bluuebunny/crossref_metadata_2025 huggingface dataset:
The European Parliament and the UK Parliament: A Relationship in Foreign Policy
Authors: Kullaa Rinna
Published: February 2016

It is often argued that the crucial democratic body of the European Union (EU) is the European parliament. Over time, the European parliament's role has increased from being a consultative body to one which has an institutionalised co‐decision authority in EU lawmaking. After the Lisbon treaty and the abolition of the Western European Union (WEU), the European parliament also has an increasingly important role as an intergovernmental European assembly. This article examines the British discussion about the country's commitment to parliamentary scrutiny, representation and supervision, in which the need for a genuine debate over representation within the EU is highlighted. British prime ministers have, in most cases, defined both the government's and parliament's stance on European integration either through their personal role, or through wide‐ranging discussions in their cabinets. However, in the 2000s, the Houses’ parliamentary committees have also influenced the shaping of the British position through their scrutiny of European policies. They were effective in the scrutiny of the Common Foreign and Defence Policy (CFDP), arguing that the government should keep parliament informed of discussions concerning the CFDP, and that the quality of the democratic process depended largely on the relationship between the British national parliament and the government. The parliamentary committees and the government both agreed that parliamentary scrutiny should not be left to the European parliament alone; the participation of national parliamentarians with specialist knowledge of the EU level was also seen as especially important.
What is the viva experience of phase 2 Radiation Oncology examination candidates? Survey and advice for future candidates
Authors: Kleiven Hilde M , Tejani Neetu , Sullivan Lisa
Published: February 2016

Introduction

Medical speciality examination is a very stressful event in medical careers. We aimed to determine the subjective experience of Radiation Oncology Royal Australian and New Zealand College of Radiologists (RANZCR) oral examination candidates. It was hoped the results would provide reassurance and advice for future candidates.

Methods

We distributed an anonymous online survey through the RANZCR membership database to Radiation Oncology Trainees and fellows who may have sat their oral examination within the last 3 years.

Results

There were 21 responses, yielding a response rate of 21%. Nineteen percent of respondents were moderately or very surprised during their viva and the most frequently noted cause was the demeanour of the examiners. The clinical cases and clinical examination station were rated very fair by over 80% of responders while the planning cases were rated very fair by 57%. During the viva, 33% thought they passed and 71% of these candidates were successful. Forty‐three percent felt they were borderline, and all of these respondents passed. Five participants (24%) failed in the first attempt and four described being unable to convey their actual knowledge. Candidates found mock examinations to be the most useful examination preparation activity. The most frequently given advice was to focus on the planning examination.

Conclusions

The majority of this select group of candidates indicated that the oral examination cases were very fair. Candidates rated the planning exam as least fair, indicating this may be the area that would benefit most from better preparation.
Gynecological involvement in eosinophilic granulomatosis with polyangiitis
Authors: Sukhdeo Aishwarya , Bertouch James
Published: February 2016

Gynceological involvement in antineutrophil cytoplasmic antibody (ANCA)‐associated vasculitides is rare. We describe a case of ANCA‐associated vasculitis in an elderly woman presenting with fevers, cough and a rash. Further investigations revealed vasculitic involvement of the ovaries, fallopian tubes, uterus and omentum with an eosinophil‐rich infiltrate.
Increased pain relief with remifentanil does not improve the success rate of external cephalic version: a randomized controlled trial
Authors: Burgos Jorge , Pijoan José I. , Osuna Carmen , Cobos Patricia , Rodriguez Leire , Centeno María del Mar , Serna Rosa , Jimenez Antonia , Garcia Eugenia , Fernandez‐Llebrez Luis , Melchor Juan C.
Published: February 2016

Introduction

Our objective was to compare the effect of two pain relief methods (remifentanil vs. nitrous oxide) on the success rate of external cephalic version.

Material and methods

We conducted a randomized open label parallel‐group controlled single‐center clinical trial with sequential design, at Cruces University Hospital, Spain. Singleton pregnancies in noncephalic presentation at term that were referred for external cephalic version were assigned according to a balanced (1:1) restricted randomization scheme to analgesic treatment with remifentanil or nitrous oxide during the procedure. The primary endpoint was external cephalic version success rate. Secondary endpoints were adverse event rate, degree of pain, cesarean rate and perinatal outcomes.

Results

The trial was stopped early after the second interim analysis due to a very low likelihood of finding substantial differences in efficacy (futility). The external cephalic version success rate was the same in the two arms (31/60, 51.7%) with 120 women recruited, 60 in each arm. The mean pain score was significantly lower in the remifentanil group (3.2 ± 2.4 vs. 6.0 ± 2.3; p < 0.01). No differences were found in external cephalic version‐related complications. There was a trend toward a higher frequency of adverse effects in the remifentanil group (18.3% vs. 6.7%, p = 0.10), with a significantly higher incidence rate (21.7 events/100 women vs. 6.7 events/100 women with nitrous oxide, p = 0.03). All reported adverse events were mild and reversible.

Conclusions

Remifentanil for analgesia decreased external cephalic version‐related pain but did not increase the success rate of external cephalic version at term and appeared to be associated with an increased frequency of mild adverse effects.
Grey matter brain injuries are common in Ugandan children with cerebral palsy suggesting a perinatal aetiology in full‐term infants
Authors: Kakooza‐Mwesige Angelina , Byanyima Rosemary K. , Tumwine James K. , Eliasson Ann‐Christin , Forssberg Hans , Flodmark Olof
Published: February 2016

Aim

There is limited literature on brain imaging studies of children with cerebral palsy (CP) in low and middle income countries. We investigated neuroimaging patterns of children withCPattending a tertiary referral centre in Uganda to determine how they differed from studies reported from high income countries and their relationship with prenatal and postnatal factors.

Methods

Precontrast and postcontrast computed tomography (CT) scans of 78CPchildren aged 2–12 years were conducted using a PhilipsMX16‐sliceCTscanner. Two radiologists, blinded to the patient's clinical status, independently reviewed the scans.

Results

AbnormalCTscans were detected in 69% of the children sampled, with very few having primary white matter injuries (4%). Primary grey matter injuries (PGMI) (44%) and normal scans (31%) were most frequent. Children with a history of hospital admission following birth were three times more likely to havePGMI(odds ratio [OR] 2.8; 95%CI1.1–7.1), suggesting a perinatal period with medical complications.

Conclusion

Brain imaging patterns in this group ofCPchildren differed markedly from imaging studies reported from high income countries, suggesting a perinatal aetiology in full‐term infants and reduced survival in preterm infants.
European Randomised Study of Screening for Prostate Cancer (ERSPC) risk calculators significantly outperform the Prostate Cancer Prevention Trial (PCPT) 2.0 in the prediction of prostate cancer: a multi‐institutional study
Authors: Foley Robert W. , Maweni Robert M. , Gorman Laura , Murphy Keefe , Lundon Dara J. , Durkan Garrett , Power Richard , O'Brien Frank , O'Malley Kieran J. , Galvin David J. , Brendan Murphy T. , William Watson R.
Published: February 2016

Objective

To analyse the performance of the Prostate Cancer Prevention Trial Risk Calculator (PCPT‐RC) and two iterations of the European Randomised Study of Screening for Prostate Cancer (ERSPC) Risk Calculator, one of which incorporates prostate volume (ERSPC‐RC) and the other of which incorporates prostate volume and the prostate health index (PHI) in a referral population (ERSPC‐PHI).

Patients and Methods

The risk of prostate cancer (PCa) and significant PCa (Gleason score ≥7) in 2001 patients from six tertiary referral centres was calculated according to the PCPT‐RC and ERSPC‐RC formulae. The calculators’ predictions were analysed using the area under the receiver‐operating characteristic curve (AUC), calibration plots, Hosmer–Lemeshow test for goodness of fit and decision‐curve analysis. In a subset of 222 patients for whom the PHI score was available, each patient's risk was calculated as per the ERSPC‐RC and ERSPC‐PHI risk calculators.

Results

The ERSPC‐RC outperformed the PCPT‐RC in the prediction of PCa, with an AUC of 0.71 compared with 0.64, and also outperformed the PCPT‐RC in the prediction of significant PCa (P<0.001), with an AUC of 0.74 compared with 0.69. The ERSPC‐RC was found to have improved calibration in this cohort and was associated with a greater net benefit on decision‐curve analysis for both PCa and significant PCa. The performance of the ERSPC‐RC was further improved through the addition of the PHI score in a subset of 222 patients. The AUCs of the ERSPC‐PHI were 0.76 and 0.78 for PCa and significant PCa prediction, respectively, in comparison with AUC values of 0.72 in the prediction of both PCa and significant PCa for the ERSPC‐RC (P = 0.12 and P = 0.04, respectively). The ERSPC‐PHI risk calculator was well calibrated in this cohort and had an increase in net benefit over that of the ERSPC‐RC.

Conclusions

The performance of the risk calculators in the present cohort shows that the ERSPC‐RC is a superior tool in the prediction of PCa; however the performance of the ERSPC‐RC in this population does not yet warrant its use in clinical practice. The incorporation of the PHI score into the ERSPC‐PHI risk calculator allowed each patient's risk to be more accurately quantified. Individual patient risk calculation using the ERSPC‐PHI risk calculator can be undertaken in order to allow a systematic approach to patient risk stratification and to aid in the diagnosis of PCa.
The Performance of Titanium‐Zirconium Implants in the Elderly: A Biomechanical Comparative Study in the Minipig
Authors: Wen Bo , Chen Jiang , Dard Michel , Cai Zhiyu
Published: February 2016

Objectives

The aim of this study was to test the following hypothesis: (1) Aging would adversely affect bone integration of implants; (2) Titanium‐zirconium‐SLActive (TiZr‐SLActive) implant might perform better in osseointegration than Ti‐SLA implant in aged group.

Materials and Methods

Thirteen miniature pigs (six of them were young adult minipigs, with other seven being aged ones.) were enrolled in this study. The right mandibular premolars (P1, P2, P3) and the first molar (M1) were extracted in all animals. Three months later, one TiZr‐SLActive and one Ti‐SLA implants were inserted into the endentulous area in mandible of each animal. The animals were sacrificed 8 weeks after placement of implants. Implants in the mandibles were used for removal torque (RT) tests, while vertebra and femur being retrieved for bone mineral density (BMD) tests.

Results

Implant success rate in the young group was significantly higher than that in the aged group. Higher survival rate of implants was also observed in younger group than that in the aged group but without significant difference. Within the young group, mean value for peak RT of Ti‐SLA implants was higher than that of TiZr‐SLActive implants without significant difference. In the aged group, the TiZr‐SLActive implants showed a higher mean value for peak RT than Ti‐SLA implants. No significant difference was found in the mean BMD in both vertebra and femur between different age groups.

Conclusions

Within the limits of this study, aging could negatively affect osseointegration of dental implants. TiZr‐SLActive implants might to some degree compensate for the compromise in osseointegration brought by aging.
Can neonatal MRI predict long‐term motor outcome following preterm birth?
Authors: Arichi Tomoki
Published: February 2016

This commentary is on the original article by Setänen et al. on pages 721–727 of this issue.
Targeting Disaster Aid in Post‐Tsunami Sri Lanka
Authors: Gunawardena Asha , Baland Jean‐Marie
Published: February 2016

In this article we examine the allocation of boats and houses, the two major types of aid made available to tsunami‐affected fishery households in Sri Lanka. We investigate the effectiveness of targeting by looking at the distributional impacts and the determinants of allocation of these transfers at the household level. We find that houses were much better targeted than boats in terms of compensating for the losses due to the tsunami. We also find that the ex post distribution of boats is much more unequal than the distribution that prevailed before the tsunami. The reverse is true for the distribution of houses, for which the government took a much more active role.
Determination of Right Ventricular Volume by Combining Echocardiographic Distance Measurements
Authors: Jorstig Stina , Waldenborg Micael , Lidén Mats , Wodecki Maciej , Thunberg Per
Published: February 2016

Background

The position of the right ventricle (RV), often partly behind the sternum, implies difficulties to image the RV free wall using transthoracic echocardiography (TTE) and consequently limits the possibilities of stroke volume calculations. The aim of this study was to evaluate whether the volume of the right ventricle (RV) can be determined by combining TTE distance measurements that do not need the RV free wall to be fully visualized.

Methods

The RV volume was approximated by an ellipsoid composed of three distances. Distance measurements, modeled RV stroke volumes (RVSV), and RV ejection fraction (RVEF) were compared to reference values obtained from cardiac magnetic resonance (CMR) imaging for 12 healthy volunteers.

Results

Inter‐modality comparisons showed that distance measurements were significantly underestimated in TTE compared to CMR. The modeled RV volumes using TTE distance measurements were underestimated compared to reference CMR volumes. There was, however, for TTE an agreement between modeled RVSV and left ventricular stroke volumes determined by biplane Simpson's rule. Similar agreement was shown between modeled RVSV based on CMR distance measurements and the CMR reference. Regarding RVEF, further studies including patients with a wider range of RVEF are needed to evaluate the method.

Conclusion

In conclusion, the ellipsoid model of the RV provides good estimates of RVSVs, but volumes based on distance measurements from different modalities cannot be used interchangeably.
Shape change in mouthguard sheets during thermoforming
Authors: Takahashi Mutsumi , Koide Kaoru , Satoh Yoshihide , Iwasaki Shin‐ichi
Published: February 2016

Background

The purpose of this study was to identify changes in sheet shape during thermoforming and the effect of the model position in the molding machine on fabricated mouthguard thickness.

Materials and Methods

Ethylene vinyl acetate mouthguard sheets (3.8 mm thick) were used that had cross‐stripes (10 × 10 mm), and the anteroposterior and bilateral lengths were used for measurements. Two forming machines were used: a vacuum‐ and a pressure‐forming machine, and two heating conditions were investigated that defined as the time when sagging of the softened sheet was 15 mm (H‐15) and 20 mm (H‐20) below the clamp, and the length of each cross‐stripes was measured. The area of each lattice was calculated using Bretschneider's formula to compare changes in sheet shape for each condition. Next, mouthguards were molded by forming machine where the working model was positioned under two different conditions: with the model anterior centered in the forming unit and with the model centered. The sheet thickness after fabrication was determined for the incisal and the molar portion, and dimensional measurements were obtained using a measuring device. Differences in the thickness were analyzed by two‐way analysis of variance (anova).

Result

In both molding machines, the change in the area under H‐20 was greater than H‐15. While the increase in area tended to expand from the center of the sheet in concentric circles, the difference between the central and surrounding areas was only approximately 5%. For both molding machines, differences in thickness after molding due to setting position of the model were not observed.

Conclusion

The results showed that shape changes of the sheet during thermoforming tend to concentrically and almost uniformly expand from the center and that it is important to center the sheet and the model when positioning the model in the forming unit.
Equine recurrent uveitis: A review of clinical assessment and management
Authors: Allbaugh R. A.
Published: February 2016

Equine recurrent uveitis (ERU) is a vision‐threatening ocular disease that practitioners must be able to identify and manage. Although not every case of acute uveitis will develop into ERU, if 2 or more episodes of uveitis are observed, a diagnosis of ERU can be made. Patient outcomes improve with early diagnosis, appropriate therapy and client education. Recent advances in surgical options and treatment of horses with ERU have improved success in managing this condition. New therapeutic strategies under investigation may further enhance results and reduce the development of complicating factors.
Glycyrrhizic acid prevents ultraviolet‐B‐induced photodamage: a role for mitogen‐activated protein kinases, nuclear factor kappa B and mitochondrial apoptotic pathway
Authors: Afnan Quadri , Kaiser Peerzada J. , Rafiq Rather A. , Nazir Lone A. , Bhushan Shashi , Bhardwaj Subhash C. , Sandhir Rajat , Tasduq Sheikh A.
Published: February 2016

Glycyrrhizic acid (GA), a natural triterpene, has received attention as an agent that has protective effects against chronic diseases including ultraviolet UV‐B‐induced skin photodamage. However, the mechanism of its protective effect remains elusive. Here, we used an immortalized human keratinocyte cell line (HaCaT) and a small animal model (BALB/c mice), to investigate the protective effects of GA against UV‐B‐induced oxidative damage, and additionally, delineated the molecular mechanisms involved in the UV‐B‐mediated inflammatory and apoptotic response. In the HaCaT cells, GA inhibited the UV‐B‐mediated increase in intracellular reactive oxygen species (ROS) and down‐regulated the release of pro‐inflammatory cytokines interleukin (IL)‐1α, ‐1β and ‐6, tumor necrosis factor (TNF)‐α and prostaglandin E2 (PGE2). GA inhibited UV‐B‐mediated activation of p38 and JNK MAP kinases, COX‐2 expression and nuclear translocation of NF‐κB. Furthermore, GA inhibited UV‐B‐mediated apoptosis by attenuating translocation of Bax from the cytosol to mitochondria, thus preserving mitochondrial integrity. GA‐treated HaCaT cells also exhibited elevated antiapoptotic Bcl‐2 protein, concomitant with reduced caspase‐3 cleavage and decreased PARP‐1 protein. In BALB/c mice, topical application of GA on dorsal skin exposed to UV‐B irradiation protected against epidermal hyperplasia, lymphocyte infiltration and expression of several inflammatory proteins, p38, JNK, COX‐2, NF‐κB and ICAM‐1. Based on the above findings, we conclude that GA protects against UV‐B‐mediated photodamage by inhibiting the signalling cascades triggered by oxidative stress, including MAPK/NF‐κB activation, as well as apoptosis. Thus, GA has strong potential to be used as a therapeutic/cosmeceutical agent against photodamage.
Validation of a cyclic plasticity computational method using fatigue full‐field deformation measurements
Authors: Cuadra J. , Baxevanakis K. P. , Loghin A. , Kontsos A.
Published: February 2016

The evolution of crack tip displacement and strain fields during uniaxial, room temperature, low‐cycle fatigue experiments of Nickel superalloy compact tension specimens was measured by a digital image correlation approach and was further used to validate a cyclic plasticity model and corresponding deformation calculations made by a finite elements methodology. The experimental results provided data trends for the opening displacements and near crack tip strains as function of cycles. A finite element model was developed to capture test conditions for a measured crack size. The model captures crack tip plasticity by using a constitutive model calibrated against stress‐strain measurements performed on a round bar. Similar quantities were extracted from the model predictions to compare with the digital image correlation measurements for model validation purposes. This type of direct comparison demonstrated that the computational model was capable to adequately capture the crack opening displacements at various stages of the specimen's fatigue life, providing in this way a tool for quantitative cyclic plasticity model validation. In addition, this integrated experimental‐computational approach provides a framework to accelerate our understanding related to interactions of fatigue test data and models, as well as ways to inform one another.
Brazilian recreational fisheries: current status, challenges and future direction
Authors: Freire K. M. F. , Tubino R. A. , Monteiro‐Neto C. , Andrade‐Tubino M. F. , Belruss C. G. , Tomás A. R. G. , Tutui S. L. S. , Castro P. M. G. , Maruyama L. S. , Catella A. C. , Crepaldi D. V. , Daniel C. R. A. , Machado M. L. , Mendonça J. T. , Moro P. S. , Motta F. S. , Ramires M. , Silva M. H. C. , Vieira J. P.
Published: February 2016

Recreational fisheries in Brazil have increased in importance and attracted many foreign recreational fishers. The objectives of this article were to summarise the available data on Brazilian recreational fisheries, to discuss some of their features and to analyse how they are performing in different regions compared with international trends. A review of published and unpublished sources together with data from recreational fishing licences was used. The participation rate was low (0.9%). Overall, there was a high diversity of fish species, with the following species/group of species repeatedly reported: Menticirrhus spp., Centropomus spp., Cynoscion spp., and Micropogonias furnieri (marine/estuarine water), and Cichla spp., Hoplias malabaricus, and Piaractus mesopotamicus, together with the introduced Oreochromis niloticus and Coptodon rendalli (fresh water). The north‐eastern region differs from the other regions: fishing occurs mostly in marine waters and fishers acquire mainly shore‐based licences, have minimum fishing expenditures and rarely release fishes. There is no estimate of the total harvest or economic value. Conflicts include catch‐and‐release‐oriented freshwater and marine recreational fishers vs consumption‐oriented coastal fishers, tournament participants vs non‐participants, commercial fishers and other leisure activities, pollution, ports, species introductions and translocations, protected areas, and federal and state laws. Cases of smooth shifts from artisanal to recreational fishing were detected, possibly associated with changes in the societal relationship with natural resources.
Soil carbon and nitrogen stocks in forests along an altitudinal gradient in the eastern Himalayas and a meta‐analysis of global data
Authors: Tashi Sonam , Singh Balwant , Keitel Claudia , Adams Mark
Published: February 2016

High‐altitude soils potentially store a large pool of carbon (C) and nitrogen (N). The assessment of total C and N stocks in soils is vital to understanding the C and N dynamics in terrestrial ecosystems. In this study, we examined effects of altitude and forest composition on soil C and N along a transect from 317 to 3300 m a.s.l. in the eastern Himalayas. We used meta‐analysis to establish the context for our results on the effects of altitude on soil C, including variation with depth. Total C and N contents of soils significantly increased with altitude, but decreased with soil depth. Carbon and N were similarly correlated with altitude and temperature, and temperature was seemingly the main driver of soil C along the altitudinal gradient. Altitude accounted for 73% of the variation in C and 47% of the variation in N stocks. Soil pH and cation exchange capacity were correlated with both soil C and N stocks. Increases in soil C and N stocks were related to forest composition, forest basal area as well as quantity of leaf litter that were in turn influenced by altitude and temperature. Concentrations of C in foliage increased by 2.1% for every 1000 m rise in altitude, while that in leaf litter increased by 2.3%.
Renal artery embolization in severe nephrotic syndrome
Authors: Solak Yalcin , Koc Osman , Ucar Ramazan , Ozbek Orhan , Ergenc Hasan , Gaipov Abduzhappar , Turk Suleyman
Published: February 2016

Introduction Severe nephrotic syndrome is associated with increased morbidity and mortality. Renal artery embolization (RAE) has been used in a number of renal diseases such as renal tumors, arteriovenous fistulas etc. However, data regarding benefits of RAE in patients with symptomatic severe proteinuria is limited. We decided to evaluate role of RAE in the setting of severe symptomatic nephrotic syndrome. Methods Eight patients who had undergone transcatheter renal artery embolization with polyvinyl alcohol (PVA) were included. Clinico‐demographic characteristics as well as baseline laboratory data including level of proteinuria, serum albumin, C‐reactive protein and LDL cholesterol levels were recorded for each patient. After RAE, outpatient clinic control laboratory values were also assessed. Findings All patients except one underwent bilateral RAE (four simultaneous or three sequential). Two patients experienced postembolization syndrome characterized by flank pain, fever, and leukocytosis, which was self‐limited and responded to analgesics in all patients. There was no technical complications associated with RAE procedure. All patients became anuric except one. Serum albumin levels increased and serum LDL‐cholesterol levels decreased considerably in treated patients. Discussion Renal artery embolization with the purpose of amelioration in nephrotic syndrome complications was effective and free of major technical complications in our patients.
Clinical significance of serum Wisteria floribunda agglutinin positive Mac‐2‐binding protein level in non‐alcoholic steatohepatitis
Authors: Nishikawa Hiroki , Enomoto Hirayuki , Iwata Yoshinori , Kishino Kyohei , Shimono Yoshihiro , Hasegawa Kunihiro , Nakano Chikage , Takata Ryo , Yoh Kazunori , Nishimura Takashi , Aizawa Nobuhiro , Sakai Yoshiyuki , Ikeda Naoto , Takashima Tomoyuki , Ishii Akio , Iijima Hiroko , Nakamura Hideji , Nishiguchi Shuhei
Published: February 2016

Aim

To examine the relationship between the Wisteria floribunda agglutinin positive Mac‐2‐binding protein (WFA+‐M2BP) level and histological findings for patients with non‐alcoholic steatohepatitis (NASH).

Methods

A total of 134 NASH patients (mean age, 51.7 years) were analyzed. We examined the effect of WFA+‐M2BP level on severity of liver fibrosis comparing with other laboratory markers, including aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio, AST to platelet ratio index (APRI), FIB‐4 index, platelet count and hyaluronic acid as serum liver fibrosis markers. Receiver–operator curve (ROC) analysis was performed for calculating the area under the ROC (AUROC).

Results

The WFA+‐M2B P‐value ranged from 0.2 cut‐off index (COI) to 9.6 COI (median, 0.9). The median values in each fibrosis stage were: 0.7 COI in F1, 0.7 COI in F2, 1.2 COI in F3 and 2.4 COI in F4 (P < 0.001). For predicting liver cirrhosis (F4), WFA+‐M2BP level had the AUROC of 0.854 (sensitivity, 69.2%; specificity, 88.4%) and for predicting advanced liver fibrosis (≥F3), WFA+‐M2BP level yielded the second highest AUROC with a level of 0.842 (sensitivity, 73.7%; specificity, 80.2%) and for predicting significant liver fibrosis (≥F2), WFA+‐M2BP level yielded the highest AUROC with a level of 0.663 (sensitivity, 47.2%; specificity, 78.6%) among six liver fibrosis markers. The median values in patients with ballooning scores 1 (n = 58) and 2 (n = 76) were 0.6 and 1.1 COI, respectively (P < 0.001).

Conclusion

Serum WFA+‐M2BP level can be useful for assessing liver histological findings in patients with NASH.
Rethinking the construction of welfare in Mexico: Going beyond the economic measures
Authors: Martinez‐Martinez Oscar A. , Lombe Margaret , Vazquez‐Rodriguez Ana‐Maria , Coronado‐Garcia Mauricio
Published: February 2016

This study utilized a multidimensional measure of social welfare composed of 26 social indicators integrated in nine categories: education, employment and social protection, income, health, housing conditions, subjective wellbeing, social capital, use of technology, and culture and leisure to help understand social welfare in Mexico. We also compared the integrated measure with the Human Development Index. Estimation was performed using the
method. Our analysis indicated that the health and housing conditions categories contributed the most to social welfare across the 32 Mexican States. In relation to the indicators, income and trust in other people were associated with welfare. Further, results on the welfare ranking of Mexican states revealed variations between the two indices
and the HDI). Specifically, only four states occupied the same position on both indices, ten recorded different positions on
moving up or down from their levels of social welfare. Implications of observed correlations are presented.
Workplace violence against nursing staff in a Saudi university hospital
Authors: Alkorashy Hanan A. Ezzat , Al Moalad Fawziah Bakheet
Published: February 2016

Background

Violence against nurses is a major challenge for healthcare administrators. It is gaining more attention because it has a negative impact on nurses, the quality of health care and health organization. Common types of violence include physical harassment, sexual abuse, aggression, mobbing and bullying. Patients, their relatives and co‐workers are considered the main perpetrators.

Aim

To determine the prevalence rate of workplace violence against nursing professionals in a university hospital in Riyadh, Saudi Arabia, most frequent type and perpetrators as well as the contributing factors.

Methods

This quantitative cross‐sectional study adapted a survey questionnaire from the Massachusetts Nurses Association Survey on Workplace Violence/Abuse to collect data from a quota sample of 370 nursing personnel.

Results

Almost half of the participants had experienced violence in the professional setting during the 12 months prior to the study. The majority of subjects perceived workplace violence as verbal abuse. Nearly all nursing professionals identified patients as the leading cause. Slightly more than half mentioned understaffing, misunderstandings, long waits for service and lack of staff training and policies for preventing crisis as contributing factors.

Conclusion and Implications for Nursing and Health Policy

The prevalence rate is extremely high among nurses in the targeted Saudi university hospital. Saudi health as well as university hospitals’ administration and policy makers should adopt and introduce a ‘zero tolerance policy', set standards and develop practical measures for preventing the incidence and for controlling the prevalence of violence against nurses. Besides, healthcare organizations, particularly hospitals, can fulfil their obligations to provide both staff and patients with more secure environment. Further research on the topic is needed.
Relationship between nurses' practice environments and nursing outcomes in Turkey
Authors: Topçu İ. , Türkmen E. , Badır A. , Göktepe N. , Miral M. , Albayrak S. , Kebapçı A. , Serbest Ş. , Özcan D.
Published: February 2016

Aim

This study aimed to understand nursing practice environment characteristics in Istanbul‐area hospitals in Turkey, the relationship between these characteristics, nurse burnout levels and nurses' intentions to leave work.

Background

A well‐known relationship exists in many countries between nursing practice environments and nurse burnout and intention to leave work. However, little is known about the relationship between practice environment characteristics and nursing outcomes in Turkey.

Methods

This cross‐sectional study was conducted among 2592 nurses in 20 Ministry of Health and 29 private hospitals in Istanbul, Turkey. A demographic questionnaire, Practice Environment Scale of the Nursing Work Index and Maslach Burnout Inventory were used for data collection.

Results

Almost half of nurses suffered from high‐level burnout related to emotional exhaustion and personal accomplishment, and one‐third reported depersonalization and the intent to leave their jobs within a year. A poor nursing practice environment was the leading factor, increasing nurses' burnout levels in all subdimensions. Burnout related to emotional exhaustion, personal accomplishment and poor practice environment increased intention to leave. Permanent positions decreased intention.

Discussion

There was a relationship between poor practice environments and nursing outcomes in Turkey.

Limitations

The use of a survey data collection method is a potential study limitation. Quantitative and qualitative methods could be combined to obtain more detailed objective data about nursing practice environments.

Conclusion

Poor practice environments, high‐level burnout and intention to leave work are significant problems in Istanbul, Turkey. Favourable practice environments and job security should be provided to improve nursing outcomes.

Implications for nursing policy

Policymakers and nurse managers should be aware of any negative issues regarding nursing practice environments and job security to improve nursing outcomes.
Delayed grafting for banked skin graft in lymph node flap transfer
Authors: Ciudad Pedro , Date Shivprasad , Orfaniotis Georgios , Dower Rory , Nicoli Fabio , Maruccia Michele , Lin Shu‐Ping , Chuang Chu‐Yi , Chuang Tsan‐Yu , Wang Gou‐Jen , Chen Hung‐Chi
Published: February 2016

Over the last decade, lymph node flap (LNF) transfer has turned out to be an effective method in the management of lymphoedema of extremities. Most of the time, the pockets created for LNF cannot be closed primarily and need to be resurfaced with split thickness skin grafts. Partial graft loss was frequently noted in these cases. The need to prevent graft loss on these iatrogenic wounds made us explore the possibility of attempting delayed skin grafting. We have herein reported our experience with delayed grafting with autologous banked split skin grafts in cases of LNF transfer for lymphoedema of the extremities. Ten patients with International Society of Lymphology stage II–III lymphoedema of upper or lower extremity were included in this study over an 8‐month period. All patients were thoroughly evaluated and subjected to lymph node flap transfer. The split skin graft was harvested and banked at the donor site, avoiding immediate resurfacing over the flap. The same was carried out in an aseptic manner as a bedside procedure after confirming flap viability and allowing flap swelling to subside. Patients were followed up to evaluate long‐term outcomes. Flap survival was 100%. Successful delayed skin grafting was done between the 4th and 6th post‐operative day as a bedside procedure under local anaesthesia. The split thickness skin grafts (STSG) takes more than 97%. One patient needed additional medications during the bedside procedure. All patients had minimal post‐operative pain and skin graft requirement. The patients were also reported to be satisfied with the final aesthetic results. There were no complications related to either the skin grafts or donor sites during the entire period of follow‐up. Delayed split skin grafting is a reliable method of resurfacing lymph node flaps and has been shown to reduce the possibility of flap complications as well as the operative time and costs.
The Trials of Lizzie Eustace: Trollope, Sensationalism, and the Condition of English Law
Authors: Ward Ian
Published: February 2016

The Eustace Diamonds was published in 1872. It was the third of Anthony Trollope's famed Palliser series. It represented, however, something of a diversion, telling the story of the ‘cunning’ Lizzie Eustace who declines to return a priceless diamond necklace to the estate of her recently deceased husband. Critics have supposed that The Eustace Diamonds can be read as a contribution to the contemporary genre of ‘sensation’ novels. Sensation novels were full of sex, crime, and scheming young women like Lizzie Eustace. The law should of course have brought to Lizzie to justice. But it does not; indeed it barely tries. For the law in The Eustace Diamonds, as in so many ‘sensation’ novels, is conspicuous only in a failure that is as metaphorical in purpose as it is prosaic.
M. NourbeSe Philip's Zong!: Metaphors, Laws, and Fugues of Justice
Authors: Quéma Anne
Published: February 2016

Focusing on Gregson v. Gilbert, the article considers colonialism as a historical chain of events with the Middle Passage as a major locus of association among humans, things, the sea, trade, transportation, maritime law, and finance speculation. Out of this assemblage emerged slavery as a racist socius through which the metaphor of the human‐thing circulated. In citing Gregson v. Gilbert, M.N. Philip's poem Zong! seeks to bear responsibility to the reified bodies of the murdered Africans by generating a poetics of relationality that disassembles and reassembles the legal words as sign‐objects on the page. Her gendered address to the law exposes the rape that Africa endured. Bearing witness to this trauma, her poem speaks to and with the dead, recognizing the singularity of the Africans' languages, of which as human‐things they were deprived. Gathering readers and listeners, the poem creates an event through which an ethics of justice might materialize.
‘Disability Means, um, Dysfunctioning People’: A Qualitative Analysis of the Meaning and Experience of Disability among Adults with Intellectual Disabilities
Authors: Monteleone Rebecca , Forrester‐Jones Rachel
Published: February 2016

Background

There has been little qualitative analysis of the experience of stigma, social comparisons and conception of identity among adults with intellectual disabilities (ID). This study aimed to develop an understanding of how adults with intellectual disabilities experience their own disability, and any implications relating to self‐esteem, stigma and social interactions.

Materials and Methods

Fifteen adults with intellectual disabilities were interviewed using semi‐structured, open‐ended questions regarding disability, social interactions and self‐esteem. Interviews were analysed independently by two researchers using interpretive phenomenological analysis.

Results

Three major themes emerged during analysis, exploring pressure on participants to behave in a socially normative way, tendency to produce personal definitions of disability and consistently limited knowledge of and discomfort around common disability terminology.

Conclusions

Participants' clearly experienced feelings of difference, despite a lack of articulation. Limited understanding of both terminology and conceptualization of disability status could negatively impact self‐esteem, person‐centred actions and political movement.
Metformin prevents the effects of Pseudomonas aeruginosa on airway epithelial tight junctions and restricts hyperglycaemia‐induced bacterial growth
Authors: Patkee Wishwanath R. A. , Carr Georgina , Baker Emma H. , Baines Deborah L. , Garnett James P.
Published: February 2016

Lung disease and elevation of blood glucose are associated with increased glucose concentration in the airway surface liquid (ASL). Raised ASL glucose is associated with increased susceptibility to infection by respiratory pathogens including Staphylococcus aureus and Pseudomonas aeruginosa. We have previously shown that the anti‐diabetes drug, metformin, reduces glucose‐induced S. aureus growth across in vitro airway epithelial cultures. The aim of this study was to investigate whether metformin has the potential to reduce glucose‐induced P. aeruginosa infections across airway epithelial (Calu‐3) cultures by limiting glucose permeability. We also explored the effect of P. aeruginosa and metformin on airway epithelial barrier function by investigating changes in tight junction protein abundance. Apical P. aeruginosa growth increased with basolateral glucose concentration, reduced transepithelial electrical resistance (TEER) and increased paracellular glucose flux. Metformin pre‐treatment of the epithelium inhibited the glucose‐induced growth of P. aeruginosa, increased TEER and decreased glucose flux. Similar effects on bacterial growth and TEER were observed with the AMP activated protein kinase agonist, 5‐aminoimidazole‐4‐carboxamide ribonucleotide. Interestingly, metformin was able to prevent the P. aeruginosa‐induced reduction in the abundance of tight junction proteins, claudin‐1 and occludin. Our study highlights the potential of metformin to reduce hyperglycaemia‐induced P. aeruginosa growth through airway epithelial tight junction modulation, and that claudin‐1 and occludin could be important targets to regulate glucose permeability across airway epithelia and supress bacterial growth. Further investigation into the mechanisms regulating metformin and P. aeruginosa action on airway epithelial tight junctions could yield new therapeutic targets to prevent/suppress hyperglycaemia‐induced respiratory infections, avoiding the use of antibiotics.
A Qualitative Study of the Maternity Care Experiences of Women with Obesity: “More than Just a Number on the Scale”
Authors: DeJoy Sharon Bernecki , Bittner Krystle , Mandel Deborah
Published: February 2016

Introduction

The prevalence of obesity among pregnant women in the United States is high. Obesity can have long‐term health consequences for both women and their offspring, so high‐quality perinatal care for women with obesity is essential. However, stigmatizing encounters with health care professionals can decrease quality and promote avoidance of care. The purpose of this study was to explore the experiences of women with obesity in the maternity care system in the United States.

Methods

In‐depth telephone interviews were conducted with 16 women with a body mass index of 30 or greater. The authors used an inductive analytical process to translate women's experiences into themes.

Results

Women with obesity reported diverse maternity care experiences, with some reporting appropriate and satisfactory care, while most reported at least one negative encounter over the course of perinatal care. Three major themes emerged from the analysis: personalized care, depersonalized care, and setting the tone.

Discussion

Interactions with providers during pregnancy had psychological and emotional effects on women with obesity and influenced the content and perceived quality of their care. Further research is required to explore this phenomenon and its implications for care of women during pregnancy and birth outcomes. In the meantime, providers may wish to consider greater sensitivity to the needs of women with obesity during the perinatal period.
Contextualising primate origins – an ecomorphological framework
Authors: Soligo Christophe , Smaers Jeroen B.
Published: February 2016

Ecomorphology – the characterisation of the adaptive relationship between an organism's morphology and its ecological role – has long been central to theories of the origin and early evolution of the primate order. This is exemplified by two of the most influential theories of primate origins: Matt Cartmill's Visual Predation Hypothesis, and Bob Sussman's Angiosperm Co‐Evolution Hypothesis. However, the study of primate origins is constrained by the absence of data directly documenting the events under investigation, and has to rely instead on a fragmentary fossil record and the methodological assumptions inherent in phylogenetic comparative analyses of extant species. These constraints introduce particular challenges for inferring the ecomorphology of primate origins, as morphology and environmental context must first be inferred before the relationship between the two can be considered. Fossils can be integrated in comparative analyses and observations of extant model species and laboratory experiments of form–function relationships are critical for the functional interpretation of the morphology of extinct species. Recent developments have led to important advancements, including phylogenetic comparative methods based on more realistic models of evolution, and improved methods for the inference of clade divergence times, as well as an improved fossil record. This contribution will review current perspectives on the origin and early evolution of primates, paying particular attention to their phylogenetic (including cladistic relationships and character evolution) and environmental (including chronology, geography, and physical environments) contextualisation, before attempting an up‐to‐date ecomorphological synthesis of primate origins.
The Relationship Among School Safety, School Liking, and Students' Self‐Esteem: Based on a Multilevel Mediation Model
Authors: Zhang Xinghui , Xuan Xin , Chen Fumei , Zhang Cai , Luo Yuhan , Wang Yun
Published: February 2016

BACKGROUND

Perceptions of school safety have an important effect on students' development. Based on the model of “context‐process‐outcomes,” we examined school safety as a context variable to explore how school safety at the school level affected students' self‐esteem.

METHODS

We used hierarchical linear modeling to examine the link between school safety at the school level and students' self‐esteem, including school liking as a mediator. The data were from the National Children's Study of China (NCSC), in which 6618 fourth‐ to fifth‐grade students in 79 schools were recruited from 100 counties in 31 provinces in China.

RESULTS

Multilevel mediation analyses showed that the positive relationship between school safety at the school level and self‐esteem was partially mediated by school liking, controlling for demographics at both student and school levels. Furthermore, a sex difference existed in the multilevel mediation model. For boys, school liking fully mediated the relationship between school safety at the school level and self‐esteem. However, school liking partially mediated the relationship between school safety at the school level and self‐esteem among girls.

CONCLUSION

School safety should receive increasing attention from policymakers because of its impact on students' self‐esteem.