bluuebunny/crossref_metadata_2025 huggingface dataset:
Situating C40 in the Evolution of Networked Urban Climate Governance
Authors: Coenen Lars , Davidson Kathryn , Gleeson Brendan
Published: December 2019

The responses by Acuto, Frantzeskaki, Gordon & Johnson, Pinault and Smeds all draw attention to the need to situate C40 in a wider political and economic context. Global city networks such as C40 facilitate, orchestrate, test and diffuse critical innovations for urban climate action through processes of experimentation. How these processes of on‐the‐ground experimentation in networked cities relate to global climate action and governance remains however poorly understood. Further research is needed to disclose and unpack the hidden politics, knowledge dynamics and institutional reconfigurations of such experiments curtailed by seemingly inclusive but rather opaque concepts such as living labs, co‐creation and co‐production.
C40 Cities Inside Out
Authors: Acuto Michele , Ghojeh Mehrnaz
Published: December 2019

C40, and city networks more in general, need to be seen 'inside out' too. In response to Davidson, Gleeson and Coenen, we argue that it is imperative to acknowledge more explicitly how networks like C40, or international urban policy programmes more generally, are situated within a broader political economy of ‘global urban governance’. We detail that this means unpacking the often convenient use of popular names like ‘C40’ and ‘Arup’ to remember that these entities are complex organisational arrangements with internal (within their own organisation) as much as transversal (across them and other similar organisations) politics and, not least, often highly mobile people shaping the ways they act and react internationally.
Surgical resection versus stereotactic body radiation therapy in early stage bronchopulmonary large cell neuroendocrine carcinoma
Authors: Lo Herman , Abel Stephen , Finley Gene , Weksler Benny , Colonias Athanasios , Wegner Rodney E.
Published: December 2019

Background

Surgery is the standard of care for early stage non‐small cell lung cancer (NSCLC). Stereotactic body radiotherapy (SBRT) is another definitive treatment option for those patients who have not been treated surgically. Comparison of approaches is being explored in NSCLC, but has yet to be compared exclusively in large cell neuroendocrine carcinoma (LCNEC) of the lung. We used the National Cancer Database (NCDB) to conduct such a comparison.

Methods

We accessed the NCDB for patients with LCNEC who were recorded as having lung stage T1‐2N0M0 treated with lobectomy/pneumonectomy or SBRT. Multivariable logistic regression identified predictors of SBRT. Multivariable Cox regression was used to identify predictors of survival propensity matching and account for indication bias.

Results

A total of 3209 patients met the criteria, of which 238 (7%) received SBRT. The median SBRT dose was 50 Gy (48–60) in four fractions (3–5). Predictors of SBRT were age >68, T1 disease, and most recent year of treatment. Predictors of survival were younger age, surgical treatment, female sex, and T1 disease. After propensity matching, median survival was 57 months versus 35 months in favor of surgical resection, P < 0.0001.

Conclusion

Surgical resection in comparison to SBRT has improved survival for patients with early stage LCNEC of the lung. SBRT represents a viable treatment alternative for those patients who do not meet the criteria for surgery.
Paper and Hill: An In‐Class Corporate Governance Case
Authors: SHEEHAN NORMAN T.
Published: December 2019

Corporate governance is a set of rules and processes that help ensure that firms are effectively run for the benefit of their stakeholders. Good corporate governance is predicated on having directors fulfill their fiduciary duties while acting as stewards of the corporation. The fact that good corporate governance is essential to a well‐functioning and prosperous society is reflected in CPA Canada's Strategy and Governance competency. Unfortunately, there are few in‐class Canadian corporate governance cases that instructors can use to help accounting students improve their understanding of these three fundamental governance concepts: director duty of care, director duty of loyalty, and the business judgment rule. This Canadian corporate governance case is based on the actual events regarding the approval of Steven Hill's employment contract as the Chair of Paper Enterprises Inc. The case is presented using PowerPoint slides, rather than in a traditional narrative format, as it intended to be used as an in‐class case that does not require advance student preparation.
The gray matter structural connectome and its relationship to alcohol relapse: Reconnecting for recovery
Authors: Mueller Susanne G. , Meyerhoff Dieter J.
Published: December 2019

Gray matter (GM) atrophy associated with alcohol use disorders (AUD) affects predominantly the frontal lobes. Less is known how frontal lobe GM loss affects GM loss in other regions and how it influences drinking behavior or relapse after treatment. The profile similarity index (PSI) combined with graph analysis allows to assess how GM loss in one region affects GM loss in regions connected to it, ie, GM connectivity. The PSI was used to describe the pattern of GM connectivity in 21 light drinkers (LDs) and in 54 individuals with AUD (ALC) early in abstinence. Effects of abstinence and relapse were determined in a subgroup of 36 participants after 3 months. Compared with LD, GM losses within the extended brain reward system (eBRS) at 1‐month abstinence were similar between abstainers (ABST) and relapsers (REL), but REL had also GM losses outside the eBRS. Lower GM connectivities in ventro‐striatal/hypothalamic and dorsolateral prefrontal regions and thalami were present in both ABST and REL. Between‐networks connectivity loss of the eBRS in ABST was confined to prefrontal regions. About 3 months later, the GM volume and connectivity losses had resolved in ABST, and insula connectivity was increased compared with LD. GM losses and GM connectivity losses in REL were unchanged. Overall, prolonged abstinence was associated with a normalization of within‐eBRS connectivity and a reconnection of eBRS structures with other networks. The re‐formation of structural connectivities within and across networks appears critical for cognitive‐behavioral functioning related to the capacity to maintain abstinence after outpatient treatment.
Addiction Research Consortium: Losing and regaining control over drug intake (ReCoDe)—From trajectories to mechanisms and interventions
Authors: Heinz Andreas , Kiefer Falk , Smolka Michael N. , Endrass Tanja , Beste Christian , Beck Anne , Liu Shuyan , Genauck Alexander , Romund Lydia , Banaschewski Tobias , Bermpohl Felix , Deserno Lorenz , Dolan Raymond J. , Durstewitz Daniel , Ebner‐Priemer Ulrich , Flor Herta , Hansson Anita C. , Heim Christine , Hermann Derik , Kiebel Stefan , Kirsch Peter , Kirschbaum Clemens , Koppe Georgia , Marxen Michael , Meyer‐Lindenberg Andreas , Nagel Wolfgang E. , Noori Hamid R. , Pilhatsch Maximilian , Priller Josef , Rietschel Marcella , Romanczuk‐Seiferth Nina , Schlagenhauf Florian , Sommer Wolfgang H. , Stallkamp Jan , Ströhle Andreas , Stock Ann‐Kathrin , Winterer Georg , Winter Christine , Walter Henrik , Witt Stephanie , Vollstädt‐Klein Sabine , Rapp Michael A. , Tost Heike , Spanagel Rainer
Published: December 2019

One of the major risk factors for global death and disability is alcohol, tobacco, and illicit drug use. While there is increasing knowledge with respect to individual factors promoting the initiation and maintenance of substance use disorders (SUDs), disease trajectories involved in losing and regaining control over drug intake (ReCoDe) are still not well described. Our newly formed German Collaborative Research Centre (CRC) on ReCoDe has an interdisciplinary approach funded by the German Research Foundation (DFG) with a 12‐year perspective. The main goals of our research consortium are (i) to identify triggers and modifying factors that longitudinally modulate the trajectories of losing and regaining control over drug consumption in real life, (ii) to study underlying behavioral, cognitive, and neurobiological mechanisms, and (iii) to implicate mechanism‐based interventions. These goals will be achieved by: (i) using mobile health (m‐health) tools to longitudinally monitor the effects of triggers (drug cues, stressors, and priming doses) and modify factors (eg, age, gender, physical activity, and cognitive control) on drug consumption patterns in real‐life conditions and in animal models of addiction; (ii) the identification and computational modeling of key mechanisms mediating the effects of such triggers and modifying factors on goal‐directed, habitual, and compulsive aspects of behavior from human studies and animal models; and (iii) developing and testing interventions that specifically target the underlying mechanisms for regaining control over drug intake.
Primary arthrodesis versus open reduction internal fixation for complete Lisfranc fracture dislocations: a retrospective study comparing functional and radiological outcomes
Authors: Kirzner Nathan , Teoh Wesley , Toemoe Sianne , Maher Tim , Mannambeth Rejith , Hughes Andrew , Goldbloom Daniel , Curry Hamish , Bedi Harvinder
Published: December 2019

Background

The aims of this retrospective study were to compare the functional and radiological outcomes of primary arthrodesis and open reduction internal fixation (ORIF) for the treatment of complete Lisfranc fracture dislocations.

Methods

A retrospective cohort study of 39 patients treated for a complete Lisfranc fracture dislocation, defined as Myerson types A and C2, over a period of 8 years at a level 1 trauma centre was performed. Of these, 18 underwent primary arthrodesis, and 21 ORIF. The primary outcome measures included the American Orthopaedic Foot and Ankle Society score, the validated Manchester Oxford Foot Questionnaire functional tool, and the secondary outcome was the radiological Wilppula classification of anatomical reduction.

Results

Significantly better functional outcomes were seen in the primary arthrodesis group. These patients had a mean Manchester Oxford Foot Questionnaire score of 30.1 points, compared with 45.1 for the ORIF group (P = 0.017). Similarly, the mean American Orthopaedic Foot and Ankle Society score was 71.8 points in the fusion group versus 62.5 in the ORIF group (P = 0.14). Functional outcome was dependent on the quality of final reduction (P < 0.001). Primary arthrodesis achieved good initial reduction in 83% cases compared to 62% with ORIF (P = 0.138). There was a loss of reduction quality of 47% in the ORIF group over time.

Conclusion

Primary arthrodesis for complete Lisfranc fracture dislocations resulted in improved functional outcomes and quality of reduction compared to open reduction and internal fixation.
Does emergency general surgery model affect staff satisfaction, training and working hours?
Authors: Kinnear Ned , Tran Minh , Han Jennie , Jolly Samantha , Herath Matheesha , Hennessey Derek , Dobbins Christopher , Sammour Tarik , Moore James
Published: December 2019

Background

Few studies have assessed the relationship between different emergency general surgery models and staff satisfaction, operative experience or working hours. The Royal Australasian College of Surgeons recommends maximum on‐call frequency of one‐in‐four for surgeons and registrars.

Methods

A cross‐sectional study was conducted of all medium‐ to major‐sized Australian public hospitals offering elective general surgery. At each site, an on‐call general surgery registrar and senior surgeon were invited to participate. Primary outcomes were staff satisfaction and registrar‐perceived operative exposure. Secondary outcomes were working hours.

Results

Among eligible hospitals, 119/120 (99%) were enrolled. Compared with traditional emergency general surgery models, hybrid or acute surgical unit models were associated with greater surgeon and registrar satisfaction on quantitative (P = 0.012) and qualitative measures. Registrar‐perceived operating exposure was unaffected by emergency general surgery model. Longest duration on‐duty was higher among traditional structures for both registrars (mean 22 versus 15 h; P = 0.0003) and surgeons (mean 59 versus 41 h; P = 0.020). On‐call frequency greater than one‐in‐four was more common in traditional structures for registrars (51% versus 28%; P = 0.012) but not surgeons (6% versus 0%; P = 0.089). Data on average hours per day off‐duty were obtained for registrars only, and were lower in traditional structures (13 versus 15 h; P = 0.00002).

Conclusion

Hybrid or acute surgical unit models may improve staff satisfaction without sacrificing perceived operative exposure. While average maximum duration on‐duty exceeded hazardous thresholds for surgeons regardless of model, unsafe working hours for registrars were more common in traditional structures. General surgical departments should review on‐call rostering to optimize staff and patient safety.
Vancomycin: Audit of American guideline‐based intermittent dose administration with focus on overweight patients
Authors: Koyanagi Mari , Anning Rebecca , Loewenthal Mark , Martin Jennifer H.
Published: December 2019

Aims

Vancomycin dosing and monitoring recommendations are poorly adhered to in many institutions internationally, with concerns of treatment failure and propelling antibiotic resistance. The primary aim of this study was to audit the rate of adherence to American guidelines, with particular interest in loading dose administration. The secondary aims were (i) to determine whether or not guideline adherence results in therapeutic concentrations across body mass index (BMI) groups and (ii) to determine whether or not this was in turn associated with morbidity and hospital mortality.

Method

Data were collected in a single tertiary hospital on all patients who had two or more serum vancomycin concentrations measured.

Result

In total, 107 patients met the inclusion criteria. Overall, 38.3% of patients were commenced on guideline adherent vancomycin doses, and 28.3% of overweight patients received an adherent first dose compared to 51.1% of non‐overweight people (difference 23%, 95% CI 4% to 41%, P = 0.024). Overweight patients were more frequently underdosed compared to non‐overweight patients (P = 0.039). The frequency and proportion of underdosing increased with BMI. Overweight patients spent a smaller fraction of their course within the therapeutic range, although the difference was not statistically significant (difference 7.7%; 95% CI 4% to 19.4%; P = 0.195). The overweight group had longer hospital length of stay (LOS), higher mortality and more treatment failures.

Conclusion

Adherence to guideline‐based prescription is poor, particularly in overweight patients. Patients who are initially underdosed have fewer therapeutic vancomycin days, regardless of BMI. Overweight patients have increased hospital LOS, hospital mortality and treatment failure.
Eight to eleven‐year follow‐up of immediately loaded implants placed in edentulous maxillae with compromised bone volume and poor bone quality: A prospective cohort study
Authors: Trbakovic Amela , Toljanic Joseph A. , Kumar Vinay V. , Thor Andreas
Published: December 2019

Background

There is a lack of long‐term evaluations of immediately loaded implants in patients with compromised maxillary bone.

Purpose

To evaluate long‐term survival and success of immediately loaded implants in subjects with poor maxillary bone quality and volume.

Material and methods

Follow‐up was performed on subjects who received six implants loaded within 24 hours with screw‐retained fixed prostheses. Twenty‐five subjects with limited bone (Lekholm and Zarb, quantity 3 and 4, and quality C and D) were included in the study. Nineteen participated in the radiographic examination and of these 17 participated in the clinical examination at the last visit. Evaluations of marginal bone loss were performed at 1, 3, 5, and 8‐11 years. The last clinical examination included removal of the prosthesis followed by registration of: plaque, pus, pocket depth, bleeding upon probing, mobility, and percussion testing.

Results

The mean follow‐up was 9 years and 2 months (101‐131 months) after surgery and showed a cumulative implant survival rate of 81.9% and success rate of 74.7%. Mean marginal bone loss was 1.29 mm (SD 2.47 mm range 0‐11 mm) with a mean pocket depth of 3.1 mm (SD 2.4 mm, range 1.5‐13.5 mm). 42.5% of the implants showed plaque retention and 72.2% showed bleeding on probing.

Conclusion

This nonaugmenting immediate loaded implant protocol for maxillary edentulous patients is a satisfactory solution for selected patients.
An unmet need: Patients with smell and taste disorders
Authors: Erskine Sally E. , Philpott Carl M.
Published: December 2019

Objectives

There are large numbers of patients with olfactory disturbance in the UK and shortfalls in assessment and support amongst mainstream practice in both primary and secondary care leading to significant quality‐of‐life impairment and potential missed diagnoses. The aim of this study was to determine the key themes which can be identified from the accounts of anosmia sufferers and to identify important areas to target for future research or service development.

Design

Qualitative analysis of written patient accounts from patients corresponding with a tertiary smell and taste clinic in the UK. This qualitative study utilised unstructured written patient accounts from consenting patients experiencing olfactory disturbances received by the smell and taste clinic. Framework analysis was performed using Nvivo 10 software.

Setting

Tertiary smell and taste clinic.

Participants

Consenting patients who contacted the smell and taste clinic with accounts of their experiences.

Main outcome measures

Themes generated by qualitative analysis with Nvivo software.

Results

Accounts submitted by 71 participants were included in the analysis; age range 31‐80 years, 45 females, 26 males. Themes identified include negative emotional impact, feelings of isolation, impaired relationships and daily functioning, impact on physical health and the difficulty and financial burden of seeking help.

Conclusions

Olfactory disturbances have a wide‐ranging impact on the lives of sufferers, compounded by a lack of knowledge of the disorder amongst clinicians. There is a role for further support and education both for sufferers and for clinicians, as well as a need to improve our understanding of olfactory disturbance.
Mucormycosis in lung transplant recipients: A systematic review of the literature and a case series
Authors: Wand Ori , Unterman Avraham , Izhakian Shimon , Fridel Ludmila , Kramer Mordechai R.
Published: December 2019

Background

Mucormycosis is a rare infection in lung transplant recipients (LTR). Our objective was to better define the clinical presentation and optimal management of this frequently lethal infection.

Methods

A systematic review of the literature was performed to identify all published cases of mucormycosis in LTR using PubMed/MEDLINE. These cases were analyzed together with a new case series from our clinic.

Results

Literature search yielded 44 articles matching the inclusion criteria, describing 121 cases. Six additional cases were identified from our clinic. Data regarding infection site and outcome were available for a total of 53 patients. The lungs were the most common site of infection (62%), followed by rhinocerebral and disseminated disease. Most cases (78%) developed in the first post‐transplant year, with over 40% of them in the first month. Additional risk factors for mucormycosis were identified in over half of the patients. Surgical debridement was uncommon in pulmonary infection (9%). Posaconazole therapy was used in 35% of cases, mostly in combination with amphotericin B. Overall mortality was 32% but varied according to site of infection.

Conclusion

Mucormycosis in LTRs tends to be an early post‐surgical infection, associated with additional risk factors and intensified immunosuppressive states, and most often affects the lungs, where surgical debridement is rarely feasible. Posaconazole as first‐line therapy should be further explored.
Assessing neurophysiological changes associated with combined transcranial direct current stimulation and cognitive‐emotional training for treatment‐resistant depression
Authors: Nikolin Stevan , Martin Donel , Loo Colleen K. , Iacoviello Brian M. , Boonstra Tjeerd W.
Published: December 2019

Transcranial direct current stimulation (tDCS), a form of non‐invasive brain stimulation, is a promising treatment for depression. Recent research suggests that tDCS efficacy can be augmented using concurrent cognitive‐emotional training (CET). However, the neurophysiological changes associated with this combined intervention remain to be elucidated. We therefore examined the effects of tDCS combined with CET using electroencephalography (EEG). A total of 20 participants with treatment‐resistant depression took part in this open‐label study and received 18 sessions over 6 weeks of tDCS and concurrent CET. Resting‐state and task‐related EEG during a 3‐back working memory task were acquired at baseline and immediately following the treatment course. Results showed an improvement in mood and working memory accuracy, but not response time, following the intervention. We did not find significant effects of the intervention on resting‐state power spectral density (frontal theta and alpha asymmetry), time–frequency power (alpha event‐related desynchronisation and theta event‐related synchronisation) or event‐related potentials (P2 and P3 components). We therefore identified little evidence of neurophysiological changes associated with treatment using tDCS and concurrent CET, despite significant improvements in mood and near‐transfer effects of cognitive training to working memory accuracy. Further research incorporating a sham‐controlled group may be necessary to identify the neurophysiological effects of the intervention.
From theory to experiments for testing the proximate mechanisms of mast seeding: an agenda for an experimental ecology
Authors: Bogdziewicz Michał , Ascoli Davide , Hacket‐Pain Andrew , Koenig Walter D. , Pearse Ian , Pesendorfer Mario , Satake Akiko , Thomas Peter , Vacchiano Giorgio , Wohlgemuth Thomas , Tanentzap Andrew
Published: December 2019

Highly variable and synchronised production of seeds by plant populations, known as masting, is implicated in many important ecological processes, but how it arises remains poorly understood. The lack of experimental studies prevents underlying mechanisms from being explicitly tested, and thereby precludes meaningful predictions on the consequences of changing environments for plant reproductive patterns and global vegetation dynamics. Here we review the most relevant proximate drivers of masting and outline a research agenda that takes the biology of masting from a largely observational field of ecology to one rooted in mechanistic understanding. We divide the experimental framework into three main processes: resource dynamics, pollen limitation and genetic and hormonal regulation, and illustrate how specific predictions about proximate mechanisms can be tested, highlighting the few successful experiments as examples. We envision that the experiments we outline will deliver new insights into how and why masting patterns might respond to a changing environment.
Towards routine DNA metabarcoding of macroinvertebrates using bulk samples for freshwater bioassessment: Effects of debris and storage conditions on the recovery of target taxa
Authors: Nichols Susan J. , Kefford Ben J. , Campbell Catriona D. , Bylemans Jonas , Chandler Eloise , Bray Jonathan P. , Shackleton Michael , Robinson Katie L. , Carew Melissa E. , Furlan Elise M.
Published: December 2019

Macroinvertebrates are commonly sampled for bioassessment of freshwater ecosystems. However, current bioassessment protocols involve laborious sorting of the animals from the debris (sample matrix) and morphological identification, where species level identifications are often difficult. DNA metabarcoding has the potential to improve bioassessment by reducing the time taken to process samples and improve the accuracy and speed of macroinvertebrate species identification.

In this study, we evaluated DNA metabarcoding of macroinvertebrate samples, which include macroinvertebrates and the debris collected in the sample nets, to test if bulk, unsorted samples can be used to assess macroinvertebrate diversity. First, we tested if the sample matrix prevented the detection of six target macroinvertebrate taxa when DNA metabarcoding. Second, we tested if sample storage influenced the detection of the same six target macroinvertebrates. We also explored different levels of replication at the sample, sub‐sample, and polymerase chain reaction levels and compared the overall macroinvertebrate families detected using DNA metabarcoding to those identified morphologically.

We found that the presence of the sample matrix did not interfere with or inhibit the detection of the six target macroinvertebrate taxa. Furthermore, we found that the various sample storage methods did not affect target macroinvertebrate detection. The reliability of detection of the target macroinvertebrates improved as hierarchical levels of replication were combined. We found strong overlap between the detection of overall macroinvertebrate family diversity when comparing DNA metabarcoding to morphological identification.

Extracting DNA from the bulk macroinvertebrate samples that included the sample matrix and using this for DNA metabarcoding could improve bioassessment by removing the need for laborious sorting of samples. Furthermore, DNA metabarcoding detection of the six target taxa was not dependent on sample storage of up to 1 year in 95% ethanol, at room temperature or after heating. DNA metabarcoding had the advantage of identifying macroinvertebrate species, but good DNA barcode libraries are needed for widespread species identifications. Further investigation should focus on including multiple samples with different macroinvertebrate composition and densities to refine and standardise bulk sample processing protocols, and on building comprehensive DNA barcode libraries for aquatic macroinvertebrates.
Employment volatility in lagging and advanced regions: The Italian case
Authors: Duran Hasan Engin , Fratesi Ugo
Published: December 2019

The presence of cycles characterizes all economic systems, but economic cycles have differentiated spatial impacts. Some regions have broader cycles with respect to the country, while others tend to be less responsive to shocks and hence have narrower cycles. Being exposed to broader cycles, that is, greater volatility, may increase the strain on a regional economic system. This paper investigates the different responsiveness to cyclical forces and volatility of regions in the long run. It does so by using quarterly employment data for the Nuts2 Italian regions over almost 40 years before and during the period 1978–2016. Explored in particular are the cross‐regional variations in employment volatility and the reasons for the patterns observed, as well as whether they have changed the following different macroeconomic policy regimes. The paper identifies the break dates of different regimes, and these regime changes will be related to policy modifications, such as the implementation of the European Monetary Union. The determinants of this regional volatility appear to be quite stable, so that the changes in volatility are explained by how these determinants have changed overtime and how they are unevenly distributed in space. In particular, the lagging regions of the country suffer, in addition to lower production and income, from higher volatility due to a structure which is weaker and more unstable. Volatility can hence be an additional issue for lagging regions.
Estimating the thickness of a faulted mechanical layer based on fault spacing: An example from Miyako‐jima Island, southern Ryukyu Arc, Japan
Authors: Maeda Sumire , Otsubo Makoto , Asahina Daisuke , Furuno Yuki
Published: December 2019

The thickness of the mechanical layer that hosts a group of faults can be estimated from the spacing of saturated faults (i.e. the constant spacing between faults when the fault system is fully developed and has attained its final fault density). We measured fault spacing for a group of saturated active normal faults on Miyako‐jima Island (southern Ryukyu Arc, Japan) and estimated the thickness of the faulted mechanical layer. The measured fault spacing is 1.30 ±0.14 km, and the thickness of the mechanical layer is < 3 km, which is the upper limit of the seismogenic zone. This faulted mechanical layer corresponds to a sedimentary layer in which earthquakes cannot occur. Results indicate that the shallow (< 3 km depth) normal faults on Miyako‐jima Island do not have the potential to cause medium‐size earthquakes as individual faults. The origin of the shallow normal faults might be related to the presence of a larger‐scale, deeper fault. The results indicate that fault spacing provides important information on the potential magnitude of earthquakes associated with active faults.
A lack of therapeutic engagement and consumer input in acute inpatient care planning limits fully accountable mental health nursing practice
Authors: Rio Josephien H. M. , Fuller Jeffrey , Taylor Kerry , Muir‐Cochrane Eimear
Published: December 2019

It is mental health consumer's human right to lead a fulfilling life as they are empowered to actively manage their recovery. This can be facilitated through care planning, yet research suggests that the care plan is not routinely created, discussed, or updated in acute mental health settings. Research on care planning and the role of the mental health nurse highlights the importance of therapeutic communication in care plan development. This paper argues that the lack of meaningful care plan discussions between consumers and mental health nurses in an acute setting is a limitation to the practice of fully accountable mental health nursing care. We explore this limitation in quality care provision by examining literature on accountability and conclude that in mental health nursing, accountability is frequently enacted through an overarching focus on the organizational need to manage risks, rather than on therapeutic engagement.
Tojapride prevents CaSR‐mediated NLRP3 inflammasome activation in oesophageal epithelium irritated by acidic bile salts
Authors: Yin Xiao‐Lan , Wu Hao‐Meng , Zhang Bei‐Huang , Zhu Ning‐Wei , Chen Ting , Ma Xiang‐Xue , Zhang Li‐Ying , Lv Lin , Zhang Min , Wang Feng‐Yun , Tang Xu‐Dong
Published: December 2019

Impairment of the oesophageal epithelium in patients with reflux oesophagitis (RE) is a cytokine‐mediated injury rather than a chemical burn. The present study was conducted to explore CaSR/NLRP3 inflammasome pathway activation and cytokines IL‐1β and IL‐18 release in oesophageal epithelia injured by refluxates and the effects of Tojapride on that signal regulation. Using a modified RE rat model with Tojapride administration and Tojapride‐pretreated SV40‐immortalized human oesophageal epithelial cells (HET‐1A) exposed to acidic bile salts pretreated with Tojapride, we evaluated the therapeutic effects of Tojapride on oesophageal epithelial barrier function, the expression of CaSR/NLRP3 inflammasome pathway‐related proteins and the release of downstream cytokines in response to acidic bile salt irritation. In vivo, Tojapride treatment ameliorated the general condition and pathological lesions of the oesophageal epithelium in modified RE rats. In addition, Tojapride effectively blocked the CaSR‐mediated NLRP3 inflammasome activation in modified RE rats. In vitro, Tojapride treatment can reverse the harmful effect of acidic bile salts, which reduced transepithelial electrical resistance (TEER), up‐regulated the CaSR‐mediated NLRP3 inflammasome pathway and increased caspase‐1 activity, LDH release and cytokines secretion. Taken together, these data show that Tojapride can prevent CaSR‐mediated NLRP3 inflammasome activation and alleviate oesophageal epithelial injury induced by acidic bile salt exposure.
A novel, fully digital approach to quantifying volume gain after soft tissue graft surgery. A pilot study
Authors: Fons‐Badal Carla , Alonso Pérez‐Barquero Jorge , Martínez‐ Martínez Nuria , Faus‐López Joan , Fons‐Font Antonio , Agustín‐Panadero Rubén
Published: December 2019

Objective

Measuring soft tissue thickness after mucogingival surgery has traditionally been performed by means of a calibrated transgingival probe. The main aim of this study was to apply a non‐invasive technique based on digital images formatted as Standard Tessellation Language (STL) files to quantify soft tissue volume after connective tissue grafting.

Clinical Innovation Report

Ten patients who presented Cairo Class I gingival recession were selected for connective tissue grafting using the tunnel technique. In all patients, the initial position of the gingiva and quantity of keratinized tissue were recorded, and gingival recession was scanned with an intra‐oral scanner. Six months after surgery, the same intra‐oral parameters were recorded and compared with the initial registers using digital volumetric analysis software.

Results

Complete root coverage was obtained in most patients (90%), mean coverage being of 2.70 mm with a mean increase in volume of 115.49 mm3 in the treated areas. No pattern was identified that indicated a statistically significant relation between gingival recession and coverage volume in mm3.

Conclusions

Digital processing of pre‐ and post‐treatment images makes it possible to measure the volume of tissue gained after tissue graft surgery simply and non‐invasively. The technique is an objective and reproducible method for measuring soft tissue thickness.
Efficacy and tolerability on melasma of a topical cosmetic product acting on melanocytes, fibroblasts and endothelial cells: a randomized comparative trial against 4% hydroquinone
Authors: Bronzina E. , Clement A. , Marie B. , Fook Chong K.T. , Faure P. , Passeron T.
Published: December 2019

Background

Recent data demonstrated that an altered basal membrane, activated melanocytes and secreted factors from keratinocytes but also fibroblasts and endothelial cells are involved in the pathophysiology of melasma.

Objectives

To evaluate the efficacy and tolerability on melasma of a new topical skin‐lightening cosmetic product combination (CCP) targeting several factors identified to be involved in melasma pathogenesis compared to 4% hydroquinone (HQ).

Methods

Forty‐three women with melasma were enrolled in a 12‐week double‐blind, randomized, parallel‐group trial and treated with CCP or 4% HQ cream. Efficacy was evaluated with the modified Melasma Area Severity Index (mMASI) score and colorimetric change. Cutaneous tolerability and patient satisfaction were also investigated.

Results

The mMASI score decreased for both products from baseline and over the study period. At week 12, 90% of the subjects who received the combination products had an improvement in pigmentation vs. 79% with HQ. Similarly, both products significantly increased Individual Typological Angle parameters. For both measures, no statistically significant difference was observed between CCP and HQ in terms of change from baseline. CPP was very well tolerated.

Conclusions

Cosmetic product combination is as effective as HQ in the management of facial dyspigmentation and represents a safe alternative.
Icariin reduces bone loss in a Rankl‐induced transgenic medaka (Oryzias latipes) model for osteoporosis
Authors: Pham Cuong V. , Pham Thanh T. , Lai Thuy T. , Trinh Dat C. , Nguyen Huong V. M. , Ha Tam T. M. , Phuong Thuong T. , Tran Long D. , Winkler Christoph , To Thuy T.
Published: December 2019

Given the limitations and side effects of many synthetic drugs, natural products are an important alternative source for drugs and medications for many diseases. Icariin (ICA), one of the main flavonoids from plants of the Epimedium genus, has been shown to ameliorate osteoporosis and improve bone health in preclinical studies. Those studies have used different in vivo models, mostly rodents, but the underlying mechanisms remain unclear. The present study shows, for the first time, that ICA reduces bone damage in a Rankl‐induced medaka fish (Oryzias latipes), a non‐rodent osteoporosis model. Live imaging was previously performed in this model to characterize antiresorptive and bone‐anabolic properties of drugs. Here, a new quantification method (IM) was established based on the length of mineralized neural arches to quantify levels of bone mineralization damage and protection in early post‐embryonic fish. This method was validated by quantification of three levels of bone damage in three independent Rankl fish lines, and by the determination of different degrees of severity of osteoporosis‐like phenotypes in one Rankl line exposed to variable Rankl induction schemes. IM was also used to quantify the efficacy of alendronate and etidronate, two common anti‐osteoporotic bisphosphonates, and revealed comparable bone protective effects for ICA and alendronate in this fish osteoporosis model. This study's data support the value of the medaka fish model for bone research and establish a method to screen for novel osteoprotective compounds.
Extract‐rich in flavonoids from Hibiscus sabdariffa calyces: Optimizing microwave‐assisted extraction method and characterization through LC‐Q‐TOF‐MS analysis
Authors: Alara Oluwaseun R. , Abdurahman Nour H. , Obanijesu Emmanuel O. , Alara John A. , Abdul Mudalip Siti K.
Published: December 2019

Hibiscus sabdariffa comprises calyx which is rich in flavonoids and numerous phytochemical compounds. Nevertheless, the extraction parameters can influence the recoveries of these bioactive compounds. It is then important to investigate the contributing effects of the process parameters and optimized their conditions to achieve higher recovery yield. Hence, this study was carried out to examine the contributing effects of microwave‐assisted extraction (MAE) process factors (irradiation time, ethanol concentration, solvent/sample ratio, temperature, and microwave power) on the yield of total flavonoid (TF) contents from H. sabdariffa calyces using one‐variable‐at‐a‐time. The significant MAE process parameters were further optimized using Box Behnken design. At the MAE optimal conditions, the extract was analyzed to identify the flavonoid compounds using liquid chromatography‐mass spectrometry quadrupole time of flight. An optimum TF content of 94.32 mg QE/g extract from H. sabdariffa calyces was obtained at the following MAE conditions: Irradiation time of 4 min; ethanol concentration of 52% vol/vol; microwave power of 450 W and solvent/sample ratio 15:1 ml/g. Moreover, 95 flavonoid compounds were tentatively identified in the extract at optimized MAE conditions. Thus, these flavonoids can be further isolated in future studies to unveil embedded potentials of H. sabdariffa calyx extract.

Practical application

The procedure described the microwave‐assisted extraction (MAE) which can serve as a guideline for extracting flavonoids from Hibiscus sabdariffa calyx. Moreover, the liquid chromatography‐mass spectrometry quadrupole time of flight analysis provided the developed conditions for identifying flavonoids from the calyces. The results obtained suggested the exact MAE conditions to achieve an optimum yield of flavonoids from H. sabdariffa calyces. Most importantly, the tentatively identified flavonoids can further be isolated and purified in future studies to unveil the embedded biological potentials.
Role of aldosterone in the activation of primary mice hepatic stellate cell and liver fibrosis via NLRP3 inflammasome
Authors: Li Yang , Zhang Yijie , Chen Tingting , Huang Yun , Zhang Yan , Geng Shiyu , Li Xu
Published: December 2019

Background and Aims

Emerging evidence suggests aldosterone (aldo) and NLRP3 inflammasome are important factors for HSC activation and liver fibrosis. However, the interaction between aldo and NLRP3 inflammasome in HSC activation and liver fibrosis remains largely unknown. The aim of this study is to investigate the relationship between aldo and NLRP3 inflammasome in liver fibrosis.

Methods

Serum and liver specimens collected from 40 patients with or without liver fibrosis were used to test the level of aldo and NLRP3. Primary HSC isolated from C57BL/6 mice were treated with aldo, and the effects of aldo on NLRP3 inflammasome and HSC activation were detected in vitro. Two animal models were used to verify the effect of aldo on liver fibrosis in vivo: hyperaldosteronism model was established in wild‐type and NLRP3 knockout (NLRP3−/−) mice by micro‐pump, and liver fibrosis mouse model was built by tetrachloromethane (CCl4).

Results

Patients with liver fibrosis showed higher aldo levels and increased NLRP3 expression in liver. In vitro, aldo induced the activation of primary mouse HSCs by promoting the expression and assembly of NLRP3 inflammasome. In vivo, NLRP3 knockout could alleviate the liver fibrosis induced by aldo in mice. In addition, treatment with spironolactone (spi) could inhibit the NLRP3 expression, HSC activation, and liver fibrosis induced by CCl4.

Conclusions

Aldo promotes the activation of HSCs and liver fibrosis through NLRP3 inflammasome relative pathways. Intervention of aldo and NLRP3 inflammasome‐related pathways may provide a promising strategy for treatment of liver fibrosis.
Successful treatment of ephelides in Asian skin using the picosecond 785‐nm laser
Authors: Chung Hye Jin , McGee Jean S. , Lee Sang Ju
Published: December 2019

Background

For ethnic skin, laser surgery for pigmented lesions presents a special challenge due to the increased risk of postprocedural complications—erythema, blistering, and postinflammatory dyspigmentation.

Aims

To describe the treatment of ephelides in Asian skin treated with a picosecond 785‐nm laser.

Patients/Methods

The first patient with ephelides on the cheeks and nose was treated with a picosecond 785‐nm laser with the treatment parameter of 1.2 J/cm2 and 3‐mm spot size. The second patient with ephelides on the cheeks was treated with a picosecond 785‐nm laser with the treatment parameter of 1.3 J/cm2 and 3‐mm spot size.

Results

After a single laser session, both patients achieved appreciable improvement without any complications.

Conclusion

This is the first case series demonstrating the efficacy and safety of the picosecond 785‐nm laser for the treatment of ephelides in Asian skin.
Dentine hypersensitivity and dentine exposure in Arab patient populations
Authors: Awad Manal A. , El Kassas Dina , Al Harthi Latfiya , Abraham Sheela , Al‐Khalifa Khalifa , Khalaf Mai , Alhabashneh Rola , Bartlett David
Published: December 2019

Background

Dentine hypersensitivity is a frequent oral complaint that is usually associated with several factors including diet and oral hygiene practices.

Objective

The aim of this study was to assess the prevalence, severity and correlates of dentine hypersensitivity and dentine exposure‐related risk indicators in a sample from six Arab countries.

Methods

A multinational cross‐sectional study was conducted on a sample of 2924 participants, attending dental practices, aged 18‐35 years from six Arab countries. Trained examiners assessed dentine hypersensitivity using the Schiff scale and scored the tooth with the highest value in each sextant. Participants were asked to complete a questionnaire that assessed the frequency of drinking and eating acidic foods and their oral health habits.

Results

Overall, the Schiff score 1 was found in 938 (32.6%), score 2 in 613 (21%) and score 3 in 274 (9%) of the participants. There was variation between countries with Saudi Arabia (13.9%) and Oman (15%) having the highest prevalence of hypersensitivity and Kuwait (2.2) and Jordan the lowest (4.8%). Participants who experienced toothache and difficulty eating once a day were significantly more likely to have Schiff score 2 or 3 (OR: 2.51, 95% CI: 1.54‐2.87; OR: 1.34, 95% CI: 1.04‐1.73, respectively). Furthermore, drinking soft drinks once a day was also significantly associated with dentine exposure (OR: 1.4, 95% CI: 1.19, 1.65).

Conclusion

In this cross‐sectional study, dentine sensitivity and exposure were common in Arab patient populations.
Effect of GSK-137647A, the first non-carboxylic FFA4 agonist, on the osteogenic and adipogenic differentiation of bone mesenchymal stem cells in db/db mice
Authors: Wang Chunlei , Liu Yanmei , Pan Yuan , Jin Hui
Published: December 2019

Objective

To investigate the effect of GSK-137647A, the first non-carboxylic FFA4 agonist, on osteogenic and adipogenic differentiation of bone mesenchymal stem cells (BMSCs) of db/db mice.

Methods

Bone mesenchymal stem cells were extracted from 8-week-old db/db mice. Cell Counting Kit-8 was used to evaluate the toxicity of GSK-137647A on BMSCs, and the optimal concentration of GSK-137647A was selected to investigate the osteogenic and adipogenic differentiation of BMSCs, and relevant indicators of osteoblasts and adipocytes were detected.

Key findings

GSK-137647A had no significant toxicity on cell growth and proliferation. Moreover, GSK-137647A showed a significant increase in mineralization of BMSCs differentiated osteoblasts compared to the control group and elevated the alkaline phosphatase (ALP) activity in a time-dependent manner. Meanwhile, the treatment of GSK-137647A decreased the adipogenic differentiation of BMSCs. The expression levels of ALP, runt-related transcription factor 2, bone morphogenetic protein 4, osterix and β-catenin were significantly increased in GSK-137647A-treated group, while the gene and protein levels of peroxisome proliferator-activated receptor γ and CCAAT/enhancer binding protein α were significantly reduced.

Conclusions

All of these results demonstrated that GSK-137647A suppressed the adipogenic differentiation and promoted osteogenic differentiation of BMSCs, which is partly attributed to the increased expression of β-catenin in wingless/integrated signalling pathway.
Prevalence of and risk factors for intravenous catheter infection in hospitalized cattle, goats, and sheep
Authors: King Ailbhe , Byrne Barbara A. , Chigerwe Munashe
Published: December 2019

Background

Intravenous catheter (IVC) use in hospitalized ruminants is a common procedure. Limited information is available describing complications associated with IVCs.

Hypotheses

Prevalence of IVC infections in hospitalized ruminants is >50%. Intravenous catheters maintained for >5 days are more likely to be infected than those maintained for <5 days. Intravenous catheters placed non‐aseptically have a higher risk for infection than those placed aseptically.

Animals

Thirty‐four cattle, 39 goats, and 33 sheep were hospitalized in a university teaching hospital.

Methods

Prospective observational study. The IVCs from cattle, goats, and sheep admitted for medical and surgical procedures were randomly selected and submitted for bacteriological culture and susceptibility testing.

Results

Prevalence values (95% confidence interval) of infected catheters were 61.8 (45.5, 78.1), 51.3 (35.3, 66.7), and 42.4% (25.2, 58.8) in cattle, goats, and sheep, respectively. Coagulase‐negativeStaphylococcusspp was the most frequently isolated bacterium. Catheter type/placement technique was a significant (P= .03) predictor of IVC infection in goats but not in cattle (P= .65) and sheep (P= .47). Antibiotic use and reason for catheter placement were not significant predictors of IVC infection in all species. Catheters maintained for >4 days had a higher likelihood of being infected than those maintained for <4 days in all species.

Conclusions and Clinical importance

Clinicians should consider replacing catheters maintained for >4 days to reduce IVC infection.