bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of underlying diabetes and presence of lung cavities on treatment outcomes in patients with pulmonary tuberculosis
Authors: Nakamura A. , Hagiwara E. , Hamai J. , Taguri M. , Terauchi Y.
Published: February 2014

Aims

We investigated the effects of diabetes and the presence of lung cavities on treatment outcomes in patients with pulmonary tuberculosis.

Methods

We conducted a retrospective review of the clinical records of all consecutive patients admitted to the Kanagawa Cardiovascular and Respiratory Centre with the diagnosis of pulmonary tuberculosis. The study outcomes examined were time to sputum culture conversion and percentage of patients with sputum culture conversion by the time 2 months of treatment, and these outcomes were compared between patients with and without diabetes.

Results

Of the 260 patients enrolled in the study, 69 were diagnosed as having diabetes mellitus, while the remaining 191 did not have diabetes. The percentage of patients with cavities was higher in the patients with diabetes (71.0%) than in those without (45.5%; P = 0.0003). The time to sputum culture conversion was significantly longer in the patients with diabetes than in those without (P = 0.0005), and the percentage of patients with a positive sputum culture at 2 months was higher in the patients with diabetes (43.5%) than in those without (18.8%; P = 0.0001). Multivariate analyses revealed that the presence/absence of lung cavities was a more important determinant of treatment outcomes than the presence/absence of diabetes.

Conclusions

The presence of lung cavities was found to be a more important determinant of the treatment outcomes than that of diabetes per se in patients with pulmonary tuberculosis.
Putting a Realistic Theory of Mind into Agency Theory: Implications for Reward Design and Management in Principal‐Agent Relations
Authors: Foss Nicolai , Stea Diego
Published: February 2014

Agency theory is one of the most important foundational theories in management research, but it rests on contestable cognitive assumptions. Specifically, the principal is assumed to hold a perfect (correct) theory regarding some of the content of the agent's mind, while he is entirely ignorant concerning other such content. More realistically, individuals have some limited access to the minds of others. We explore the implications for classical agency theory of realistic assumptions regarding the human potential for interpersonal sensemaking. We discuss implications for the design and management of rewards, and trace implications for value creation in principal‐agent relations.
Blue light inhibits transforming growth factor‐β1‐induced myofibroblast differentiation of human dermal fibroblasts
Authors: Taflinski Leonie , Demir Erhan , Kauczok Jens , Fuchs Paul Christian , Born Matthias , Suschek Christoph V. , Opländer Christian
Published: February 2014

Transforming growth factor‐β1 (TGF‐β1) is the major promoter of phenotypic shift between fibroblasts and myofibroblasts accompanied by the expression and incorporation of α‐smooth muscle actin (α‐SMA). This differentiation is crucial during normal wound healing and wound closure; however, myofibroblasts are considered as the main effecter cell type in fibrosis, for example in scleroderma and hypertrophic scarring. As blue light has exerted antiprolific and toxic effects in several cell types, we investigated whether blue light irradiations with a light‐emitting diode array (420 nm) were able to affect proliferation and differentiation of human dermal fibroblasts (HDF). We found that repeated irradiation with non‐toxic doses significantly inhibits TGF‐β1‐induced differentiation of HDF into myofibroblasts shown by α‐SMA immunocytochemistry and Western blotting. Additionally, used doses reduced proliferation and myofibroblast contractibility measured by resazurin and collagen gel contraction assays. It could be demonstrated that blue light mediates cell toxicity by oxidative stress due to the generation of singlet oxygen. We postulate that irradiations at non‐toxic doses induce low‐level oxidative stress and energy‐consuming cellular responses, which both may effect proliferation stop and interfere with myofibroblast differentiation. Thus, targeting differentiation, proliferation and activity of myofibroblasts by blue light may represent a useful strategy to prevent or reduce pathological fibrotic conditions.
Cognitive dysfunction mediates the effects of poor physical fitness on decreased functional independence in heart failure
Authors: Alosco Michael L , Spitznagel Mary Beth , Sweet Lawrence H , Josephson Richard , Hughes Joel , Gunstad John
Published: February 2014

Aim

Heart failure (HF) patients require assistance with activities of daily living (ADL). Poor physical fitness has recently been identified as a contributor to the high rates of disability inHF, though the mechanisms for such effects are unclear. Although not previously examined, decreased fitness might adversely impactADLinHFthrough its known association with cognitive impairment, a key correlate of self‐care abilities in this population. We sought to test this possibility using a model‐based approach.

Methods

A total of 197 patients withHFcompleted a physical fitness test and a neuropsychological test battery. A totalADLcomposite was derived from theLawtonBrody scale. Structural equation modeling tested whether cognitive function mediated the association between physical fitness and totalADL.

Results

Fitness was reduced, and cognitive dysfunction and impairedADLwere prevalent. The initially significant association between fitness and totalADLwas attenuated when cognitive function was introduced as a mediator. This model showed good fit (comparative fit index = 0.91: root mean‐square error of approximations = 0.077) with a significant indirect pathway between physical fitness and totalADLthrough cognitive function: Decreased physical fitness was associated with cognitive dysfunction (β = 0.35), which predicted greater assistance withADL(β = 0.22).

Conclusions

Poor physical fitness might lead to decreased functional independence inHFthrough its negative effects on cognitive function. Prospective studies are required to confirm our findings, identify other mechanisms by which poor fitness impactsADL, and examine whether exercise interventions can improve cognition and help preserveADLindependence inHF.Geriatr Gerontol Int 2015; 15: 174–181.
Perceived challenges and attitudes to regimen and product selection from Italian haemophilia treaters: the 2013 AICE survey
Authors: Franchini M. , Coppola A. , Rocino A. , Zanon E. , Morfini M. ,   the Italian Association of Haemophilia Centers (AICE) Working Group
Published: February 2014

Despite great advances in haemophilia care in the last 20 years, a number of questions on haemophilia therapy remain unanswered. These debated issues primarily involve the choice of the product type (plasma‐derived vs. recombinant) for patients with different characteristics: specifically, if they were infected by blood‐borne virus infections, and if they bear high or low risk of inhibitor development. In addition, the most appropriate treatment regimen in non‐inhibitor and inhibitor patients compel physicians operating at the haemophilia treatment centres (HTCs) to take important therapeutic decisions, which are often based on their personal clinical experience rather than on evidence‐based recommendations from published literature data. To know the opinion on the most controversial aspects in haemophilia care of Italian expert physicians, who are responsible for common clinical practice and therapeutic decisions, we have conducted a survey among the Directors of HTCs affiliated to the Italian Association of Haemophilia Centres (AICE). A questionnaire, consisting of 19 questions covering the most important topics related to haemophilia treatment, was sent to the Directors of all 52 Italian HTCs. Forty Directors out of 52 (76.9%) responded, accounting for the large majority of HTCs affiliated to the AICE throughout Italy. The results of this survey provide for the first time a picture of the attitudes towards clotting factor concentrate use and product selection of clinicians working at Italian HTCs.
Quality assessment of commercial paprikas
Authors: Velázquez Rocio , Hernández Alejandro , Martín Alberto , Aranda Emilio , Gallardo Gustavo , Bartolomé Teresa , Córdoba Maria G.
Published: February 2014

Several quality parameters of smoked, oven‐dried and sun‐dried paprikas were studied. Smoked paprikas showed the highest American Spice Trade Association (ASTA) units and pigment concentrations, whereas oven‐dried paprikas showed the best browning index and red/yellow pigment ratio, and sun‐dried paprikas had the highest redness for reflected colour. The colour stability results showed drastic overall colour change (ΔE) and decreased redness and ASTA units of the sun‐dried and oven‐dried paprikas after two and 5 days of UV exposure. Degradation of the smoked paprika colour parameters was progressive, and they showed less degradation even after 30 days. The evaluation of the antioxidant activity showed higher DPPH radical‐scavenging capacity in the smoked samples. The profiles of volatile phenolic compounds of the smoked samples are responsible for the differences in the antioxidant capacity. The great differences in colour stability and antioxidant activity make smoked paprika the best choice for use in the food industry.
Using Invariance to Examine Cheating in Unproctored Ability Tests
Authors: Wright Natalie A. , Meade Adam W. , Gutierrez Sara L.
Published: February 2014

Despite their widespread use in personnel selection, there is concern that cheating could undermine the validity of unproctored Internet‐based tests. This study examined the presence of cheating in a speeded ability test used for personnel selection. The same test was administered to applicants in either proctored or unproctored conditions. Item response theory differential functioning analyses were used to evaluate the equivalence of the psychometric properties of test items across proctored and unproctored conditions. A few items displayed different psychometric properties, and the nature of these differences was not uniform. Theta scores were not reflective of widespread cheating among unproctored examinees. Thus, results were not consistent with what would be expected if cheating on unproctored tests was pervasive.
A Meta‐analysis of Letters of Recommendation in College and Graduate Admissions: Reasons for hope
Authors: Kuncel Nathan R. , Kochevar Rachael J. , Ones Deniz S.
Published: February 2014

Letters of recommendation are used extensively in academic admissions and personnel selection. Despite their prominence, comparatively little is known about their predictive power for multiple outcomes. This meta‐analysis combine the existing literature for college grade point average (GPA), academic outcomes of GPA, performance ratings, degree attainment, and research productivity for nonmedical school graduate programs, and GPA and internship performance ratings for medical school students. Intercorrelations with other commonly used predictors are also estimated and used to estimate incremental predictive power. Overall, letters of recommendation, in their current form, are generally positively but weakly correlated with multiple aspects of performance in post‐secondary education. However, letters do appear to provide incremental information about degree attainment, a difficult and heavily motivationally determined outcome.
Adult T‐cell leukaemia/lymphoma can mimic other lymphomas in a non‐endemic area: dilemmas in diagnosis and treatment
Authors: Huang C‐T. , Lee Y‐H. , Chow K‐C. , Yang C‐F. , Chen P. C‐H. , Hsiao L‐T. , Gau J‐P. , Tzeng C‐H. , Liu C‐Y. , Chiou T‐J.
Published: February 2014

Background

The diagnosis of Adult T‐cell leukaemia/lymphoma (ATL) in non‐endemic regions is challenging.

Aim

This study analyses the clinicopathologic features and diagnostic processes of ATL patients in Taiwan.

Methods

ATL patients diagnosed and treated at Taipei Veterans General Hospital from 1998 through 2010 were retrospectively identified. The diagnosis of ATL was confirmed by in situ detection of human T‐cell leukaemia virus type 1 (HTLV‐1) when necessary. Patients' data were reviewed and analysed.

Results

Fourteen ATL patients were identified, among whom six (42.9%) had an antecedent diagnosis of other malignant lymphomas before the ATL diagnosis, including two diagnosed with Hodgkin disease (HD), one with peripheral T‐cell lymphoma, two with chronic lymphocytic leukaemia and one with angioimmunoblastic T‐cell lymphoma. Of the 14 patients, eight (57%) were subclassified as the acute type, three (21.4%) as the lymphoma type, and three (21.4%) as the chronic type ATL. Five of six (83.3%) patients with initial non‐ATL misdiagnosis were diagnosed with non‐acute type ATL. In particular, a patient with an antecedent diagnosis of HD presented with typical Reed–Sternberg (RS)‐like cells harbouring Epstein–Barr virus genomes in affected lymph nodes. The patient progressed to acute type ATL 3 years after the initial diagnosis, and HTLV‐1 genomes were identified in the previous RS‐like cells.

Conclusion

In non‐endemic areas, such as Taiwan, ATL, particularly the non‐acute type, may mimic other lymphomas and easily be misdiagnosed. HTLV‐1 serology should be routinely screened in all malignant lymphoma patients. In situ detection of HTLV‐1 is helpful in cases with diagnostic dilemmas.
Implementing Change in Architectural Design in Elementary School Art Education in Slovenia
Authors: Batič Janja
Published: February 2014

This article reports on a study of the effects of an action research project that aimed to improve the practice of teaching art in elementary schools in Slovenia. The specific focus was on the planning and execution of art tasks relating to architectural design. The planned improvements were based on the process of architectural design from recognising a real problem to finding solutions to art problems. The subjects of the research were 80 10‐year‐old fifth graders and their art and classroom teachers from two elementary schools in Maribor, Slovenia. We evaluated the effects of the implemented changes on pupils' artistic creativity by testing the pupils before and after the action research by using an artistic creativity test with which we were able to monitor the level of pupils' creative development. Test drawings made by pupils before and after the action research were evaluated by monitoring six factors of artistic creativity: sensitivity to problems, elaboration, flexibility, fluency, originality and redefinition. By using a dependent t‐test for paired samples, we examined whether there were any statistically significant differences between the initial and the final tests for each factor separately. We found that the effects of all the implemented changes were positive, with pupils scoring higher in the final tests for each of the six factors of creativity. Findings from the action research suggest that changes to the architectural design classes yielded the best results in the last action step which enabled pupils to get a sense of space during an educational walk.
Sustainable Design Re‐examined: Integrated Approach to Knowledge Creation for Sustainable Interior Design
Authors: Lee Young S.
Published: February 2014

The article focuses on a systematic approach to the instructional framework to incorporate three aspects of sustainable design. It also aims to provide an instruction model for sustainable design stressing a collective effort to advance knowledge creation as a community. It develops a framework conjoining the concept of integrated process in sustainable building practice and the learning as knowledge creation theory. It presents a case study where the framework was applied to a project emphasising the role of interior design in downtown rehabilitation by addressing economy, community and environment collectively. The integrated process involving various stakeholders for sustainable solutions is a collective effort to teach sustainable design as a knowledge creating community and sustaining knowledge advancement in society.
Primula farinosa in Denmark; genetic diversity and population management
Authors: Buurgaard Sørensen Sabine , Larsen Bjarne , Orabi Jihad , Ørgaard Marian
Published: February 2014

During the past centuries Danish populations of Primula farinosa have seriously declined in number. We investigated the genetic structure and genetic diversity of plants of seven populations from two different regions, Zealand and Bornholm in Denmark, using three AFLP markers. Two populations from nearby Scania, Sweden were included as reference. We found 54 unambiguously polymorphic loci. The genetic structure analysis suggested division of the 268 plants into three distinct groups, to a large extent matching the geographical distribution of the populations. Analysis of molecular variance (AMOVA) indicated significant genetic differentiation of 67% within populations and 33% among the populations. Our results suggest that genetic differentiation among regions and unique local genetic diversity should carefully be considered in future conservation attempts if we are to maintain as much genetic variation as possible. We present a historical overview of the decline in Danish populations and discuss conservation management and restoration strategies.
ExplainingEuropean Disintegration
Authors: Vollaard Hans
Published: February 2014

While the possibility ofEuropean disintegration is prominently on the public agenda,EuropeanUnion (EU) studies have so far largely neglected the issue. This article looks for a proper theoretical starting point to conceptualize and explainEuropean disintegration. Theories aboutEuropean integration, but also international politics, comparative federalism, optimum currency areas and imperial decline appear to be problematic bases to this end. Some of these theories suffer from a state bias. Other theories are too narrowly focused to explain the complex process of disintegration. Yet others fail to interconnect coherently the manifold disintegrative factors. A theoretical framework on polity formation developed by Bartolini is the most promising basis from which to examineEuropean disintegration as it avoids the problems just mentioned. It shows that Eurosceptic dissatisfaction mainly induces partial exits within theEUdue to theEU's weak lock‐in power, its problematic voice structuring and the lack of proper full exit options.
Antimicrobial Activities of Ethanol Extracts of Rhus javanica and Terminalia chebula Against Shigella Species
Authors: Yang Seung‐Kuk , Kim Hyun‐Jung , Oh Se‐Wook
Published: February 2014

This study investigated the antimicrobial activities of Oriental medicinal plant extracts against four Shigella species, i.e., Shigella sonnei, Shigella flexneri, Shigella boydii and Shigella dysenteriae. Twelve Oriental medicinal plants were extracted with 80% ethanol. When the Rhus javanica extract was used at 0.01% concentration, 98.09% of the S. sonnei cells were injured. And S. boydii showed significantly different percentages of injured cells at 0.01% and 0.5% of R. javanica extracts, and S. dysenteriae at 0.01%, 0.1% and 0.5% concentrations of the extracts (P < 0.05). Among the tested Shigella species, S. sonnei was the most easily injured, showing a higher percentage of injured cells at low R. javanica extract concentrations. The growth inhibitory effects of the R. javanica and Terminalia chebula extracts on the Shigella species at different concentrations (i.e., 1, 10 and 100 ppm) were calculated using the modified Gompertz equation. R. javanica extracts used at 100 ppm inhibited the growth of S. flexneri and S. dysenteriae for the entire cultivation period (>48 h). However, the T. chebula extract used at the same concentration did not completely inhibit the growth and caused an increased lag time corresponding to 227.0% and 174.4% for S. flexneri and S. dysenteriae, respectively.

Practical Applications

Shigellosis results in at least 600,000 deaths worldwide each year. And in the U.S.A., it is a major bacteria involved in food poisoning, reported in 10,000–20,000 patients (Centers for Disease Control and Prevention). In the present study, ethanol extracts of oriental medicinal plants were used as basic materials for controlling Shigella species, and there are potentials for medicinal plants, as a natural antimicrobial agent, to be used in the development of eco‐friendly reduction technology on Shigella species.
Liquid versus solid energy intake in relation to body composition among Australian children
Authors: Zheng M. , Allman‐Farinelli M. , Heitmann B. L. , Toelle B. , Marks G. , Cowell C. , Rangan A.
Published: February 2014

Background

The debate about whether energy consumed in liquid form is more obesogenic than energy consumed in solid form remains equivocal. We aimed to evaluate the effects of liquid versus solid energy intake and different beverage types on changes in childhood adiposity.

Methods

Our analyses included 8‐year‐old Australian children (n = 158) participating in the Childhood Asthma Prevention Study. Dietary information was collected using three 24‐h recalls at age 9 years. Multivariate linear regression was used to evaluate the effects of liquid versus solid energy intake and different beverage types on changes in body mass index (BMI) Z‐score from ages 8 to 11.5 years (△BMIz8–11.5y) and percentage body fat (%BF) at age 11.5 years (%BF11.5y). Substitution models were used to evaluate the effects of substituting other beverage types for sugar‐sweetened beverages (SSB).

Results

Liquid energy intake (1 MJ day–1) was more closely associated with both △BMIz8–11.5y (β = 0.23, P = 0.02) and %BF11.5y (β = 2.31%, P = 0.01) than solid energy intake (△BMIz8–11.5y: β = 0.12, P = 0.01 and %BF11.5y: β = 0.80%, P = 0.07). SSB consumption (100 g day–1) was directly associated with △BMIz8–11.5y (β = 0.08, P = 0.02) and %BF11.5y (β = 0.92%, P = 0.004),whereas diet drinks (100 g day–1) were inversely associated with △BMIz8–11.5y (β = 0.18, P = 0.02). Substitution of 100 g of SSB by 100 g of water or diet drink, but not other beverages, was inversely associated with both △BMIz8–11.5y and %BF11.5y (P < 0.01).

Conclusions

Our findings indicate that liquid energy is more obesogenic than solid energy. In particular, SSB, but not other beverage types, are a significant predictor of childhood adiposity and replacing SSB with water can have long‐term beneficial effects on childhood adiposity.
An Evaluation of Equitable Access to a Community‐Based Maternal and Newborn Health Program in Rural Ethiopia
Authors: Spangler Sydney A. , Barry Danika , Sibley Lynn
Published: February 2014

Introduction

The Maternal and Newborn Health in Ethiopia Partnership (MaNHEP) aimed to promote equitable access to safe childbirth and postnatal care through a community‐based educational intervention. This study evaluates the extent to which MaNHEP reached women who are socially and materially disadvantaged and, thus, at high risk for inadequate access to care.

Methods

The data used in this analysis are from MaNHEP's cross‐sectional 2010 baseline and 2012 endline surveys of women who gave birth in the prior year. A logistic regression model was fit to examine the effects of sociodemographic characteristics on participation in the MaNHEP program. Descriptive statistics of select characteristics by birth and postnatal care provider were also calculated to explore trends in services use.

Results

Using data from the endline survey (N = 1019), the regression model showed that age, parity, education, and geographic residence were not significantly associated with MaNHEP exposure. However, women who were materially disadvantaged were still less likely to have participated in the program than their better‐off counterparts. From the baseline survey (N = 1027) to the endline survey, women's use of skilled and semiskilled providers for birth care and postnatal care increased substantially, while use of untrained providers or no provider decreased. These shifts were greater for women with less personal wealth than for women with more personal wealth.

Discussion

MaNHEP appears to have succeeded in meeting its equity goals to a degree. However, this study also supports the intractable relationship between wealth inequality and access to maternal and newborn health services. Strategies targeting the poor in diverse contexts may eventually prove consistently effective in equitable services delivery. Until that time, a critical step that all maternal and newborn health programs can take is to monitor and evaluate to what extent they are reaching disadvantaged groups within the populations they serve.
Factors Shaping Interactions Among Community Health Workers in Rural Ethiopia: Rethinking Workplace Trust and Teamwork
Authors: Dynes Michelle M. , Stephenson Rob , Hadley Craig , Sibley Lynn M.
Published: February 2014

Introduction

Worldwide, a shortage of skilled health workers has prompted a shift toward community‐based health workers taking on greater responsibility in the provision of select maternal and newborn health services. Research in mid‐ and high‐income settings suggests that coworker collaboration increases productivity and performance. A major gap in this research, however, is the exploration of factors that influence teamwork among diverse community health worker cadres in rural, low‐resource settings. The purpose of this study is to examine how sociodemographic and structural factors shape teamwork among community‐based maternal and newborn health workers in Ethiopia.

Methods

A cross‐sectional survey was conducted with health extension workers, community health development agents, and traditional birth attendants in 3 districts of the West Gojam Zone in the Amhara region of Ethiopia. Communities were randomly selected from Maternal and Newborn Health in Ethiopia Partnership (MaNHEP) sites; health worker participants were recruited using a snowball sampling strategy. Fractional logit modeling and average marginal effects analyses were carried out to identify the influential factors for frequency of work interactions with each cadre.

Results

One hundred and ninety‐four health workers participated in the study. A core set of factors—trust in coworkers, gender, and cadre—were influential for teamwork across groups. Greater geographic distance and perception of self‐interested motivations were barriers to interactions with health extension workers, while greater food insecurity (a proxy for wealth) was associated with increased interactions with traditional birth attendants.

Discussion

Interventions that promote trust and gender sensitivity and improve perceptions of health worker motivations may help bridge the gap in health services delivery between low‐ and high‐resource settings. Inter‐cadre training may be one mechanism to increase trust and respect among diverse health workers, thereby increasing collaboration. Large‐scale, longitudinal research is needed to understand how changes in trust, gender norms, and perceptions of motivations influence teamwork over time.
A Qualitative Study of Attitudes and Values Surrounding Stillbirth and Neonatal Mortality Among Grandmothers, Mothers, and Unmarried Girls in Rural Amhara and Oromiya Regions, Ethiopia: Unheard Souls in the Backyard
Authors: Sisay Mitike Molla , Yirgu Robel , Gobezayehu Abebe Gebremariam , Sibley Lynn M.
Published: February 2014

Introduction

In Ethiopia, neonatal mortality and stillbirth are high and underreported. This study explored values related to neonatal mortality and stillbirth and the visibility of these deaths in rural Ethiopia among 3 generations of women.

Methods

We conducted a qualitative study in 6 rural districts of the Oromiya and Amhara regional states during May 2012. We included 30 focus groups representing grandmothers, married women (mothers), and unmarried girls in randomly selected kebeles (villages).

Results

Until the 40th day of life, neonates are considered to be strangers to the community (not human). Their deaths are not talked about; they are buried in the house or in the backyard. Mothers are forbidden to mourn their loss lest they offend God and bring on future neonatal losses. Women who repeatedly lose their neonates may be blamed, mistreated, and dishonored through divorce. Neonatal death and stillbirth are attributed to supernatural powers, although some women and girls associate these deaths with poverty and lack of education. The desire for increased visibility of neonatal death is mixed. Unlike the grandmothers and unmarried girls, most of the married women want death to be visible to draw the attention of policy makers. Women prefer home birth and consider themselves lucky to be able to give birth at home. At present, there is no national vital registration system.

Discussion

Neonatal death and stillbirth are hidden and the magnitude is likely underrepresented. The delayed recognition of personhood, attribution of death to supernatural causes, social repercussions for women who experience a pregnancy loss, preference for home birth, and lack of a vital registration system all contribute to the invisibility of perinatal deaths. Increasing the visibility of (and counting) these deaths may require multifaceted behavior‐change interventions.
Improving Coverage of Postnatal Care in Rural Ethiopia Using A Community‐based, Collaborative Quality Improvement Approach
Authors: Tesfaye Solomon , Barry Danika , Gobezayehu Abebe Gebremariam , Frew Aynalem Hailemichael , Stover Kim Ethier , Tessema Hana , Alamineh Lamesgin , Sibley Lynn M.
Published: February 2014

Introduction

Ethiopia has high maternal and neonatal mortality and low use of skilled maternity care. The Maternal and Newborn Health in Ethiopia Partnership (MaNHEP), a 3.5‐year learning project, used a community collaborative quality improvement approach to improve maternal and newborn health care during the birth‐to‐48‐hour period. This study examines how the promotion of community maternal and newborn health (CMNH) family meetings and labor and birth notification contributed to increased postnatal care within 48 hours by skilled providers or health extension workers.

Methods

Baseline and endline surveys, monthly quality improvement data, and MaNHEP's CMNH change package, a compendium of the most effective changes developed and tested by communities, were reviewed. Logistic regression assessed factors associated with postnatal care receipt. Monthly postnatal care receipt was plotted with control charts.

Results

The baseline (n = 1027) and endline (n = 1019) surveys showed significant increases in postnatal care, from 5% to 51% and from 15% to 47% in the Amhara and Oromiya regions, respectively (both P < .001). Notification of health extension workers for labor and birth within 48 hours was closely linked with receipt of postnatal care. Women with any antenatal care were 1.7 times more likely to have had a postnatal care visit (odds ratio [OR], 1.67; 95% confidence interval [CI], 1.10‐2.54; P < .001). Women who had additionally attended 2 or more CMNH meetings with family members and had access to a health extension worker's mobile phone number were 4.9 times more likely to have received postnatal care (OR, 4.86; 95% CI, 2.67‐8.86; P < .001).

Discussion

The increase in postnatal care far exceeds the 7% postnatal care coverage rate reported in the 2011 Ethiopian Demographic and Health Survey (EDHS). This result was linked to ideas generated by community quality improvement teams for labor and birth notification and cooperation with community‐level health workers to promote antenatal care and CMNH family meetings.
CDK5 protects from caspase‐induced Ataxin‐3 cleavage and neurodegeneration
Authors: Liman Jan , Deeg Sebastian , Voigt Aaron , Voßfeldt Hannes , Dohm Christoph P. , Karch André , Weishaupt Jochen , Schulz Jörg B. , Bähr Mathias , Kermer Pawel
Published: February 2014

Spinocerebellar ataxia type 3 (SCA3) is one of at least nine inherited neurodegenerative diseases caused by an expansion of a polyglutamine tract within corresponding disease‐specific proteins. In case of SCA3, mutation of Ataxin‐3 results in aggregation of misfolded protein, formation of intranuclear as well as cytosolic inclusion bodies and cell death in distinct neuronal populations. Since cyclin‐dependent kinase‐5 (CDK5) has been shown to exert beneficial effects on aggregate formation and cell death in various polyglutamine diseases, we tested its therapeutic potential for SCA3. Our data show increased caspase‐dependent Ataxin‐3 cleavage, aggregation, and neurodegeneration in the absence of sufficient CDK5 activity. This disease‐propagating effect could be reversed by mutation of the caspase cleavage site in Ataxin‐3. Moreover, reduction of CDK5 expression levels by RNAi in vivo enhances SCA3 toxicity as assayed in a Drosophila model for SCA3. In summary, we present CDK5 as a potent neuroprotectant, regulating cleavage and thereby toxicity of Ataxin‐3 and other polyglutamine proteins.

image

We propose that increased caspase‐dependent cleavage of mutated Ataxin‐3, because of missing CDK5 shielding, leads to aggregation and cell death. Moreover, reduction of CDK5 expression levels by RNAi in vivo enhances SCA3 toxicity as assayed in a Drosophila model for SCA3. We think that CDK5 functions as a shield against cleavage‐induced toxification and thereby is an interesting target for therapeutic intervention in polyQ disease in general.
The Simple Microeconomics of Public‐Private Partnerships
Authors: IOSSA ELISABETTA , MARTIMORT DAVID
Published: February 2014

We build on the existing literature in public‐private partnerships (PPP) to analyze the main incentive issues in PPPs and the shape of optimal contracts in those contexts. We present a basic model of procurement in a multitask environment in which a risk‐averse firm chooses noncontractible efforts in cost reduction and quality improvement. We first consider the effect on incentives and risk transfer of bundling building and management stages into a single contract, allowing for different assumptions on feasible contracts and information available to the government. Then we extend the model in novel directions. We study the relationship between the operator and its financiers and the impact of private finance. We discuss the trade‐off between incentive and flexibility in PPP agreements and the dynamics of PPPs, including cost overruns. We also consider how institutions, and specifically the risk of regulatory opportunism, affect contract design and incentives. The conclusion summarizes policy implications on the desirability of PPPs.
Contracting for Infrastructure Projects as Credence Goods
Authors: DULLECK UWE , GONG JIONG , LI JIANPEI
Published: February 2014

Large infrastructure projects are a major responsibility of urban and regional governments, who usually lack expertise to fully specify the demanded projects. Contractors, typically experts on such projects due to experience with similar projects, advise of the needed design as well as the cost of construction in their bids. Producing the right design is costly. We model such infrastructure projects taking into account their credence goods feature and the costly design effort they require and examine the performance of commonly used contracting methods. We show that when building costs are homogeneous and public information, simultaneous bidding involving shortlisting of two contractors and contingent compensation of both contractors on design efforts outperforms sequential search. If building costs are private information of the contractors and are revealed to them after design cost is sunk, sequential search may be superior to simultaneous bidding.
Ex-vivo permeation study of chlorin e6-polyvinylpyrrolidone complexes through the chick chorioallantoic membrane model
Authors: Chutoprapat Romchat , Chan Lai W , Heng Paul W S
Published: February 2014

Objective

To investigate the influence of the hydrophilic polymer, polyvinylpyrrolidone (PVP) on the ex-vivo permeability of the poorly water-soluble photosensitizer, chlorin e6 (Ce6) using the chick chorioallantoic membrane (CAM) model.

Methods

The CAM was removed from the fertilized chicken egg at embryo age of 15 days. The permeation profiles of Ce6 and PVP complexes (Ce6-PVP) at 1 : 0, 1 : 1, 1 : 10, 1 : 50 and 1 : 100 w/w in different pH conditions were first studied using the CAM model with Franz diffusion cell over 8 h. The solution viscosity of the formulations and apparent solubility of Ce6 were also investigated.

Key findings

The permeability of Ce6 was found to be directly proportional to the amount of PVP used and the apparent solubility of Ce6. Permeability was only marginally affected by the solution viscosity of the formulations. The permeability of Ce6 was lowered in the acidic pH. Ce6-PVP at 1 : 100 w/w gave the highest percentage release of Ce6 across the CAM, with 23% at pH 3 and 55% at pH 7.4, after 8 h, respectively.

Conclusions

The present work suggests that PVP had served as penetration enhancer for the poorly water-soluble Ce6 and the CAM can serve as a useful biological membrane model for preclinical permeability study of biological and pharmaceutical substances. The Ce6-PVP formulation at 1 : 100 w/w can be applied for the further clinical investigation.
Mental health service users' experiences of diabetes care by Mental Health Nurses: an exploratory study
Authors: Nash M.
Published: February 2014

Accessible summary

Little is known about mental health service users’ experiences of physical conditions such as diabetes.

Stigma and diagnostic overshadowing occurred when seeking help with physical problems.

A split in mental and physical health left two distinct illness identities – the mental health service user who is largely ignored in primary care and the diabetic who is largely ignored in mental health.

Most participants mentioned experiencing physical complications of diabetes.

This paper is a report of a study exploring mental health service users' (MHSUs') experiences of diabetes care. Diabetes is a growing clinical concern in mental health nursing practice. However, little is known about MHSUs' experience of diabetes care. This is a descriptive qualitative study. Semi‐structured telephone interviews were held between June and October 2011, with seven MHSUs who had diabetes. Participants reported experiences of stigma and diagnostic overshadowing (DO) when reporting symptoms of diabetes or when feeling unwell. Participants also encountered a split between their mental health and diabetes care needs, which resulted in a lack of holistic or integrated care. All participants mentioned experiencing complications of diabetes even to the extent of diabetic ketoacidosis. Mental health nurses (MHNs) must critically reflect on their attitudes towards service users that report physical symptoms to ensure that stigma and DO do not constitute barriers to appropriate screening and treatment. The complex relationship that exists between mental illness and diabetes requires MHNs to ensure physical and mental health care are wholly integrated and not split. Education needs are apparent so that symptoms and complications can be recognized and treated accordingly.
Grazing behaviour, physical activity and metabolic profile of two Holstein strains in an organic grazing system
Authors: Thanner S. , Schori F. , Bruckmaier R. M. , Dohme‐Meier F.
Published: February 2014

The challenge for sustainable organic dairy farming is identification of cows that are well adapted to forage‐based production systems. Therefore, the aim of this study was to compare the grazing behaviour, physical activity and metabolic profile of two different Holstein strains kept in an organic grazing system without concentrate supplementation. Twelve Swiss (HCH; 566 kg body weight (BW) and 12 New Zealand Holstein‐Friesian (HNZ; 530 kg BW) cows in mid‐lactation were kept in a rotational grazing system. After an adaptation period, the milk yield, nutrient intake, physical activity and grazing behaviour were recorded for each cow for 7 days. On three consecutive days, blood was sampled at 07:00, 12:00 and 17:00 h from each cow by jugular vein puncture. Data were analysed using linear mixed models. No differences were found in milk yield, but milk fat (3.69 vs. 4.05%, P = 0.05) and milk protein percentage (2.92 vs. 3.20%, P < 0.01) were lower in HCH than in HNZ cows. Herbage intake did not differ between strains, but organic matter digestibility was greater (P = 0.01) in HCH compared to HNZ cows. The HCH cows spent less (P = 0.04) time ruminating (439 vs. 469 min/day) and had a lower (P = 0.02) number of ruminating boli when compared to the HNZ cows. The time spent eating and physical activity did not differ between strains. Concentrations of IGF‐1 and T3 were lower (P ≤ 0.05) in HCH than HNZ cows. In conclusion, HCH cows were not able to increase dry matter intake in order to express their full genetic potential for milk production when kept in an organic grazing system without concentrate supplementation. On the other hand, HNZ cows seem to compensate for the reduced nutrient availability better than HCH cows but could not use that advantage for increased production efficiency.
Effects of silicate resupply to silicate‐deprived Thalassiosira weissflogii (Bacillariophyceae) in stationary or senescent phase: short‐term patterns of growth and cell death
Authors: Jiang Yuelu , Yin Kedong , Berges John A. , Harrison Paul J.
Published: February 2014

The ability of nutrient‐deprived phytoplankton to recover in the short term when nutrients are resupplied has been studied for nitrogen and phosphorus, but the case for silicate (Si) is poorly understood. Si‐limited Thalassiosira weissflogii (Grunow) Fryxell et Hasle (grown in batch culture) was harvested in stationary phase (when cell numbers stopped increasing ~2 d after Si depletion) and senescence (when cell numbers declined ~4 d after Si depletion) and Si was resupplied at different concentrations (from 0 to 100 μM). Cell numbers, proportion of dead cells, variable fluorescence emissions (Fv/Fm), and activities of proteases were measured during Si depletion and for 24 h after Si resupply. As Si was depleted, the specific growth rate declined, dead cells increased from ~2% in log phase, to ~25% in stationary phase to over 35% in senescence, and activities of proteases associated with cell death increased several‐fold. Concentration‐dependent recovery of growth rate was seen after 24 h for cultures resupplied with Si in stationary phase but not in senescence. However, resupply of Si at 100 μM to stationary phase cultures alone increased protease activity to nearly the levels seen in senescence. Differences in the responses to Si resupply suggest that the ability and time to recover from Si depletion depend not only on the growth phase but also on the concentration resupplied.
Molecular phylogeny revealed complex evolutionary process in Elymus species
Authors: SUN Genlou
Published: February 2014

Recent molecular phylogenetic studies on Elymus have added to our understanding of the origination of Elymus species. However, evolutionary dynamics and speciation of most species in Elymus are unclear. Molecular phylogeny has demonstrated that reticulate evolution has occurred extensively in the genus, as an example, the largest subunit of RNA polymerase II (rpb2) and phosphoenolpyruvate carboxylase (pepC) data revealed two versions of the St genome, St1 and St2 contributing to speciation of E. caninus. Phylogenetic analyses of E. pendulinus uncovered additional genome‐level complexity. Our data indicated that both chloroplast and nuclear gene introgression have occurred in the evolutionary process of E. pendulinus. Non‐donor species genomes have been detected in several Elymus species, such as in allohexaploid E. repens (StStStStHH), a Taeniatherum‐like (Ta genome in Triticeae) GBSSI sequence, Bromus‐ (Bromeae) and Panicum‐like (Paniceae) ITS sequences have been detected. The chloroplast DNA data indicated that Pseudoroegneria is the maternal genome donor to Elymus species, but whether different Elymus species originated from different St donors remains an open question. The origin of the Y genome in Elymus is puzzling. It is clear that the Y genome is distinct from the St genome, but unclear on the relationships of Y to other genomes in Triticeae. Introgressive hybridization may be an important factor complicating the evolutionary history of the species in Elymus. The extent of introgression and its role in creating diversity in Elymus species should be the objective of further investigations.
A Questionnaire for the Evaluation of Quality of Life after Penile Prosthesis Implant: Quality of Life and Sexuality with Penile Prosthesis (QoLSPP)
Authors: Caraceni Enrico , Utizi Lilia
Published: February 2014

Introduction

Penile prosthesis implantation is considered to be a satisfactory treatment for erectile dysfunction. Previous studies have assessed mainly prosthesis function and perioperative complications and have measured satisfaction only with regard to sexual performance. Very little, if anything, has been reported on the most relevant question: To what extent does the implant affect the patient's life?

Aim

To develop and validate the pathology-specific Quality of Life and Sexuality with Penile Prosthesis (QoLSPP) questionnaire, which evaluates patients' quality of life after penile prosthesis implantation.

Methods

Sixty-nine patients aged 32–82 years who received a three-component hydraulic prosthesis between 1997 and 2009 participated in the study; 47 participated in the retest of the instrument. The QoLSPP questionnaire was developed to examine general and sexual quality of life in four domains: functional, personal, relational, and social. All psychometric properties of the QoLSPP were validated. Internal validity was assessed by means of exploratory factor analysis. Cronbach's alpha was used to evaluate the internal consistency of the items within each factor. Paired-sample t-tests were used to investigate metric stability. Independent-samples t-tests and nonparametric tests were used to evaluate the sensitivity.

Main Outcome Measures

The main outcome measure for the questionnaire was quality of life as biological and psychosocial–relational well-being. Main outcome measures for validation were internal validity, metric stability, and sensitivity of the QoLSPP.

Results

The QoLSPP met the psychometric requirements of internal validity and reliability. Metric stability and sensitivity were tested and confirmed. Respondents reported high satisfaction levels in all quality of life domains. All domains were significantly and positively correlated; the functional domain was most predictive of overall quality of life. More than half of respondents perceived their partners to be very satisfied.

Conclusions

Prosthesis implantation was correlated with high quality of life in recipients and high perceived quality of couple relationships; partner satisfaction affected patients' quality of life, self-image, relation to the outside world, and satisfaction with implant function.
Female Clitoral Priapism: An Over-the-Counter Option for Management
Authors: Unger Cecile A. , Walters Mark D.
Published: February 2014

Introduction

Female priapism is a rare condition that is not commonly described in the literature. There are many treatment strategies for the management of priapism, including conservative and safe over-the-counter options.

Aim

To describe a case of a woman who presented with clitoral priapism, who was managed conservatively with a simple over-the-counter treatment plan.

Methods

A 29-year-old gravida 0 para 0 presented to the emergency room with painful clitoral priapism lasting for 5 days. Despite cessation of the suspected causal agents, trazodone and wellbutrin, her symptoms persisted.

Results

The patient was managed conservatively with analgesics and around-the-clock oral pseudoephedrine and experienced complete resolution of her symptoms.

Conclusions

Oral pseudoephedrine may be a reasonable option for certain patients, and may be considered as a first-line therapy and adjunct to conservative measures.