bluuebunny/crossref_metadata_2025 huggingface dataset:
Evidence for the occurrence of gingival recession and non‐carious cervical lesions as a consequence of traumatic toothbrushing
Authors: Heasman Peter A. , Holliday Richard , Bryant Andrew , Preshaw Philip M.
Published: December 2014

Aim

To identify the best available evidence for the effect of toothbrushing on the initiation and progression of gingival recession and non‐carious cervical lesions (NCCLs).

Methods

A protocol was developed for the questions: Does traumatic toothbrushing, compared to normal toothbrushing, lead to an increased prevalence of non‐inflammatory gingival recession? [FQ1] and NCCLs? [FQ2]. The search covered four electronic databases. Bibliographies of review articles, relevant texts, World and European Workshops were screened. Hand searches were performed of the Journals of Clinical Periodontology, Periodontology, Periodontal Research and IADR abstracts.

Results

A meta‐analysis included 159 subjects and showed that subjects who used MTBs (manual toothbrush) had greater gingival recession after 12 months when compared with those using PTBs (powered toothbrush). Thirteen cross‐sectional studies identified the most frequent toothbrushing factors associated with gingival recession as being toothbrushing frequency, a horizontal or scrub toothbrushing method, bristle hardness, toothbrushing duration and the frequency of changing a toothbrush. The principal toothbrushing factors associated with NCCLs were toothbrushing method and frequency.

Conclusion

The data to support or refute the association between toothbrushing and gingival recession and NCCLs remain largely inconclusive.
Factors determining the smooth flow and the non‐operative time in a one‐induction room to one‐operating room setting
Authors: Mulier Jan P. , De Boeck Liesje , Meulders Michel , Beliën Jeroen , Colpaert Jan , Sels Annabel
Published: December 2014

Rationale, aims and objectives

What factors determine the use of an anaesthesia preparation room and shorten non‐operative time?

Methods

A logistic regression is applied to 18 751 surgery records from AZ Sint‐Jan Brugge AV, Belgium, where each operating room has its own anaesthesia preparation room. Surgeries, in which the patient's induction has already started when the preceding patient's surgery has ended, belong to a first group where the preparation room is used as an induction room. Surgeries not fulfilling this property belong to a second group. A logistic regression model tries to predict the probability that a surgery will be classified into a specific group. Non‐operative time is calculated as the time between end of the previous surgery and incision of the next surgery. A log‐linear regression of this non‐operative time is performed.

Results

It was found that switches in surgeons, being a non‐elective surgery as well as the previous surgery being non‐elective, increase the probability of being classified into the second group. Only a few surgery types, anaesthesiologists and operating rooms can be found exclusively in one of the two groups. Analysis of variance demonstrates that the first group has significantly lower non‐operative times. Switches in surgeons, anaesthesiologists and longer scheduled durations of the previous surgery increases the non‐operative time. A switch in both surgeon and anaesthesiologist strengthens this negative effect. Only a few operating rooms and surgery types influence the non‐operative time.

Conclusion

The use of the anaesthesia preparation room shortens the non‐operative time and is determined by several human and structural factors.
Evidence‐informed person‐centred health care (part II): Are ‘cognitive biases plus’ underlying the EBM paradigm responsible for undermining the quality of evidence?
Authors: Seshia Shashi S. , Makhinson Michael , Young G. Bryan
Published: December 2014

Introduction

Recently, some leaders of the evidence‐based medicine (EBM) movement drew attention to the “unintended” negative consequences associated with EBM. The term ‘cognitive biases plus’ was introduced in part I to encompass cognitive biases, conflicts of interests, fallacies and certain behaviours.

Hypothesis

‘Cognitive biases plus’ in those closely involved in creating and promoting the EBM paradigm are responsible for their (1) inability to anticipate and then recognize flaws in the tenets of EBM; (2) discounting alternative views; and (3) delaying reform.

Methods

A narrative review style was used, with methods as in part I.

Appraisal of literature

Over the past two decades there has been mounting qualitative and quantitative methodological evidence to suggest that the faith placed in (1) the EBM hierarchy with randomized controlled trials and systematic reviews at the summit; (2) the reliability of biostatistical methods to quantitate data; and (3) the primacy of sources of pre‐appraised evidence, is seriously misplaced. Consequently, the evidence that informs person‐centred care is compromised.

Discussion

Arguments focusing on ‘cognitive biases plus’ are offered to support our hypothesis. To the best of our knowledge, EBM proponents have not provided an explanation.

Conclusions

Reform is urgently needed to minimize continuing risks to patients. If our hypothesis is correct, then in addition to the suggestions made in part I, deficiencies in the paradigm must be corrected. Meaningful solutions are only possible if the biases of scientific inbreeding and groupthink are minimized by collaboration between EBM leaders and those who have been sounding warning bells.
Arabidopsis ROOT HAIR DEFECTIVE3 is involved in nitrogen starvation‐induced anthocyanin accumulation
Authors: Wang Jing , Wang Yan , Yang Ju , Ma Chunli , Zhang Ying , Ge Ting , Qi Zhi , Kang Yan
Published: December 2014

Anthocyanin accumulation is a common phenomenon seen in plants under environmental stress. In this study, we identified a new allele of ROOT HAIR DEFECTIVE3 (RHD3) showing an anthocyanin overaccumulation phenotype under nitrogen starvation conditions. It is known that ethylene negatively regulates light‐ and sucrose‐induced anthocyanin biosynthesis. We hypothesized that RHD3 achieves its negative effect on anthocyanin biosynthesis via an ethylene‐regulating pathway. In support of this, similar to rhd3 mutants, the Arabidopsis ethylene signaling mutants etr1, ein2, and ein3/eil1 showed an anthocyanin overaccumulation phenotype under nitrogen starvation conditions. The ethylene precursor ACC strongly suppressed anthocyanin accumulation, dependent on ETR1, EIN2, EIN3/EIL1, and, partially, RHD3. In addition, inactivating RHD3 partially reversed the suppressive effect of ETO1 inactivation‐evoked endogenous ethylene production on anthocyanin accumulation. The expression of nitrogen starvation‐induced anthocyanin biosynthesis genes was negatively regulated by RHD3, but ethylene response genes were positively regulated by RHD3. Wild‐type seedlings overexpressing RHD3 showed similar phenotypes to rhd3 mutants, indicating the existence of a fine‐tuned relationship between gene expression and function. RHD3 was initially identified as a gene involved in root hair development. This study uncovered a new physiological function of RHD3 in nitrogen starvation‐induced anthocyanin accumulation and ethylene homeostasis. [Correction added on 6 August 2015, after first online publication: “RND3” corrected to “RHD3”.]
Jasmonic acid‐isoleucine formation in grapevine (Vitis vinifera L.) by two enzymes with distinct transcription profiles
Authors: Böttcher Christine , Burbidge Crista A. , di Rienzo Valentina , Boss Paul K. , Davies Christopher
Published: December 2014

The plant hormone jasmonic acid (JA) is essential for stress responses and the formation of reproductive organs, but its role in fruit development and ripening is unclear. Conjugation of JA to isoleucine is a crucial step in the JA signaling pathway since only JA‐Ile is recognized by the jasmonate receptor. The conjugation reaction is catalyzed by JA‐amido synthetases, belonging to the family of Gretchen Hagen3 (GH3) proteins. Here, in vitro studies of two grapevine (Vitis vinifera L. cv Shiraz) GH3 enzymes, VvGH3‐7 and VvGH3‐9, demonstrated JA‐conjugating activities with an overlapping range of amino acid substrates, including isoleucine. Expression studies of the corresponding genes in grape berries combined with JA and JA‐Ile measurements suggested a primary role for JA signaling in fruit set and cell division and did not support an involvement of JA in the ripening process. In response to methyl JA (MeJA) treatment, and in wounded and unwounded (distal) leaves, VvGH3‐9 transcripts accumulated, indicating a participation in the JA response. In contrast, VvGH3‐7 was unresponsive to MeJA and local wounding, demonstrating a differential transcriptional regulation of VvGH3‐7 and VvGH3‐9. The transient induction of VvGH3‐7 in unwounded, distal leaves was suggestive of the involvement of an unknown mobile wound signal.
Validation of the Chinese Version of the Dementia Screening Questionnaire for Individuals with Intellectual Disabilities (DSQIID‐CV)
Authors: Li R. S. Y. , Kwok H. W. M. , Deb S. , Chui E. M. C. , Chan L. K. , Leung D. P. K.
Published: December 2014

Background

An increasing number of people with intellectual disabilities (ID) are at risk of developing age‐related disorders such as dementia because of a dramatic increase in life expectancy in this population in the recent years. There is no validated dementia screening instrument for Chinese people with ID. The Dementia Screening Questionnaire for Individuals with Intellectual Disabilities (DSQIID) was reported to be a valid, user‐friendly, easy‐to‐use observer‐rated instrument. It was developed in the UK and has good psychometric properties. Validation of a Chinese version of the DSQIID will facilitate its application among the Chinese population.

Method

The DSQIID was translated into the Chinese version (DSQIID‐CV). By purposive sampling, service users with ID aged 40 years or over were recruited through two large centres serving adults with ID in Hong Kong. Carers who had taken care of the participants continuously for the past 6 months were invited to complete the DSQIID‐CV. All participants were examined by qualified psychiatrists to determine the presence or absence of dementia.

Results

Two hundred people with ID whose age ranged between 40 and 73 years (mean 51 years, SD = 7.34 years) were recruited to the study. A clinical diagnosis of dementia was established in 13 participants. An overall total score of 22 as a screening cut‐off provided the optimum levels of specificity (0.995) and sensitivity (0.923). The DSQIID‐CV showed good internal consistency (alpha = 0.945) for all its 53 items, and excellent test‐retest reliability (0.978, n = 46) and inter‐rater reliability (1.000, n = 47). Exploratory factor analysis resulted in a four‐factor solution explaining 45% of the total variance.

Conclusions

The DSQIID‐CV is shown to have robust psychometric properties. It is the first valid and reliable dementia screening instrument for Chinese adults with ID.
Financial Capability and Asset Accumulation for Children's Education: Evidence from an Experiment of Child Development Accounts
Authors: HUANG JIN , NAM YUNJU , SHERRADEN MICHAEL , CLANCY MARGARET
Published: December 2014

On the basis of theoretical framework of financial capability, this study investigates the roles of financial access and financial knowledge in savings and asset accumulation for children's postsecondary education. We use data from SEED for Oklahoma Kids (N =2,704), a statewide policy experiment offering Child Development Accounts (CDAs) to treatment participants. This study employs quantile regressions with two dependent variables: savings amount (net deposits made by caregivers of children) and total asset amount (the sum of savings, financial incentives offered by the experiment, and investment earnings). Results identify positive and statistically significant interactions between treatment status and financial knowledge, suggesting that access to CDAs moderates the association between financial knowledge and asset accumulation. Providing empirical support for the theory of financial capability, the findings call for interventions that enhance financial knowledge, expand financial access, and improve asset accumulation for all children.
Transnational Anticorruption Law in Action: Cases from Argentina and
Brazil
Authors: Davis Kevin E. , Jorge Guillermo , Machado Maíra R.
Published: December 2014

Debates over whether transnational and international legal institutions
are fair, effective, or legitimate responses to corruption of local public
officials have an important empirical dimension. We use case studies to
examine whether foreign legal institutions serve as fair, effective, and
legitimate complements to local anticorruption institutions. We refer to
this set of claims as the “institutional complementarity theory.” The first
case study centers on proceedings concerning bribes paid by subsidiaries of
Siemens AG, a German company, to obtain and retain a contract to provide
national identity cards for the Argentine government. The second case study
examines events stemming from overbilling in the construction of a
courthouse in Brazil. Analysis of these cases suggests that the
institutional complementary theory is credible. At the same time, the
findings suggest that local institutions have greater potential, and foreign
institutions have more limited potential, than the theory assumes.
Lower Urinary Tract Symptoms and Urinary Incontinence During Pregnancy
Authors: BALIK Gülşah , GÜVEN Emine Seda G. , TEKIN Yeşim B. , ŞENTÜRK Şenol , KAĞITCI Mehmet , ÜSTÜNER Işık , METE URAL Ülkü , ŞAHIN Figen K.
Published: December 2014

Objective

Lower urinary tract symptoms (LUTS) can frequently be seen in pregnant women. Pregnancy and delivery have been considered as risk factors in the occurrence of pelvic floor dysfunction and determinants of LUTS. The main associated risk factor is parity. In the present study, we aim to determine the frequency of LUTS and urinary incontinence (UI) during pregnancy and the associated risk factors.

Methods

This prospective study was carried out in a total of 250 women during their 28‐ and 40‐gestational week checks. The Urinary Distress Inventory‐6, the Incontinence Impact Questionnaire‐7, and International Consultation on Incontinence Questionnaire‐Short Form were used to determine LUTS and its effect on quality of life.

Results

The mean age and gestational age of the participants were 29.41 ± 5.70 year (range 18–44) and 35.45 ± 2.98 weeks (range 28–40), respectively. The prevalence of LUTS was 81.6%. The prevalence of UI during pregnancy was 37.2%. Stress urinary incontinence, urge urinary incontinence and mixed urinary incontinence were diagnosed as 15.6, 4.8 and 16.8%, respectively. We found that advanced age, smoking and multiparity were risk factors associated with incontinence. Incontinence reduced pregnant women's quality of life.

Conclusions

Lower urinary tract symptoms are commonly seen among pregnant women and these symptoms negatively affect the quality of life of pregnant women. Advanced age, smoking and multiparity were risk factors associated with urinary incontinence and LUTS. Obstetricians should be on the lookout for individual urological problems in pregnancy. Resolving any urological issues and cessation of smoking for the affected individuals will help alleviate the problem.
Global invasion history of the tropical fire ant: a stowaway on the first global trade routes
Authors: Gotzek Dietrich , Axen Heather J. , Suarez Andrew V. , Helms Cahan Sara , Shoemaker DeWayne
Published: December 2014

Biological invasions are largely thought to be contemporary, having recently increased sharply in the wake of globalization. However, human commerce had already become global by the mid‐16th century when the Spanish connected the New World with Europe and Asia via their Manila galleon and West Indies trade routes. We use genetic data to trace the global invasion of one of the world's most widespread and invasive pest ants, the tropical fire ant, Solenopsis geminata. Our results reveal a pattern of introduction of Old World populations that is highly consistent with historical trading routes suggesting that Spanish trade introduced the tropical fire ant to Asia in the 16th century. We identify southwestern Mexico as the most likely source for the invasive populations, which is consistent with the use of Acapulco as the major Spanish port on the Pacific Ocean. From there, the Spanish galleons brought silver to Manila, which served as a hub for trade with China. The genetic data document a corresponding spread of S. geminata from Mexico via Manila to Taiwan and from there, throughout the Old World. Our descriptions of the worldwide spread of S. geminata represent a rare documented case of a biological invasion of a highly invasive and globally distributed pest species due to the earliest stages of global commerce.
Metronidazole‐induced encephalopathy and myoclonus: Case report and a review of the literature
Authors: Yagi Takuya , Shihashi Gen , Oki Koichi , Suzuki Shigeaki , Shinoda Masahiro , Itano Osamu , Kitagawa Yuko , Suzuki Norihiro
Published: December 2014

We describe a 36‐year‐old man with metronidazole‐induced encephalopathy in the course of alcoholic liver cirrhosis who developed periodic myoclonus on the head and fixed eye position with ocular myoclonus in the vertical direction. Involuntary movements are rare in patients with metronidazole‐induced encephalopathy, because neurological manifestations of metronidazole‐induced encephalopathy usually include ataxic gait, dysarthria and confusion. Involuntary movements including myoclonus should be considered as the clinical manifestation of metronidazole‐induced encephalopathy. In addition, we review the literature of metronidazole‐induced encephalopathy patients who developed myoclonus with regard to the clinical characteristics.
Experiences of UK patients with hepatitis C virus infection accessing phlebotomy: A qualitative analysis
Authors: Clements Amanda , Grose Jane , Skirton Heather
Published: December 2014

This study provides an understanding of the experiences and perceptions of phlebotomy in people with infection who have venous damage related to injecting drug use with the aim of improving their care. Narrative interviews were conducted with 10 attendees of a phlebotomy service within an acute Trust in the south–west of England. The participants had hepatitis C infection and poor venous access due to current or former drug use. Interview audiotapes were analyzed, and the themes – conflict, emotional responses, the patient as expert, and offering solutions – were identified. In the context of this study, we discuss the difficulties associated with phlebotomy, which might explain why individuals with hepatitis C infection and venous damage disengage from health services and are less likely to undertake antiviral treatment. This research adds to the literature on phlebotomy for vulnerable groups, and recommends hepatitis C virus clinics within drug agencies, the need to review training and policy, and the development of “phlebotomy passports” to enable continuity of care between services.
Keystone species in seed dispersal networks are mainly determined by dietary specialization
Authors: Mello Marco Aurelio Ribeiro , Rodrigues Francisco Aparecido , Costa Luciano da Fontoura , Kissling W. Daniel , Şekercioğlu Çağan H. , Marquitti Flavia Maria Darcie , Kalko Elisabeth Klara Viktoria
Published: December 2014

A central issue in ecology is the definition and identification of keystone species, i.e. species that are relatively more important than others for maintaining community structure and ecosystem functioning. Network theory has been pointed out as a robust theoretical framework to enhance the operationality of the keystone species concept. We used the concept of centrality as a proxy for a species’ relative importance for the structure of seed dispersal networks composed of either frugivorous bats or birds and their food‐plants. Centrality was expected to be determined mainly by dietary specialization, but also by body mass and geographic range size. Across 15 Neotropical datasets, only specialized frugivore species reached the highest values of centrality. Furthermore, the centrality of specialized frugivores varied widely within and among networks, whereas that of secondary and opportunistic frugivores was consistently low. A mixed‐effects model showed that centrality was best explained by dietary specialization, but not by body mass or range size. Furthermore, the relationship between centrality and those three ecological correlates differed between bat– and bird–fruit networks. Our findings suggest that dietary specialization is key to understand what makes a frugivore species a keystone in seed dispersal networks, and that taxonomic identity also plays a significant role. Specialized frugivores may play a central role in network structuring and ecosystem functioning, which has important implications for conservation and restoration.
The lost generation hypothesis: could climate change drive ectotherms into a developmental trap?
Authors: Van Dyck Hans , Bonte Dries , Puls Rik , Gotthard Karl , Maes Dirk
Published: December 2014

Climate warming affects the rate and timing of the development in ectothermic organisms. Short‐living, ectothermic organisms (including many insects) showing thermal plasticity in life‐cycle regulation could, for example, increase the number of generations per year under warmer conditions. However, changed phenology may challenge the way organisms in temperate climates deal with the available thermal time window at the end of summer. Although adaptive plasticity is widely assumed in multivoltine organisms, rapid environmental change could distort the quality of information given by environmental cues that organisms use to make developmental decisions. Developmental traps are scenarios in which rapid environmental change triggers organisms to pursue maladaptive developmental pathways. This occurs because organisms must rely upon current environmental cues to predict future environmental conditions and corresponds to a novel case of ecological or evolutionary traps. Examples of introduced, invasive species are congruent with this hypothesis. Based on preliminary experiments, we argue that the dramatic declines of the wall brown Lasiommata megera in northwestern Europe may be an example of a developmental trap. This formerly widespread, bivoltine (or even multivoltine) butterfly has become a conundrum to conservationist biologists. A split‐brood field experiment with L. megera indeed suggests issues with life‐cycle regulation decisions at the end of summer. In areas where the species went extinct recently, 100% of the individuals developed directly into a third generation without larval diapause, whereas only 42.5% did so in the areas where the species still occurs. Under unfavourable autumn conditions, the attempted third generation will result in high mortality and eventually a lost or ‘suicidal’ third generation in this insect with non‐overlapping, discrete generations. We discuss the idea of a developmental trap within an integrated framework for assessing the vulnerability of species to climate change.
Intraoperative optimization to decrease postoperative PRBC transfusion in children undergoing craniofacial reconstruction
Authors: Nguyen Thanh T. , Lam Humphrey V. , Phillips Maxie , Edwards Clasherrol , Austin Thomas M.
Published: December 2014

Background

Craniofacial reconstructive surgery for craniosynostosis is associated with large blood loss and intraoperative transfusion. This blood loss may continue through the initial postoperative period, potentially resulting in transfusion postoperatively. The purpose of this study is to determine if there is an association between any modifiable intraoperative factors and postoperative blood transfusion in this patient population.

Methods

A cohort of 55 pediatric patients who underwent primary craniofacial reconstruction at Vanderbilt Children's Hospital from January 1, 2013 to April 31, 2014 was analyzed. The authors analyzed 20 different demographic and perioperative variables for statistical associations with postoperative PRBC transfusion using multiple logistic regression with optimal models being selected by Bayesian model averaging.

Results

The optimal regression model only included initial PACU Hct as a predictor and showed a significant association between this variable and postoperative PRBC transfusion (odds ratio 0.69, 95% CI 0.55–0.87, P = 0.0016). Based on the average decrease in postoperative hematocrit (Hct) and the postoperative transfusion trigger, an initial PACU Hct threshold of 30 was calculated. In our patient sample, an initial PACU Hct above 30 was associated with a 50% decrease in the absolute risk of receiving a PRBC transfusion postoperatively.

Conclusions

Based on this retrospective analysis, it may be justifiable to transfuse residual volume from previously exposed intraoperative PRBCs to a Hct above 30 to decrease the likelihood of subsequent blood transfusions from different donors in the postoperative period.
Outcomes in pediatric hepatitis C transplant recipients: Analysis of the UNOS database
Authors: Gupta Meera , Bahirwani Ranjeeta , Levine Matthew H. , Malik Saloni , Goldberg David , Reddy K. Rajender , Shaked Abraham
Published: December 2014

HCV may lead to the development of ESLD in late childhood and, consequently, contributes to the need for liver transplantation. The aim of this study was to examine post‐transplant outcomes in HCV‐positive pediatric patients with ESLD from any cause and to determine the impact of the PELD scoring system, introduced in February 2002, on post‐transplant patient and graft survival. A retrospective analysis of the UNOS database from 1994 to 2010 was performed to assess graft and patient survival in pediatric HCV‐seropositive liver transplant recipients. Graft survival and patient survival comparing subjects in the pre‐PELD era and post‐PELD era were analyzed using Kaplan–Meier statistics. Factors associated with survival were identified using Cox regression analysis. Of 120 pediatric HCV transplant recipients, 80 were transplanted in the pre‐PELD era and 40 were transplanted post‐PELD. Median serum total bilirubin, INR, and creatinine were 4.8 mg/dL, 1.6, and 0.7 mg/dL in the pre‐PELD era vs. 5.5 mg/dL, 1.7, and 0.6 mg/mL, respectively, in the post‐PELD era (p NS). One‐yr graft survival in the pre‐PELD vs. post‐PELD era was 65.0% and 89.7%, respectively (p < 0.01); corresponding three‐yr graft survival was 57.3% vs. 76.2% (p = 0.04). One‐yr patient survival in the pre‐PELD vs. post‐PELD era was 79.0% and 97.5%, respectively (p < 0.01); corresponding three‐yr survival was 79.0% vs. 89.4% (p = 0.17). Twenty‐eight patients (23.3%) were retransplanted: 24 (30%) in the pre‐PELD era (median time to retransplant 272 days) and four (10%) in the post‐PELD era (median time to retransplant 586 days). Early follow‐up demonstrates a trend toward improved pediatric HCV liver transplant graft and patient survival in the post‐PELD era. Superior outcomes may be attributed to pretransplant factors, improved surgical technique and better treatment options for HCV infection.
Total laryngectomy pre-operative assessment and education in an Ear, Nose & Throat ward: a best practice implementation project
Authors: Ge Xiangyu , Wang Wei , Zhang Ping , Wu Jiangfang
Published: December 2014

Executive Summary

Background

Pre-operative assessment and education plays an essential part in perioperative nursing practice. Due to the clinical consequences of total laryngectomy, sufficient pre-operative assessment and education would improve patient's post-operative journey.

Objectives

The aim of this implementation project was to integrate the available evidence of pre-operative assessment and education into practice, and to improve the compliance of best practice to audit criteria, to reduce the incidence of complications.

Methods

This project utilized the audit and feedback model using the Joanna Briggs Institute Practical Application of Clinical Evidence System. This included a baseline audit, feedback and implementation of strategies, and a follow-up cycle. Five evidence based audit criteria were audited in an ear, nose and throat ward of a hospital in Fudan. 32 patients and 29 nursing staff were involved in this project.

Results

Improvements in the compliance rates of all criteria have been shown, ranging from 94% to 100% in the follow up audit cycle.

Conclusions

This project demonstrated an improvement in evidence-based practices in regards to pre-operative education and assessment. Further challenges will focus on developing strategies to sustain these improvements in compliance.
Post-operative care of total laryngectomy patients in the ward: a best practice implementation project
Authors: Wu Peixia
Published: December 2014

Executive Summary

Objectives

The aim of this project was to improve the local practice of nursing care for total laryngectomy patients in Shanghai Eye & Ear Nose and Throat (ENT) hospital, thereby making a contribution towards improving patient outcomes.

Methods

A baseline audit, change strategy and implementation, then follow-up audit cycle were conducted. Six evidence based criteria identified by the Joanna Briggs Institute were audited in the ENT ward of Eye & ENT Hospital of Fudan University in Shanghai. Fifteen patients and twenty nurses were involved in the baseline audit, and ten patients and twenty nurses in the post implementation audit.

Results

The baseline audit was poor across four of the six criteria. The assessment of patient humidification, hydration, nutrition, and drainage sites was not carried out. Following the implementation of interventions, the post audit cycle achieved a considerable improvement in 5 out of the 6 criteria, with assessment of drainage sites remaining unchanged.

Conclusion

This project assisted in improving evidence-based practices for total laryngectomy patient's post-operative care. Attempts to implement drainage site assessment were unsuccessful. Strategies in sustaining the momentum of compliance are required.
Total laryngectomy discharge planning in an acute hospital setting in China: a best practice implementation project
Authors: Chunyi Gui
Published: December 2014

Executive Summary

Background

Total laryngectomy patients will meet various kinds of physical and psychosocial problems after the surgery. And the adjustment and rehabilitation of total laryngectomy require the input of skilled members of a multidisciplinary team, especially the specialized nurses. To provide the patients a comprehensive and evidence-based discharge plan is recommended.

Objectives

The aim of this project was to integrate the available evidence of discharge plan for total laryngectomy into practice, and implement strategies to improve compliance with acceptable practice.

Methods

The project carried out a pre- and post-implementation audit procedure using the Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research into Practice programs. Five audit criteria were established according to the available best-evidence on the discharge plan for total laryngectomy. The program was divided into three phases and conducted over five months in the ear, nose and throat ward, ward 7, Eye and Ear Nose and Throat (ENT) Hospital, Fudan University, Shanghai. 8 nurses and 15 patients were involved in baseline audit. 6 nurses and 15 patients were audited in the post-implementation audit.

Results

The post-implementation audit findings revealed a significant improvement in education on discharge for total laryngectomy, as well as in supplying patients with post-laryngectomy care products, and ongoing nursing support after discharge.

Conclusion

The project provided nurses with a good opportunity to receive evidence-based training about total laryngectomy patient education on discharge, and highlighted that providing the patients with evidence-based education after total laryngectomy should be the responsibility of an ear, nose and throat specialist nurse.
Validation Process of Pose Accuracy Estimation in Parallel Robots
Authors: Jáuregui-Correa J. C. , López-Cajún C. S. , García-Arredondo A. , Hernández-Martínez E. E. , Ceccarelli M.
Published: December 2014

This research ponders the origin of errors due to manufacturing and assembling processes that affect pose accuracy of any given robot. The estimation of these errors allows designers to define the influence of individual elements in the overall compliance. Two methods for assessing pose accuracy in parallel robots are presented in this paper: the simplified and the comprehensive methods. The former, based on the assumption that each actuator has a constant error, produces a preliminary rough estimation of pose accuracy; the latter, based on error propagation, requires the measurement of the displacement error of each actuator. Both methods were applied to estimate the accuracy of a high-precision Stewart platform and to verify it experimentally. These methods were validated through an actual platform, and results showed good agreement between them.
Heat Transfer in Reacting Cooling Films: Influence and Validation of Combustion Modeling in Numerical Simulations
Authors: Pohl Stephanie , Frank Gabriele , Pfitzner Michael
Published: December 2014

The demand for increased performance and lower weight of gas turbines gives rise to higher fuel-to-air ratios and a more compact design of the combustion chamber, thereby increasing the potential of fuel escaping unburnt from the combustor. Chemical reactions are likely to occur when the coolant air, used to protect the turbine blades, interacts with the unreacted fuel. Within this work, Reynolds-averaged Navier–Stokes (RANS) simulations of reacting cooling films exposed to high temperature fuel-rich exhaust gases are performed using the commercial computational fluid dynamics (CFD) code ansys fluent and validated against experimental results obtained at the Air Force Research Laboratory in Ohio. The results underline that the choice of the turbulence model has a significant impact on the evolution of the flow field and the mixing effectiveness. The flamelet as well as the equilibrium combustion model is able to predict an adequate distance of the reaction zone normal to the wall. Its thickness, however, is still much smaller and its onset too far upstream as compared to the experimental results. According to the present analysis, the flamelet combustion model applied along with k–ω shear stress transport (SST) or k–ε turbulence model turned out to be an appropriate choice in order to model near wall reacting flows with reasonable prospect of success.
Optical Methods for Studies of Self-Excited Oscillations and the Effect of Dampers in a High Pressure Single Sector Combustor
Authors: Meier U. , Lange L. , Heinze J. , Hassa C. , Sadig S. , Luff D.
Published: December 2014

Self-excited periodic instabilities in a staged lean burn injector could be forced by operating the combustor at off-design conditions. These pressure oscillations were studied in a high pressure single sector combustor with optical access. Two damper configurations were installed and tested with respect to their damping efficiency in relation to the configuration without dampers. For a variety of test conditions, derived from a part load case, time traces of pressure in the combustor were measured, and amplitudes were derived from their Fourier transformation. These measurements were performed for several combinations of the operating parameters, i.e., injector pressure drop, air/fuel ratio (AFR), pilot/main fuel split, and preheat temperature. These tests “ranked” the respective damper configurations and their individual efficiency with respect to the configuration without dampers. Although a general trend could be observed, the ranking was not strictly consistent for all operating conditions. For several test cases, preferably with pronounced self-excited pressure oscillations, phase-resolved planar optical measurement techniques were applied to investigate the change of spatial structures of fuel, reaction zones, and temperature distributions over a period of an oscillation. A pulsating motion was detected for both pilot and main flame, driven by a pulsating transport of the liquid fuel. This pulsation, in turn, is caused by a fluctuating air velocity, in connection with a prefilming airblast type atomizer. A phase shift between pilot and main injector heat release was observed, corresponding to a shift of fuel penetration. Local Rayleigh indices were calculated qualitatively, based on phase-resolved OH chemiluminescence used as marker for heat release, and corresponding pressure values. This identified regions, where a local amplification of pressure oscillations occurred. These regions were largely identical to the reaction regions of pilot and main injector, whereas the recirculation zone between the injector flows was found to exhibit a damping effect.
Comprehensive MRI simulation methodology using a dedicated MRI scanner in radiation oncology for external beam radiation treatment planning
Authors: Paulson Eric S. , Erickson Beth , Schultz Chris , Allen Li X.
Published: December 2014

Purpose:

The use of magnetic resonance imaging (MRI) in radiation oncology is expanding rapidly, and more clinics are integrating MRI into their radiation therapy workflows. However, radiation therapy presents a new set of challenges and places additional constraints on MRI compared to diagnostic radiology that, if not properly addressed, can undermine the advantages MRI offers for radiation treatment planning (RTP). The authors introduce here strategies to manage several challenges of using MRI for virtual simulation in external beam RTP.

Methods:

A total of 810 clinical MRI simulation exams were performed using a dedicated MRI scanner for external beam RTP of brain, breast, cervix, head and neck, liver, pancreas, prostate, and sarcoma cancers. Patients were imaged in treatment position using MRI‐optimal immobilization devices. Radiofrequency (RF) coil configurations and scan protocols were optimized based on RTP constraints. Off‐resonance and gradient nonlinearity‐induced geometric distortions were minimized or corrected prior to using images for RTP. A multidisciplinary MRI simulation guide, along with window width and level presets, was created to standardize use of MR images during RTP. A quality assurance program was implemented to maintain accuracy and repeatability of MRI simulation exams.

Results:

The combination of a large bore scanner, high field strength, and circumferentially wrapped, flexible phased array RF receive coils permitted acquisition of thin slice images with high contrast‐to‐noise ratio (CNR) and image intensity uniformity, while simultaneously accommodating patient setup and immobilization devices. Postprocessing corrections and alternative acquisition methods were required to reduce or correct off‐resonance and gradient nonlinearity induced geometric distortions.

Conclusions:

The methodology described herein contains practical strategies the authors have implemented through lessons learned performing clinical MRI simulation exams. In their experience, these strategies provide robust, high fidelity, high contrast MR images suitable for external beam RTP.
An integrative approach to understanding bird origins
Authors: Xu Xing , Zhou Zhonghe , Dudley Robert , Mackem Susan , Chuong Cheng-Ming , Erickson Gregory M. , Varricchio David J.
Published: December 2014

Recent discoveries of spectacular dinosaur fossils overwhelmingly support the hypothesis that birds are descended from maniraptoran theropod dinosaurs, and furthermore, demonstrate that distinctive bird characteristics such as feathers, flight, endothermic physiology, unique strategies for reproduction and growth, and a novel pulmonary system originated among Mesozoic terrestrial dinosaurs. The transition from ground-living to flight-capable theropod dinosaurs now probably represents one of the best-documented major evolutionary transitions in life history. Recent studies in developmental biology and other disciplines provide additional insights into how bird characteristics originated and evolved. The iconic features of extant birds for the most part evolved in a gradual and stepwise fashion throughout archosaur evolution. However, new data also highlight occasional bursts of morphological novelty at certain stages particularly close to the origin of birds and an unavoidable complex, mosaic evolutionary distribution of major bird characteristics on the theropod tree. Research into bird origins provides a premier example of how paleontological and neontological data can interact to reveal the complexity of major innovations, to answer key evolutionary questions, and to lead to new research directions. A better understanding of bird origins requires multifaceted and integrative approaches, yet fossils necessarily provide the final test of any evolutionary model.
Evidence for a single loss of mineralized teeth in the common avian ancestor
Authors: Meredith Robert W. , Zhang Guojie , Gilbert M. Thomas P. , Jarvis Erich D. , Springer Mark S.
Published: December 2014

Edentulism, the absence of teeth, has evolved convergently among vertebrates, including birds, turtles, and several lineages of mammals. Instead of teeth, modern birds (Neornithes) use a horny beak (rhamphotheca) and a muscular gizzard to acquire and process food. We performed comparative genomic analyses representing lineages of nearly all extant bird orders and recovered shared, inactivating mutations within genes expressed in both the enamel and dentin of teeth of other vertebrate species, indicating that the common ancestor of modern birds lacked mineralized teeth. We estimate that tooth loss, or at least the loss of enamel caps that provide the outer layer of mineralized teeth, occurred about 116 million years ago.
When contact changes minds: An experiment on transmission of support for gay equality
Authors: LaCour Michael J. , Green Donald P.
Published: December 2014

Can a single conversation change minds on divisive social issues, such as same-sex marriage? A randomized placebo-controlled trial assessed whether gay (
n
= 22) or straight (
n
= 19) messengers were effective at encouraging voters (
n
= 972) to support same-sex marriage and whether attitude change persisted and spread to others in voters’ social networks. The results, measured by an unrelated panel survey, show that both gay and straight canvassers produced large effects initially, but only gay canvassers’ effects persisted in 3-week, 6-week, and 9-month follow-ups. We also find strong evidence of within-household transmission of opinion change, but only in the wake of conversations with gay canvassers. Contact with gay canvassers further caused substantial change in the ratings of gay men and lesbians more generally. These large, persistent, and contagious effects were confirmed by a follow-up experiment. Contact with minorities coupled with discussion of issues pertinent to them is capable of producing a cascade of opinion change.
Convergent transcriptional specializations in the brains of humans and song-learning birds
Authors: Pfenning Andreas R. , Hara Erina , Whitney Osceola , Rivas Miriam V. , Wang Rui , Roulhac Petra L. , Howard Jason T. , Wirthlin Morgan , Lovell Peter V. , Ganapathy Ganeshkumar , Mountcastle Jacquelyn , Moseley M. Arthur , Thompson J. Will , Soderblom Erik J. , Iriki Atsushi , Kato Masaki , Gilbert M. Thomas P. , Zhang Guojie , Bakken Trygve , Bongaarts Angie , Bernard Amy , Lein Ed , Mello Claudio V. , Hartemink Alexander J. , Jarvis Erich D.
Published: December 2014

Song-learning birds and humans share independently evolved similarities in brain pathways for vocal learning that are essential for song and speech and are not found in most other species. Comparisons of brain transcriptomes of song-learning birds and humans relative to vocal nonlearners identified convergent gene expression specializations in specific song and speech brain regions of avian vocal learners and humans. The strongest shared profiles relate bird motor and striatal song-learning nuclei, respectively, with human laryngeal motor cortex and parts of the striatum that control speech production and learning. Most of the associated genes function in motor control and brain connectivity. Thus, convergent behavior and neural connectivity for a complex trait are associated with convergent specialized expression of multiple genes.
Extinctions of aculeate pollinators in Britain and the role of large-scale agricultural changes
Authors: Ollerton Jeff , Erenler Hilary , Edwards Mike , Crockett Robin
Published: December 2014

Pollinators are fundamental to maintaining both biodiversity and agricultural productivity, but habitat destruction, loss of flower resources, and increased use of pesticides are causing declines in their abundance and diversity. Using historical records, we assessed the rate of extinction of bee and flower-visiting wasp species in Britain from the mid-19th century to the present. The most rapid phase of extinction appears to be related to changes in agricultural policy and practice beginning in the 1920s, before the agricultural intensification prompted by the Second World War, often cited as the most important driver of biodiversity loss in Britain. Slowing of the extinction rate from the 1960s onward may be due to prior loss of the most sensitive species and/or effective conservation programs.
Superplastic nanofibrous slip zones control seismogenic fault friction
Authors: Verberne Berend A. , Plümper Oliver , Matthijs de Winter D.A. , Spiers Christopher J.
Published: December 2014

Understanding the internal mechanisms controlling fault friction is crucial for understanding seismogenic slip on active faults. Displacement in such fault zones is frequently localized on highly reflective (mirrorlike) slip surfaces, coated with thin films of nanogranular fault rock. We show that mirror-slip surfaces developed in experimentally simulated calcite faults consist of aligned nanogranular chains or fibers that are ductile at room conditions. These microstructures and associated frictional data suggest a fault-slip mechanism resembling classical Ashby-Verrall superplasticity, capable of producing unstable fault slip. Diffusive mass transfer in nanocrystalline calcite gouge is shown to be fast enough for this mechanism to control seismogenesis in limestone terrains. With nanogranular fault surfaces becoming increasingly recognized in crustal faults, the proposed mechanism may be generally relevant to crustal seismogenesis.
Antigen modification regulates competition of broad and narrow neutralizing HIV antibodies
Authors: McGuire Andrew T. , Dreyer Anita M. , Carbonetti Sara , Lippy Adriana , Glenn Jolene , Scheid Johannes F. , Mouquet Hugo , Stamatatos Leonidas
Published: December 2014

Some HIV-infected individuals develop broadly neutralizing antibodies (bNAbs), whereas most develop antibodies that neutralize only a narrow range of viruses (nNAbs). bNAbs, but not nNAbs, protect animals from experimental infection and are likely a key component of an effective vaccine. nNAbs and bNAbs target the same regions of the viral envelope glycoprotein (Env), but for reasons that remain unclear only nNAbs are elicited by Env immunization. We show that in contrast to germline-reverted (gl) bNAbs, glnNAbs recognized diverse recombinant Envs. Moreover, owing to binding affinity differences, nNAb B cell progenitors had an advantage in becoming activated and internalizing Env compared with bNAb B cell progenitors. We then identified an Env modification strategy that minimized the activation of nNAb B cells targeting epitopes that overlap those of bNAbs.