bluuebunny/crossref_metadata_2025 huggingface dataset:
Dietetics workforce preparation and preparedness in Australia: A systematic mapping review to inform future dietetics education research
Authors: Morgan Kate , Kelly Jaimon T. , Campbell Katrina L. , Hughes Roger , Reidlinger Dianne P.
Published: July 2018

Aim

The present study aimed to systematically map and summarise existing research regarding dietetics workforce preparation and preparedness that has been conducted in Australia. The secondary aim was to then identify gaps in the literature to inform future priority areas in Australian dietetics education research.

Methods

The databases MEDLINE, CINAHL, Embase, ERIC, Informit and PsycINFO were systematically searched from inception until July 2017 using key search terms to identify eligible studies. Extracted data were independently reviewed, and study quality was appraised by multiple researchers. Results were categorised by setting and primary focus/foci and then narratively summarised.

Results

Sixty‐eight studies were included from 3779 records identified. Dietetics education research in Australia has spanned almost 30 years with more than half of studies (51%; 35/68) published in the last five years. The greatest proportion of research was conducted in the university setting (43%; 29/68), with students as participants (48%; 43/90) and was focused on the medical nutrition therapy area of dietetics practice (43%; 29/68). Published studies involving graduates (14%; 13/90); conducted in the workplace (12%; 8/68); and regarding emerging areas of dietetics practice (0%; 0/90) are lacking. Employment outcomes of dietetics graduates across Australia were last published over 25 years ago.

Conclusions

This review provides a map for dietetics educators and researchers in Australia to guide future research regarding the preparation and preparedness of dietitians. Advancing the Australian dietetics workforce of the future will require a strategic, coordinated and collaborative approach to address the research gaps identified in this review.
Statistical Models to Predict and Assess Spatial and Temporal Low‐Flow Variability in New England Rivers and Streams
Authors: Detenbeck Naomi E.
Published: July 2018

In the northern hemisphere, summer low flows are a key attribute defining both quantity and quality of aquatic habitat. I developed one set of models for New England streams/rivers predicting July/August median flows averaged across 1985–2015 as a function of weather, slope, % imperviousness, watershed storage, glacial geology, and soils. These models performed better than most United States Geological Survey models for summer flows developed at a statewide scale. I developed a second set of models predicting interannual differences in summer flows as a function of differences in air temperature, precipitation, the North Atlantic Oscillation (NAO) index, and lagged NAO. Use of difference equations eliminated the need for transformations and accounted for serial autocorrelations at lag 1. The models were used in sequence to estimate time series for monthly low flows and for two derived flow metrics (tenth percentile [Q10] and minimum 3‐in‐5 year average flows). The first metric is commonly used in assessing risk to low‐flow conditions over time, while the second has been correlated with increased probability of localized extinctions for brook trout. The flow metrics showed increasing trends across most of New England for 1985–2015. However, application of summer flow models with average and extreme climate projections to the Taunton River, Massachusetts, a sensitive watershed undergoing rapid development, projected that low‐flow metrics will decrease over the next 50 years.
Graphs in phylogenetic comparative analysis: Anscombe's quartet revisited
Authors: Revell Liam J. , Schliep Klaus , Valderrama Eugenio , Richardson James E.
Published: July 2018

In 1973, the statistician Francis Anscombe used a clever set of bivariate datasets (now known as Anscombe's quartet) to illustrate the importance of graphing data as a component of statistical analyses. In his example, each of the four datasets yielded identical regression coefficients and model fits, and yet when visualized revealed strikingly different patterns of covariation between x and y.

Phylogenetic comparative methods (the set of methodologies that use phylogenies, often combined with phenotypic trait data, to make inferences about evolution) are statistical methods too; yet visualizing the data and phylogeny in a sensible way that would permit us to detect unexpected patterns or unanticipated deviations from model assumptions is not a routine component of phylogenetic comparative analyses.

Here, we use a quartet of phylogenetic datasets to illustrate that the same estimated parameters and model fits can be obtained from data that were generated using markedly different procedures—including pure Brownian motion evolution and randomly selected data uncorrelated with the tree. Just as in the case of Anscombe's quartet, when graphed the differences between the four datasets are quickly revealed.

The intent of this article is to help build the general case that phylogenetic comparative methods are statistical methods and consequently that graphing or visualization should invariably be included as an essential step in our standard data analytical pipelines.

Phylogenies are complex data structures and thus visualizing data on trees in a meaningful and useful way is a challenging endeavour. We recommend that the development of graphical methods for simultaneously visualizing data and tree should continue to be an important goal in phylogenetic comparative biology.
What do they need to know? Core skills for postgraduate development studies students
Authors: Engel Susan , Simpson Reeves Laura
Published: July 2018

Despite offerings at most universities, development studies in Australia does not have a professional body nor an academic association to prescribe core skills and standards, or to facilitate discussions about curriculum requirements and core competencies of graduates. This article analyses postgraduate coursework programmes focused on international and/or community development at 10 universities in Australia. It examines the faculty or school in which the programme is located, the core competencies the programmes aim to instil in graduates and how each programme is framed. In particular, it examines which skills have been defined as core requirements in line with the new Australian Qualifications Framework. The research found that, across Australia, development studies alternatively focuses students on critical thinking and understanding the history of ‘development’ or on teaching the practical skills (such as project and finance management) needed as development workers. We argue that the discipline needs to think more about core competencies and engage more actively in attempts to decolonise development studies teaching.
Tissue-resident memory T cells are epigenetically cytotoxic with signs of exhaustion in human urinary bladder cancer
Authors: Hartana C A , Ahlén Bergman E , Broomé A , Berglund S , Johansson M , Alamdari F , Jakubczyk T , Huge Y , Aljabery F , Palmqvist K , Holmström B , Glise H , Riklund K , Sherif A , Winqvist O
Published: July 2018

Tissue-resident memory T (TRM) cells are CD8+ T lymphocytes that reside in the tissues, including tumours. This T cell subset possesses a magnitude of cytotoxicity, but its epigenetic regulation has not been studied. Here, we investigate the impact of perforin DNA methylation in TRM cells and correlate it with their functional potential. Fifty-three urothelial urinary bladder cancer (UBC) patients were recruited prospectively. The DNA methylation status of the perforin gene (PRF1) locus in TRM cells was investigated by pyrosequencing. Flow cytometry with ViSNE analysis and in-vitro stimulation were used to evaluate TRM cell phenotypes. We discovered that tumour TRM cells have low DNA methylation in the PRF1 locus (32·9% methylation), which corresponds to increased numbers of perforin-expressing TRM cells. Surprisingly, programmed cell death 1 (PD-1) expression is high in tumour TRM cells, suggesting exhaustion. Following interleukin-15 and T cell receptor stimulation, perforin and T-bet expressions are enhanced, indicating that TRM cells from tumours are not terminally exhausted. Moreover, a high number of TRM cells infiltrating the tumours corresponds to lower tumour stage in patients. In conclusion, TRM cells from UBC tumours are epigenetically cytotoxic with signs of exhaustion. This finding identifies TRM cells as potential new targets for cancer immunotherapy.
Allergic contact dermatitis caused by dexpanthenol—Probably a frequent allergen
Authors: Fernandes Rosa A. , Santiago Luís , Gouveia Miguel , Gonçalo Margarida
Published: July 2018

Background

Panthenol (synonym: dexpanthenol), the alcohol analogue of panthothenic acid, is frequently included in moisturizers, wound‐healing agents, and other cosmetics, and has been shown to be responsible for allergic contact dermatitis (ACD).

Objectives

To evaluate the frequency of ACD caused by dexpanthenol, and to characterize reactive patients.

Methods

We retrospectively reviewed the files of patients patch tested between 2009 and 2017 in the Department of Dermatology of the Coimbra's University Hospital and describe patients who reacted to dexpanthenol 5% pet., tested initially in a cosmetic/vehicle series and in the last 3 years in consecutive patients.

Results

Among 2171 patients, 26 (1.2%) had positive patch test reactions to dexpanthenol, mostly patients tested for chronic eczema (88.5%, n = 23), either widespread (5), or localized to the hands (5), face (4), or legs (7). Relevance could be traced in 20 patients (76.9%), related to the use of Bepanthene cream (15), moisturizers (3), topical medications (1), and a shampoo (1). Twenty‐five of 26 patients (96.2%) reacted to several other allergens, mostly ingredients of cosmetic or pharmaceutical products.

Conclusions

Although ACD caused by dexpanthenol is considered to be rare, it may be frequently overlooked. As we found a relatively high frequency of relevant cases, in agreement with a previous study, the inclusion of dexpanthenol in patch test series, at least in cosmetic and topical drug series, is encouraged.
Reduction in TIMP‐2 serum levels predicts remission of inflammatory bowel diseases
Authors: Carbone Federico , Bodini Giorgia , Brunacci Matteo , Bonaventura Aldo , Vecchiè Alessandra , Liberale Luca , Crespi Mattia , Baldissarro Isabella , Dallegri Franco , Savarino Vincenzo , Montecucco Fabrizio , Giannini Edoardo G.
Published: July 2018

Background

Growing evidence indicates tissue inhibitors of matrix metalloproteinases (TIMPs) as potential players in inflammatory bowel disease (IBD), but, no prospective data are available in IBD remission/relapse.

Material & methods

In this prospective pilot study, a cohort of IBD patients (n = 32) was enrolled and treated with monoclonal anti‐TNF‐α antibodies. Patients were clinically followed up for a median period of 54 weeks. Serum circulating levels of C‐reactive protein (CRP), TIMP‐1 and ‐2, matrix metalloproteinase (MMP)‐9 and ‐8, myeloperoxidase (MPO) and neutrophil elastase (NE) were assessed by ELISA at enrolment and at the end of the treatment.

Results

The percentage (%) TIMP‐2 reduction from baseline to end of treatment was independently associated with IBD remission at the end of treatment and follow‐up as well. ROC curve analysis further confirmed the good prognostic accuracy of % TIMP‐2 reduction over the treatment period. Conversely, no other change in inflammatory molecule concentrations was able to predict short‐ or long‐term IBD remission.

Conclusions

This study indicates TIMP‐2 reduction during IBD treatment with monoclonal anti‐TNF‐α antibodies as a potential prognostic parameter of short and long term remission. To understand if TIMP‐2 is an innocent biomarker or an active pathophysiological factor in IBD remains to be clarified.
Spatiotemporal patterns of mountain whitefish (Prosopium williamsoni) in response to a restoration of longitudinal connectivity
Authors: Kiffney Peter M. , Cram Ben , Faulds Paul L. , Burton Karl , Koehler Michele , Quinn Thomas P.
Published: July 2018

To examine the role of longitudinal connectivity on the spatial and temporal dynamics of mountain whitefish (Prosopium williamsoni), we quantified movement and population dynamics following installation of the Landsburg Dam fishway, Cedar River, WA, USA. Mountain whitefish is widely distributed, poorly studied and not the focus of restoration. Before the fishway, mountain whitefish were not observed above the dam. Here, we focus on snorkel counts collected at reach and mesohabitat (e.g. pools) scales over 11 summers on the 20‐km above‐dam segment following restoration. A camera within the ladder provided number, size and movement timing, thereby informing on behaviour and recolonisation. Segment‐scale abundance increased following fish passage reaching an asymptote in 7 years, and mountain whitefish were detected throughout the main stem in 10 years. Annual movement through the ladder increased over time and was positively correlated with instream abundance and discharge, but negatively correlated with water temperature. About 60% of fish movements occurred in spring and early summer, potentially for foraging opportunities. Reach‐scale abundance peaked between 7 and 10 km from the dam; deep, cool (~10.6 to 11.6°C) conditions characterised these reaches. At the mesohabitat scale, mountain whitefish detection increased with depth and velocity after accounting for distance from the dam. Our results show how restoring longitudinal connectivity allowed this nontarget species to colonise newly available habitat. Their response supports the critical roles of longitudinal connectivity and environmental conditions, that manifest at different spatial scales, in dictating how freshwater fish respond to habitat disturbance.
The “concept‐reality mismatch” in the globalization era as a psychosocial stressor contributing to the occurrence of mental disorders
Authors: Bou Khalil Rami
Published: July 2018

Aims

The “concept‐reality mismatch” in the globalization era is a novel conceptualization of psychosocial stress due to difficulties in experiencing five of the most important positive emotions for psychological well‐being. These emotions are love, trust, faith, pleasure and self‐esteem.

Methods

a narrative overview of the literature using the terms “positive emotions,” “positive psychology,” “globalization” and “self‐discrepancy” has been done. Selected articles are those considered to support the basic ideas mentioned in this hypothesis.

Results

Differences in how adolescents and young adults experience positive emotions in real life in relation to their conceptual background exist. Authentic love described in books and movies might become perceived as more difficult to find. Trust, in the era of long distance relationships, is being built based on different criteria than those adolescents and young adults are taught to apply. Faith is challenged by the facility of accessing scientific data and by the lack of parental positive influence towards religiosity. Pleasure is being claimed as a right to cope with stress even artificially. Self‐esteem is becoming more and more restricted to wealth, beauty and fame as promoted by modern communication technologies.

Conclusions

The “concept‐reality mismatch” may be considered as an essential and preventable psychosocial stressor contributing to the development of mental and substance use disorders in the modern world. Studies evaluating this hypothesis and elaborating on its management strategies are needed in the near future.
Genome‐wide association study: Exploring the genetic basis for responsiveness to ketogenic dietary therapies for drug‐resistant epilepsy
Authors: Schoeler Natasha E. , Leu Costin , Balestrini Simona , Mudge Jonathan M. , Steward Charles A. , Frankish Adam , Leung Mary‐Anne , Mackay Mark , Scheffer Ingrid , Williams Ruth , Sander Josemir W. , Cross J. Helen , Sisodiya Sanjay M.
Published: July 2018

Objective

With the exception of specific metabolic disorders, predictors of response to ketogenic dietary therapies (KDTs) are unknown. We aimed to determine whether common variation across the genome influences the response to KDT for epilepsy.

Methods

We genotyped individuals who were negative for glucose transporter type 1 deficiency syndrome or other metabolic disorders, who received KDT for epilepsy. Genotyping was performed with the Infinium HumanOmniExpressExome Beadchip. Hospital records were used to obtain demographic and clinical data. KDT response (≥50% seizure reduction) at 3‐month follow‐up was used to dissect out nonresponders and responders. We then performed a genome‐wide association study (GWAS) in nonresponders vs responders, using a linear mixed model and correcting for population stratification. Variants with minor allele frequency <0.05 and those that did not pass quality control filtering were excluded.

Results

After quality control filtering, the GWAS of 112 nonresponders vs 123 responders revealed an association locus at 6p25.1, 61 kb upstream of CDYL (rs12204701, P = 3.83 × 10−8, odds ratio [A] = 13.5, 95% confidence interval [CI] 4.07‐44.8). Although analysis of regional linkage disequilibrium around rs12204701 did not strengthen the likelihood of CDYL being the candidate gene, additional bioinformatic analyses suggest it is the most likely candidate.

Significance

CDYL deficiency has been shown to disrupt neuronal migration and to influence susceptibility to epilepsy in mice. Further exploration with a larger replication cohort is warranted to clarify whether CDYL is the causal gene underlying the association signal.
Corruption and women in cabinets: Informal barriers to recruitment in the executive
Authors: Stockemer Daniel , Sundström Aksel
Published: July 2018

Research on corruption and women in politics has mainly focused on legislatures, generally finding that corruption decreases the election of women. This article turns the spotlight to the executive branch—an arena where selection is less transparent than recruitment to legislative seats—and examines if corruption decrease the share of ministers who are women. Drawing on feminist institutionalist theories, we posit that in an environment of high political corruption, (male) elites involved in cabinet formation will tend to appoint ministers whom they can trust with secretive tasks. In systems with corrupt networks, relative newcomers, such as women, should face obstacles to career advancement. The article tests this reasoning empirically on a global sample of countries across time. Using a new indicator measuring corruption in executive bodies, we find support for our argument; corruption tends to hinder women's presence in cabinets, albeit only in democracies and not autocracies.
In search of a revolution: Raison d'état and the freedom argument
Authors: Afolayan Adeshina
Published: July 2018

The concept of revolution conceptually objectifies the impotent socio‐economic and political desires and preferences of human beings against powerful and constricting social formations. It conjures the pictures of possibilities. It is not surprising that the violent happenings in the Middle East have been quickly dubbed “revolutions” by scholars and the Western media. This essay presents a consequentialist argument that deploys Arendt's freedom argument to interrogate a revolution in terms of the outcomes the revolution presents the people with regard to the expansion of their capacities. Conceptually, the concept of revolution is a receding philosophical horizon especially in a context of shifting political and personal allegiances and ideologies defined by the Middle East which eventually conditioned the outcome of the Arab Spring. The minimal justification for a revolution is to transcend the existing order which constrains freedom and democratic empowerment. This essay argues that, despite its vaunted popularity, the Arab Spring was a series of uprisings that were undermined by the freedom argument. The essay however critically interrogates the larger question of what the Arab Spring portends for West Africa in terms of the understanding of freedom and how that becomes the first condition for a liberated citizenry. In the first part of the essay, I outline the theoretical framework that makes the question of a revolution possible. And this concerns the specific formation of the modern state and its monopoly of the use of force. In the second part, I interrogate the Arab Spring, which has been hailed as a contemporary “revolution,” and the implications of that critique for the understanding of politics in West Africa.
People who experience seclusion in adult mental health inpatient services: An examination of health of the nation outcome scales scores
Authors: Jury Angela , Lai Jennifer , Tuason Charito , Koning Ashley , Smith Mark , Boyd Lois , Swanson Caro , Fergusson David , Gruar Angela
Published: July 2018

The Health of the Nation Outcomes Scales (HoNOS) provides an overview of a person's behaviour, impairment, clinical symptoms, and social functioning. This study investigated the profile of people who had been secluded in New Zealand's adult mental health inpatient services using 12 individual HoNOS ratings. Routinely collected clinical data were extracted from the Programme for the Integration of Mental Health Data (PRIMHD). This is the national data set for mental health and addiction services. A logistic regression model was fitted to the data which adjusted for age, sex, ethnicity, bed nights, compulsory treatment, and district health board. After adjustment, three HoNOS items significantly predicted the risk of seclusion: overactive, aggressive, disruptive, or agitated behaviour (adjusted OR = 4.82, 95% CI [3.88, 5.97], P < 0.001); problem drinking or drug‐taking (adjusted OR = 1.51, 95% CI [1.25, 1.82], P < 0.001); and problems with hallucinations and delusions (adjusted OR = 1.33, 95% CI [1.09, 1.63], P = 0.006). In addition, two HoNOS items were protective for seclusion: nonaccidental self‐injury (adjusted OR = 0.65, 95% CI [0.51, 0.83], P < 0.001) and depressed mood (adjusted OR = 0.58, 95% CI [0.47, 0.72], P < 0.001). Thus, responding effectively to agitation and/or aggression, substance use, and psychosis plays an important role in reducing the use of seclusion. Mental health nurses and other workers can reduce seclusion through early assessment, effective communication, de‐escalation techniques, reduction tools, trauma‐informed care, and consulting with consumers and whānau.
A causal model for the quality of nursing care in Thailand
Authors: Boonpracom R. , Kunaviktikul W. , Thungjaroenkul P. , Wichaikhum O.
Published: July 2018

Background

A growing global nursing shortage has affected the quality of care (QOC) provision.

Aim

To test the structure‐process‐outcome model for quality of nursing care in regional medical centres in Thailand.

Methods

A cross‐sectional study with multi‐stage, proportional stratified random sampling. The sample comprised 136 units, 916 nurses and 943 patients from nine regional medical centres. Data were collected from six instruments in February–June 2016 and analysed with structural equation modelling.

Results

The modified model fitted the empirical data. The nurse practice environment (NPE) had a negative direct effect on pressure ulcer prevalence and a positive direct effect on patient satisfaction, perceived QOC and interpersonal processes of care (IPC). Increasing the patient‐to‐nurse ratio had a positive direct effect on catheter‐associated urinary tract infections and pressure ulcer prevalence and had negative direct effects on patient satisfaction and perceived QOC. Skill mix had negative direct effects on the two former conditions but had a positive direct effect on patient satisfaction. The patient‐to‐nurse ratio and skill mix also had indirect effect on four outcomes via NPE.

Limitations

The generalizability of findings may be limited to settings similar to this study.

Conclusion

We empirically demonstrated that NPE, patient‐to‐nurse‐ ratio and skill mix had direct effects on unfinished nursing care and four outcomes. Also, the IPC had significant influence on patient satisfaction.

Implications for nursing and health policy

The findings add to increasing international evidence that favourable nurse working conditions, low nurse‐to‐patient ratio and richer skill mix result in positive patient outcomes. Health systems can foster nurses to perform high‐quality care by improving work conditions, and providing sufficient nurses and resources.
Blood pressure control rates measured in specialty vs primary care practices within a large integrated health system
Authors: Billups Sarah J. , Saseen Joseph J. , Vande Griend Joseph P. , Schilling Lisa M.
Published: July 2018

Blood pressure measurement is a diagnostic test and a key component of assessing and managing hypertension, a major contributor to cardiovascular risk. Based on real‐world clinical observations within a large, university‐based, accountable care organization, we sought to assess whether blood pressure control results varied by the assessment setting, primary care versus specialty. We studied the most recent outpatient measurement for patients with hypertension during the 2016 calendar year and categorized each as being performed in a primary care or specialty setting, and as being controlled (<140/90 mm Hg) or uncontrolled. Among the 86 512 patients identified, the 43 364 whose most recent blood pressure measurement was in a specialty setting were significantly less likely to be controlled compared to the 43 148 whose most recent measurement was in primary care (63% vs 68%, respectively, OR = 0.83 [0.80‐0.85]). For the 27 955 patients who had measurements performed in both settings during the year, the control rates based upon their most recent specialty and primary care measurements were 63% and 71%, respectively (OR = 0.62, 0.60‐0.65). For the subsets of patients whose measurements in each setting were within 30 or within seven days of each other, the odds of control in the specialty versus primary care setting were 0.63 (0.58‐0.75) and 0.65 (0.57‐0.75), respectively. Health systems should weigh the value of performing blood pressure measurement in specialty settings that do not manage this condition, taking into consideration the resources required to perform it and the potential negative consequences of inaccurate measurements.
Dual effects of baicalin on osteoclast differentiation and bone resorption
Authors: Lu Xuanyuan , He Wei , Yang Wanlei , Li Jianlei , Han Weiqi , Liu Qian , Zhang Tan , Jiang Jiawei , Qin An , Qian Yu
Published: July 2018

Osteoclasts (OC) are critical cells responsible for many bone diseases such as osteoporosis. It is of great interest to identify agents that can regulate the activity of OC to treat osteolytic bone diseases. In this study, we found that baicalin exerted a two‐way regulatory effect on OC in a concentration‐dependent manner in vitro and in vivo. In detail, baicalin at a low concentration (below 1 μmol/L) enhanced OC differentiation and bone resorption, but baicalin at a high concentration (above 2 μmol/L) exhibited inhibitory effects on OC. We demonstrated that baicalin at low concentrations enhanced the mitogen‐activated protein kinase (MAPK) (ERK) signalling pathway and activated c‐Fos and NFATc1 expression, and thus enhanced gene expression, OC differentiation and bone resorption. However, baicalin at higher levels not only suppressed ERK phosphorylation and c‐fos and NFATc1 expression, but also altered the expression of apoptosis‐related proteins, and therefore inhibiting OC function. This dual effect was further verified in an LPS‐induced mouse calvarial osteolysis model, evidenced by enhanced osteolysis at a lower concentration but reduced bone loss at a higher concentration. Overall, our findings indicate that baicalin exerts dose‐dependent effects on OC formation and function. Therefore, caution should be applied when using baicalin to treating OC‐related bone diseases.
Cost‐effectiveness of a tailored Helicobacter pylori eradication strategy based on the presence of a 23S ribosomal RNA point mutation that causes clarithromycin resistance in Korean patients
Authors: Cho Jun‐Hyung , Jeon Seong Ran , Kim Hyun Gun , Jin So‐Young , Park Suyeon
Published: July 2018

Background and Aim

The Helicobacter pylori eradication rate using conventional triple therapy has decreased due to clarithromycin (CAM) resistance in H. pylori. Recently, dual priming oligonucleotide (DPO)‐based multiplex polymerase chain reaction (PCR) can be used to detect H. pylori and point mutations in the 23S ribosomal RNA gene causing CAM resistance. This study aimed to evaluate the success rate and cost‐effectiveness of tailored H. pylori eradication using DPO‐PCR.

Methods

The H. pylori‐positive patients diagnosed by a rapid urease test or DPO‐PCR were enrolled from a single academic hospital. The patients with positive rapid urease test results received a CAM‐based triple regimen. In the tailored therapy group that underwent DPO‐PCR testing, patients with A2142G and/or A2143G point mutations were treated with a bismuth‐containing quadruple regimen. The cost‐effectiveness of H. pylori eradication success was evaluated according to the average cost per patient and the incremental cost‐effectiveness ratio.

Results

A total of 243 patients were allocated to the triple therapy group and 124 patients to the tailored therapy group. The first‐line eradication rate of H. pylori was significantly higher in the tailored therapy group than in the conventional triple therapy group (92.7% vs 76.5%, P < 0.001). The average costs per patient for tailored therapy were $307.37 and $299.59 for first‐line and second‐line treatments, respectively. Compared with triple therapy, the incremental cost‐effectiveness ratios of tailored therapy were $3.96 and −$3.81 per patient for first‐line and second‐line treatments, respectively.

Conclusion

In Korea, tailored H. pylori eradication using DPO‐PCR may be more cost‐effective than conventional triple therapy.
Traumatic Experiences in Childhood and Adult Substance Use in a Nonclinical Sample: The Mediating Role of Arousal/Reactivity
Authors: Love Heather A. , Torgerson Chelsey N.
Published: July 2018

The vast majority of adults in the United States experience at least one traumatic event during childhood. According to the self‐medication hypothesis of substance use disorders, adult survivors of childhood trauma may cope with trauma‐related symptoms via alcohol or drug use. The purpose of this study is to identify through which specificPTSDsymptom clusters childhood trauma exposure are associated with adult substance use. Participants of this study (N = 627) were not recruited based on substance use or traumatic exposure. Results of this study demonstrate that arousal/reactivity partially mediates the association between childhood trauma and current substance use. Implications for treatment include recommendations for trauma‐informed approaches that aim to decrease arousal/reactivity and subsequently substance use.
Evaluation of the efficacy of transdermal drug delivery of calcipotriol plus betamethasone versus tacrolimus in the treatment of vitiligo
Authors: Ibrahim Zeinab A. , Hassan Ghada F. , Elgendy Hoda Y. , Al‐shenawy Hanan A.
Published: July 2018

Background

Vitiligo is a common pigmentary disorder affecting about 1% of the general population. There are numerous medical and surgical treatments. Microneedling is an evolving treatment technique for an expanding number of dermatologic conditions. It is used also to augment transdermal drug delivery through pores created in the stratum corneum.

Aim

To evaluate the efficacy of microneedling with tacrolimus versus its efficacy with calcipotriol plus betamethasone in vitiligo treatment.

Methods

Twenty‐five patients having vitiligo were selected and their symmetrical patches were divided into side A (right side) which received microneedling with dermapen and topical calcipotriol plus betamethasone and side B (left side) which received microneedling and topical tacrolimus. Every patient received a session every 2 weeks for a maximum 6 months (12 sessions) and follow‐up for 3 months. Skin biopsies were taken before and after the treatment to evaluate the clinical results.

Results

On side A, 60% of the patients showed excellent improvement while 32% showed excellent response on side B. The mean percentage of improvement was significantly higher on side A than side B (P = 0.017*). It was effective in the most resistant sites of vitiligo such as: elbows, knees, extremities, and acral area. Histopathological examination showed a significant expression of HMB45 on side A more than side B (P = 0.005*).

Conclusion

The combination of microneedling with calcipotriol plus betamethasone is more effective than its combination with tacrolimus. They are both effective in resistant sites. Both methods are safe, cheap, and good tolerated office techniques with minimal side effects.
Wrinkles, brown spots, and cancer: Relationship between appearance‐ and health‐based knowledge and sunscreen use
Authors: Cao Hongjing , Brehm Mary , Hynan Linda , Goff Heather W.
Published: July 2018

Background

There is increasing understanding that sunscreen use is associated with reduced photoaging and that appearance‐based messages are more effective than health‐based messages in promoting daily sunscreen use. We hypothesized that persons with greater awareness of the effects of photoaging use sunscreen more consistently.

Methods

Cross‐sectional survey of adults in Dallas, TX, assessing sunscreen‐related knowledge, behavior, and information source.

Results

Each respondent averaged 2.5 ± 1.7 hours of self‐reported sun exposure daily with the least reported time being 0.15 hours. Eighty‐eight percent reported that sun exposure caused skin cancer “a lot.” Eighty‐nine percent “agreed” or “strongly agreed” that “sun exposure causes most signs of skin aging.” Over 70% “agreed” or “strongly agreed” to an appearance‐based reason for their sunscreen use. Sixty‐six percent reported they would consider using sunscreen if anticipating sun exposure lasting 2 hours or less. Only 30% reported using sunscreen daily. Greater photoaging knowledge was positively associated with sunscreen adherence (at least P < 0.05 with each knowledge item). Those with darker complexions or skin less likely to burn reported less knowledge of photoaging (ρ = −0.219, P ≤ 0.001) and had lower sunscreen use (ρ = 0.301, P < 0.001).

Conclusion

Despite most respondents reporting knowledge of health and appearance risks of sun exposure and a motivation to prevent them with sunscreen, most do not use sunscreen adequately. This discrepancy could be due to people perceiving risks of sun exposure based on duration of continuous exposure. There may be misconceptions that short‐interval sun exposure that does not result in sunburn is less harmful than extended exposure.
The Impact of Delivery in a Rural County on a Cohort of Women Living with HIV Infection and Their Infants
Authors: Lazenby Gweneth B. , Powell Anna M. , Sullivan Scott A. , Soper David E.
Published: July 2018

Purpose

We sought to determine if infants born in rural counties had an increased risk of contracting HIV.

Methods

Data were obtained from the South Carolina Department of Health and Environmental Control for all women living with HIV delivering from 2004 to 2014. In this retrospective cohort study, maternal and neonatal outcomes from urban and rural counties were compared. Binomial statistical analyses were conducted using Wilcoxon Rank Sum Tests, χ2 or Fisher's exact tests. Logistic regression analyses were performed to evaluate factors associated with perinatal HIV infection.

Findings

Six hundred and sixty‐six women living with HIV had 868 pregnancies and delivered 885 infants; 17% (148) were born in rural counties. Eleven infants (1.2%) were diagnosed with perinatal HIV infection. The proportion of women taking antenatal antiretroviral therapy (ART) was similar between rural and urban counties (84% vs 87%; P = .3), but women in urban counties were more likely to have an HIV RNA viral load <40 copies/mL before delivery (32% vs 42%; P = .05). Factors associated with perinatal HIV infection were intra‐ and postpartum maternal HIV diagnosis (aOR 61.4 [95% CI: 6.7‐562.5]; P < .001), parenteral drug use (aOR 7.5 [1.6‐34.7]; P = .01), and preterm birth (<37 weeks gestation) (aOR 4.6 [1.2‐17.8]; P = .3).

Conclusions

Delivery in a rural county was not associated with an increased risk of perinatal HIV transmission. Women delivering in rural counties taking ART were less likely to have HIV viral suppression, which is a risk factor for perinatal HIV infection.
Growth and survival of juvenile red drum, Sciaenops ocellatus, acclimated to freshwater at three different stocking densities in a partial recirculation system
Authors: Vela Miguel A. , Villarreal Humberto , Araneda Marcelo , Espinosa‐Faller F. J.
Published: July 2018

Preliminary technical baseline information for the inland culture of juvenile red drum, Sciaenops ocellatus, in a freshwater fish hatchery is presented. Three initial stocking densities (d1 = 83, d2 = 167, and d3 = 250 fish/m3) were tested in a semirecirculation system for 575 days using a commercially available feed (48.1% protein, 25% lipids, and 0.13% fiber). Initial and final mean fish weight were 7.11 ± 0.02 g and 287.6 ± 27 g. As carrying capacity appeared to have been reached, only data from Days 1–333 were analyzed. One‐way ANOVA analyses indicated that the survival rate of the smaller density (d1 =40 ± 3.7%) was significantly different from the other two densities (d3 = 21 ± 1.1% and d2 = 23 ± 1.0%), which did not differ between them. Absolute growth rate (0.87 ± 0.02 g/day) was not significantly different between densities (F = 0.23. p = .801). Neither was weight significantly different between treatments. There were significant differences in the feed conversion rate (FCR) between densities (F = 8.54; p = .02). FCR for d1 was significantly lower than for the two other densities, which did not differ from each other. A von Bertalanffy growth model was adjusted (R2 = 0.95), and weight–length relationship presented negative allometric values (b = 2.85, R2 = 0.98).
Knockdown of a mucin‐like gene in Meloidogyne incognita (Nematoda) decreases attachment of endospores of Pasteuria penetrans to the infective juveniles and reduces nematode fecundity
Authors: Phani Victor , Shivakumara Tagginahalli N. , Davies Keith G , Rao Uma
Published: July 2018

Mucins are highly glycosylated polypeptides involved in many host–parasite interactions, but their function in plant‐parasitic nematodes is still unknown. In this study, a mucin‐like gene was cloned from Meloidogyne incognita (Mi‐muc‐1, 1125 bp) and characterized. The protein was found to be rich in serine and threonine with numerous O‐glycosylation sites in the sequence. Quantitative real‐time polymerase chain reaction (qRT‐PCR) showed the highest expression in the adult female and in situ hybridization revealed the localization of Mi‐muc‐1 mRNA expression in the tail area in the region of the phasmid. Knockdown of Mi‐muc‐1 revealed a dual role: (1) immunologically, there was a significant decrease in attachment of Pasteuria penetrans endospores and a reduction in binding assays with human red blood cells (RBCs), suggesting that Mi‐MUC‐1 is a glycoprotein present on the surface coat of infective second‐stage juveniles (J2s) and is involved in cellular adhesion to the cuticle of infective J2s; pretreatment of J2s with different carbohydrates indicated that the RBCs bind to J2 cuticle receptors different from those involved in the interaction of Pasteuria endospores with Mi‐MUC‐1; (2) the long‐term effect of RNA interference (RNAi)‐mediated knockdown of Mi‐muc‐1 led to a significant reduction in nematode fecundity, suggesting a possible function for this mucin as a mediator in the interaction between the nematode and the host plant.
Silenced retrotransposons are major rasiRNAs targets in Arabidopsis galls induced by Meloidogyne javanica
Authors: Ruiz‐Ferrer Virginia , Cabrera Javier , Martinez‐Argudo Isabel , Artaza Haydeé , Fenoll Carmen , Escobar Carolina
Published: July 2018

Root‐knot nematodes (RKNs, Meloidogyne spp.) are sedentary biotrophic pathogens that establish within the vascular cylinder of plant roots, forming a gall and inducing several feeding cells, giant cells (GCs), essential for completion of their life cycle. GCs suffer gene expression changes, repeated mitosis and endoreduplication events. Transcriptomics has revealed that an extensive down‐regulation of transcripts, a molecular signature of early‐developing galls and GCs that is conserved in tomato and Arabidopsis, may be achieved through small RNA (sRNA) gene silencing pathways. The role of some microRNAs (miRNAs) in plant–RKN interactions has recently been addressed, but little is known about the regulatory roles of other sRNA types. Here, we perform a differential accumulation analysis to show which repeat‐associated small interfering RNAs (rasiRNAs) are distinctive or enriched in early Arabidopsis galls vs. uninfected roots. Those distinctive from galls are preferentially located in pericentromeric regions with predominant sizes of 24 and 22 nucleotides. Gall‐distinctive rasiRNAs target primarily GYPSY and COPIA retrotransposons, which show a marked repression in galls vs. uninfected roots. Infection tests and phenotypic studies of galls from Meloidogyne javanica in Arabidopsis mutants impaired in post‐transcriptional gene silencing and/or canonical RNA‐directed DNA methylation (RdDM) pathways, as well as quantitative polymerase chain reaction analysis, suggest the implication of canonical and non‐canonical RdDM pathways during gall formation, possibly through the regulation of retrotransposons. This process may be crucial for the maintenance of genome integrity during the reprogramming process of galls/GCs from their vascular precursor cells, and/or to ensure a faithful DNA replication during the repeated mitosis/endoreduplication that concurs with feeding site formation.
Molecular mechanisms that limit the costs of NLR‐mediated resistance in plants
Authors: Richard Manon M. S. , Gratias Ariane , Meyers Blake C. , Geffroy Valérie
Published: July 2018

Crop diseases cause significant yield losses, and the use of resistant cultivars can effectively mitigate these losses and control many plant diseases. Most plant resistance (R) genes encode immune receptors composed of nucleotide‐binding and leucine‐rich repeat (NLR) domains. These proteins mediate the specific recognition of pathogen avirulence effectors to induce defence responses. However, NLR‐triggered immunity can be associated with a reduction in growth and yield, so‐called ‘fitness costs’. Recent data have shown that plants use an elaborate interplay of different mechanisms to control NLR gene transcript levels, as well as NLR protein abundance and activity, to avoid the associated cost of resistance in the absence of a pathogen. In this review, we discuss the different levels of NLR regulation (transcriptional, post‐transcriptional and at the protein level). We address the apparent need for plants to maintain diverse modes of regulation. A recent model suggesting an equilibrium ‘ON/OFF state’ of NLR proteins, in the absence of a pathogen, provides the context for our discussion.
Multidimensional improvement in connective tissue disease‐associated interstitial lung disease: Two courses of pulse dose methylprednisolone followed by low‐dose prednisone and tacrolimus
Authors: Yamano Yasuhiko , Taniguchi Hiroyuki , Kondoh Yasuhiro , Ando Masahiko , Kataoka Kensuke , Furukawa Taiki , Johkoh Takeshi , Fukuoka Junya , Sakamoto Koji , Hasegawa Yoshinori
Published: July 2018

Background and objective

Corticosteroids and immunosuppressive agents are considered mainstays of therapy for connective tissue disease‐related interstitial lung disease (CTD‐ILD); however, tacrolimus with corticosteroid therapy has not been fully investigated. Our objectives were to examine the multidimensional therapeutic benefit and tolerability of the combined therapy for the initial treatment of patients with CTD‐ILD.

Methods

In this retrospective case series, we identified consecutive CTD‐ILD patients treated with tacrolimus plus intravenous (i.v.) methylprednisolone (1000 mg i.v. 3 days a week for 2 weeks) followed by low‐dose prednisolone (10 mg/day). We assessed the multidimensional therapeutic benefit and tolerability including lung physiology, exercise capacity, exercise oxygen desaturation, modified Medical Research Council (MMRC) and St George's Respiratory Questionnaire (SGRQ).

Results

A total of 26 ILD patients with the underlying CTD diagnoses included 11 with rheumatoid arthritis, 9 with dermatomyositis, 4 with Sjögren's syndrome and 2 others. From baseline to 12 months, the combined therapy significantly improved forced vital capacity (FVC; 77.8% to 94.6%, P < 0.001), diffusing capacity of the lung for carbon monoxide (DLCO; 66.1% to 75.1%, P < 0.001), 6‐min walk distance (6MWD; 530 to 568 m, P = 0.02), lowest oxygen saturation on pulse oximetry (SpO2; 85% to 89%, P = 0.01), MMRC (1.3 to 0.8, P = 0.01) and SGRQ (38 to 21, P < 0.001). During the study period, only one patient's therapy was discontinued due to an adverse event and none had a life‐threatening adverse event attributed to the combined therapy.

Conclusion

In our cohort of CTD‐ILD, two courses of pulse dose methylprednisolone therapy followed by prednisone and oral tacrolimus appeared to be well tolerated, and to have multidimensional efficacy.
Fecal microbiota transplantation for recurrent Clostridium difficile infection in patients with solid organ transplants: an institutional experience and review of the literature
Authors: Lin Steven C. , Alonso Carolyn D. , Moss Alan C.
Published: July 2018

Clostridium difficile, an anaerobic gram‐positive, spore‐forming bacillus, has become the most common cause of nosocomial infectious diarrhea, and is associated with increased mortality in all populations. Patients who have received solid organ transplants (SOT) are at increased risk of Clostridium difficile infection (CDI) and CDI recurrence (rCDI). This may be related to chronic immunosuppression, frequent antibiotic exposure, and increased or prolonged hospitalizations. Increased morbidity and mortality from CDI is well‐described in SOT patients. Conventional treatments for index and recurrent CDI include vancomycin and fidaxomicin. Fecal microbiota transplantation has emerged as an effective and safe alternative for treating rCDI in the general population. Reports of its safety in certain immunocompromised populations, such as those with inflammatory bowel disease, appear reassuring, but outcomes among SOT patients are less well known. Here, we summarize the experiences published to date on the treatment of rCDI with FMT in SOT patient, and also describe our detailed FMT protocol and experience in treating a series of SOT patients with rCDI. In addition to reporting the safety and efficacy of our FMT experience, we also discuss the diagnostic challenges and considerations in this population of solid organ transplant recipients.
O movimento do Canto Coral no sistema educativo português da Primeira República ao Estado Novo
Authors: Aguiar Maria Cristina , Vieira Maria Helena
Published: July 2018

Neste artigo é feita uma abordagem ao despontar do movimento do Canto Coral no sistema de ensino português, do alvor da Primeira República ao enraizar do Estado Novo. Centrando toda a reflexão ao nível da prática vocal/coral, e salientando a tensão existente entre o caráter progressista das artes e o cariz conservador do Estado Novo, são ainda apresentadas as circunstâncias históricas e sociais que antecederam o ensino à distância. Refere-se o papel da Rádio Escolar e da Telescola na divulgação do ensino da música e da prática vocal. Esta reflexão resulta da realização de um estudo de caso múltiplo centrado no paradigma qualitativo que incidiu na análise da forma como se tem vindo a realizar o ensino de canto em Portugal no 1º ciclo do ensino básico, genérico e especializado, e que permitiu inferir que o ensino de canto não está ainda generalizado em nenhuma destas vertentes de ensino.