bluuebunny/crossref_metadata_2025 huggingface dataset:
15‐year follow‐up of the Second Nordic Mantle Cell Lymphoma trial (MCL2): prolonged remissions without survival plateau
Authors: Eskelund Christian W. , Kolstad Arne , Jerkeman Mats , Räty Riikka , Laurell Anna , Eloranta Sandra , Smedby Karin E. , Husby Simon , Pedersen Lone B. , Andersen Niels S. , Eriksson Mikael , Kimby Eva , Bentzen Hans , Kuittinen Outi , Lauritzsen Grete F. , Nilsson‐Ehle Herman , Ralfkiær Elisabeth , Ehinger Mats , Sundström Christer , Delabie Jan , Karjalainen‐Lindsberg Marja‐Liisa , Workman Christopher T. , Garde Christian , Elonen Erkki , Brown Peter , Grønbæk Kirsten , Geisler Christian H.
Published: July 2016

In recent decades, the prognosis of Mantle Cell Lymphoma (MCL) has been significantly improved by intensified first‐line regimens containing cytarabine, rituximab and consolidation with high‐dose‐therapy and autologous stem cell transplantation. One such strategy is the Nordic MCL2 regimen, developed by the Nordic Lymphoma Group. We here present the 15‐year updated results of the Nordic MCL2 study after a median follow‐up of 11·4 years: For all patients on an intent‐to‐treat basis, the median overall and progression‐free survival was 12·7 and 8·5 years, respectively. The MCL International Prognostic Index (MIPI), biological MIPI, including Ki67 expression (MIPI‐B) and the MIPI‐B including mIR‐18b expression (MIPI‐B‐miR), in particular, significantly divided patients into distinct risk groups. Despite very long response durations of the low and intermediate risk groups, we observed a continuous pattern of relapse and the survival curves never reached a plateau. In conclusion, despite half of the patients being still alive and 40% in first remission after more than 12 years, we still see an excess disease‐related mortality, even among patients experiencing long remissions. Even though we consider the Nordic regimen as a very good choice of regimen, we recommend inclusion in prospective studies to explore the benefit of novel agents in the frontline treatment of MCL.
Partial recovery of senescence and differentiation disturbances in CD8+ T cell effector-memory cells in HIV-1 infection after initiation of anti-retroviral treatment
Authors: Eberhard J M , Ahmad F , Hong H S , Bhatnagar N , Keudel P , Schulze zur Wiesch J , Schmidt R E , Meyer-Olson D
Published: July 2016

Immune senescence as well as disturbed CD8+ T cell differentiation are a hallmark of chronic HIV infection. Here, we investigated to what extent immune senescence is reversible after initiation of anti-retroviral treatment (ART). Peripheral blood mononuclear cells (PBMCs) from a cohort of HIV patients with different disease courses, including untreated viral controllers (n = 10), viral non-controllers (n = 16) and patients on ART (n = 20), were analysed and compared to uninfected controls (n = 25) by flow cytometry on bulk and HIV-specific major histocompatibility complex (MHC) class I tetramer+ CD8+ T cells for expression of the memory markers CCR7 and CD45RO, as well as the senescence marker CD57 and the differentiation and survival marker CD127. Furthermore, a subset of patients was analysed longitudinally before and after initiation of ART. Frequencies of CD57+CD8+ T cells decreased after initiation of ART in central memory (Tcm) but not in effector memory T cell populations (TemRO and TemRA). The frequency of CD127+CD8+ cells increased in Tcm and TemRO. We observed a reduction of CD127– T cells in Tcm, TemRO and partially in TemRA subsets after initiation of ART. Importantly, HIV-specific CD8+ TemRO cells predominantly displayed a CD127–CD57+ phenotype in untreated HIV-patients, whereas the CD127+CD57– phenotype was under-represented in these patients. The frequency of the CD127+CD57–CD8+ T cell subpopulation correlated strongly with absolute CD4+ counts in HIV-infected patients before and after initiation of ART. These findings can be interpreted as a phenotypical correlate of CD8+ memory T cell differentiation and the premature ‘ageing’ of the immune system, which was even observed in successfully virally suppressed HIV patients.
MicroRNA-26a–interleukin (IL)-6–IL-17 axis regulates the development of non-alcoholic fatty liver disease in a murine model
Authors: He Q , Li F , Li J , Li R , Zhan G , Li G , Du W , Tan H
Published: July 2016

Non-alcoholic fatty liver disease (NAFLD) is a hepatic presentation of obesity and metabolic syndrome. MicroRNA 26a (Mir-26a) has been reported to play functions in cellular differentiation, cell growth, cell apoptosis and metastasis. A recent paper indicated that Mir-26a regulated insulin sensitivity and metabolism of glucose and lipids. However, the role of Mir-26a in NAFLD still needs to be investigated further. In our current study, vectors encoding pre-Mir-26a (LV-26a) and an empty lentiviral vector (LV-Con) delivered approximately 2 × 107 transforming units of recombinant lentivirus were injected into mice through the tail vein. LV-26a-infected mice were protected from glucose dysmetabolism and showed markedly decreased total liver weight, hepatic triglyceride deposition and serum alanine transaminase (ALT) concentration when compared with LV-Con-treated mice. LV-26a-treated mice also exhibited decreased infiltration of immune cells in the liver – something attributed to reduce infiltration of T cell receptor (TCR)-γδ+, granulocyte-differentiation antigen-1 (Gr-1)+ cells and CD11b+ cells. Next, we found that Mir-26a inhibited the expression of interleukin (IL)−17 and IL-6 in vivo and in vitro. Furthermore, the decreased expression of IL-17 in the liver tissue induced by Mir-26a was abrogated completely by IL-6 overexpression. The decreased total liver weight, hepatic triglyceride deposition and serum ALT concentration induced by Mir-26a was also abrogated completely by IL-6 over-expression. In conclusion, the Mir-26a–IL-6–IL-17 axis regulates the development of NAFLD in a murine model.
Simple Incentives and Group Dependence for Successful Payments for Ecosystem Services Programs: Evidence from an Experimental Game in Rural Lao PDR
Authors: Salk Carl , Lopez Maria‐Claudia , Wong Grace
Published: July 2016

In this article, we use a new game‐based tool to evaluate the immediate and longer term behavioral change potential of three different payments for ecosystem services (PES) delivery mechanisms: direct payments for individual performance, direct payments for group performance, and insurance. Results from four rural shifting‐cultivation dependent communities in Lao PDR suggest that easily understood group‐oriented incentives yield the greatest immediate resource‐use reduction and experience less free‐riding. Group‐based incentives may succeed because they motivate participants to communicate about strategies and coordinate their actions and are perceived as fair. No incentive had a lasting effect after it ceased, but neither did any crowd out the participants’ baseline behavior. Temporary reductions in resource dependence may provide a buffer for development of new livelihoods and longer term change. Games like the one developed here can help policy makers appropriately target environmental incentive programs to local contexts and teach program participants how incentive schemes work.
Robust anti‐obesity and metabolic effects of a dual GLP‐1/glucagon receptor peptide agonist in rodents and non‐human primates
Authors: Henderson S. J. , Konkar A. , Hornigold D. C. , Trevaskis J. L. , Jackson R. , Fritsch Fredin M. , Jansson‐Löfmark R. , Naylor J. , Rossi A. , Bednarek M. A. , Bhagroo N. , Salari H. , Will S. , Oldham S. , Hansen G. , Feigh M. , Klein T. , Grimsby J. , Maguire S. , Jermutus L. , Rondinone C. M. , Coghlan M. P.
Published: July 2016

Aims

To characterize the pharmacology of MEDI0382, a peptide dual agonist of glucagon‐like peptide‐1 (GLP‐1) and glucagon receptors.

Materials and methods

MEDI0382 was evaluated in vitro for its ability to stimulate cAMP accumulation in cell lines expressing transfected recombinant or endogenous GLP‐1 or glucagon receptors, to potentiate glucose‐stimulated insulin secretion (GSIS) in pancreatic β‐cell lines and stimulate hepatic glucose output (HGO) by primary hepatocytes. The ability of MEDI0382 to reduce body weight and improve energy balance (i.e. food intake and energy expenditure), as well as control blood glucose, was evaluated in mouse models of obesity and healthy cynomolgus monkeys following single and repeated daily subcutaneous administration for up to 2 months.

Results

MEDI0382 potently activated rodent, cynomolgus and human GLP‐1 and glucagon receptors and exhibited a fivefold bias for activation of GLP‐1 receptor versus the glucagon receptor. MEDI0382 produced superior weight loss and comparable glucose lowering to the GLP‐1 peptide analogue liraglutide when administered daily at comparable doses in DIO mice. The additional fat mass reduction elicited by MEDI0382 probably results from a glucagon receptor‐mediated increase in energy expenditure, whereas food intake suppression results from activation of the GLP‐1 receptor. Notably, the significant weight loss elicited by MEDI0382 in DIO mice was recapitulated in cynomolgus monkeys.

Conclusions

Repeated administration of MEDI0382 elicits profound weight loss in DIO mice and non‐human primates, produces robust glucose control and reduces hepatic fat content and fasting insulin and glucose levels. The balance of activities at the GLP‐1 and glucagon receptors is considered to be optimal for achieving weight and glucose control in overweight or obese Type 2 diabetic patients.
Enhancement of antifungal activity of Burkholderia pyrrocinia JK‐SH007 genetically modified with Bacillus subtilis Chi113 gene
Authors: He L.‐M. , Ye J.‐R. , Ren J.‐H. , Huang L. , Wu X.‐Q.
Published: July 2016

Previous studies showed that Burkholderia pyrrocinia JK‐SH007 is a potential biocontrol agent of poplar canker disease. In this report, B. pyrrocinia JK‐SH007 was genetically modified by introducing the Bacillus subtilis Chi113 gene to enhance its antifungal activity. The green fluorescence of B. pyrrocinia JK‐SH007E1 can be detected because of its transformation with plasmid pHKT2‐Chi113 containing a gfp reporter gene. Real‐time quantitative PCR (qPCR) showed that the B. subtilis Chi113 gene was highly expressed in B. pyrrocinia JK‐SH007E1 at mRNA level. The chitinase activity and the antifungal activity of B. pyrrocinia JK‐SH007E1 were significantly increased, and the clear halo was visible on the colloidal chitin agar plate. In addition, the constructed recombinant plasmid pHKT2‐Chi113 was stably maintained for at least 100 generations in the absence of antibiotic selection in B. pyrrocinia JK‐SH007E1. In western blot analysis, the Chi113‐GFP fusion protein was detected in B. pyrrocinia JK‐SH007E1 using the GFP polyclonal antibody. In conclusion, the B. subtilis Chi113 gene was successfully transformed into B. pyrrocinia JK‐SH007 and was expressed both at mRNA level and protein level. Moreover, the antifungal activity of B. pyrrocinia JK‐SH007 was improved through this genetic modification.
Shot hole disease on Prunus laurocerasus caused by Neofusicoccum parvum in Serbia
Authors: Zlatković M. , Keča N. , Wingfield M. J. , Jami F. , Slippers B.
Published: July 2016

Between 2010 and 2014, symptoms of a shot hole disease were observed on cherry laurel (Prunus laurocerasus L.) trees and shrubs in parks and other public plantings in Belgrade, Serbia. Ten symptomatic leaves were collected from each of the diseased plants and the associated fungus isolated and identified using multigene phylogenetic analyses and asexual morphological characters. The pathogen was identified as Neofusicoccum parvum. The same symptoms were produced when the pathogen was inoculated on test plants. To the best of our knowledge, this is the first report of N. parvum causing shot hole disease on P. laurocerasus.
Vitamin D deficiency and its risk factors in Malaysian children with epilepsy
Authors: Fong Choong Yi , Kong Ann Nie , Poh Bee Koon , Mohamed Ahmad Rithauddin , Khoo Teik Beng , Ng Rui Lun , Noordin Mazidah , Nadarajaw Thiyagar , Ong Lai Choo
Published: July 2016

Objective

Long‐term use of antiepileptic drugs (AEDs) is a significant risk factor for vitamin D deficiency in children with epilepsy. The aims of our study were to evaluate the prevalence and risk factors for vitamin D deficiency among Malaysian children with epilepsy.

Methods

Cross‐sectional study of ambulant children with epilepsy on long‐term AEDs for >1 year seen in three tertiary hospitals in Malaysia from April 2014 to April 2015. Detailed assessment of pubertal status, skin pigmentation, sunshine exposure behavior, physical activity, dietary vitamin D and calcium intake, anthropometric measurements and bone health blood tests (vitamin D, alkaline phosphatase, calcium, phosphate, and parathyroid hormone levels) were obtained on all patients. Vitamin D deficiency was defined as 25‐hydroxy vitamin D [25(OH)D] levels ≤35 nmol/L and insufficiency as 25(OH)D levels of 36–50 nmol/L.

Results

A total of 244 children (146 male) participated in the study. Ages ranged between 3.7 and 18.8 years (mean 12.3 years). 25(OH)D levels ranged between 7.5 and 140.9 nmol/L (mean 53.9 nmol/L). Vitamin D deficiency was identified in 55 patients (22.5%), and a further 48 (19.7%) had vitamin D insufficiency. Multivariate logistic regression analysis identified polytherapy >1 AED (odds ratio [OR] 2.16, 95% confidence interval [CI] 1.07–4.36), age >12 years (OR 4.16, 95% CI 1.13–15.30), Indian ethnicity (OR 6.97, 95% CI 2.48–19.55), sun exposure time 30–60 min/day (OR 2.44, 95% CI 1.05–5.67), sun exposure time <30 min/day (OR 3.83, 95% CI 1.61–9.09), and female (OR 2.61, 95% CI 1.31–5.20) as statistically significant (p < 0.05) risk factors for vitamin D deficiency.

Significance

Despite living in the tropics, a high proportion of Malaysian children with epilepsy are at risk of vitamin D deficiency. Targeted strategies including vitamin D supplementation and lifestyle advice of healthy sunlight exposure behavior should be implemented among children with epilepsy, particularly for those at high risk of having vitamin D deficiency.
Equine odontoclastic tooth resorption and hypercementosis
Authors: Hole S. L. , Staszyk C.
Published: July 2016

Equine odontoclastic tooth resorption and hypercementosis (EOTRH) is a progressive and painful disease syndrome that affects aged horses. It affects incisor, canine and infrequently cheek teeth, and is characterised by gingival inflammation, oedema and recession, calculus deposition, feed accumulation, subgingival swellings with or without associated draining tracts, bulbous enlargement of teeth, tooth mobility, associated periodontal disease, tooth fracture and/or tooth loss. The aetiology of EOTRH is likely to be multi‐factorial. However, histopathological findings consistently suggest an aetiological contribution of initial biomechanical stresses and strains, followed by secondary involvement of micro‐organisms. Diagnosis is based on clinical presentation, age and radiographic changes including lytic changes, widening or loss of the periodontal ligament, hypercementosis, tooth fracture and alveolar bone loss. Treatment of EOTRH is not currently possible, but the condition can be managed to some degree, quite successfully for many years in some cases. However, the disease is progressive and invariably results in extraction of the tooth or teeth involved. The prognosis is most probably guarded at best and poor in most cases; however, complete removal of affected teeth carries a good prognosis for an improved quality of life in the short to medium term.
Unravelling the joint effects of flow regime, climatic variability and dispersal mode on beta diversity of riverine communities
Authors: Rolls Robert J. , Heino Jani , Chessman Bruce C.
Published: July 2016

Differences in the composition of ecological communities among rivers with contrasting flow regimes have been detected in many regions worldwide. However, we know little of how climatic variation alters these spatial patterns for constituent species with varying dispersal modes and strengths.

We predicted that beta diversity (spatial variation in composition) of macroinvertebrate and fish assemblages among streams with near‐perennial, mildly intermittent and highly intermittent flow regimes would be greater during prolonged drought than under wetter climate conditions. We hypothesised that changes in beta diversity between these climate phases would be greater for taxa with stronger dispersal ability. We tested these predictions with biomonitoring data from Australian subtropical rivers.

Differences in average community composition among flow regimes were statistically significant for six groups of macroinvertebrates with differing dispersal (non‐swimmers, weak swimmers, strong swimmers, non‐fliers, weak fliers and strong fliers) and two groups of fish (potamodromous and diadromous), but not for locally dispersing fish. For each of these biotic groups, shifts in assemblage composition between supra‐seasonal drought and a subsequent non‐drought period were either statistically non‐significant or of similar magnitude among flow regimes. Therefore, beta diversity among flow regimes did not change significantly with climate phase.

Beta diversity within flow‐regime classes was greater during the drought than afterwards or not significantly different between climate phases, depending on the flow regime and biotic group. Stronger powers of flight were associated with greater change in beta diversity between climate phases in near‐perennial streams, but stronger powers of swimming were not. Within‐regime beta diversity was driven more by replacement of taxa among samples than by nestedness, except for diadromous fish in near‐perennial streams.

Our findings are consistent with the hypothesis that decreasing hydrological connectivity and greater environmental heterogeneity during prolonged drought increase beta diversity of stream communities. However, changes in beta diversity between climate phases were not as pronounced as we expected. The communities may have been somewhat drought resistant because the magnitude and duration of the drought were within the range of historical variability and because surface water persisted at study sites during drought‐imposed flow cessations. Our findings suggest that maintenance of refuge pools will be critical to lessening drought impacts on river biodiversity at landscape scales, particularly if drought duration and intensity increase in the future.
Fluorescent‐based evaluation of chaperone‐mediated autophagy and microautophagy activities in cultured cells
Authors: Sato Masahiro , Seki Takahiro , Konno Ayumu , Hirai Hirokazu , Kurauchi Yuki , Hisatsune Akinori , Katsuki Hiroshi
Published: July 2016

The autophagy‐lysosome protein degradation is further classified into macroautophagy (MA), microautophagy (mA), and chaperone‐mediated autophagy (CMA). While MA is involved in various functions and disease pathogenesis, little is known about CMA and mA because of the absence of easy methods to assess their activities. We have recently established a method to assess CMA activity using glyceraldehyde 3‐phosphate dehydrogenase (GAPDH), a CMA substrate, and HaloTag (HT) system. Another group has recently identified a mammalian mA pathway, in which substrates are delivered to late endosomes in an heat shock cognate protein (Hsc)70‐dependent manner. Because Hsc70 is also involved in CMA, our method would detect both CMA and mA activities. In this study, we attempted to assess CMA and mA activities separately through the siRNA‐mediated knockdown of CMA‐ and mA‐related proteins. Knockdown of LAMP2A, a CMA‐related protein, and TSG101, an mA‐related protein, significantly but only partially decreased the punctate accumulation of GAPDH‐HT in AD293 cells and primary cultured rat cortical neurons. Compounds that activate CMA significantly increased GAPDH‐HT puncta in TSG101‐knockdown cells, but not in LAMP2A‐knockdown cells, suggesting that punctate accumulation of GAPDH‐HT under LAMP2A‐ and TSG101‐knockdown represents mA and CMA activities, respectively. We succeeded in establishing the method to separately evaluate CMA and mA activities by fluorescence observation.
Effect of non‐alcoholic fatty liver disease on left ventricular diastolic function and geometry in the Korean general population
Authors: Jung Ju Young , Park Sung Keun , Ryoo Jae‐Hong , Oh Chang‐Mo , Kang Jeong Gyu , Lee Jae‐Hon , Choi Joong‐Myung
Published: July 2016

Aim

Previous studies showed that non‐alcoholic fatty liver disease (NALFD) could be related to subclinical left ventricular (LV) diastolic dysfunction and remodeling. However, this association is still equivocal in the general population. Thus, this study was carried out to examine whether NAFLD is associated with the risk for LV diastolic dysfunction and remodeling.

Methods

A cross‐sectional study was carried out for 20 821 Korean men and women who received a health checkup including echocardiography from 2011 to 2012. The study population was divided into three groups of normal, mild and moderate‐to‐severe NAFLD detected by ultrasonography. Using multivariable logistic regression analysis, the odd ratios of abnormal LV relaxation and remodeling were analyzed according to the degree of NAFLD. Additionally, adjusted mean values of LV diastolic functional and structural parameters were evaluated in the three groups.

Results

Compared with the normal group, the mild and moderate‐to‐severe NAFLD groups had higher odd ratios for abnormal LV relaxation (mild group 1.29, 95% confidence interval 1.15–1.46; moderate‐to‐severe group 1.95, 95% confidence interval 1.61–2.35) and increased relative wall thickness (>0.42; mild group 1.26, 95% confidence interval 1.05–1.52; moderate‐to‐severe group 1.46, 95% confidence interval 1.08–1.95). Analyzing adjusted mean values of LV parameters also showed the significant association between the degree of NAFLD and impaired LV diastolic function and concentric LV remodeling.

Conclusions

The risk for LV diastolic dysfunction and remodeling proportionally increased according to the degree of NAFLD. NAFLD is significantly associated with LV functional and structural alteration.
Design, synthesis and characterization of linear unnatural amino acids for skin moisturization
Authors: Arezki N. R. , Williams A. C. , Cobb A. J. A. , Brown M. B.
Published: July 2016

Objectives

This work aimed to design, synthesize and characterize replacement natural moisturizing factor (NMF) composed of modified hygroscopic linear amino acids to pre‐empt or repair skin barrier dysfunction.

Methods

Following synthesis and characterization, thermo‐gravimetric analysis and quantum mechanics molecular modelling quantified and depicted water binding to the new compounds. Deliquescence relative humidity demonstrated the water‐scavenging ability of the compounds, whereas snake skin moisturizing studies showed they increased water uptake into snake skin.

Results

From thermal analysis, N‐hydroxyglycine showed greatest water‐holding capacity followed by N‐hydroxyserine, l‐homoserine and α‐hydroxyglycine; coupled with quantum mechanics molecular modelling, between 8 and 12 molecules of water could associate with each molecule of either N‐hydroxyglycine, N‐hydroxyserine or l‐homoserine. All of our modified amino acids were efficacious and induced similar or greater water uptake compared with the established moisturizing compounds hyaluronic acid, glycerine and urea in snake skin. Incorporated at 10% in Oilatum, N‐hydroxyserine induced >200% greater moisture uptake into dry snake skin compared to treatment with water alone, with efficacy related to the molecule structure and ability to bind to 12 water molecules. Oilatum cream spiked with all our unnatural amino acid hydrotropes increased water uptake into snake skin compared with Oilatum alone.

The compound series was designed to elucidate some structure – efficacy relationships. Amino acid chirality did not affect the water‐holding capacity but did affect uptake into skin. Compounds with high melting points and bond energies tended to decrease water‐holding capacity. With isosteric replacement, the more electronegative atoms gave greater water‐holding capacities.

Conclusions

This work demonstrates the potential of unnatural amino acid hydrotropes as skin moisturizers and has developed some predictive ‘rules’ for further design and refinement of chemical structures.
Pre‐school children and marketing communications
Authors: Preston Christopher
Published: July 2016

Within the context of an existing body of work regarding children and marketing communications, which largely places meaningful interaction with marketing communication as out with the ability of pre‐school children, research has been conducted upon parents of pre‐school children, nursery teachers and pre‐school children themselves within the environment of their nursery. Parents relate their experience that typically from the age of three their children recognize television advertising and have commenced retail interactions. Nursery teachers have noted that the children under their care personally interact within the context of brands, and the children themselves via their own verbalisations provide indications that in some cases at least 4‐year‐old children have an idea of advertising intent, and 3‐year‐old children typically are able to recognize advertising as being distinct from programme material.
Taking personal responsibility: Nurses' and assistant nurses' experiences of good nursing practice in psychiatric inpatient care
Authors: Gabrielsson Sebastian , Sävenstedt Stefan , Olsson Malin
Published: July 2016

Therapeutic nurse–patient relationships are considered essential for good nursing practice in psychiatric inpatient care. Previous research suggests that inpatient care fails to fulfil patients' expectations in this regard, and that nurses might experience the reality of inpatient care as an obstruction. The aim of the present study was to explore nurses' and assistant nurses' experiences of good nursing practice in the specific context of psychiatric inpatient care. Qualitative interviews were conducted with 12 skilled, relationship‐oriented nurses and assistant nurses in order to explore their experiences with nursing practice related to psychiatric inpatient care. Interviews were transcribed and analysed using an interpretive descriptive approach. Findings describe good nursing practice as a matter of nurses and assistant nurses taking personal responsibility for their actions and for the individual patient as a person. Difficulties in providing dignified nursing care and taking personal responsibility cause them to experience feelings of distress and frustration. Shared values and nursing leadership supports being moral and treating patients with respect, having enough time supports being present and connecting with patients, and working as a part of a competent team with critical daily discussions and diversity supports being confident and building trust. The findings suggest that taking personal responsibility is integral to good nursing practice. If unable to improve poor circumstances, nurses might be forced to promote their own survival by refuting or redefining their responsibility. Nurses need to prioritize being with patients and gain support in shaping their own nursing practice. Nursing leadership should provide moral direction and defend humanistic values.
Vascular assessment of wound healing: a clinical review
Authors: Li William W , Carter Marissa J , Mashiach Elad , Guthrie Stephen D
Published: July 2016

Although macrovascular screening of patients with chronic wounds, particularly in the lower extremities, is accepted as part of clinical practice guidelines, microvascular investigation is less commonly used for a variety of reasons. This can be an issue because most patients with macrovascular disease also develop concomitant microvascular dysfunction. Part of the reason for less comprehensive microvascular screening has been the lack of suitable imaging techniques that can quantify microvascular dysfunction in connection with non‐healing chronic wounds. This is changing with the introduction of fluorescence microangiography. The objective of this review is to examine macro‐ and microvascular disease, the strengths and limitations of the approaches used and to highlight the importance of microvascular angiography in the context of wound healing.
Micro Four‐Layer SiC Coating on Matrix Graphite Spheres of HTR Fuel Elements by Two‐Step Pack Cementation
Authors: Zhou Ping , Liu Xiaoxue , Zhao Hongsheng , Li Ziqiang , Zheng Zujie , Zhang Kaihong , Liu Bing
Published: July 2016

A micro four‐layer SiC coating, which includes inner transition layer, fine‐grained layer, dense bulk layer, and outer loose layer, was fabricated on the matrix graphite spheres of high‐temperature gas‐cooled reactor fuel elements to improve the oxidation‐resistant property by a two‐step pack cementation process. According to the experiment results, the micro four‐layer can be differentiated by SiC grain size and microstructure variation. The oxidation tests at 1773 K for 200 h reveal that the coating structure could effectively improve the oxidation resistance of matrix graphite spheres with a weight gain of 0.52 wt%, and the fine‐grained and dense bulk layers are evidenced as two main antioxidation layers. Although the thermal expansion coefficients of SiC and matrix graphite do not match each other so well, no obvious stress cracking was observed after thermal shocking tests from 1773 K to room temperature for 100 times.
Scaling Effects in Perovskite Ferroelectrics: Fundamental Limits and Process‐Structure‐Property Relations
Authors: Ihlefeld Jon F. , Harris David T. , Keech Ryan , Jones Jacob L. , Maria Jon‐Paul , Trolier‐McKinstry Susan
Published: July 2016

Ferroelectric materials are well‐suited for a variety of applications because they can offer a combination of high performance and scaled integration. Examples of note include piezoelectrics to transform between electrical and mechanical energies, capacitors used to store charge, electro‐optic devices, and nonvolatile memory storage. Accordingly, they are widely used as sensors, actuators, energy storage, and memory components, ultrasonic devices, and in consumer electronics products. Because these functional properties arise from a noncentrosymmetric crystal structure with spontaneous strain and a permanent electric dipole, the properties depend upon physical and electrical boundary conditions, and consequently, physical dimension. The change in properties with decreasing physical dimension is commonly referred to as a size effect. In thin films, size effects are widely observed, whereas in bulk ceramics, changes in properties from the values of large‐grained specimens is most notable in samples with grain sizes below several micrometers. It is important to note that ferroelectricity typically persists to length scales of about 10 nm, but below this point is often absent. Despite the stability of ferroelectricity for dimensions greater than ~10 nm, the dielectric and piezoelectric coefficients of scaled ferroelectrics are suppressed relative to their bulk counterparts, in some cases by changes up to 80%. The loss of extrinsic contributions (domain and phase boundary motion) to the electromechanical response accounts for much of this suppression. In this article, the current understanding of the underlying mechanisms for this behavior in perovskite ferroelectrics is reviewed. We focus on the intrinsic limits of ferroelectric response, the roles of electrical and mechanical boundary conditions, grain size and thickness effects, and extraneous effects related to processing. In many cases, multiple mechanisms combine to produce the observed scaling effects.
The effect of Nurse GraduaTeness on patient mortality: a cross‐sectional survey (the NuGaT study)
Authors: Gkantaras Ioannis , Mahfoud Ziyad R. , Foreman Brent , Thompson David R. , Cannaby Ann Marie , Deshpande Deepak Hanmanthrao , Watson Roger , Topping Annie , Gray Richard
Published: July 2016

Aim

To investigate the relationship between patient mortality and the educational preparation (graduateness) of the nurses who cared for them.

Background

There have been 18 studies over the last two decades examining the effect of nurses’ educational qualifications on mortality. All but three have used mortality data aggregated at the hospital level that has been combined with surveys of nurses to estimate the level of graduateness in the population. Data collection and extraction generally has been done at different points in time.

Design

A retrospective, cross‐sectional study.

Method

Routine administrative patient data were extracted (May–August 2015). The primary outcome was all‐cause patient mortality at discharge. We were able to identify the individual nurses who provided care during patients inpatient stay using an identification number. We were then able to calculate the ‘graduateness’ of the nursing care patients received by dividing the number of recorded episodes of care provided by baccalaureate prepared nurses with the total number of care episodes.

Results

After adjusting for confounding, we observed a significant association between patient mortality and nurse graduateness. Our observations suggest an optimum level of baccalaureate prepared nurses of approximately 70%. Above this level, there appears to be no additional decrease in mortality rates.

Conclusion

This study represents an important methodological step forward over previous approaches. Our observations are generally consistent with existing literature and confirm the importance of baccalaureate nurse education.
Development and psychometric analysis of the Patient Perceptions of Patient‐Empowering Nurse Behaviours Scale (PPPNBS)
Authors: Jerofke Teresa , Weiss Marianne
Published: July 2016

Aim

To (1) develop and psychometrically test the Patient Perceptions of Patient‐Empowering Nurse Behaviours Scale, which measures patient perceptions of empowering nurse behaviours during hospitalization; and (2) refine to a shorter, more useful form, for measurement in clinical settings.

Background

Although patient empowerment has been promoted as a way to engage patients in chronic illness care, there is not a measure reported by patients as recipients of empowering nurse behaviours during hospitalization.

Design

Psychometric evaluation of construct and predictive validity, reliability and item reduction.

Method

Data gathered during hospitalization and six weeks postdischarge between April 2012 ‐ August 2014 were used to determine the validity and reliability of the long and short‐form Patient Perceptions of Patient‐Empowering Nurse Behaviours Scale in a sample of 395 chronically ill medical and surgical adult patients.

Results

The long and short‐form Patient Perceptions of Patient‐Empowering Nurse Behaviours Scale demonstrated strong reliability and convergent validity with pre‐discharge 13‐item Patient Activation Measure scores. Both forms of the Patient Perceptions of Patient‐Empowering Nurse Behaviours Scale predicted postdischarge 13‐item Patient Activation Measure scores and the long‐form predicted physical health status. Confirmatory factor analysis demonstrated improved model fit for the short‐form instrument when compared with the long‐form fit. The short‐form Patient Perceptions of Patient‐Empowering Nurse Behaviours Scale explained 98% of the variance of the long‐form Patient Perceptions of Patient‐Empowering Nurse Behaviours Scale.

Conclusion

The results provide evidence supporting reliability and validity of both forms. While the scales measure patient reports and not direct observation of empowering nurse behaviours, incorporating patients' experiences as recipients of care is necessary to validate the contribution of nursing care to patients' engagement in chronic illness management.
A path analysis of stress and premenstrual symptoms in Korean international and Korean domestic students
Authors: Lee Yaelim , Im Eun‐Ok
Published: July 2016

Aims

To identify the relationships between perceived stress, acculturative stress and premenstrual symptoms, among other associated factors (e.g. depressive symptoms, coping self‐efficacy, perceived social support) of premenstrual symptoms suggested in the literature by testing the conceptual framework of the ‘Stress and Premenstrual Experience Model: Women in Cultural Transition’.

Background

Level of perceived stress has been cited as a major influencing factor for women's premenstrual symptoms; however, how these two elements are related, including possible mediators and moderators, remains unclear.

Design

A longitudinal causal‐comparative web‐based study design.

Methods

Data collection occurred between November, 2014 ‐ February, 2015. The convenience sampling method was used to recruit 98 Korean international students and 89 Korean domestic students. Weekly surveys were conducted for 10 weeks to capture women's levels of perceived stress, acculturative stress and premenstrual symptoms from two menstrual cycles. The survey data collected during the premenstrual phase was analysed using path analyses.

Results/findings

The hypothesized pathways based on the conceptual model were partially supported in the study. Depressive symptoms were a partial mediator between perceived stress and premenstrual symptoms and between acculturative stress and symptoms in Korean international students. The perceived social support was a moderator between perceived stress and premenstrual symptoms in Korean domestic students.

Conclusion

This study proposes a revised conceptual model that will contribute to the understanding of stress and premenstrual symptom severity in women in the acculturation process and concludes with suggestions and implications for future nursing practice and research.
Cardiovascular medication adherence among patients with cardiac disease: a systematic review
Authors: Al‐Ganmi Ali Hussein , Perry Lin , Gholizadeh Leila , Alotaibi Abdulellah Modhi
Published: July 2016

Aims

The aim of this study was to critically appraise and synthesize the best available evidence on the effectiveness of interventions suitable for delivery by nurses, designed to enhance cardiac patients' adherence to their prescribed medications.

Background

Cardiac medications have statistically significant health benefits for patients with heart disease, but patients' adherence to prescribed medications remains suboptimal.

Design

A systematic quantitative review of intervention effects.

Data Sources

We conducted systematic searches for English‐language, peer‐reviewed randomized controlled trial publications via Medline, EMBASE, CINAHL, the Cochrane Library, ProQuest, Web of Science and Google Scholar published between January 2004–December 2014.

Review methods

According to pre‐determined inclusion and exclusion criteria, eligible studies were identified and data extracted using a predefined form. Of 1962 identified papers; 14 studies met the study inclusion criteria, were assessed for risk of bias using the Cochrane Collaboration tool; and included in the review.

Results

Study findings were presented descriptively; due to the heterogeneity of studies meta‐analysis was not possible. Included papers described interventions categorized as: (1) multifaceted; and (2) behavioural and educational, comprising: (a) text message and mail message; (b) telephone calls; (c) motivational interviewing and (d) nurse‐led counselling and education.

Conclusions

Substantial heterogeneity limited the robustness of conclusions, but this review indicated that motivational interviewing, education and phone or text messaging appeared promising as means to enhance cardiac medication adherence. Future research should integrate multifaceted interventions that target individual behaviour change to enhance adherence to cardiovascular medications, to build on the beneficial outcomes indicated by this review.
Impact of Mental Disorders on the Association Between Adherence to Antihypertensive Agents and All‐Cause Healthcare Costs
Authors: Gentil Lia , Vasiliadis Helen Maria , Préville Michel , Berbiche Djamal
Published: July 2016

Depression and anxiety are factors associated with poor adherence to medications that lead to increased healthcare costs. The authors hypothesize that these conditions will moderate the association between adherence and healthcare costs. The aim was to examine the healthcare costs associated with adherence to antihypertensive agents in the elderly with and without depression and anxiety. The sample included participants with hypertension and used hypertensive agents (N=926). Medication possession ratio was used to calculate medication adherence. Mean total healthcare costs included costs for inpatient stays, emergency department visits, outpatient visits, physician fees, and outpatient medications. Mental disorders were assessed using a questionnaire based onDiagnostic and Statistical Manual of Mental Disorders, Fourth Editioncriteria. The total healthcare costs were significantly greater for nonadherent participants with depression/anxiety than for adherent participants without depression/anxiety (Δ$1841,P<.0001). This study suggests that treating mental disorders in elderly patients with hypertension will decrease total healthcare costs.
The association of feeding behaviour with the resistance and tolerance to parasites in recently diverged sticklebacks
Authors: Anaya‐Rojas Jaime M. , Brunner Franziska S. , Sommer Nina , Seehausen Ole , Eizaguirre Christophe , Matthews Blake
Published: July 2016

Divergent natural selection regimes can contribute to adaptive population divergence, but can be sensitive to human‐mediated environmental change. Nutrient loading of aquatic ecosystems, for example, might modify selection pressures by altering the abundance and distribution of resources and the prevalence and infectivity of parasites. Here, we used a mesocosm experiment to test for interactive effects of nutrient loading and parasitism on host condition and feeding ecology. Specifically, we investigated whether the common fish parasiteGyrodactylussp. differentially affected recently diverged lake and stream ecotypes of three‐spined stickleback (Gasterosteus aculeatus). We found that the stream ecotype had a higher resistance toGyrodactylussp. infections than the lake ecotype, and that both ecotypes experienced a cost of parasitism, indicated by negative relationships between parasite load and both stomach fullness and body condition. Overall, our results suggest that in the early stages of adaptive population divergence of hosts, parasites can affect host resistance, body condition and diet.
Cisplatin for testicular germ cell tumors: a rapid review
Authors: Hu Zhiqiang , Yu Jiajie , Gui Ge , Chen Yuan , Huang Rui , Jiang Lucan , Kwong Joey S.W. , Li Youping , Zhang Lingli
Published: July 2016

Objective

Cisplatin is one of efficacious medicines for TGCT, but is not in 18th WHO EML now. The Union for International Cancer Control recommended cisplatin to the 19th WHO EML for TGCT. To evaluate the effectiveness, safety and cost of cisplatin for TGCT according to the requirements of WHO EML Expert Committee, and to provide the evidence whether cisplatin should be included in WHO EML.

Method

We searched The Cochrane Library, PubMed, EMbase, NHS EED, US National Guideline Clearinghouse (NGC) and WHO guidelines. Guidelines and systematic reviews (SRs) on cisplatin for TGCT were included. Two reviewers selected studies and extracted relevant information independently. Quality of SRs was appraised through AMSTAR.

Results

Seven guidelines and four SRs were included in this rapid review. Quality of SRs was moderate according to AMSTAR. The results showed that: (a) effectiveness: cisplatin‐based chemotherapy significantly improved in response rates and overall survival for more advanced disease (stage II and stage III). Bleomycin, etoposide, and cisplatin (BEP)—one of the most widely used of cisplatin‐based chemotherapy regimens should be considered as the standard treatment of good‐prognosis patients with survival rates of 90% and as the best option for intermediate‐ or poor‐prognosis patients with survival rates of 75% and 50%, respectively. (b) Safety: nephrotoxicity, ototoxicity and peripheral neuropathy are common adverse effects of cisplatin. (c) Cost: there was no relevant study about cost of cisplatin for TGCT. But the affordability of cispaltin is good for Chinese patients, due to it is in health insurance directory of China.

Conclusions

We recommend cisplatin to be listed in 19th WHO EML for TGCT, due to adequate evidence of effectiveness and good affordability.
A Review on Osmotic Dehydration of Fruits and Vegetables: An Integrated Approach
Authors: Ramya V. , Jain N. K.
Published: July 2016

Osmotic dehydration is a simultaneous mass transfer process which mainly promotes the flow of water molecules from the food to osmo‐active solution and some migration of solutes from the solution into the food, thus maintaining good organoleptic and functional properties in the finished product. This paper presents mechanism of osmotic dehydration and recent developments regarding the factors affecting osmotic dehydration process viz., pretreatment factors (blanching, coating, ultrasound treatment, high pressure processing, pulsed electric field effect, etc.), product‐related factors and osmotic solution related factors (temperature of osmotic solution, concentration of osmotic agent, type of osmotic agent, agitation/stirring process during osmotic process, osmotic solution and food mass ratio). The details on mathematical modeling of mass transfer during osmotic dehydration of foods and benefits of osmotic dehydration which includes energy saving methods and quality of final product are reviewed.

Practical Application

Osmosis is a physical phenomenon that has been extensively studied in various disciplines of science and engineering. Osmotic dehydration has diverse applications in fruits and vegetables. Thus it can be used to decrease the post harvest losses. Being a simple process, it facilitates processing of fruits and vegetables with retention of initial fruit characteristics viz., colour, aroma, texture and nutritional composition. Since no preservative was used, it does not adversely affect the human body. This process could be used on small scale for development of self‐entrepreneurs and home scale industries. The mathematical models can be used for understanding the mass transfer phenomenon during the process. The economic interest relates to the reduced energy consumption as compared to conventional drying. This review serves to provide an updated status on osmotic dehydration and its research gap which is useful for academics, research purpose and processing industries.