bluuebunny/crossref_metadata_2025 huggingface dataset:
Invasive Aspergillosis in solid‐organ transplant recipients: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice
Authors: Husain Shahid , Camargo Jose F.
Published: March 2019

These updated AST‐IDCOP guidelines provide information on epidemiology, diagnosis, and management of Aspergillus after organ transplantation. Aspergillus is the most common invasive mold infection in solid‐organ transplant (SOT) recipients, and it is the most common invasive fungal infection among lung transplant recipients. Time from transplant to diagnosis of invasive aspergillosis (IA) is variable, but most cases present within the first year post‐transplant, with shortest time to onset among liver and heart transplant recipients. The overall 12‐week mortality of IA in SOT exceeds 20%; prognosis is worse among those with central nervous system involvement or disseminated disease. Bronchoalveolar lavage galactomannan is preferred for the diagnosis of IA in lung and non‐lung transplant recipients, in combination with other diagnostic modalities (eg, chest CT scan, culture). Voriconazole remains the drug of choice to treat IA, with isavuconazole and lipid formulations of amphotericin B regarded as alternative agents. The role of combination antifungals for primary therapy of IA remains controversial. Either universal prophylaxis or preemptive therapy is recommended in lung transplant recipients, whereas targeted prophylaxis is favored in liver and heart transplant recipients. In these guidelines, we also discuss newer antifungals and diagnostic tests, antifungal susceptibility testing, and special patient populations.
Tissue and blood protozoa including toxoplasmosis, Chagas disease, leishmaniasis, Babesia, Acanthamoeba, Balamuthia, and Naegleria in solid organ transplant recipients— Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice
Authors: La Hoz Ricardo M. , Morris Michele I. ,   the Infectious Diseases Community of Practice of the American Society of Transplantation
Published: March 2019

These updated guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation review the diagnosis, prevention, and management of tissue and blood protozoal infections in the pre‐ and post‐transplant period. Significant new developments in the field have made it necessary to divide the previous single guideline published in 2013 into two sections, with the intestinal parasites separated from this guideline devoted to tissue and blood protozoa. The current update reflects the increased focus on donor screening and risk‐based recipient monitoring for parasitic infections. Increased donor testing has led to new recommendations for recipient management of Toxoplasma gondii and Trypanosoma cruzi. Molecular diagnostics have impacted the field, with access to rapid diagnostic testing for malaria and polymerase chain reaction testing for Leishmania. Changes in Babesia treatment regimens in the immunocompromised host are outlined. The risk of donor transmission of free‐living amebae infection is reviewed. Changing immigration patterns and the expansion of transplant medicine in developing countries has contributed to the recognition of parasitic infections as an important threat to transplant outcomes. Medications such as benznidazole and miltefosine are now available to US prescribers as access to treatment of tissue and blood protozoa is increasingly prioritized.
Screening of donor and candidate prior to solid organ transplantation—Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice
Authors: Malinis Maricar , Boucher Helen W. ,   on behalf of the AST Infectious Diseases Community of Practice
Published: March 2019

This updated section of the guideline from the Infectious Diseases Community of Practice of the American Society of Transplantation reviews the screening of donor and candidate prior to solid organ transplantation. Screening of donor and candidate is vital for optimizing post‐transplant outcomes. Risk assessment based on detailed history and appropriate diagnostic evaluation is essential. Serologic screening for certain viral infections is important and aids in immunization counseling and risk mitigation of recipients. In addition to serology, nucleic acid testing for hepatitis B, hepatitis C and human immunodeficiency virus has been required for deceased and living donors. Certain endemic exposure may warrant additional evaluation beyond recommended standard testing. Diagnosed infection in the donor or recipient warrants treatment as well as additional testing and/or prophylaxis to mitigate risk for post‐transplant complications. Certain infections in the immediate pre‐transplant period may warrant delay of transplantation.
Real‐world prevalence of the inclusion criteria for the LEADER trial: Data from a national general practice network
Authors: Hinton William , Feher Michael , Munro Neil , Walker Megan , de Lusignan Simon
Published: March 2019

Aims

To explore the prevalence and describe the clinical characteristics of people with type 2 diabetes with a similar cardiovascular (CV) profile to that of the LEADER trial participants in a primary care setting in England.

Materials and methods

In this cross‐sectional analysis, using the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) network database, we identified people with type 2 diabetes meeting the LEADER inclusion criteria. We identified people's CV risk factors using computerized medical records. Additionally, we assessed the prescription pattern of glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs) in this cohort.

Results

Of 1 275 461 adults, we identified 84 394 with type 2 diabetes, of whom 14 000 (16.6%) met the LEADER inclusion criteria for established or high‐risk CV disease (RCGP RSC‐CVD group). The LEADER cohort was younger than the RCGP RSC‐CVD group (64.2 vs 73.2 years), had higher mean glycated haemoglobin (71.6 vs 67.1 mmol/mol) and blood pressure (BP) values (systolic BP: 135.9 vs 132.9 mmHg; diastolic BP: 77.2 vs 72.7 mmHg), and a higher mean body mass index (32.5 vs 30.9 kg/m2). In the RCGP RSC‐CVD group, only 1215 people (8.7%) had ever been prescribed a GLP‐1RA and 760 (5.4%) had ever received liraglutide.

Conclusions

In a cohort of English general practice patients, one in six people with type 2 diabetes met the LEADER inclusion criteria, and less than one in 10 of these received liraglutide, a drug which has demonstrated CV benefits amongst others. There is scope to improve the outlook in people with type 2 diabetes and high CV risk through evidence‐based use of specific GLP‐1RAs.
Postsystolic index for distinguishing coronary artery disease in left bundle branch block
Authors: Nabati Maryam , Mahmoudi Payam , Yazdani Jamshid , Parsaee Homa
Published: March 2019

Background

Left bundle branch block (LBBB) is associated with a high risk of death, particularly from ventricular tachyarrhythmia and myocardial infarction. It is difficult to clinically differentiate between ischemic and nonischemic LBBB. In this study, we investigated whether advanced echocardiographic variables, such as strain delay index (SDI) and postsystolic index (PSI), can be used to distinguish coronary artery disease (CAD) in patients with LBBB.

Methods

Our study included 102 patients with LBBB. All patients underwent echocardiography. The left ventricular ejection fraction (LVEF), left ventricular mass, PSI, SDI, global longitudinal strain (GLS), and time‐to‐peak longitudinal strain were then calculated. Coronary angiography was performed, and the patients were divided into groups with significant CAD and without significant CAD.

Results

Patients in the group with significant CAD were older than the patients in the group without significant CAD. The group had a higher prevalence of diabetes mellitus, hypertension, hyperlipidemia, and family history of CAD than the group without significant CAD. The group with significant CAD also had lower LVEF and GLS than the group without significant CAD. The group without significant CAD showed a direct correlation between LVEF and SDI and an inverse correlation between LVEF and PSI: P value = 0.040 and r = 0.255, and P value = 0.001 and r = −0.427, respectively. However, the group with significant CAD did not show any significant correlation between LVEF and SDI or PSI.

Conclusion

Strain delay index and PSI may be useful markers in distinguishing CAD in patients with LBBB and preserved LVEF.
Piloting a more intensive 8‐week mindfulness programme in early‐ and mid‐adolescent school students
Authors: Johnson Catherine , Wade Tracey
Published: March 2019

Aim

It is unclear how adult mindfulness‐based interventions (MBIs) should be modified for youth, and at what ages programmes should be implemented for optimal impact. Recent non‐replication with a 9‐week programme in early adolescence suggested abbreviated programme content might be insufficient and/or that this age group are less receptive.

Method

This controlled quasi‐experimental design tested a more intensive 8‐week MBI (longer meditation and session duration, plus inquiry) in Year 8 (Mage = 13.47; SD = 0.35) and Year 10 (Mage = 15.47; SD = 0.40) secondary students for feasibility and acceptability (N = 143, 45.9% female).

Results

Within this format students rated the content as agreeable, and school staff deemed content developmentally appropriate, across both age bands. Efficacy was tested in a small subsample (N = 90) to provide an estimate of effect size. Linear mixed modelling demonstrated significant between‐group differences in depression (Cohen's d = 0.61; 95% CI = 0.19 to 1.03) and anxiety (d = 0.52; 95% CI = 0.10 to 0.94) at 4‐month follow‐up, but not immediately post‐intervention.

Conclusion

An MBI more closely modelled on adult curricula was acceptable to students, although session duration was harder to timetable by schools. Promising effect sizes support further investigation in a larger sample.
No borders during the post‐glacial assembly of European bryophytes
Authors: Ledent A. , Désamoré A. , Laenen B. , Mardulyn P. , McDaniel S. F. , Zanatta F. , Patiño J. , Vanderpoorten A.
Published: March 2019

Climatic fluctuations during the Last Glacial Maximum (LGM) exerted a profound influence on biodiversity patterns, but their impact on bryophytes, the second most diverse group of land plants, has been poorly documented. Approximate Bayesian computations based on coalescent simulations showed that the post‐glacial assembly of European bryophytes involves a complex history from multiple sources. The contribution of allochthonous migrants was 95–100% of expanding populations in about half of the 15 investigated species, which is consistent with the globally balanced genetic diversities and extremely low divergence observed among biogeographical regions. Such a substantial contribution of allochthonous migrants in the post‐glacial assembly of Europe is unparalleled in other plants and animals. The limited role of northern micro‐refugia, which was unexpected based on bryophyte life‐history traits, and of southern refugia, is consistent with recent palaeontological evidence that LGM climates in Eurasia were much colder and drier than what palaeoclimatic models predict.
Interpreting Probabilistic Classifications From Diagnostic Psychometric Models
Authors: Bradshaw Laine , Levy Roy
Published: March 2019

Although much research has been conducted on the psychometric properties of cognitive diagnostic models, they are only recently being used in operational settings to provide results to examinees and other stakeholders. Using this newer class of models in practice comes with a fresh challenge for diagnostic assessment developers: effectively reporting results and supporting end users to accurately interpret results. Achieving the goal of communicating results in a way that leads users of the assessment to make accurate interpretations requires a prerequisite step that cannot be taken for granted. The assessment developers must first accurately interpret results from a psychometric, or measurement, standpoint. Through this article, we seek to begin a discussion about reasonable interpretations of the results that classification‐based models provide about examinees. Interpretations from published research and ongoing practice show different—and sometimes conflicting—ways to interpret these results. This article seeks to formalize a comparison, critique, and discussion among the interpretations. Before beginning this discussion, we first present background on the results provided by classification‐based models regarding the examinees. We then structure our discussion around key questions an assessment development team needs to answer themselves prior to constructing reports and interpretative guides for end users of the assessment.
Me against who? Male guppies adjust mating behaviour according to their rival’s presence and attractiveness
Authors: Órfão Inês , Barbosa Miguel , Ojanguren Alfredo F. , Vicente Luís , Varela Susana A. M. , Magurran Anne E.
Published: March 2019

Sexual selection theory suggests that males need to constantly reappraise their mating decisions to take account of the presence and the phenotypes of their rivals. Here we examine this expectation by asking: (i) If the presence of a rival influences male mating behaviour; (ii) How important is the attractiveness of the rival (absolute attractiveness) in shaping male behaviour; and (iii) How does a male's attractiveness in comparison to his rival (relative attractiveness) influence a male's mating decisions. Using the Trinidadian guppy, a species in which female mate choice (based on males’ attractive traits) plays an important role in male mating outcomes, we recorded the frequency of courtship displays and unsolicited attempts by focal males. First, we quantified focal male mating behaviour with and without a rival. Since the probability of a successful mating is, on average, halved by the presence of a rival, we predicted that under competition the focal male would invest more in less costly mating tactic—unsolicited attempts. Second, we examined how the rival's standard length and area of orange coloration mediated focal male mating behaviour. We found that rival presence influenced how focal males responded to females in terms of both mating tactics. However, the rival attractiveness elicited changes only in male courtship display. Focal males increased courtship display rate if his rival was small or if possessed large amounts of orange, regardless of considering rival absolute or relative attractiveness. Our results show that males invest in the costlier mating tactic when there is no rival or in the presence of a smaller rival. Interestingly, they make a similar investment in the presence of an attractive orange rival. Overall, this study highlights the importance of fine‐grained male decisions in mating encounters and shows that mating tactics are differentially shaped by multiple competition risk cues.
Pharmacokinetics and safety of repeated oral dosing of acetaminophen in adult horses
Authors: Mercer M. A. , McKenzie H. C. , Davis J. L. , Wilson K. E. , Hodgson D. R. , Cecere T. E. , McIntosh B. J.
Published: March 2019

Background

There are no published studies on the pharmacokinetics of acetaminophen at the dosage used clinically (20 mg/kg), nor has the safety of multiple doses in horses been investigated.

Objective

Define the pharmacokinetic parameters of oral acetaminophen at 20 mg/kg in adult horses as a single dose, and twice daily for 14 days to assess the safety of multiple dosing.

Study design

Pharmacokinetic study, multiple dose safety study.

Methods

Eight healthy Thoroughbred geldings were given acetaminophen (20 mg/kg; 500 mg tablets) orally as a single dose followed by doses every 12 h for 14 days. Serial blood samples were collected for determination of plasma acetaminophen concentrations using high performance liquid chromatography with ultraviolet detection. Serum biochemical analysis, gastroscopy and liver biopsy were examined during the safety study.

Results

Following a single dose, mean maximum concentration (Cmax) was 16.61 μg/mL at 1.35 h (Tmax), and drug concentration was below the lower limit of detection in most horses by 24 h. Elimination half‐life (T1/2) was 2.78 h. No significant accumulation was noted following multiple doses. Average Cmax of acetaminophen following multiple oral dosing was 15.85 μg/mL, with a Tmax of 0.99 h and T1/2 of 4 h. Serum activities of sorbitol dehydrogenase were significantly decreased and total bilirubin concentrations were significantly increased following the last dose. No statistically significant changes were noted in gastroscopy scores.

Main limitations

Only one dose level (20 mg/kg) was studied, sample size was small and only a single breed and sex was used, with no pretreatment liver biopsies.

Conclusion

This study described the pharmacokinetics of acetaminophen following single and multiple 20 mg/kg oral doses in adult horses and demonstrated the safety of acetaminophen with multiple oral dosing over 14 days.

The summary is available in Portuguese – see Supporting information
Continuous fluid infusion per rectum compared with intravenous and nasogastric fluid administration in horses
Authors: Khan A. , Hallowell G. D. , Underwood C. , van Eps A. W.
Published: March 2019

Background

Rectal fluid administration may offer a simple, safe and inexpensive alternative to intravenous or nasogastric fluid therapy in equine clinical cases.

Objectives

To evaluate the tolerance and effects of rectally administered fluid and compare the measurements of haemodilution and intravascular volume with those during nasogastric and intravenous fluid administration.

Study design

Randomised controlled experimental trial.

Methods

Six clinically normal Standardbred geldings were used in a 4‐way crossover study: each received three different fluid treatments (intravenous, nasogastric and rectal) at 5 mL/kg/h for 6 h and underwent a control (no treatment) with water and feed withheld. Bodyweight was measured at baseline and 6 h. Packed cell volume (PCV), total solids (TS), albumin, electrolytes, lactate, urine specific gravity, vital parameters, gastrointestinal borborygmi and central venous pressure were measured every 2 h.

Results

Rectal fluid administration with plain water was well tolerated and caused clinical chemistry changes consistent with haemodilution, indicating absorption. Mean (95% confidence interval)PCVdecreased from 40% [40–42] at 0 h to 35% [34–36] at 6 h during rectal fluid treatment (P<0.001), similar to decreases inPCVoccurring also with i.v. and nasogastric (NGT) treatment (P<0.001). TheTSalso decreased with i.v. and rectal fluid (P<0.001). There was a decrease in bodyweight in the control (P<0.001) but not with any of the fluid treatments.

Main limitations

A small sample size of healthy, euhydrated horses and a relatively short duration of fluid administration was used.

Conclusions

Rectal fluid administration requires clinical evaluation, but may offer an inexpensive, safe alternative or adjunct to i.v. fluid administration, particularly when administration viaNGTis not possible or contraindicated.

The Summary is available in Portuguese ‐ see Supporting Information
An outbreak of strangles associated with a novel genotype of Streptococcus equi subspecies equi in donkeys in China during 2018
Authors: Dong J. , Gao N. , Waller A. S. , Cook F. R. , Fan S. , Yuan D. , Du Y. , Li F. , Norimine J. , Zhu W.
Published: March 2019

Background

Strangles is a highly contagious respiratory disease of equids caused by the bacterium Streptococcus equi subspecies equi.

Objectives

To identify the cause of an outbreak of strangles that occurred on donkey farms within the Shandong Province of China and determine the prevalence of the disease.

Study design

Cross‐sectional.

Methods

Samples were taken from clinically affected animals to measure the prevalence of strangles within the population of donkeys at six intensive farms in China and identify the SeM type of isolate recovered from affected animals. Diagnosis was confirmed by bacterial isolation, biochemical tests and PCR. Epidemiological data were analysed using Chi‐square test and a Fisher's exact two‐sided test. The SeM gene of S. equi isolates recovered from affected animals was determined and compared with the SeM database PubMLST‐seM.

Results

In July and August 2018, an outbreak of strangles occurred on six donkey farms within the Shandong Province of China. The overall prevalence of disease within the different donkey herds was 13.4%. Younger animals were worst affected with 40.3% (83/206) of donkey foals aged under 1 year exhibiting clinical signs compared with 12.5% (191/1525) of donkeys aged one to 2 years and 3.8% (17/442) of donkeys over 2 years of age. Analysis of SeM sequencing data identified that the farms were affected by the same strain of S. equi, SD201807, which contains the novel 136 allele of SeM.

Main limitations

Healthy donkeys were not sampled in this study.

Conclusions

The number of intensive donkey breeding farms in China has risen recently. The higher numbers of animals that are in closer proximity to one another raise the potential for the transmission of infectious diseases such as strangles. This is the first description of a strangles outbreak among donkey herds in China.

The Summary is available in Chinese – see Supporting information.
Laboratory constraints on feeding behaviours in polymorphic bluegill sunfish (Lepomis macrochirus)
Authors: Moran Clinton J. , Rzucidlo Caroline L. , Ellerby David J. , Gerry Shannon P.
Published: March 2019

Evaluating fish feeding behaviours is imperative to understanding prey resource use in the field. Previous work on fish feeding has taken place almost exclusively in a laboratory setting, which may impose artificial restrictions. Thus, we aimed to evaluate the constraints the captive setting places on fish feeding behaviours.

We recorded polymorphic (littoral and pelagic) bluegill sunfish (Lepomis macrochirus) feeding in the laboratory and the field using a high‐speed camera and underwater cameras. Following successful strikes video events, were digitised using ImageJ (laboratory) and Argus (field).

Gape velocity, ram velocity, and body deceleration were higher in the field than in captive fish. Significantly greater gape velocity in field fish suggests that these fish feed with greater suction pressure than captive fish. Prey effects were detected, as brine shrimp feeding events were characterised by slower gape and ram velocities and a smaller gape. Feeding events on brine shrimp in the field were similar to feeding events on worms in the laboratory suggesting an artefact of training.

These results indicate that feeding behaviours measured in the laboratory may not be representative of feeding behaviours in the wild. Further consideration of organismal performance and laboratory constraints should be taken in future functional studies.
Behavioural plasticity and trophic niche shift: How wintering geese respond to habitat alteration
Authors: Lei Jialin , Jia Yifei , Wang Yuyu , Lei Guangchun , Lu Cai , Saintilan Neil , Wen Li
Published: March 2019

The accelerated rate of human‐induced environmental change poses a significant challenge for wildlife. The ability of wild animals to adapt to environmental changes has important consequences for their fitness, survival, and reproduction. Behavioural flexibility, an immediate adjustment of behaviour in response to environmental variability, may be particularly important for coping with anthropogenic change. The main aim of this study was to quantify the response of two wintering goose species (bean goose Anser fabalis and lesser white‐fronted goose Anser erythropus) to poor habitat condition at population level by studying foraging behaviour. In addition, we tested whether behavioural plasticity could alter trophic niche.

We characterised foraging behaviours and calculated daily home range (HR) of the geese using global positioning system tracking data. We calculated standard ellipse areas to quantify niche width using the δ13C and δ15N values of individual geese. We linked behavioural plasticity with habitat quality using ANCOVA (analysis of covariance) models. We also tested the correlation between standard ellipse areas and HR using ANCOVA model.

We found significant differences in geese foraging behaviours between years in their daily foraging area, travel distance and speed, and turning angle. Specifically, the birds increased their foraging area to satisfy their daily energy intake requirement in response to poor habitat conditions. They flew more sinuously and travelled faster and longer distances on a daily basis. For the endangered lesser white‐fronted goose, all behaviour variables were associated with habitat quality. For bean goose, only HR and turning angle were correlated with habitat quality. The birds, especially the lesser white‐fronted goose, may have had a higher trophic position under poor conditions.

Our findings indicate that wintering geese showed a high degree of behavioural plasticity. However, more active foraging behaviours under poor habitat condition did not lead to a broader trophic niche. Habitat availability could be responsible to the divergent responses of foraging HR and isotopic niche to human‐induced environmental change. Therefore, maintaining natural hydrological regimes during the critical period (i.e. September–November) to ensure that quality food resources are available is central to the future of populations of geese within the East Asian–Australasian Flyway.
Phenotypic variability of rusty crayfish (Faxonius rusticus) at the leading edge of its riverine invasion
Authors: Messager Mathis L. , Olden Julian D.
Published: March 2019

Species around the globe are undergoing phenotypic shifts at ecologically relevant timescales as they invade new ecosystems and respond to changing environments. Disentangling the contribution of environmental gradients from the process of range expansion in shaping these changes, and identifying the specific traits undergoing selection, are both critical to anticipate the secondary spread and impact of invasive species.

Here, we investigate phenotypic changes in rusty crayfish (Faxonius rusticus), a nuisance invasive species, through an extensive survey of their invasion gradient in multiple tributaries of the John Day River (JDR, Oregon, U.S.A.), a major tributary of the Columbia River.

Rusty crayfish in the JDR have developed better physiological condition (intrinsic growth and/or reproductive potential measured as RNA/DNA ratio) but less competitive morphology (lighter body and smaller claws) as they spread upstream and downstream from their location of initial introduction. In addition, rusty crayfish in invasion front populations are at a lower trophic level than conspecifics closer to core areas.

By accounting for variations in temperature, primary productivity, and prey (macroinvertebrates) biomass throughout the invasion extent of rusty crayfish, our findings suggest that low conspecific densities at the invasion edge and spatial sorting primarily drive these phenotypic changes. The trends observed here are thus likely to intensify over time as rusty crayfish continues to rapidly spread throughout the JDR and reach the mainstem Columbia River.

Our study shows that phenotypic shifts can manifest rapidly over environmental gradients experienced during the range expansion of aquatic invasive species. Patterns in both morphological and functional traits documented in the JDR demonstrate the importance of both environmental factors and dispersal processes in shaping these responses in riverine networks.
Global environmental changes impact soil hydraulic functions through biophysical feedbacks
Authors: Robinson David A. , Hopmans Jan W. , Filipovic Vilim , van der Ploeg Martine , Lebron Inma , Jones Scott B. , Reinsch Sabine , Jarvis Nick , Tuller Markus
Published: March 2019

Although only representing 0.05% of global freshwater, or 0.001% of all global water, soil water supports all terrestrial biological life. Soil moisture behaviour in most models is constrained by hydraulic parameters that do not change. Here we argue that biological feedbacks from plants, macro‐fauna and the microbiome influence soil structure, and thus the soil hydraulic parameters and the soil water content signals we observe. Incorporating biological feedbacks into soil hydrological models is therefore important for understanding environmental change and its impacts on ecosystems. We anticipate that environmental change will accelerate and modify soil hydraulic function. Increasingly, we understand the vital role that soil moisture exerts on the carbon cycle and other environmental threats such as heatwaves, droughts and floods, wildfires, regional precipitation patterns, disease regulation and infrastructure stability, in addition to agricultural production. Biological feedbacks may result in changes to soil hydraulic function that could be irreversible, resulting in alternative stable states (ASS) of soil moisture. To explore this, we need models that consider all the major feedbacks between soil properties and soil‐plant‐faunal‐microbial‐atmospheric processes, which is something we currently do not have. Therefore, a new direction is required to incorporate a dynamic description of soil structure and hydraulic property evolution into soil‐plant‐atmosphere, or land surface, models that consider feedbacks from land use and climate drivers of change, so as to better model ecosystem dynamics.
Loss of oral self‐care ability results in a higher risk of pneumonia in older inpatients: A prospective cohort study in a Japanese rural hospital
Authors: Fujiwara Aya , Minakuchi Hajime , Uehara Junji , Miki Haruna , Inoue‐Minakuchi Mami , Kimura‐Ono Aya , Nawachi Kumiko , Maekawa Kenji , Kuboki Takuo
Published: March 2019

Objectives

To identify significant risk factors associated with incidence of mortality and pneumonia in whole‐community‐based older inpatients resident in Japanese rural region.

Methods

Patients older than 65 years admitted between 1 April and 15 April 2010 to a core hospital located in a rural region were exhaustively recruited, and incidence of mortality and pneumonia during the 32‐month follow‐up period were evaluated. Independent variables at baseline measurement included age, gender, body mass index, Charlson comorbidity index, functional dependency, oral self‐care ability index, number of remaining teeth, hyposalivation and nutritional status. Dependent variables were incidence of mortality and pneumonia. Survival and non‐pneumonia curves were drawn using Kaplan‐Meier analysis. Cox proportional hazards analysis was performed to identify the risk factors related to incidence of mortality and pneumonia.

Results

The survival rate of 46 patients (male/female: 11/35; mean age: 83.8 ± 6.8 years) was 52.1%, and the incidence of pneumonia was 60.9%. Malnutrition and gender (male) were identified as significant risk factors for mortality (odds ratio [OR]: 8.18 and 4.90; 95% confidence interval [CI]: 1.77‐37.3 and 1.50‐16.0; P < 0.01 and <0.01, respectively). Loss of oral self‐care ability and gender (male) were identified as significant risk factors for incidence of pneumonia (OR: 8.97 and 4.58; 95% CI: 1.70‐47.4 and 1.50‐14.0; P = 0.01 and <0.01, respectively).

Conclusions

Malnutrition and loss of oral self‐care ability were significant risk factors for incidence of mortality and pneumonia, respectively. In response, supplying nutrition with appropriate diet and personalised oral care might contribute to reduction in mortality and prevention of pneumonia.
The impact of severe asthma on patients’ autonomy: A qualitative study
Authors: Eassey Daniela , Reddel Helen K. , Ryan Kath , Smith Lorraine
Published: March 2019

Background

People living with severe asthma may have ongoing debilitating symptoms despite high‐dose treatment. Clinical guidelines for severe asthma recommend concepts such as patient centeredness, shared decision making and self‐management, at the heart of which lies autonomy.

Objective

This study aimed to explore the role of autonomy in patients’ narratives about their experiences of living with and managing severe asthma.

Methods

In‐depth semi‐structured interviews were video‐ and/or audio‐recorded and transcribed. Data were categorized using a hybrid approach to analysis incorporating both inductive and deductive methods, informed by the self‐determination construct of autonomy. Analysis and comparison across and within categories were conducted to develop final themes.

Results

Twenty‐nine face‐to‐face interviews, lasting 1.5‐4 hours, were conducted across Australia. Patients’ autonomy was enacted or challenged in a range of situations, such as interacting with health‐care providers, maintaining employment, managing symptoms, and dealing with threats to self‐identity. Two main themes were discerned from the analysis: (a) the desire to live an “unconstrained” life; and (b) preservation of self‐identity.

Conclusion

Our findings suggest that autonomy is broader than conventional medical concepts such as decision making and information seeking. Future research should consider these findings when developing and implementing patient‐driven self‐management interventions for those living with severe asthma.
Effects of alpha‐lipoic acid therapy on experimentally induced apical periodontitis: a biochemical, histopathological and micro‐CT analysis
Authors: Aksoy U. , Savtekin G. , Şehirli A. Ö. , Kermeoğlu F. , Kalender A. , Özkayalar H. , Sayıner S. , Orhan K.
Published: March 2019

Aim

To investigate the possible therapeutic effects of alpha‐lipoic acid (ALA) in a model of chronic apical periodontitis in rats by analysing biochemical, histopathological and micro‐CT parameters.

Methodology

The study was approved by the Animal Ethics Committee of the Near East University. Thirty‐two Wistar rats were divided into four groups of eight rats each: Control Group; ALA Group; AP Group; AP + ALA Group. In the AP and AP + ALA groups, the pulp chambers of the mandibular first molars were surgically exposed and were left open to the oral environment for 4‐weeks to allow the establishment of periapical lesions. The rats in the Control and AP groups were treated intraperitoneally with saline solution (with a daily dose of 100 mg kg−1, for 28 days after periapical lesion induction). The rats in the ALA and AP + ALA groups were treated intraperitoneally with ALA (with a daily dose of 100 mg kg−1, for 28 days after periapical lesion induction). After decapitation, the trunk blood was collected for the assessment of biochemical parameters. The mandibles were surgically removed and dissected for histopathologic analysis and further scanned with micro‐CT. Groups of data were compared with a two‐way analysis of variance (two‐way anova) followed by Sidak's multiple comparison tests. Values of P < 0.05 were regarded as significant.

Results

TNF‐α, IL‐1β, MMP‐1, MMP‐2 levels were significantly lower in AP + ALA group compared with AP group (P < 0.05). There was a significant difference between the AP and AP + ALA groups according to assessment of the inflammatory scores (P < 0.05). The periapical inflammatory infiltrates were significantly more severe (P < 0.05) in the AP group. The AP + ALA group exhibited lower values both in terms of surface area and volume of resorption cavities than the AP group and this difference was significant (P < 0.05).

Conclusion

alpha‐lipoic acid treatment provided therapeutic effects on the inhibition of periapical bone loss.
Financial capability and emergency savings among South Africans living above and below the poverty line
Authors: Reyers Michelle
Published: March 2019

Emergency savings provide a buffer against financial shocks, particularly among low‐income households. Despite the importance of these funds in lessening financial hardship, many households have not set aside emergency funds. It has been suggested that financial capability may play a role in financial behaviour. Therefore, this study considers whether financial capability is associated with saving for emergencies and whether there are differences in factors that predict emergency savings behaviour among those living below and above the poverty line. Using data from a sample of South Africans, logistic regression is used to determine the predictors of emergency savings. The study finds that those with higher levels of financial capability, related to financial self‐efficacy and having access to a bank account, are more likely to have emergency savings compared with those with lower levels of financial capability. However, no evidence is found to suggest a relationship between objectively measured financial knowledge and emergency savings. Therefore, the findings suggest that self‐assessed financial ability, as measured by financial self‐efficacy, might be more important than objectively assessed ability in the context of individuals making responsible financial choices. Differences in the predictors of emergency savings for those living above and below the poverty line related to socioeconomic and demographic differences, whereas the same financial capability predictors were significant predictors in both samples. The study provides unique insights into the predictors of emergency savings in a developing market context and identifies the characteristics of those who are likely to be financially resilient to unexpected economic shocks. The importance of the broader financial capability construct in predicting emergency savings, for both those living above and below the poverty line, suggests that programmes aimed at encouraging emergency savings should focus on enhancing financial self‐efficacy and financial inclusion.
The Global North Goes to the Global North Minus? Intersections of the Integration of Highly Skilled, Non‐Jewish Female Partner and Spousal Migrants from the Global North in Israel
Authors: Kranz Dani
Published: March 2019

Using Global Northern, non‐Jewish, female, highly skilled partners and spouses of Israeli Jewish citizens in Israel as a case study, and depicting their interactions with bureaucracy, integration into the labour market, gendered aspects of integration and clashes between self‐perception and ascription this paper teases out that, despite its specificity, the case of Israel allows forming conclusions about the precariousness of a class of presumed privileged migrants. The central finding is that Global Northerners experience a status deprivation, which includes deskilling and social marginalization. This nexus was experienced as limiting personal agency, which allows for questioning their presumed status of privileged migrants; it concurrently underscores the importance of the analytically difficult and diffuse nexus of personality and agency. The ethnographic data demonstrates that individuals coped with the challenges differently, suggesting that specific personalities and intra‐ and interpersonal resourcefulness underpin individual resilience thresholds.
A Comparison of Methods for Poverty Estimation in Developing Countries
Authors: Das Sumonkanti , Haslett Stephen
Published: March 2019

Small area estimation is a widely used indirect estimation technique for micro‐level geographic profiling. Three unit level small area estimation techniques—the ELL or World Bank method, empirical best prediction (EBP) and M‐quantile (MQ) — can estimate micro‐level Foster, Greer, & Thorbecke (FGT) indicators: poverty incidence, gap and severity using both unit level survey and census data. However, they use different assumptions. The effects of using model‐based unit level census data reconstructed from cross‐tabulations and having no cluster level contextual variables for models are discussed, as are effects of small area and cluster level heterogeneity. A simulation‐based comparison of ELL, EBP and MQ uses a model‐based reconstruction of 2000/2001 data from Bangladesh and compares bias and mean square error. A three‐level ELL method is applied for comparison with the standard two‐level ELL that lacks a small area level component. An important finding is that the larger number of small areas for which ELL has been able to produce sufficiently accurate estimates in comparison with EBP and MQ has been driven more by the type of census data available or utilised than by the model per se.
The smart negative pressure (SNaP) wound care system: A case series from Singapore
Authors: Wee Ian J. Y. , Mak Manfred , O'Donnell Gavin , Tan Jerilyn , Chong Tze T. , Tang Tjun Y.
Published: March 2019

The Smart Negative Pressure (SNaP) wound care system is a novel device that is single‐patient use, ultra‐portable, and light weight and does not rely on battery or need recharging. A systematic search was performed on major databases to identify relevant articles including case reports, retrospective case series, and randomised controlled trials. Ten studies were identified, showing that the SNaP wound care system is an effective tool in treating small‐sized wounds and may serve as an alternative to current electrically powered modalities. Furthermore, the system's small size and convenience leads to greater patient satisfaction and improves quality of life. Finally, we report our initial positive experiences with two cases in our institution. Although the evidence thus far has been encouraging, and patient satisfaction is higher than other wound care systems, further evidence is required to determine its superiority over current systems in terms of wound‐healing outcomes.
Effect of A‐site substitutions on energy storage properties of BaTiO3‐BiScO3 weakly coupled relaxor ferroelectrics
Authors: Nayak Sanjib , Venkateshwarlu Sarangi , Budisuharto Anthony Setiadi , Jørgensen Mads Ry Vogel , Borkiewicz Olaf , Beyer Kevin A. , Pramanick Abhijit
Published: March 2019

Weakly coupled relaxors based on compositions (1‐x) BaTiO3‐xBiMeO3, where Me is a metal ion, have attracted attention as potential candidates for high‐temperature high‐energy density capacitors. However, the necessary Bi content is typically high with x = 0.3‐0.4. In order to reduce problems associated with compatibility for base metal electrodes and due to additional problems due to Bi volatility, it is desirable to lower the Bi content in the overall composition for these materials. Here, we have explored a possible way to reduce BiMeO3 content through additional A‐site substitutions viz. Ca and Sn. The relaxor nature and energy storage properties of Sn‐modified (Ba,Ca)(Ti)O3‐BiScO3 ceramics were determined from their dielectric and ferroelectric behaviors. The material showed attractive properties in terms of a frequency‐independent (200 Hz‐1 MHz) dielectric response from room temperature to 200°C, extremely low loss and high‐energy storage efficiency. The structural phenomena underlying the functional properties of Sn‐modified (Ba,Ca)TiO3‐BiScO3 are characterized from temperature‐dependent X‐ray diffraction and pair distribution function analysis. In broader terms, the study illustrates the potential for tailoring relaxor behavior in Pb‐free ferroelectrics by combining phenomena, such as quantum fluctuations and lone pair stereochemical effect associated with different solid‐solution substitutions.
Orthostatic hypotension: From pathophysiology to clinical applications and therapeutic considerations
Authors: Magkas Nikolaos , Tsioufis Costas , Thomopoulos Costas , Dilaveris Polychronis , Georgiopoulos Georgios , Sanidas Elias , Papademetriou Vasilios , Tousoulis Dimitrios
Published: March 2019

Orthostatic hypotension (OH), that is blood pressure fall when standing from the supine to the erect position, is a common cardiovascular disorder, highly prevalent in elderly and frail individuals and in patients with multiple comorbidities. Orthostatic hypotension is considered a manifestation of dysfunction of the autonomic nervous system, caused or facilitated by several neurological or non‐neurological diseases and conditions, while its clinical significance is increasingly recognized as a cause of impairment of quality of life and potentially of worse outcomes. Indeed, OH has been extensively studied and numerous prospective cohort studies support its association with adverse events, including coronary artery disease, heart failure, stroke, cognitive dysfunction, and, most importantly, mortality rates. Specific pharmacological and non‐pharmacological interventions have been established for the treatment of OH. However, randomized data evaluating the impact of therapeutic interventions on morbidity and mortality outcomes are lacking. Thus, despite that OH seems to have important prognostic implications indicated by several reported associations with adverse events, it remains unclear whether OH treatment could improve prognosis. In the present review, we discuss the clinical applications associated with ΟΗ by outlining the current perspectives on ΟΗ definition, diagnosis, pathophysiology, prognostic role, and treatment.
Susceptibility of Cypriot Tuta absoluta populations to four targeted insecticides and control failure likelihood
Authors: Michaelides Georgios , Seraphides Nicos , Pitsillou Maria , Sfenthourakis Spyros
Published: March 2019

Tuta absoluta, known as the South American tomato pinworm, is one of the most disastrous pests of tomato cultivations, presently menacing tomato cultivations worldwide. In 2006, T. absoluta invaded Spain from South America. Since then, it was rapidly spread to most European, African and Asian countries. Such alien invasive species can minimize crop production, whereas the increasing use of insecticides raises various environmental concerns as well as on control costs, control failure and the toxicity to non‐target organisms. The S. American tomato pinworm is mostly controlled by chemical insecticides, and failure to control it is not a rare phenomenon. Resistance to numerous insecticides has been reported and is mainly due to the fact that farmers do not follow a sustainable resistance management scheme. Several examples have been reported from several countries where the tomato pinworm is present. In order to develop a successful insecticide resistance management (IRM) strategy for any major pest, one needs to identify the baseline toxicity to insecticides and then monitor susceptibility levels. In Cyprus, the current status of susceptibility levels to the main insecticides that are used to control T. absoluta has never been studied before. Herein, nine Cypriot populations of the pest were subjected to laboratory bioassays between 2016 and 2018 using the main insecticides applied against it. We found that the insecticides chlorantraniliprole and indoxacarb could not control the Cypriot T. absoluta populations anymore, with a resistance ratio (RR) >28 and 3–23, respectively. Furthermore, mortality achieved by those two insecticides was 20.6%–72% for chlorantraniliprole and 27.5%–78% for indoxacarb. However, the insecticides emamectin benzoate and spinosad are very effective, since mortality to both of them ranged between 99.5% and 100%.