bluuebunny/crossref_metadata_2025 huggingface dataset:
Overexpression of Tet3 in donor cells enhances goat somatic cell nuclear transfer efficiency
Authors: Han Chengquan , Deng Ruizhi , Mao Tingchao , Luo Yan , Wei Biao , Meng Peng , Zhao Lu , Zhang Qing , Quan Fusheng , Liu Jun , Zhang Yong
Published: May 2018

Ten–eleven translocation 3 (TET3) mediates active DNA demethylation of paternal genomes during mouse embryonic development. However, the mechanism of DNA demethylation in goat embryos remains unknown. In addition, aberrant DNA methylation reprogramming prevalently occurs in embryos cloned by somatic cell nuclear transfer (SCNT). In this study, we reported that TET3 is a key factor in DNA demethylation in goat pre‐implantation embryos. Knockdown of Tet3 hindered DNA demethylation at the two‐ to four‐cell stage in goat embryos and decreased Nanog expression in blastocysts. Overexpression of Tet3 in somatic cells can initiate DNA demethylation, reduce 5‐methylcytosine level, increase 5‐hydroxymethylcytosine level and promote the expression of key pluripotency genes. After SCNT, overexpression of Tet3 in donor cells corrected abnormal DNA hypermethylation of cloned embryos and significantly enhanced in vitro and in vivo developmental rate (P < 0.05). We conclude that overexpression of Tet3 in donor cells significantly improves goat SCNT efficiency.
Factors regulating carbon sinks in mangrove ecosystems
Authors: Li Shi‐Bo , Chen Po‐Hung , Huang Jih‐Sheng , Hsueh Mei‐Li , Hsieh Li‐Yung , Lee Chen‐Lu , Lin Hsing‐Juh
Published: May 2018

Mangroves are recognized as one of the richest carbon storage systems. However, the factors regulating carbon sinks in mangrove ecosystems are still unclear, particularly in the subtropical mangroves. The biomass, production, litterfall, detrital export and decomposition of the dominant mangrove vegetation in subtropical (Kandelia obovata) and tropical (Avicennia marina) Taiwan were quantified from October 2011 to July 2014 to construct the carbon budgets. Despite the different tree species, a principal component analysis revealed the site or environmental conditions had a greater influence than the tree species on the carbon processes. For both species, the net production (NP) rates ranged from 10.86 to 27.64 Mg C ha−1 year−1 and were higher than the global average rate due to the high tree density. While most of the litterfall remained on the ground, a high percentage (72%–91%) of the ground litter decomposed within 1 year and fluxed out of the mangroves. However, human activities might cause a carbon flux into the mangroves and a lower NP rate. The rates of the organic carbon export and soil heterotrophic respiration were greater than the global mean values and those at other locations. Only a small percentage (3%–12%) of the NP was stored in the sediment. The carbon burial rates were much lower than the global average rate due to their faster decomposition, indicating that decomposition played a critical role in determining the burial rate in the sediment. The summation of the organic and inorganic carbon fluxes and soil heterotrophic respiration well exceeded the amount of litter decomposition, indicating an additional source of organic carbon that was unaccounted for by decomposition in the sediment. Sediment‐stable isotope analyses further suggest that the trapping of organic matter from upstream rivers or adjacent waters contributed more to the mangrove carbon sinks than the actual production of the mangrove trees.
Challenges to representing the population from new forms of consumer data
Authors: Lansley Guy , Cheshire James
Published: May 2018

A large share of human activity is now routinely captured and stored by commercial organisations as consumer data. These new forms of data have provided many new and exciting opportunities for understanding population trends at fine spatial scales. In many settings, they have reduced our dependence on theory and traditional modelling approaches and fundamentally changed how geographers approach producing representations of the population. However, consumer data are typically created for commercial benefit and do not have academic standard data quality controls, and so, in repurposing the data for social research, we encounter inherent issues of veracity. Without an understanding of uncertainty, social scientists can risk overstretching consumer datasets beyond the specific populations or phenomena they directly pertain to. Moreover, the technical characteristics of large and complex datasets also make it challenging to generate valid information efficiently. Therefore, this paper reviews the major challenges to harnessing consumer data to produce valid spatial representations of the population at large.
Revisiting Joan Acker's work with the support of Joan Acker
Authors: Sayce Susan
Published: May 2018

This article is a personal tribute to working with Joan Acker. I worked with Joan in 2012, helping to edit her own thoughts and reflection on how other academics evaluate and used her own theorizing, specifically her seminal work on the gender substructure and inequality regimes. However, while this article is a tribute to Joan, her work and her thinking; it is also a personal thank you to someone I will miss for her generosity and also her activism in challenging inequalities in organizations and beyond. She continues to inspire me and hopefully others to challenge for social justice. In her 80s, Joan remained committed to addressing inequalities in social relations and how these were experienced within a dynamic social and work environment. During our collaboration, she called upon academics to put theory into practice to help address visible and invisible inequalities in organizational processes. This article is inspired by that experience and it will reveal Joan's views about her own, and other academics, theorizing of her two key concepts: the gender substructure of organizations and inequality regimes in organizations and the overlap with intersectionality. This article will offer a unique opportunity to gain insight into Joan's thinking as an academic sociologist as well as a feminist activist thereby uniting Joan as a person with her concepts.
Managing paediatric bleeding disorder patients undergoing surgical procedures: Leveraging the electronic medical record
Authors: Tarango C. , Dahale D. , Dodson N. , Otte A. , Schoettker P. J.
Published: May 2018

Introduction

Individuals with bleeding disorders have a high risk of bleeding complications with surgical procedures. Careful planning and management of peri‐operative treatment is vital for their safety. Yet, inter‐provider communication and communication between patients/families and providers is not reliable.

Aim

Our haemophilia treatment centre (HTC) created a care gap report that used the electronic medical record to inform our team when patients with bleeding disorders were scheduled for procedures.

Methods

An electronic medical record‐based patient registry was linked to the hospital’s surgical schedule and a report was run daily by HTC staff for the upcoming 14 days. We determined the number of surgeries scheduled for patients with a bleeding disorder without the knowledge of the HTC, identified by the care gap report during the 6 months prior to and 2 years after implementing the report.

Results

Had the report been in effect 6 months prior, the majority of surgery cases would have been detected and planned for an average of 10 days prior to the procedure. Following implementation, the report identified 62 of 225 surgeries on patients with known bleeding disorders where the HTC did not have prior communication from the patient/family or surgical team.

Conclusion

This surgery care gap report provides the date and time of procedures on bleeding disorder patients without relying on contact from patients/families or the surgical team. Its use has resulted in an improved peri‐operative process for patients with bleeding disorders undergoing surgical procedures and potentially prevented surgery cancellations.
Erythrocyte sedimentation rate measured using microhemagglutination is not elevated in monoclonal gammopathy compared with other diseases
Authors: Kim M. , Ju Y.‐S. , Lee E. J. , Lee E. , Jeon K. , Lee J. , Kang H. J. , Kim H.‐S. , Lee J.‐S. , Kim H. J. , Lee Y. K.
Published: May 2018

Background

The erythrocyte sedimentation rate (ESR) as measured using the Westergren method is extremely elevated in patients with monoclonal gammopathy (MG) owing to the abundance of positively charged paraproteins. However, it has not been determined if the ESR is likewise high in patients with MG when measured using alternate ESR methods.

Methods

The ESR was measured using both the modified Westergren and microhemagglutination method (TEST1) in 36 patients with MG and in 159 individuals with other diseases.

Results

Erythrocyte sedimentation rates measured by the Westergren vs microhemagglutination methods showed substantial, but not remarkably high correlation. ESR measured using the Westergren method was higher in MG than in non‐MG patients; however, ESR measured using microhemagglutination was not different in the 2 groups, resulting in a larger ΔESR (microhemagglutination ESR—Westergren ESR) in MG patients. When considered as continuous variables, none of the tested interfering plasma proteins (C‐reactive protein, globulin, or fibrinogen) showed substantial correlations with Westergren or microhemagglutination ESRs. MG and low hematocrit were the only factors independently associated with ΔESR on multivariate analysis.

Conclusion

We demonstrated, for the first time, that the ESR as measured by microhemagglutination is not elevated in patients with MG compared with those without. The ESR does not correlate with a particular plasma protein, showing that its measurement is multifactorial. The presence of MG is an independent factor for ΔESR.
CD57 identifies T cells with functional senescence before terminal differentiation and relative telomere shortening in patients with activated PI3 kinase delta syndrome
Authors: Cura Daball Paola , Ventura Ferreira Monica Sofia , Ammann Sandra , Klemann Christian , Lorenz Myriam R , Warthorst Ursula , Leahy Timothy Ronan , Conlon Niall , Roche Justin , Soler‐Palacín Pere , Garcia‐Prat Marina , Fuchs Ilka , Fuchs Sebastian , Beier Fabian , Brümmendorf Tim H , Speckmann Carsten , Olbrich Peter , Neth Olaf , Schwarz Klaus , Ehl Stephan , Rensing‐Ehl Anne
Published: May 2018

Premature T‐cell immunosenescence with CD57+ CD8+ T‐cell accumulation has been linked to immunodeficiency and autoimmunity in primary immunodeficiencies including activated PI3 kinase delta syndrome (APDS). To address whether CD57 marks the typical senescent T‐cell population seen in adult individuals or identifies a distinct population in APDS, we compared CD57+ CD8+ T cells from mostly pediatric APDS patients to those of healthy adults with similarly prominent senescent T cells. CD57+ CD8+ T cells from APDS patients were less differentiated with more CD27+ CD28+ effector memory T cells showing increased PD1 and Eomesodermin expression. In addition, transition of naïve to CD57+ CD8+ T cells was not associated with the characteristic telomere shortening. Nevertheless, they showed the increased interferon‐gamma secretion, enhanced degranulation and reduced in vitro proliferation typical of senescent CD57+ CD8+ T cells. Thus, hyperactive PI3 kinase signaling favors premature accumulation of a CD57+ CD8+ T‐cell population, which shows most functional features of typical senescent T cells, but is different in terms of differentiation and relative telomere shortening. Initial observations indicate that this specific differentiation state may offer the opportunity to revert premature T‐cell immunosenescence and its potential contribution to inflammation and immunodeficiency in APDS.
ImmTAC/Anti‐PD‐1 antibody combination to enhance killing of cancer cells by reversing regulatory T‐cell‐mediated immunosuppression
Authors: Zhang Huanling , Li Yanyan , Liu Xiaoping , Liang Zhaoduan , Yan Mengyong , Liu Qiang , Chen Anan , Bao Yifeng , Zhou Chengzhi , Li Shiyue , Yee Cassian , Li Yi
Published: May 2018

Recently, bi‐functional molecules that can redirect immune effectors to tumour cells have emerged as potentially robust mediators of tumour regression in clinical trials. Two modalities in particular, bi‐specific antibodies for T‐cell redirection and activation (BiTe) and immune‐mobilizing monoclonal T‐cell receptors against cancer (ImmTAC), are being evaluated in efficacy studies as ‘off‐the‐shelf’ reagents. Optimal therapy will require an understanding and means to address regulatory mechanisms of limiting efficacy. In light of this, we evaluated the impact of induced regulatory T (iTreg) cells on the efficacy of tumour cell killing redirected by ImmTAC and demonstrated down‐regulation of T‐cell proliferation and expression of CD25, CD107a, Granzyme B and Perforin by ImmTAC‐redirected T cells. Significant recovery of ImmTAC potency, however, could be achieved when combined with an anti‐programmed cell death protein 1 monoclonal antibody. Furthermore, we found that among lung cancer patients failing to respond to ImmTAC therapy, there was a significantly higher fraction of Treg cells in the peripheral blood mononuclear cells of lung cancer patients than in healthy donors. These results provide in vitro evidence for an iTreg cell‐mediated immunosuppression of ImmTAC‐redirected T‐cell responses. Whilst immune checkpoint blockade can reverse the Treg cell suppression, it forms a rational basis for a combination of the blockade with ImmTAC in clinical trials.
Ultra‐rapid microwave sintering of pure and Y2O3‐doped MgAl2O4
Authors: Bykov Yury V. , Egorov Sergei V. , Eremeev Anatolii G. , Kholoptsev Vladislav V. , Plotnikov Ivan V. , Rybakov Kirill I. , Sorokin Andrei A. , Balabanov Stanislav S. , Belyaev Alexander V.
Published: May 2018

MgAl2O4 samples were microwave sintered to near‐full density in rapid processes with heating rates on the order of 100°C/min and zero isothermal hold. The experiments were carried out using a gyrotron system for microwave processing of materials operating at a frequency of 24 GHz with a maximum power of 6 kW. In the regimes with a preset heating rate sustained by the automatically regulated microwave power, the maximum achieved density was about 95% of the theoretical value in pristine MgAl2O4 samples (maximum sintering temperature 1650°C) and about 97% in 1 wt.% Y2O3‐doped samples (1700°C). In the regimes with a fixed microwave power (about 3.5 kW), translucent spinel samples with a relative density above 99% were obtained at 1700°C. The duration of the high‐temperature stage of sintering was 1.5‐10 minutes. The suggested mechanism responsible for the enhanced densification involves development of a thermal instability and formation of transient liquid phases at grain boundaries. The estimated specific absorbed power in the samples during the high‐temperature stage of ultra‐rapid microwave sintering was 27‐80 W/cm3, similar to the values observed in dc field‐assisted flash sintering experiments.
First principles investigation on mechanical and thermal properties of α‐ and β‐YAlB4 ultra‐high temperature ceramics
Authors: Dai Fu‐Zhi , Feng Zhihai , Zhou Yanchun
Published: May 2018

Ultra‐high temperature ceramics (UHTCs) exhibit a unique combination of excellent properties that makes them promising candidates for applications in extreme environments. Various UHTCs are needed due to diverse harsh conditions that UHTCs are faced with in different applications. Due to structural similarity to ZrB2, possible high melting point and possible protective oxide scale formed in oxygen rich and water vapor environments, REAlB4 (RE: rare‐earth) is suggested a good candidate for UHTCs. In the present work, temperature‐dependent mechanical and thermal properties of both α‐YAlB4 (YCrB4 type, space group Pbam) and β‐YAlB4 (ThMoB4 type, space group Cmmm) were investigated by first principles calculations in combination with quasi‐harmonic approach. Due to the structural similarity between α‐YAlB4 and β‐YAlB4, their properties are very similar to each other, which are approximately transverse isotropic with properties in (001) plane being almost the same and differing from properties out of (001) plane. The results reveal that resistance to normal strain in (001) plane (~460 GPa) is higher than that along [001] direction (~320 GPa) and thermal expansion in (001) plane (~10 × 10−6 K−1) is lower than that along [001] direction (~17 × 10−6 K−1), which is because the stiff boron networks are parallel to (001) plane. The average thermal expansion coefficient is around 12 × 10−6 K−1, which is fairly high among UHTCs and compatible with metallic frameworks. The combination of high thermal expansion coefficient and protective oxidation scale forming ability suggest that REAlB4 is promising for practical applications not only as high‐temperature structural ceramic but also as oxidation resistant coating for alloys.
Pore filling behavior of YSZ under CMAS attack: Implications for designing corrosion‐resistant thermal barrier coatings
Authors: Shan Xiao , Luo Lirong , Chen Wenfu , Zou Zhonghua , Guo Fangwei , He Limin , Zhang Aiping , Zhao Xiaofeng , Xiao Ping
Published: May 2018

To understand the pore filling behavior in thermal barrier coatings during calcium‐magnesium‐alumino‐silicate (CMAS) infiltration process, porous yttria‐stabilized zirconia pellets with different sizes of spherical pores were prepared to simulate thermal barrier coatings. The pores (D50 ranging from 6 to 77 μm) were introduced to the pellets using poly methyl methacrylate as pore forming agents. Then the pellets were sintered to remove the pore forming agents and to achieve a similar volume fraction of porosity with thermal barrier coatings. After CMAS infiltration, only some small pores in the CMAS‐infiltrated zones were filled by CMAS, whereas all large pores (larger than 13 μm) remained unfilled; besides, the results also show that even open pores can resist filling by CMAS. The reason may relate to pore diameters; if the diameter of a pore is relatively large, the pore surface will not be completely wetted by liquid CMAS, the liquid meniscus will be discontinuous, and therefore the pore cannot be filled. The key insight gained from this study is that introducing “CMAS‐proof” pores into thermal barrier coatings may be a potential way to mitigate CMAS damage.
Addressing the vexed issue of authorship and author order: A discussion paper
Authors: McCann Terence V. , Polacsek Meg
Published: May 2018

Aims

To review and discuss authorship and author order in the context of nursing and midwifery publications and to present a set of principles to guide and justify author order.

Background

Variation in author order trends is evident across different authors, disciplines and countries. Confusion and conflict between authors give rise to important issues concerning ethics and collaboration and may delay publication. Lack of transparency in authorship practices also impedes judgements when individual contributions are used in support of employment, promotion, tenure and/or research funding applications.

Design

Discussion paper.

Data sources

A literature search of BioMed Central, Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE with Full Text and PubMed for original peer‐reviewed papers published in English between 2007 ‐ 2017, in the disciplines of nursing and midwifery.

Implications for nursing

Much is written about authorship practices across disciplines and countries. Despite existing authorship guidelines, author order remains an area of confusion and contention. Disputes about authorship and author order have the potential to cause distrust and breakdowns in research relationships, thereby disrupting nursing and midwifery scholarship and research. The main issues concern honorary and ghost authorship, authorship versus acknowledgement, confusion about collaboration, author order, research students as co‐authors, equal author credit and the need for explicit guidelines.

Conclusion

Good communication and mutual respect are crucial to the authorship process. However, clear instructions are needed to guide decisions on authorship and author order. It is recommended that the “first‐last‐author‐emphasis” be adopted uniformly internationally across nursing and midwifery research.
Discursive constructions of professional identity in policy and regulatory discourse
Authors: Fealy Gerard , Hegarty Josephine‐Mary , McNamara Martin , Casey Mary , O'Leary Denise , Kennedy Catriona , O'Reilly Pauline , O'Connell Rhona , Brady Anne‐Marie , Nicholson Emma
Published: May 2018

Aim

To examine and describe disciplinary discourses conducted through professional policy and regulatory documents in nursing and midwifery in Ireland.

Background

A key tenet of discourse theory is that group identities are constructed in public discourses and these discursively constructed identities become social realities. Professional identities can be extracted from both the explicit and latent content of discourse. Studies of nursing's disciplinary discourse have drawn attention to a dominant discourse that confers nursing with particular identities, which privilege the relational and affective aspects of nursing and, in the process, marginalize scientific knowledge and the technical and body work of nursing.

Design

We used critical discourse analysis to analyse a purposive sample of nursing and midwifery regulatory and policy documents.

Method

We applied a four‐part, sequential approach to analyse the selected texts. This involved identifying key words, phrases and statements that indicated dominant discourses that, in turn, revealed latent beliefs and assumptions. The focus of our analysis was on how the discourses construct professional identities.

Findings

Our analysis indicated recurring narratives that appeared to confer nurses and midwives with three dominant identities: “the knowledgeable practitioner,” the “interpersonal practitioner” and the “accountable practitioner.” The discourse also carried assumptions about the form and content of disciplinary knowledge.

Conclusions

Academic study of identity construction in discourse is important to disciplinary development by raising nurses’ and midwives’ consciousness, alerting them to the ways that their own discourse can shape their identities, influence public and political opinion and, in the process, shape public policy on their professions.
A systematic mixed studies review of women's experiences of perineal trauma sustained during childbirth
Authors: Crookall Rebecca , Fowler Gillian , Wood Caroline , Slade Pauline
Published: May 2018

Aim

To explore the quantitative/qualitative literature on women's experiences of perineal trauma sustained during childbirth and the impact it may have on psychological/emotional well‐being.

Background

Obstetric complications during childbirth can be a risk factor for postpartum psychological distress. Perineal trauma is one of the most frequent obstetric complications and it is important to understand any impact on psychological/emotional well‐being.

Design

A convergent qualitative design using a hybrid deductive–inductive thematic synthesis approach to data transformation was used.

Data sources

Web of knowledge, CINAHL, MEDLINE, AMED, PsyArticles, PsycInfo until May 2017.

Review methods

Stage 1: transforming findings from the qualitative, quantitative and mixed methods studies into themes using thematic synthesis. Stage 2: integrating themes from the quantitative studies into those derived from the qualitative studies.

Results

Records (N = 2,152) found of which 11 qualitative, 22 quantitative and 1 mixed methods were included in this review. Five themes were derived from thematic synthesis of qualitative studies “The mystery of perineal trauma”, “The misery of perineal suturing”, “The postnatal perineum”, “Normalisation and feeling dismissed” and “Adjusting to a new normal—Coping and compromise” and five themes identified from the quantitative studies, experience of birth (N = 4), sexual functioning (N = 12), social functioning (N = 2), psychological health (N = 8) and quality of life (N = 5).

Conclusion

Perineal trauma can have a negative impact on psychological/emotional well‐being, however, the literature is conflicted and in need of clarification. Future research should clearly describe the perineal status of the women in the sample, use validated measures and consider the timing of such measures.
Parenting stress and depressive symptoms in Taiwanese mothers of young children with autism spectrum disorder: Association with children’s behavioural problems
Authors: Hou Yuh‐Ming , Stewart Lydia , Iao Lai‐Sang , Wu Chin‐Chin
Published: May 2018

Background

This study examined the severity of parenting stress and depressive symptoms in Taiwanese mothers of young children with autism spectrum disorder (ASD) compared to mothers of young children with developmental delay (DD). The associations between parenting stress, depressive symptoms, and children’s behavioural problems were also tested.

Methods

The study sample included 51 young children with ASD (mean age = 31 months), 51 young children with DD (mean age = 30 months) and their mothers.

Results

The results confirmed that mothers of young children with ASD experienced higher levels of parenting stress and depressive symptoms than mothers of young children with DD. In addition, children’s behavioural problems were robust predictors of parenting stress and depressive symptoms in mothers of young children with ASD, but not in mothers of young children with DD.

Conclusion

The findings indicated that one of the critical goals in early intervention for young children with ASD and their families is to reduce children’s behavioural problems.
The recent financial crisis, start‐up financing and survival
Authors: Deloof Marc , Vanacker Tom
Published: May 2018

We investigate the effects of the recent financial crisis on start‐up financing and survival using a dataset that covers all Belgian new business registrations between 2006 and 2009. We find that bank debt is the single most important source of funding, even for start‐ups founded during the crisis. However, start‐ups founded in crisis years use less bank debt and have a higher likelihood of bankruptcy, even after controlling for their creditworthiness. These effects are stronger for start‐ups that are more dependent on bank debt, such as start‐ups founded in bank dependent industries and start‐ups founded by entrepreneurs who are more likely to be financially constrained.
Visualizing the quantile survival time difference curve
Authors: Heinzl Harald , Mittlboeck Martina
Published: May 2018

The difference between the pth quantiles of 2 survival functions can be used to compare patients' survival between 2 therapies. Setting p = 0.5 yields the median survival time difference. Varying p between 0 and 1 defines the quantile survival time difference curve which can be straightforwardly estimated by the horizontal differences between 2 Kaplan‐Meier curves. The estimate's variability can be visualized by adding either a bundle of resampled bootstrap step functions or, alternatively, approximate bootstrap confidence bands. The user‐friendly SAS software macro %kmdiff enables the straightforward application of this exploratory graphical approach. The macro is described, and its application is exemplified with breast cancer data. The advantages and limitations of the approach are discussed.
Allied health clinicians using translational research in action to develop a reliable stroke audit tool
Authors: Abery Philip , Kuys Suzanne , Lynch Mary , Low Choy Nancy
Published: May 2018

Objective

To design and establish reliability of a local stroke audit tool by engaging allied health clinicians within a privately funded hospital.

Methods

Design: Two‐stage study involving a modified Delphi process to inform stroke audit tool development and inter‐tester reliability. Participants: Allied health clinicians. Interventions: A modified Delphi process to select stroke guideline recommendations for inclusion in the audit tool. Reliability study: 1 allied health representative from each discipline audited 10 clinical records with sequential admissions to acute and rehabilitation services. Main Outcome Measures: Recommendations were admitted to the audit tool when 70% agreement was reached, with 50% set as the reserve agreement. Inter‐tester reliability was determined using intra‐class correlation coefficients (ICCs) across 10 clinical records.

Results

Twenty‐two participants (92% female, 50% physiotherapists, 17% occupational therapists) completed the modified Delphi process. Across 6 voting rounds, 8 recommendations reached 70% agreement and 2 reached 50% agreement. Two recommendations (nutrition/hydration; goal setting) were added to ensure representation for all disciplines. Substantial consistency across raters was established for the audit tool applied in acute stroke (ICC .71; range .48 to .90) and rehabilitation (ICC.78; range .60 to .93) services.

Conclusions

Allied health clinicians within a privately funded hospital generally agreed in an audit process to develop a reliable stroke audit tool. Allied health clinicians agreed on stroke guideline recommendations to inform a stroke audit tool. The stroke audit tool demonstrated substantial consistency supporting future use for service development. This process, which engages local clinicians, could be adopted by other facilities to design reliable audit tools to identify local service gaps to inform changes to clinical practice.
The Sanguicolous Apostome Metacollinia luciensis Jankowski 1980 (Colliniidae, Apostomatia, Ciliophora) Is Not Closely Related to Other Sanguicolous Apostomes
Authors: Lynn Denis H. , Strüder‐Kypke Michaela C.
Published: May 2018

The apostome family Colliniidae includes species that are adapted to the hemocoel/blood of various invertebrates, particularly crustaceans. To explore the phylogeny of these sanguicolous apostomes, Metacollinia luciensis was collected in August 2015 at Roscoff from the amphipod host, Orchestia gammarellus. Ciliates were Protargol stained and DNA was extracted. The small subunit rRNA (SSUrRNA) and cytochrome c oxidase subunit I (cox1) genes were amplified. Molecular phylogenetic analyses of the SSUrRNA genes unambiguously grouped M. luciensis with other apostomes with robust bootstrap support, but separated it distinctly from the pseudocolliniid clade. While there are only cox1 sequences for a subset of these apostomes, M. luciensis was also distant from the pseudocolliniids and separated from them by species of the exuviotrophic apostome Hyalophysa. These results confirm the distinctness of the families Colliniidae and Pseudocolliniidae.
Long‐term course of inflammatory bowel disease after the Great East Japan Earthquake
Authors: Miyazawa Teruko , Shiga Hisashi , Kinouchi Yoshitaka , Takahashi Seiichi , Tominaga Gen , Takahashi Hiroki , Takagi Sho , Obana Nobuya , Kikuchi Tatsuya , Omori Shinya , Sato Yuichirou , Takahashi Shuichiro , Umemura Ken , Endo Katsuya , Kakuta Yoichi , Matsuura Masaki , Kimura Tomoya , Kuroha Masatake , Shimosegawa Tooru
Published: May 2018

Background and Aim

This study analyzed inflammatory bowel disease activity for 2 years after the Great East Japan Earthquake.

Methods

We compared the relapse rates of patients with ulcerative colitis or Crohn's disease 1 and 2 years after the earthquake with rates immediately after the earthquake. To evaluate continuous disease courses, we also performed multivariate time‐to‐event analyses from the time of the earthquake to the onset of additional treatments.

Results

Of 903 patients with ulcerative colitis or Crohn's disease in our previous study, we could evaluate 2‐year courses in 677 patients (394 ulcerative colitis and 283 Crohn's disease). Compared with the relapse rates of ulcerative colitis and Crohn's disease immediately after the earthquake (15.8% and 7.0%, respectively), those in the corresponding periods in 2012 (2.5% and 1.1%, respectively) and 2013 (2.3% and 2.5%, respectively) significantly decreased. There were 226 patients who required additional treatments after the earthquake. Multivariate time‐to‐event analyses revealed that only patients who had experienced the death of family members or friends were likely to need additional treatments (hazard ratio = 1.77, 95% confidence interval = 1.25–2.47). No other factors had a significant influence.

Conclusions

The relapse rates 1 and 2 years after the earthquake significantly decreased. The factors that influenced long‐term relapse were different from those that influenced short‐term relapse.
Incomplete functional and morphological recovery after acute and acute recurrent pancreatitis in children
Authors: Puttaiah Kadyada Srikanth , Thapa Babu Ram , Kaushal Karanvir , Walia Rama , Rana S V , Dhaka Narendra , Lal Sadhna B , Prasad Rajendra , Das Subhamoy , Thakur Rajini , Kamal Kishore
Published: May 2018

Background and Aim

There is lack of data on functional and morphological recovery after an attack of acute pancreatitis (AP) or acute recurrent pancreatitis (ARP) in children. This study aims to evaluate the functional impairment and morphological changes in the pancreas after recovery.

Methods

All consecutive patients presenting with AP (n = 61) or ARP (n = 35), as per standard diagnostic criteria, were enrolled. After 2 months of pancreatitis, fecal elastase‐1 (FE‐1) (μg/g) and 2‐h oral glucose tolerance test to calculate oral disposition index (DIo) (mmol/L) (β‐cell function) were performed. Morphological changes were assessed by endoscopic ultrasound and transabdominal ultrasound. Patients with chronic pancreatitis (CP) (n = 27) and healthy children (HC) (n = 26) were included as controls for functional parameters.

Results

At a median follow up of 12 (4–44) and 11 (2–108) months, 66.7% and 75.9% (P = 0.57) of AP and ARP demonstrated exocrine insufficiency (FE‐1 < 200), respectively. Mean (SD) FE‐1 was 183.64 ± 150.94 (AP), 135.70 ± 103.80 (ARP), 46.56 ± 30.20 (CP), and 240.00 ± 181.83 (HC) (P < 0.001; anova) (AP vs CP, ARP vs CP, and CP vs HC; P < 0.001). Prediabetes due to insulin resistance was seen in 16.6% and 22.6% (P = 0.56) of AP and ARP. Median (interquartile range) DIo (mmol/L) was comparable between AP (4.20 [2.36, 8.3]) and HC (5.20 [2.89, 8.68]), but was low in ARP (2.97 [1.80, 5.12]), which was comparable with CP (1.91 [1.20, 2.83]). Endoscopic ultrasound demonstrated morphological changes in 25% and 37% (P = 0.34) of AP and ARP, respectively.

Conclusion

There was high frequency of biochemical evidence of exocrine insufficiency. β‐Cell function (DIo) was preserved among AP but was poor in ARP. Nearly one‐third showed morphological changes in imaging.
“I Have Been Formed in This Revolution”: Revolution as Infrastructure, and The People It Creates in Cuba
Authors: Holbraad Martin
Published: May 2018

¿Cómo forman personas las revoluciones? Basado en un total de nueve meses de trabajo etnográfico realizado en la habana, este trabajo toma como punto de partida la narración de una mujer de mediana edad sobre su involucramiento con estructuras e instituciones estatales durante el curso de la construcción de la casa en la que vive. Al describir etnográficamente las formas en que estos involucramientos personales con el estado se entrelazan con otras áreas de su vida, sugiero que su sensación de haber sido “formada dentro de la revolución” es, en parte significativa, debida a la forma en que el proceso revolucionario penetra o “fluye” profundamente en las facetas más íntimas de su vida. Contrastando esta forma de subjetivación con el programa más explícito de transformación moral de Che Guevara, sugiero que la inmanencia del tal proceso de ‘penetración infraestuctural’ nos permite articular una conceptualización alternativa de la formación de la subjetividad revolucionaria.
Sticky Price Models, Durable Goods, and Real Wage Rigidities
Authors: ÇENESIZ M. ALPER , GUIMARÃES LUÍS
Published: May 2018

The standard two‐sector New Keynesian model with durable goods is at odds with conventional wisdom and vector autoregression (VAR) evidence: Following a monetary shock, the model generates (i) either negative or no comovement across sectoral outputs and (ii) aggregate neutrality of money when durable goods' prices are flexible. We reconcile theory with evidence by incorporating real wage rigidities into the standard model: As long as durable goods' prices are more flexible than nondurable goods' prices, we obtain positive sectoral comovement and, thus, aggregate nonneutrality of money.
The efficacy and tolerability of 5‐aminolevulinic acid 5% thermosetting gel photodynamic therapy (PDT) in the treatment of mild‐to‐moderate acne vulgaris. A two‐center, prospective assessor‐blinded, proof‐of‐concept study
Authors: Serini Stefano Maria , Cannizzaro Maria Vittoria , Dattola Annunziata , Garofalo Virginia , Del Duca Esther , Ventura Alessandra , Milani Massimo , Campione Elena , Bianchi Luca
Published: May 2018

Background

Acne vulgaris is a chronic inflammatory skin disease, commonly treated with topical or systemic drugs, according to the severity of the condition. Retinoids and antibiotic compounds are considered cornerstone approaches in this condition. However, low adherence to the therapy and the issue of bacterial resistance undermine the efficacy in the long term. Photodynamic therapy (PDT) with 20% aminolevulinic acid (ALA) has shown to be effective in the treatment of inflammatory acne. Skin tolerability, however, could be a limiting factor for a widespread use of this approach. A new formulation of 5% ALA in thermosetting gel has been recently available. This formulation allows a more convenient application procedure without occlusion and better and more efficient release of the active compound in comparison with traditional ALA formulations like creams or ointments.

Study aim

To evaluate in a two‐center, assessor‐blinded, prospective, proof‐of‐concept study, the efficacy, and tolerability of red‐light (630 nm) PDT with a new 5‐ALA “low‐dose” topical gel formulation (5%) in the treatment of inflammatory mild‐to‐moderate acne vulgaris (AV).

Subjects and methods

A total of 35 subjects with moderate AV of the face (mean age: 24 ± 8 years, 13 men and 22 women) were enrolled, after their written informed consent. The primary outcome was the evolution of GAG (Global Acne Grade System) score at baseline and after an average of three, 630‐nm, 15‐minute, PDT sessions, performed every 2 weeks. GAG score was also calculated in a follow‐up visit 6 months after the last PDT session. Skin tolerability was assessed during PDT sessions with a patient‐reported discomfort level evaluation score from 0 (no discomfort at all) to 3 (severe discomfort).

Results

At baseline, the GAG score was 21 ± 6. After the last PDT session, the GAG score evaluated in a blinded fashion (digital photographs) was significantly reduced to 6.5 ± 5.7, representing a 70% reduction (P = .0001, Wilcoxon test; mean difference 14.9; 95% CI of the difference: 12.1‐17.6). At the follow‐up visit, the GAG score was 6.7 ± 6.8. The 5% ALA thermosetting gel Red‐light PDT was in general very well tolerated with a discomfort mean level score of 0.5 ± 1.

Conclusion

This proof‐of‐concept study supports the efficacy of 5% ALA thermosetting gel red‐light PDT in inflammatory acne of the face with a relevant clinical improvement of inflammatory lesions with a very good tolerability profile. Clinical improvement was maintained in the medium term (Trial Registration Number: ISRCTN66066651).
Distinguishing immunohistochemical features of alopecia areata from androgenic alopecia
Authors: Kamyab Kambiz , Rezvani Mohammad , Seirafi Hasan , Mortazavi Samira , Teymourpour Amir , Abtahi Shahab , Nasimi Maryam
Published: May 2018

Background

Distinction between alopecia areata (AA) and androgenic alopecia (AGA) can be made according to clinical presentation and biopsy findings. However, it is sometimes difficult to differentiate them, especially when the diffuse pattern of both AA and AGA is in the differential diagnosis of hair loss in androgen‐dependent areas.

Objectives

To evaluate the characteristics of inflammatory cell infiltration using CD3, CD4, CD8, and CD20 antigens, in AA and AGA to find some consistent histological clues for distinguishing these two entities.

Methods

A retrospective analysis of patients with diagnosed AA (30 cases) and AGA (30 cases) was performed based on the clinical and histopathological criteria. We studied immunohistochemical findings for CD3, CD4, CD8, and CD20 in all selected cases.

Results

Immunohistochemical stains for CD4 and CD20 were not helpful in differentiating AA from AGA, but the inflammation density for AA was significantly (P‐value = .025, .001) higher than AGA in CD3 (specificity= 86.7% and sensitivity= 96.7%) and CD8 (specificity= 50% and sensitivity=86.6%). Our findings revealed that intrafollicular CD3 (P‐value = .017) and CD8 (P‐value = ˂.001) infiltrations were significantly higher in AA samples in comparison with AGA.

Conclusion

Characterization of CD3 and CD8 in IHC samples is helpful, especially when the density of CD3 and CD8 T cells are significant in more than 50% of the infiltrated cells and are located intrafolliculary. Moreover, the most specific and sensitive test for differentiating of AA from AGA is CD3.
Nursing as a pathway to women's empowerment and intergenerational mobility
Authors: Brownie Sharon , Wahedna Abdul Haq , Crisp Nigel
Published: May 2018

Aim and objective

To assess the impact of nursing education on the intergenerational mobility of graduates of nursing upskilling programmes.

Background

Challenges for low‐ and middle‐income countries include poverty and limited access to health, education and social services compounded by workforce shortages, inequality and female disempowerment. Little is known about the impact of nursing education on women's empowerment and intergenerational mobility in such settings.

Design

A cross‐sectional study using data collected through an online alumni survey.

Methods

Data were collected March to May 2016 using an online questionnaire, as part of a larger nursing programme alumni survey. Intergenerational mobility was assessed by comparing the respondents’ educational qualification with their fathers’ and mothers’ education levels. Descriptive statistics were analysed using frequencies and percentages. Associations between parental and respondents’ education levels were assessed using chi‐square tests.

Results

Out of 446 female respondents who completed the survey, 379 and 366 indicated their fathers’ and mothers’ education level, respectively. A third of the respondents’ mothers had no formal schooling; lower levels of parental education are significantly associated with increase in respondents age (p < 0.001) and associated shift from Uganda to Kenya and Tanzania (p < 0.001). Respondents had a marked upward intergenerational education mobility with 76% (278/366) and 59% (223/379) of them achieving a qualification two levels above their mothers and fathers, respectively. Tanzanian respondents had significantly higher rates of upward mobility than Kenyan and Ugandan respondents.

Conclusions

Nursing education positively impacted gender, economic factors and health outcomes. Further research is needed to confirm the “triple impact” of nursing education on improving health, gender equality and economic growth in low‐ and middle‐income countries.

Relevance to clinical practice

Nurses are frontline providers of healthcare services. Provision of high‐quality nursing upgrade programmes enhances nursing leadership ability, with aligned improvements in health outcomes while supporting gender empowerment and intergenerational mobility.
Resources for work‐related well‐being: A qualitative study about healthcare employees’ experiences of relationships at work
Authors: Schön Persson Sophie , Nilsson Lindström Petra , Pettersson Pär , Nilsson Marie , Blomqvist Kerstin
Published: May 2018

Aims and objectives

To explore municipal healthcare employees’ experiences of relationships with care recipients and colleagues. The specific research questions were when do the relationships enhance well‐being, and what prerequisites are needed for such relationships to occur?

Background

Employees in health and social care for older people often depict their work in negative terms, and they often take a high number of sick leaves. Despite the heavy workload, other employees express well‐being at work and highlight social relationships as one reason for this. However, a greater understanding of how these relationships can act as resources for workplace well‐being is needed.

Design

The design of the study was qualitative and exploratory.

Methods

Qualitative interview studies were conducted with 23 healthcare employees in municipal health care. Thematic analysis was used to analyse the data.

Results

Two themes were identified as resources for promoting relationships between employees and care recipients or colleagues: (a) Being personal—a close interpersonal relationship to a care recipient—and (b) Colleague belongingness—a sense of togetherness within the working group. Spending quality time together, providing long‐term care and providing additional care were prerequisites for a close interpersonal relationship with care recipients. Trust, mutual responsibility and cooperation were prerequisites for a sense of togetherness within the working group.

Conclusions

The findings provide an empirical base to raise awareness of relationships with care recipients and colleagues as health aspects. Relationships among employees in health care are vital resources that must be considered to create sustainable workplaces and consequently improve the quality of care.

Relevance to clinical practice

The results of this study advocate health promotion efforts based on interpersonal relationships at the workplace. Dialogues in the working groups, based on the employees’ experiences of positive daily situations, may be a promoting method for the work‐related well‐being of the employees.
Subclinical leaflet thrombosis following transcatheter aortic valve replacement
Authors: Kanjanauthai Somsupha , Pirelli Luigi , Nalluri Nikhil , Kliger Chad A.
Published: May 2018

Since the inception of transcatheter aortic valve replacement (TAVR), there have been significant reductions in complications due to improvements of transcatheter heart valve (THV) designs and technologies. Given expanding TAVR applications, reducing complications further and better understanding THV durability has become a focus within the structural heart space. Recently, dedicated cardiac computed tomographic angiography (CTA) performed at 1 month post‐TAVR has identified subclinical leaflet thrombosis (SLT), with rates as high as 40%. From the SLT imaging hallmarks of hypoattenuated leaflet thickening (HALT) to hypoattenuation affecting motion (HAM), a postulated timeline of THV thrombosis advancing to clinical symptoms can be recognized. This review article focuses on leaflet thrombosis particularly following TAVR explaining the spectrum of this disease process, its diagnosis, current treatment options, and future directions in the field.