietary vitamin D intake. Fasting vitamin D status was quantified by serum 25‐hydroxyvitamin D [25(OH)D] using liquid chromatography tandem mass spectrometry. The method of triads was applied using these three measurements to determine the overall validity of the FFQ.

Results

Vitamin D intakes from 4d‐WFR ranged between 0.42 and 31.65 μg day−1, whereas intakes determined from the FFQ ranged from 1.03 to 36.08 μg day−1. Serum 25(OH)D concentrations ranged between 12.89 and 279.00 nmol L−1. The mean (SD) difference between the FFQ and 4d‐WFR was +1.62 ( 3.86). There were strong correlations between the vitamin D intake estimated by the FFQ and that from the 4d‐WFR (r = 0.562) and also with serum 25(OH)D concentrations (r = 0.567). Vitamin D intake estimated from the 4d‐WFR was also strongly correlated with serum 25(OH)D concentrations (r = 0.411). The overall validity coefficient calculated using the method of triads was high (0.881).

Conclusions

The vitamin D FFQ has been validated for use in future studies aiming to assess habitual vitamin D intake.
A nested case–control study on dietary fat consumption and the risk for gallstone disease
Authors: Bertola Compagnucci A. , Perroud H. A. , Batallés S. M. , Villavicencio R. , Brasca A. , Berli D. , Pezzotto S. M.
Published: August 2015

Background

Gallstone disease (GD) incidence and prevalence rates differ between populations. Diet and lifestyle may be involved in GD development. To our knowledge, no study to date has evaluated quantitative data on diet when studying the relationship between fat consumption levels and GD in an Argentinean population. The present study aimed to assess the association between dietary fat intake and GD.

Methods

A nested case–control study design was applied. Data were taken from subjects who participated in a previous cross‐sectional study carried out in a random sample of asymptomatic people in Rosario, Argentina. Participants underwent a personal interview, and current weight and height, ancestor's ethnicity, and socio‐economic status were recorded. Applying a food‐frequency questionnaire and a food photography atlas, quantitative dietary data were estimated by combining the intake frequency, portion size and food composition. Logistic regression analysis was used to compute odds ratios and 95% confidence intervals adjusted by age, sex, ancestor's ethnicity, body mass index and daily total energy intake as potential confounders.

Results

In total, 114 patients were studied (49 cases and 65 controls), without any statistically significant differences for age, sex, socio‐economic status, body mass index and ancestry. The mean energy intake was higher in cases than in controls, and significant differences were found for dietary fat consumption. Obese or overweight people have a higher GD risk than subjects with normal weight. Increased GD risks were associated with high intakes of energy, total fat, and saturated and monounsaturated fatty acids.

Conclusions

According to our results, total fat, saturated and monounsaturated fatty acids high intakes are associated with increased GD risk.
Perineal Injury During Childbirth Increases Risk of Postpartum Depressive Symptoms and Inflammatory Markers
Authors: Dunn Alexis B. , Paul Sudeshna , Ware Laurel Z. , Corwin Elizabeth J.
Published: August 2015

Introduction

Perineal lacerations during childbirth affect more than 65% of women in the United States. Little attention has been given to the long‐term biologic consequences associated with perineal lacerations or possible associations with postpartum mental health. In this article, we describe the results of a study that explored inflammatory cytokines in women who reported perineal lacerations during childbirth and the relationship with stress and depressive symptoms during the first 6 months postpartum.

Methods

A repeated measures design was used to explore the relationship between varying degrees of perineal lacerations, inflammatory cytokines, postpartum stress, and depressive symptoms in 153 women over 6 months. Depressive symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS), and maternal stress was measured using the Perceived Stress Scale. Plasma was analyzed for proinflammatory (tumor necrosis factor alpha, interleukin 6 (IL‐6), interleukin‐1 beta, interferon gamma) and anti‐inflammatory (interleukin 10) cytokines. Levels of cytokines were compared between women with or without varying degrees of injury.

Results

A relationship was identified between symptoms of depression and a second‐degree or more severe perineal laceration starting at one month postpartum (P = .04) and continuing through 3 months postpartum (P = .03). Similarly, stress symptoms were higher at 3 months postpartum (P = .02). Markers of inflammation were significantly higher among this group, with IL‐6 increased at 2 weeks postpartum (P = .02) and remaining elevated through 2 months postpartum (P = .003); there were also significant differences in pro‐ to anti‐inflammatory cytokine ratios out to 6 months postpartum. Regression analysis indicated that second‐degree or more severe lacerations accounted for 5.9% of the variance in EPDS score at one month postpartum (P = .024, F = 2.865, t = 2.127), increasing substantially when the one month stress score was included as well.

Discussion

This study suggests that perineal lacerations, inflammation, stress, and depressed mood are associated; however, more research is needed to elucidate the actual relationship between inflammation and mental health in women who experience such injuries.
Prevalence of Perineal Lacerations in Women Giving Birth at Midwife‐Led Birth Centers in Japan: A Retrospective Descriptive Study
Authors: Suto Maiko , Takehara Kenji , Misago Chizuru , Matsui Mitsuaki
Published: August 2015

Introduction

Perineal lacerations during birth can cause ongoing physical, psychological, and social problems. However, the prevalence of lacerations following normal spontaneous vaginal birth in women with low‐risk pregnancies is unknown. We investigated the prevalence of perineal lacerations and factors associated with lacerations among low‐risk Japanese women who had normal spontaneous vaginal births.

Methods

Pregnant women who were cared for between January 1, 2008, and June 30, 2011, in 3 midwife‐led birth centers in Tokyo, Japan, where invasive medical interventions are rarely applied, were included. We investigated the prevalence of perineal lacerations and conducted univariate and multivariate analyses on the relationship between the prevalence of lacerations and selected maternal and neonatal characteristics.

Results

A total of 1881 pregnant women had initial antenatal care at one of the 3 study sites. Of these, 1521 were eligible for inclusion. Intact perineum rates were 49.5% (209/422) and 69.9% (768/1099) in nulliparous and multiparous women, respectively. First‐degree lacerations occurred in 36.7% (155/422) of nulliparous women and 27.1% (298/1099) of multiparous women, and second‐degree lacerations occurred in 13.5% (57/422) of nulliparous women and 3.0% (33/1099) of multiparous women. One multiparous woman experienced a third‐degree laceration (0.1%). No women suffered fourth‐degree or cervical lacerations. Logistic regression analyses showed that older age (≥ 35 years), the hands‐and‐knees position, and using a birthing chair during birth increased the risk of perineal laceration both in nulliparous and in multiparous women. In addition, waterbirths increased the risk of perineal laceration in multiparous women.

Discussion

In normal spontaneous vaginal births among a low‐risk population, it is possible to avoid episiotomy and achieve a high rate of intact perineum, with few second‐degree and third‐degree lacerations.
Does 3D orientation account for variation in osteon morphology assessed by 2D histology?
Authors: Hennig Cheryl , Thomas C. David L. , Clement John G. , Cooper David M. L.
Published: August 2015

The primary microstructural unit of cortical bone, the secondary osteon or Haversian system, is widely assumed to have a cylindrical shape. It is generally accepted that osteons are roughly circular in cross‐section and deviations from circularity have been attributed to deviations from longitudinal orientation. To our knowledge this idealized geometric relationship, which assumes osteons are perfect cylinders, has not been rigorously explored. As such, we sought to explore two research questions: (i) Does the orientation of osteons in 3D explain variation in shapes visualized in 2D? (ii) Can differences in osteon 3D orientation explain previously reported age‐related differences observed in their 2D cross‐sectional shape (e.g. more circular shape and decreased area with age)? To address these questions we utilized a combination of 2D histology to identify osteon shape and superimposed micro‐computed tomography data to assess osteon orientation in 3D based upon the osteonal canal. Shape was assessed by the inverse of Aspect Ratio (On.AspR−1, based on a fitted ellipse) – which ranged from 0 (infinitely elongated shape) to 1 (perfectly circular). A sample (n = 27) of human female anterior femoral cortical bone samples from across the human lifespan (20–87 years) were included in the analysis, which involved 1418 osteons. The overall mean measure of On.AspR−1 was 0.703 (1.42 Aspect Ratio). Mean osteon orientation was 79.1° (90° being longitudinal). While we anticipated a positive relation between orientation and On.AspR−1, we found the opposite – a weak negative correlation (with more oblique 3D osteon alignment, the 2D shape became more circular as reflected by increased On.AspR−1). When analysis of covariance was performed with age and orientation as covariates, the negative relation with orientation was replaced by a significant relation with age alone. This relation with age accounted for 41% of the variation of On.AspR−1. The results revealed that osteons, on average, are not circular in cross‐section and that 3D orientation cannot account for deviation from circular shape. Osteons thus are strictly speaking not cylinders, as they tend to have elliptical cross‐sections. We observed that osteons did become less elliptical in cross‐section with age independent of orientation – suggesting this is a real change in morphology.
How the embryo makes a limb: determination, polarity and identity
Authors: Tickle Cheryll
Published: August 2015

The vertebrate limb with its complex anatomy develops from a small bud of undifferentiated mesoderm cells encased in ectoderm. The bud has its own intrinsic polarity and can develop autonomously into a limb without reference to the rest of the embryo. In this review, recent advances are integrated with classical embryology, carried out mainly in chick embryos, to present an overview of how the embryo makes a limb bud. We will focus on how mesoderm cells in precise locations in the embryo become determined to form a limb and express the key transcription factors Tbx4 (leg/hindlimb) or Tbx5 (wing/forelimb). These Tbx transcription factors have equivalent functions in the control of bud formation by initiating a signalling cascade involving Wnts and fibroblast growth factors (FGFs) and by regulating recruitment of mesenchymal cells from the coelomic epithelium into the bud. The mesoderm that will form limb buds and the polarity of the buds is determined with respect to both antero‐posterior and dorso‐ventral axes of the body. The position in which a bud develops along the antero‐posterior axis of the body will also determine its identity – wing/forelimb or leg/hindlimb. Hox gene activity, under the influence of retinoic acid signalling, is directly linked with the initiation of Tbx5 gene expression in the region along the antero‐posterior axis of the body that will form wings/forelimbs and determines antero‐posterior polarity of the buds. In contrast, Tbx4 expression in the regions that will form legs/hindlimbs is regulated by the homeoprotein Pitx1 and there is no evidence that Hox genes determine antero‐posterior polarity of the buds. Bone morphogenetic protein (BMP) signalling determines the region along the dorso‐ventral axis of the body in which both wings/forelimbs and legs/hindlimbs develop and dorso‐ventral polarity of the buds. The polarity of the buds leads to the establishment of signalling regions – the dorsal and ventral ectoderm, producing Wnts and BMPs, respectively, the apical ectodermal ridge producing fibroblast growth factors and the polarizing region, Sonic hedgehog (Shh). These signals are the same in both wings/forelimbs and legs/hindlimbs and control growth and pattern formation by providing the mesoderm cells of the limb bud as it develops with positional information. The precise anatomy of the limb depends on the mesoderm cells in the developing bud interpreting positional information according to their identity – determined by Pitx1 in hindlimbs – and genotype. The competence to form a limb extends along the entire antero‐posterior axis of the trunk – with Hox gene activity inhibiting the formation of forelimbs in the interlimb region – and also along the dorso‐ventral axis.
Realising skilled companionship in nursing: a utopian idea or difficult challenge?
Authors: Dierckx de Casterlé Bernadette
Published: August 2015

Aims and objectives

The question being considered in this discussion article is whether nurses' practice can be usefully characterised in terms of skilled companionship.

Background

A nurse's role might be characterised as one of a ‘skilled companion,’ a concept that brings together the scientific and moral basis of nursing practice. It is this focus on integrating both ‘skill’ and ‘companionship’ characteristics of nurses' practice that largely determines their effectiveness as care providers and their specific contribution to health care outcomes.

Methods

Discursive article that invites readers to explore and arrive at a more comprehensive understanding of nurses' daily practice, one from an ethical perspective that is based on empirical data from the study of patients' caring experiences, nurses' caring experiences and nurses' ethical practice in daily care.

Conclusions

Research in this era of health care highlights an important dilemma that the nursing profession is confronted with daily: realising nurses' role as a skilled companion in an environment where this concept of nursing care is discouraged, or even thwarted. Although the ethical dimension is explicitly and universally recognised as a core dimension of nursing care, research clearly highlights nurses' difficulties in translating this element into daily practice. Most disturbing in these findings is that both patients and nurses feel compelled to reach a compromise to ‘survive’ in this often‐chaotic caring environment.

Relevance to clinical practice

It appears today that nurses' intrinsic strengths and potential are largely underutilised in daily practice. More than ever, the nursing profession is challenged to reflect on the future position, aspirations and responsibilities of nurses, to make clear choices, and to act accordingly. Viewing and implementing the nurse's role as one of a skilled companion promise better health care delivery in a postmodern world.
Exome and genome sequencing: a revolution for the discovery and diagnosis of monogenic disorders
Authors: Stranneheim H. , Wedell A.
Published: August 2015

Massively parallel DNA sequencing has revolutionized analyses of human genetic variation. From having been out of reach for individual research groups and even more so for clinical diagnostic laboratories until recently, it is now possible to analyse complete human genomes within reasonable time frames and at a reasonable cost using technologies that are becoming increasingly available. This represents a huge advance in our ability to provide correct diagnoses for patients with rare inherited disorders and their families. This paradigm shift is especially dramatic within the area of monogenic disorders. Not only can rapid and safe diagnostics of virtually all known single‐gene defects now be established, but novel causes of disease in previously unsolved cases can also be identified, illuminating novel pathways important for normal physiology. This greatly increases the capability not only to improve management of rare disorders, but also to improve understanding of pathogenetic mechanisms relevant for common, complex diseases.
Insight into glucosidase II from the red marine microalgaPorphyridiumsp. (Rhodophyta)
Authors: Levy‐Ontman Oshrat , Fisher Merav , Shotland Yoram , Tekoah Yoram , (Malis) Arad Shoshana
Published: August 2015

N‐glycosylation of proteins is one of the most important post‐translational modifications that occur in various organisms, and is of utmost importance for protein function, stability, secretion, and loca‐lization. Although the N‐linked glycosylation pathway of proteins has been extensively characterized in mammals and plants, not much information is available regarding the N‐glycosylation pathway in algae. We studied the α 1,3‐glucosidase glucosidase II (GANAB) glycoenzyme in a red marine microalgaPorphyridiumsp. (Rhodophyta) using bioinformatic and biochemical approaches. TheGANAB‐gene was found to be highly conserved evolutionarily (compo‐sed of all the common features of α and β subunits) and to exhibit similar motifs consistent with that of homolog eukaryotesGANABgenes. Phylogenetic analysis revealed its wide distribution across an evolutionarily vast range of organisms; while the α subunit is highly conserved and its phylogenic tree is similar to the taxon evolutionary tree, the β subunit is less conserved and its pattern somewhat differs from the taxon tree. In addition, the activity of the red microalgalGANABenzyme was studied, including functional and biochemical characterization using a bioassay, indicating that the enzyme is similar to other eukaryotes orthologGANABenzymes. A correlation between polysaccharide production andGANABactivity, indicating its involvement in polysaccharide biosynthesis, is also demonstrated. This study represents a valuable contribution toward understanding the N‐glycosylation and polysaccharide biosynthesis pathways in red microalgae.
Leucine metabolism regulates TRI6 expression and affects deoxynivalenol production and virulence in Fusarium graminearum
Authors: Subramaniam Rajagopal , Narayanan Swara , Walkowiak Sean , Wang Li , Joshi Manisha , Rocheleau Hélène , Ouellet Thérèse , Harris Linda J.
Published: August 2015

TRI6 is a positive regulator of the trichothecene gene cluster and the production of trichothecene mycotoxins [deoxynivalenol (DON)] and acetylated forms such as 15‐Acetyl‐DON) in the cereal pathogen Fusarium graminearum. As a global transcriptional regulator, TRI6 expression is modulated by nitrogen‐limiting conditions, sources of nitrogen and carbon, pH and light. However, the mechanism by which these diverse environmental factors affect TRI6 expression remains underexplored. In our effort to understand how nutrients affect TRI6 regulation, comparative digital expression profiling was performed with a wild‐type F. graminearum and a Δtri6 mutant strain, grown in nutrient‐rich conditions. Analysis showed that TRI6 negatively regulates genes of the branched‐chain amino acid (BCAA) metabolic pathway. Feeding studies with deletion mutants of MCC, encoding methylcrotonyl‐CoA‐carboxylase, one of the key enzymes of leucine metabolism, showed that addition of leucine specifically down‐regulated TRI6 expression and reduced 15‐ADON accumulation. Constitutive expression of TRI6 in the Δmcc mutant strain restored 15‐ADON production. A combination of cellophane breach assays and pathogenicity experiments on wheat demonstrated that disrupting the leucine metabolic pathway significantly reduced disease. These findings suggest a complex interaction between one of the primary metabolic pathways with a global regulator of mycotoxin biosynthesis and virulence in F. graminearum.
Use of Transparent Film Dressing for Dermoscopy of Mucosal Lesions
Authors: Sorrell Jennifer , Lauren Christine T.
Published: August 2015

Genital and mucosal nevi are not uncommonly encountered in children. These type of nevi highlight challenges in performing a thorough dermoscopic examination. Contact dermoscopy can provide additional information about a nevus that non‐contact dermoscopy cannot. We propose applying a sterile transparent film dressing over the dermatoscope to act as a waterproof barrier that is also impermeable to bacteria and viruses. This provides a sanitary way to evaluate nevi in genital skin as well as on other mucosal surfaces.
Efficacy of pediatric acute pancreatitis scores at a Japanese tertiary center
Authors: Hashimoto Naoya , Yotani Nobuyuki , Michihata Nobuaki , Tang Julian , Sakai Hirokazu , Ishiguro Akira
Published: August 2015

Background

Pediatric acute pancreatitis (AP) is a rare but important clinical entity associated with significant morbidity. Predicting the severity and outcome of AP in pediatric patients can be challenging because there are few validated severity scoring systems. Moreover, the etiology of pediatric AP in the Japanese population is different from that of Western populations. The performance of severity scores in pediatric AP with a high prevalence of severe cases is still unknown. The aim of this study was to assess the performance of existing severity scoring systems when used for Japanese children at a tertiary care center.

Methods

We reviewed the electronic medical records of all children (≤18 years) treated for AP at between 2002 and 2012 at National Center for Child Health and Development, Tokyo. The modified Glasgow acute pancreatitis severity score (modified Glasgow), Ranson criteria (Ranson), Balthazar computed tomography severity index (CTSI), and pediatric acute pancreatitis severity (PAPS) score were assessed for their ability to distinguish severe pancreatitis from the milder forms.

Results

Thirty‐three Japanese children with AP were identified. Among them, 37 episodes were analyzed for the performance of the scoring systems and 33 for the etiology. The most common etiology of AP was structural abnormality (n = 8). Sensitivity for the modified Glasgow, Ranson, PAPS, and CTSI was 42.9%, 52.4%, 81.0%, and 50.0%, respectively, while specificity was 81.3%, 81.3%, 37.5%, and 76.9%, respectively.

Conclusion

We found PAPS to be the most reliable when used for discriminating the severe form of AP from the milder forms at a Japanese tertiary pediatric care center.
The Impact of a Nurse‐Led Home Visitation Program on Hypertension Self‐Management among Older Community‐Dwelling Koreans
Authors: Park Eunok , Kim JinShil
Published: August 2015

Objectives

To examine the impact of a nurse‐led home visitation program for hypertension self‐management among older community‐dwelling Koreans.

Design and Sample

As part of a larger community‐based home visitation project aimed at behavioral change in this vulnerable population, a single group pre‐ and posttest design was used.

Measures

Visiting nurses affiliated to public health center assisted vulnerable elders with hypertension self‐management tailored according to their health problems through home visits for a period of 2–4 months.

Results

A total of 13,452 hypertensive persons over the age of 65 completed the intervention. All outcomes were significantly improved and included hypertension knowledge, blood pressure monitoring, dietary management, medication adherence, and self‐confidence in hypertension self‐management (p < .001). Changes in hypertension knowledge, medication adherence, and self‐confidence varied by gender with women showing greater knowledge improvement than men but less improvement in medication adherence and confidence in hypertension self‐management. There was a marginal interaction effect for gender and age on dietary management (F = 3.55, p = .063), with men (≥75 years) showing greater improvement than their female counterparts after the intervention.

Conclusions

This nurse‐led home visitation intervention can be helpful in self‐management skill building among hypertensive Korean elders. The program may improve medication adherence and health‐promoting behavioral changes.
The inflammasome and danger molecule signaling: at the crossroads of inflammation and pathogen persistence in the oral cavity
Authors: Yilmaz Özlem , Lee Kyu Lim
Published: August 2015

Inflammasomes are an oligomeric assembly of multiprotein complexes that activate the caspase‐1‐dependent maturation and the subsequent secretion of inflammatory interleukin‐1beta and interleukin‐18 cytokines in response to a ‘danger signal’ in vertebrates. The assessment of their significance continues to grow rapidly as the complex biology of various chronic inflammatory conditions is better dissected. Increasing evidence strongly links inflammasomes and host‐derived small ‘danger molecule ATP’ signaling with the modulation of the host immune response by microbial colonizers as well as with potential altering of the microbiome structure and intermicrobial interactions in the host. All of these factors eventually lead to the destructive chronic inflammatory disease state. In the oral cavity, a highly dynamic and multifaceted interplay takes place between the signaling of endogenous danger molecules and colonizing microbes on the mucosal surfaces. This interaction may redirect the local microenvironment to favor the conversion of the resident microbiome toward pathogenicity. This review outlines the major components of the known inflammasome complexes/mechanisms and highlights their regulation, in particular, by oral microorganisms, in relation to periodontal disease pathology. Better characterization of the cellular and molecular biology of the inflammasome will probably identify important potential therapeutic targets for the treatment and prevention of periodontal disease, as well as for other debilitating chronic diseases.
Neutrophil activation and periodontal tissue injury
Authors: Herrmann Jens Martin , Meyle Jörg
Published: August 2015

Neutrophilic polymorphonuclear leukocytes (PMNL) track, engage and eliminate foreign entities, including bacteria, fungi and subcellular particles. PMNL are the major host‐cell line involved in the acute response during the early stages of infections, including those in the oral cavity. Rather short lived, they are among the fastest moving cells in the human body and travel great distances only to be immolated after encountering and neutralizing antigens. Although their role as the first line of host defense is well established, their role in chronic granulomatous inflammations, diseases and infections remains poorly understood, and many questions on the activation, motility, bactericidity and termination of PMNL in these conditions remain unanswered. This review aims to summarize our current understanding of the molecular mechanisms of PMNL activation and signaling events. Recent evidence indicates the presence of collateral tissue damage caused by poorly regulated PMNL pursuits of periodontal bacteria. Imbalances between the antigenic challenge and the primary host response may augment periodontal tissue breakdown. Thereafter, orchestrated regulation of the resolution of inflammation fails in the presence of a pathogenic periodontal biofilm.
Local inflammatory reactions in patients with diabetes and periodontitis
Authors: Sonnenschein Sarah K. , Meyle Joerg
Published: August 2015

The impact of diabetes mellitus on the prevalence, severity and progression of periodontal disease has been known for many years and intense efforts have been made to elucidate the underlying mechanisms. It is widely reported that hyperglycemia causes numerous systemic changes, including altered innate immune‐cell function and metabolic changes. The aim of this review was to summarize and discuss the evidence for mechanisms that probably play a role in the altered local inflammatory reactions in the periodontium of patients with diabetes, focusing on local changes in cytokine levels, matrix metalloproteinases, reactive oxygen species, advanced glycation end‐products, immune‐cell functions, the RANKL/osteoprotegerin axis and toll‐like receptors. Apart from the systemic effects of diabetes, recent evidence suggests that local changes in the periodontal tissues are characterized by enhanced interactions between leukocytes and endothelial cells and by altered leukocyte functions [resulting in increased levels of reactive oxygen species and of proinflammatory cytokines (interleukin‐1β, interleukin‐6 and tumor necrosis factor‐α)]. These local changes are amplified by the enhanced accumulation of advanced glycation end‐products and their interaction with receptors for advanced glycation end‐products. Furthermore, the increased levels of proinflammatory cytokines lead to an up‐regulation of RANKL in periodontal tissues, stimulating further periodontal tissue breakdown.
Activation and resolution of periodontal inflammation and its systemic impact
Authors: Hasturk Hatice , Kantarci Alpdogan
Published: August 2015

Inflammation is a highly organized event impacting upon organs, tissues and biological systems. Periodontal diseases are characterized by dysregulation or dysfunction of resolution pathways of inflammation that results in failure to heal and in a dominant chronic, progressive, destructive and predominantly unresolved inflammation. The biological consequences of inflammatory processes may be independent of the etiological agents, such as trauma, microbial organisms and stress. The impact of the inflammatory pathological process depends upon the tissues or organ system affected. Whilst mediators are similar, there is tissue specificity for the inflammatory events. It is plausible that inflammatory processes in one organ could directly lead to pathologies in another organ or tissue. Communication between distant parts of the body and their inflammatory status is also mediated by common signaling mechanisms mediated via cells and soluble mediators. This review focuses on periodontal inflammation, its systemic associations and advances in therapeutic approaches based on mediators acting through orchestration of natural pathways to resolution of inflammation. We also discuss a new treatment concept in which natural pathways of resolution of periodontal inflammation can be used to limit systemic inflammation and promote healing and regeneration.
Globalization and the Retreat of Citizen Participation in Collective Action: A Challenge for Public Administration
Authors: Adres Eitan , Vashdi Dana R. , Zalmanovitch Yair
Published: August 2015

Globalization challenges the ability of contemporary public administration to encourage citizen participation in collective action through behaviors such as tax compliance and contributions to public goods. The authors introduce a new individual‐level approach to globalization, arguing that people vary in the extent to which they are globalized and that an individual's level of globalism (ILG) reflects attitudes and dispositions that influence the way he or she resolves the social dilemma of participation in collective action (i.e., the decision to contribute versus follow a “free‐ride” strategy). Using a four‐country sample, the article examines the relationship betweenILGand collective action participation decisions in three behavioral experiments. Findings support the hypothesis that regardless of country‐level globalization, a more globalized individual complies less willingly with tax codes, donates less to local nongovernmental organizations, and prefers to adopt a free‐ride strategy in a public goods game. The consequences for public administration are discussed.