bluuebunny/crossref_metadata_2025 huggingface dataset:
Small colon stenosis secondary to ulcerative colitis in threeStandardbred foals
Authors: Kopper J. , Stewart S. , Habecker P. , Aitken M. R. , Southwood L. L.
Published: February 2015

ThreeStandardbred foals, a colt approximately one month old and 2 fillies approximately 4.5 months old, from the same farm, presented toUniversity ofPennsylvania'sNewBoltonCentre over the course of 3 months for further evaluation due to acute onset of colic. All foals had a history of diarrhoea prior to presentation. On presentation, the foals had abdominal distension, dull demeanour and repeatedly lay down and rolled. Exploratory celiotomy revealed a segment of stenotic (lumen diameter 1–4 mm) small colon with marked distension of the colon proximal to the stenotic segment.Post mortemexamination of the foals confirmed stenosis of the small colon with a segment of ulcerative colitis associated with the stenotic region. An aetiological agent was not identified.
Equine endometrial cytology: Collection techniques and interpretation
Authors: Ferris R. A. , Bohn A. , McCue P. M.
Published: February 2015

Endometritis is an important cause of reproductive pathology in the horse. Endometrial cytology preparations from unguarded swabs, guarded swabs or brushes, cap of a guarded swab, low volume lavage or even an endometrial biopsy sample can be utilised to rapidly evaluate uterine health. These cells can easily be stained with a modified Wright's stain and evaluated for the presence or absence of inflammatory cells and pathogens. Commonly visualised cell types are easily identified with a traditional light microscope at 400× or 1000× magnification. This technique provides an easy and rapid way to diagnose endometritis in the horse.
Is your practice diagnosing cheek teeth diastemata?
Authors: Easley J. , Odenweller S.
Published: February 2015

Diastema (pleural diastemata) is the most common disorder predisposing the horse to periodontal disease. These can affect the incisors or cheek teeth but pose more significant problems in the cheek teeth. Cheek teeth diastema can be congenital or develop secondary to other pathology. This condition is underdiagnosed in clinical practice due to lack of awareness of its seriousness and also due to poor dental examination techniques. A thorough dental examination requires both digital palpation and visual inspection of the oral cavity. Proper patient restraint and the use of a mouth speculum, bright light source, dental mirror or oral endoscope are required to fully inspect the equine oral cavity. Diastemata diagnosed early and managed properly can prevent the progression of periodontal disease and allow affected horses to preserve their dentition into old age.
Minimally‐invasive plate osteosynthesis of a Salter‐Harris type 2 fracture of the proximal phalanx in a filly
Authors: Van Spijk J. N. , Fürst A. E. , Del Chicca F. , Ringer S. K. , Jackson M. A.
Published: February 2015

A 7‐month‐old Warmblood filly was referred to the equine hospital because of a Salter‐Harris type 2 fracture of the proximal physis of the right hind P1. On admission, the filly had acute grade 3/5 lameness at the walk and diffuse swelling in the area of the right hind proximal phalanx. Radiographs were taken to assess the fracture and plan treatment. Surgical treatment using two 4.5 mm narrow locking compression plates (PIP‐LCPs) resulted in fracture stabilisation and rapid healing. This case report suggests that internal fixation using PIP‐LCPs is useful for the treatment of Salter‐Harris type 2 fractures of the proximal physis of P1 in large foals.
The role of PPARγ‐mediated signalling in skin biology and pathology: new targets and opportunities for clinical dermatology
Authors: Ramot Yuval , Mastrofrancesco Arianna , Camera Emanuela , Desreumaux Pierre , Paus Ralf , Picardo Mauro
Published: February 2015

Peroxisome proliferator‐activated receptors (PPARs) are ligand‐activated transcription factors that modulate the expression of multiple different genes involved in the regulation of lipid, glucose and amino acid metabolism. PPARs and cognate ligands also regulate important cellular functions, including cell proliferation and differentiation, as well as inflammatory responses. This includes a role in mediating skin and pilosebaceous unit homoeostasis: PPARs appear to be essential for maintaining skin barrier permeability, inhibit keratinocyte cell growth, promote keratinocyte terminal differentiation and regulate skin inflammation. They also may have protective effects on human hair follicle (HFs) epithelial stem cells, while defects in PPARγ‐mediated signalling may promote the death of these stem cells and thus facilitate the development of cicatricial alopecia (lichen planopilaris). Overall, however, selected PPARγ modulators appear to act as hair growth inhibitors that reduce the proliferation and promote apoptosis of hair matrix keratinocytes. The fact that commonly prescribed PPARγ‐modulatory drugs of the thiazolidine‐2,4‐dione class can exhibit a battery of adverse cutaneous effects underscores the importance of distinguishing beneficial from clinically undesired cutaneous activities of PPARγ ligands and to better understand on the molecular level how PPARγ‐regulated cutaneous lipid metabolism and PPARγ‐mediated signalling impact on human skin physiology and pathology. Surely, the therapeutic potential that endogenous and exogenous PPARγ modulators may possess in selected skin diseases, ranging from chronic inflammatory hyperproliferative dermatoses like psoriasis and atopic dermatitis, via scarring alopecia and acne can only be harnessed if the complexities of PPARγ signalling in human skin and its appendages are systematically dissected.
Functional glycine receptor in cultured human keratinocytes
Authors: Inoue Kaori , Takei Kentaro , Denda Mitsuhiro
Published: February 2015

We previously demonstrated that a series of neural receptors, those play a crucial role in nerve system, also expressed in epidermal keratinocytes. We also demonstrated that topical application of glycine on hairless mice skin after the barrier disruption also accelerated the barrier recovery and it was blocked by the strychnine. Glycine is known as one of the most important inhibitory neurotransmitters in the mammalian central nervous system. Thus, we hypothesized that glycine receptor also functionally expressed in the epidermal keratinocytes. In the present study, we first studied the expression of glycine receptor message in cultured human keratinocytes. Then we demonstrate for the first time the existence of a functional receptor with electrophysiological properties of glycine receptors in cultured human epidermal keratinocytes. Finally, we demonstrated immune‐histochemical study against anti‐glycine receptor subunits in human skin. Results of the present study might indicate new target of the clinical dermatology.
Characterizing differences in precipitation regimes of extreme wet and dry years: implications for climate change experiments
Authors: Knapp Alan K. , Hoover David L. , Wilcox Kevin R. , Avolio Meghan L. , Koerner Sally E. , La Pierre Kimberly J. , Loik Michael E. , Luo Yiqi , Sala Osvaldo E. , Smith Melinda D.
Published: February 2015

Climate change is intensifying the hydrologic cycle and is expected to increase the frequency of extreme wet and dry years. Beyond precipitation amount, extreme wet and dry years may differ in other ways, such as the number of precipitation events, event size, and the time between events. We assessed 1614 long‐term (100 year) precipitation records from around the world to identify key attributes of precipitation regimes, besides amount, that distinguish statistically extreme wet from extreme dry years. In general, in regions where mean annual precipitation (MAP) exceeded 1000 mm, precipitation amounts in extreme wet and dry years differed from average years by ~40% and 30%, respectively. The magnitude of these deviations increased to >60% for dry years and to >150% for wet years in arid regions (MAP<500 mm). Extreme wet years were primarily distinguished from average and extreme dry years by the presence of multiple extreme (large) daily precipitation events (events >99th percentile of all events); these occurred twice as often in extreme wet years compared to average years. In contrast, these large precipitation events were rare in extreme dry years. Less important for distinguishing extreme wet from dry years were mean event size and frequency, or the number of dry days between events. However, extreme dry years were distinguished from average years by an increase in the number of dry days between events. These precipitation regime attributes consistently differed between extreme wet and dry years across 12 major terrestrial ecoregions from around the world, from deserts to the tropics. Thus, we recommend that climate change experiments and model simulations incorporate these differences in key precipitation regime attributes, as well as amount into treatments. This will allow experiments to more realistically simulate extreme precipitation years and more accurately assess the ecological consequences.
Carbon footprint of rice production under biochar amendment – a case study in a Chinese rice cropping system
Authors: Liu Qi , Liu Benjuan , Ambus Per , Zhang Yanhui , Hansen Veronika , Lin Zhibin , Shen Dachun , Liu Gang , Bei Qicheng , Zhu Jianguo , Wang Xiaojie , Ma Jing , Lin Xingwu , Yu Yongchang , Zhu Chunwu , Xie Zubin
Published: February 2015

As a controversial strategy to mitigate global warming, biochar application into soil highlights the need for life cycle assessment before large‐scale practice. This study focused on the effect of biochar on carbon footprint of rice production. A field experiment was performed with three treatments: no residue amendment (Control), 6 t ha−1 yr−1 corn straw (CS) amendment, and 2.4 t ha−1 yr−1 corn straw‐derived biochar amendment (CBC). Carbon footprint was calculated by considering carbon source processes (pyrolysis energy cost, fertilizer and pesticide input, farmwork, and soil greenhouse gas emissions) and carbon sink processes (soil carbon increment and energy offset from pyrolytic gas). On average over three consecutive rice‐growing cycles from year 2011 to 2013, the CS treatment had a much higher carbon intensity of rice (0.68 kg CO2‐C equivalent (CO2‐Ce) kg−1 grain) than that of Control (0.24 kg CO2‐Ce kg−1 grain), resulting from large soil CH4 emissions. Biochar amendment significantly increased soil carbon pool and showed no significant effect on soil total N2O and CH4 emissions relative to Control; however, due to a variation in net electric energy input of biochar production based on different pyrolysis settings, carbon intensity of rice under CBC treatment ranged from 0.04 to 0.44 kg CO2‐Ce kg−1 grain. The results indicated that biochar strategy had the potential to significantly reduce the carbon footprint of crop production, but the energy‐efficient pyrolysis technique does matter.
Surgical extraction of impacted teeth in elderly patients. A retrospective analysis of perioperative complications – the experience of a single institution
Authors: Trybek Grzegorz , Chruściel‐Nogalska Małgorzata , Machnio Małgorzata , Smektała Tomasz , Malinowski Jerzy , Tutak Marcin , Sporniak‐Tutak Katarzyna
Published: February 2015

Objective

The aim of this retrospective study was to investigate the most frequent complications and assess their overall rate associated with the surgical extraction of impacted teeth in an elderly patient population.

Background

Oral health needs of the elders are often associated with surgical procedures for the creation of appropriate conditions for any further prosthetic treatment. One such process is the removal of severely decayed, fractured or impacted teeth detrimental to the fit or appearance of dentures. While broken and decayed teeth leave little doubt for their removal, impacted teeth divide opinion, some extreme regarding their prophylactic removal and the appropriate age for the procedure.

Material and methods

Material was selected from the archives of an Out‐Patient Dental Surgery Clinic of the Regional Centre of Dentistry in Szczecin, from 2002 to 2013. The database was independently screened by two investigators according to inclusion and exclusion criteria. After selection process, all included records were screened using a data extraction form to obtain the necessary data.

Results

The total number of impacted teeth was 73, of which 29% were partially impacted. The overall complication rate was 24.6%. The most common complications were as follows: haematoma, nerve disturbances and local infections.

Conclusion

Surgical extraction in patients above 60 years of age is fraught with a high risk of possible complications.
Evaluation of the efficiency of denture cleaners for removing denture adhesives
Authors: Harada‐Hada Kae , Hong Guang , Abekura Hitoshi , Murata Hiroshi
Published: February 2015

Objective

We developed a new scoring index for assessing the removability of denture adhesives and evaluated the removal efficiency of denture cleaners.

Background

Although our understanding of the importance of denture care is increasing, little is known about the effectiveness and efficiency of denture cleaners on denture adhesives. Therefore, guidelines for proper cleaning are necessary.

Materials and methods

We used five denture cleaner solutions on two cream adhesives, one powder adhesive and one cushion adhesive. After immersion in the denture cleaners for a designated time, we evaluated the area of the sample plate still covered by denture adhesive.

Results

Cream adhesives were removed more completely after immersion in majority of the denture cleaners than in water. Powder adhesive was removed more quickly than cream adhesives. Cushion adhesive was not removed by immersion in either the denture cleaners or water control.

Conclusion

Some denture cleaners could liquefy cream adhesives more than water, but these differences were not observed in case of powder and cushion adhesives.
Dentist skill and setting to address dental treatment needs of care home residents in Wales
Authors: Morgan Maria Z. , Johnson Ilona G. , Hitchings Esther , Monaghan Nigel P. , Karki Anup J.
Published: February 2015

Objective

To explore the relationship between treatment plans, complexity anticipated in delivering those plans, and the special care dental skills and settings identified as appropriate.

Background

In older adults, many factors may complicate dental treatment including health and disability problems. Assessment of dental treatment needs amongst care home residents provides information about clinical care required and clinical experience needed for this population.

Material and methods

Analysis of dental data collected in a 2010 Welsh survey. Data analysed included treatment plan information, complexity assessment and dental expertise and settings required to deliver the treatment plans.

Results

The majority of participating residents needed simple dentistry, that is examinations, oral hygiene instruction, scaling of teeth, fillings, new dentures and fluoride application. Additional time was the commonest complexity factor. A large proportion of participants required dental treatment within a domiciliary setting. A similar proportion required care within a primary care setting (typically with care from a general dental practitioner) or a special care clinic (typically with care from a dentist with special care experience). Treatment plans involving specialists were more likely to be associated with poor general health, higher levels of interventional treatment and greater complexity.

Conclusion

Most treatment need in care homes is basic restorative, periodontal and preventive care. Half of this could be managed by general dentists, some on a domiciliary basis and the rest in primary care dental clinics. The commonest complexity was additional time. More complex treatments were associated with care in clinics, skills in special care dentistry and multidisciplinary care.
Clinical and psychosocial factors predicting health‐related quality of life in hemodialysis patients
Authors: Kang Gun Woo , Lee In Hee , Ahn Ki Sung , Lee Jonghun , Ji Yunmi , Woo Jungmin
Published: February 2015

Many patients with end‐stage renal disease have significant impairment in health‐related quality of life (HRQoL). Most previous studies have focused on clinical factors; however, quality of life can also be affected by psychosocial factors. The aim of this study was to identify the possible predictors of HRQoL among clinical and psychosocial factors in hemodialysis (HD) patients. The study included 101 patients who were undergoing HD. Psychosocial factors were evaluated using the Hospital Anxiety and Depression Scale, Multidimensional Scale of Perceived Social Support, Montreal Cognitive Assessment, and Pittsburgh Sleep Quality Index. We also assessed laboratory and clinical factors, including albumin, Kt/V as a marker of dialysis adequacy, normalized protein catabolic rate, and duration of HD. The Euro Quality of Life Questionnaire 5‐Dimensional Classification (EQ‐5D) was used to evaluate HRQoL. The mean EQ‐5D index score was 0.704 ± 0.199. The following variables showed a significant association with the EQ‐5D index: age (P < 0.001), depression (P < 0.001), anxiety (P < 0.001), support from friends (P < 0.001), cognitive function (P < 0.001), duration of HD (P = 0.034), triglyceride (P = 0.031), total iron‐binding capacity (P = 0.036), and phosphorus (P = 0.037). Multiple regression analysis showed that age (95% confidence interval [CI] −0.008 to −0.002), anxiety (95% CI −0.025 to −0.009), and support from friends (95% CI 0.004 to 0.018) were independent predictors of impaired HRQoL. This study explored determinants of impaired HRQoL in HD patients. We found that impaired HRQoL was independently associated with age, anxiety, and support from friends. We should consider psychosocial as well as clinical factors when evaluating ways to improve HRQoL in HD patients.
Pregnancy Outcome Following Prenatal Exposure to Triptan Medications: A Meta‐Analysis
Authors: Marchenko Alexander , Etwel Fatma , Olutunfese Olukayode , Nickel Cheri , Koren Gideon , Nulman Irena
Published: February 2015

Background

Migraine is a common disorder among women of childbearing age. Triptan medications are effective and commonly used to treat migraines in pregnancy. However, the reproductive safety of this group of drugs has not yet been confirmed. The aim of this study was to determine the reproductive safety of triptan medications by performing a literature review and a meta‐analysis.

Methods

Available publications regarding pregnancy outcomes following prenatal exposure to triptans from 1991 to 2013 were identified and reviewed according to the inclusion criteria. A random‐effects meta‐analysis model was implemented to combine the available pregnancy outcome data for the exposed and comparison groups.

Results

One case–control study and 5 cohort studies met the inclusion criteria. The included studies provided information on duration of gestation, major congenital malformations, and spontaneous abortions of infants following prenatal triptan exposure. The 6 studies included 4208 infants of women who used sumatriptan or other triptan medications, and 1,466,994 children of women who did not use triptans during pregnancy. No significant increases in rates for major congenital malformations (MCMs), prematurity, or spontaneous abortions were found when comparing the triptan‐exposed group to the migraine – no triptans control group (odds ratio [OR] = 0.84 [0.61‐1.16]; OR = 0.90 [0.35‐2.30]; OR = 1.27 [0.58‐2.79], respectively). There were no increased rate of MCMs (OR = 1.18 [0.97‐1.44]) or prematurity (OR = 1.16 (0.67‐1.99) when the triptan‐exposed group was compared with the healthy controls; however, there was a significant increase in the rates of spontaneous abortions (OR = 3.54 [2.24‐5.59]). When the migraine no‐triptan group was compared with healthy controls, a significant increase in the rates of MCMs was found (OR = 1.41 [1.11‐1.80]).

Conclusion

The use of triptans during pregnancy does not appear to increase the rates for MCMs or prematurity. The increased rates of spontaneous abortions in the triptan‐exposed group and the increased rates of MCM in the migraine no‐triptan group require further research.
Nerve Block for the Treatment of Headaches and Cranial Neuralgias – A Practical Approach
Authors: Dach Fabíola , Éckeli Álan L. , Ferreira Karen dos S. , Speciali José G.
Published: February 2015

Background

Several studies have presented evidence that blocking peripheral nerves is effective for the treatment of some headaches and cranial neuralgias, resulting in reduction of the frequency, intensity, and duration of pain.

Objectives

In this article we describe the role of nerve block in the treatment of headaches and cranial neuralgias, and the experience of a tertiary headache center regarding this issue. We also report the anatomical landmarks, techniques, materials used, contraindications, and side effects of peripheral nerve block, as well as the mechanisms of action of lidocaine and dexamethasone.

Conclusions

The nerve block can be used in primary (migraine, cluster headache, and nummular headache) and secondary headaches (cervicogenic headache and headache attributed to craniotomy), as well in cranial neuralgias (trigeminal neuropathies, glossopharyngeal and occipital neuralgias). In some of them this procedure is necessary for both diagnosis and treatment, while in others it is an adjuvant treatment. The block of the greater occipital nerve with an anesthetic and corticosteroid compound has proved to be effective in the treatment of cluster headache. Regarding the treatment of other headaches and cranial neuralgias, controlled studies are still necessary to clarify the real role of peripheral nerve block.
Traditional and Alternative Treatments for Depression: Implications for Migraine Management
Authors: Peck Kelly R. , Smitherman Todd A. , Baskin Steven M.
Published: February 2015

Background

Migraine is frequently comorbid with major depressive disorder, the presence of which confers increased disability and various clinical challenges.

Methods/Results

The present article reviews empirically supported pharmacologic and cognitive‐behavioral interventions for depression, as well as the emerging yet generally mixed efficacy for various complementary and alternative medicine depression treatments.

Discussion and Conclusion

Clinical implications and treatment strategies for migraine patients with comorbid depression are discussed. The literature reviewed here draws together clinical practice options for clinicians.
Paediatric European Network for Treatment of AIDS (PENTA) guidelines for treatment of paediatric HIV‐1 infection 2015: optimizing health in preparation for adult life
Authors: Bamford A , Turkova A , Lyall H , Foster C , Klein N , Bastiaans D , Burger D , Bernardi S , Butler K , Chiappini E , Clayden P , Della Negra M , Giacomet V , Giaquinto C , Gibb D , Galli L , Hainaut M , Koros M , Marques L , Nastouli E , Niehues T , Noguera‐Julian A , Rojo P , Rudin C , Scherpbier HJ , Tudor‐Williams G , Welch SB ,   (PENTA Steering Committee)
Published: February 2015

The 2015 Paediatric European Network for Treatment of AIDS (PENTA) guidelines provide practical recommendations on the management of HIV‐1 infection in children in Europe and are an update to those published in 2009. Aims of treatment have progressed significantly over the last decade, moving far beyond limitation of short‐term morbidity and mortality to optimizing health status for adult life and minimizing the impact of chronic HIV infection on immune system development and health in general. Additionally, there is a greater need for increased awareness and minimization of long‐term drug toxicity. The main updates to the previous guidelines include: an increase in the number of indications for antiretroviral therapy (ART) at all ages (higher CD4 thresholds for consideration of ART initiation and additional clinical indications), revised guidance on first‐ and second‐line ART recommendations, including more recently available drug classes, expanded guidance on management of coinfections (including tuberculosis, hepatitis B and hepatitis C) and additional emphasis on the needs of adolescents as they approach transition to adult services. There is a new section on the current ART ‘pipeline’ of drug development, a comprehensive summary table of currently recommended ART with dosing recommendations. Differences between PENTA and current US and World Health Organization guidelines are highlighted and explained.
Rules of engagement: the joint influence of trainer expressiveness and trainee experiential learning style on engagement and training transfer
Authors: Rangel Bertha , Chung Wonjoon , Harris T. Brad , Carpenter Nichelle C. , Chiaburu Dan S. , Moore Jenna L.
Published: February 2015

We investigated the joint effect of trainer expressiveness and trainee experiential learning style on training transfer intentions. Extending prior research where trainer expressiveness has been established as a positive predictor of transfer, we show that trainer expressiveness is more impactful for trainees with high (vs. low) experiential learning styles. Based on our findings, trainees' experiential styles – also related to one's intuition – emerge as important enhancers of transfer intentions, and should be considered in future research and when assigning trainees to learning. In addition, we found that the effect of trainer expressiveness on transfer intentions is mediated by trainee engagement.
Using the training reactions questionnaire to analyze the reactions of university students undergoing career‐related training inJordan: a prospective human resource development approach
Authors: Khasawneh Samer , Al‐Zawahreh Abdelghafour
Published: February 2015

The primary purpose of the present study was to validate Morgan and Casper's training reactions questionnaire (TRQ) for use inJordan. The study also investigated the reactions of university students to career‐related training programs. Another purpose of the study was to determine the impact of certain aspects of training programs on the overall satisfaction of university students with the quality of the programs. The validatedTRQwas administered to a purposive sample of 304 participants who completed at least two training programs. Results showed that theTRQis valid for use inJordan. Results also indicated that participants exhibited high levels of satisfaction with all aspects of the training programs completed. Further, based on regression analyses, results indicated that utility of training had the highest explained variance followed by course materials and course structure. Finally, the study provided a number of practical and theoretical implications for the field of study.
Venous thromboembolism rates in patients undergoing major hip and knee joint surgery at Waitemata District Health Board: a retrospective audit
Authors: Dixon J. , Ahn E. , Zhou L. , Lim R. , Simpson D. , Merriman E. G.
Published: February 2015

Background/Aim

Symptomatic venous thromboembolism (VTE) complicates approximately 4% of major orthopaedic surgical procedures performed without thromboprophylaxis. Randomised clinical trials demonstrate primary thromboprophylaxis reduces VTE rates to <1%, with low rates of clinically important bleeding, using low molecular weight heparin (LMWH), oral FXa inhibitors or thrombin inhibitors. We reviewed the rates of VTE in patients undergoing major hip/knee joint surgery at Waitemata District Health Board (WDHB).

Methods

Cases of VTE within 90 days of orthopaedic surgery were identified by retrospective audit of data from the haematology VTE database. The number of major hip/knee joint surgeries at WDHB from January 2006 to December 2010 was obtained from clinical coding data.

Results

The cumulative incidence of VTE within 90 days of surgery was 3.29%. The median time from surgery to diagnosis was 7 days. Deep vein thrombosis comprised 75% of cases, 77.6% distal and 23.2% proximal. Pulmonary embolism comprised 26.5% of VTE; 47.7% had right heart strain on computed tomography/echocardiography. Hip fracture surgery comprised one‐third of patients. Of patients developing VTE, 85.5% had chemical thromboprophylaxis – aspirin 73%, LMWH 20 mg 16%, LMWH 40 mg 16%, therapeutic LMWH 3%, unfractionated heparin twice daily 1%, and warfarin 4%; 75.6% received mechanical prophylaxis, while 4% of patients received no prophylaxis.

Conclusion

VTE incidence after major hip/knee joint surgery at WDHB is high, with pulmonary embolism comprising almost one‐third of all VTE in this study, indicating the prophylaxis given is suboptimal. Implementation of appropriate, extended duration prophylaxis as per evidence‐based guidelines is required to reduce these rates.
Determinants of cerebral white matter changes in patients with stroke
Authors: Chou P.‐S. , Chen C.‐H. , Wu M.‐N. , Lin Y.‐H. , Lai C.‐L. , Lin R.‐T. , Yang Y.‐H.
Published: February 2015

Background/Aim

Cerebral white matter changes (WMC) are commonly observed in magnetic resonance imaging (MRI) scans of elderly people. Information about the prevalence of WMC is limited, and little is known about site‐specific risk factors for the subcortical and periventricular regions in patients with ischaemic stroke. The study aims to analyse the prevalence and severity of WMC and investigate the risk factors of periventricular WMC (PVWMC) and deep WMC (DWMC) separately in patients with ischaemic stroke.

Methods

The data were collected between January and December 2013 from a medical centre in southern Taiwan. Every patient underwent a cerebral MRI scan, and WMC was separately rated as PVWMC and DWMC by using the modified Fazekas scale.

Results

In total, 527 patients who had experienced ischaemic stroke were included. The mean age of the patients was 67.0 ± 12.5 years (range: 31–94) and 62% of them were men. The mean age was significantly different among the four grades of severity in both the PVWMC (P < 0.001) and DWMC (P < 0.001) groups after adjustments for sex and vascular risk factors. Hypertension was independently correlated with severity of DWMC (P = 0.032) but not with PVWMC (P = 0.222). In multiple logistic regressions model, hypertension was a significant independent indicator of DWMC (odds ratio = 4.30; 95% confidence interval = 1.70–10.89).

Conclusion

Our results suggest a region‐specific pathogenesis of cerebral white matter in Asian patients with ischaemic stroke that may differ from those in the general population.
Idiosyncratic reactions are the most common cause of abnormal liver function tests in patients with cystic fibrosis
Authors: Jong T. , Geake J. , Yerkovich S. , Bell S. C.
Published: February 2015

Background

Beta‐lactam antibiotic‐related liver enzyme derangement can limit treatment options for infective exacerbations in cystic fibrosis (CF) bronchiectasis.

Aim

To identify risk factors for elevated liver function tests (LFT) in CF patients receiving parenteral antibiotics.

Methods

All patients attending The Prince Charles Hospital (TPCH) Adult CF Centre in 2012 were identified using the CF Research Database and CF Data Registry. Biochemistry and haematology panels between 1 January 2012 and 31 December 2012 for each patient were retrieved from Queensland Health Pathology and private pathology providers. Patients with LFT more than three times the upper limit of normal were identified. For each laboratory test, concurrently administered antibiotic(s) were analysed from TPCH pharmacy dispensing system for patients who received intravenous (IV) antibiotic treatment.

Results

Abnormal liver enzymes were evident in significantly more patients receiving IV antibiotics than patients who did not (43% vs 18%, P < 0.001). Pre‐existing CF‐related liver disease and total IV antibiotic treatment days were not associated with abnormal LFT. Higher C‐reactive protein and peripheral eosinophil counts were not more common in patients with abnormal LFT. Male sex, poorer lung function and lower leucocyte counts were associated with abnormal LFT; however, these variables only explained 4.2% of the variance in the multivariable logistic model.

Conclusion

Elevated LFT are common during IV antibiotic treatment in CF. Although specific antibiotic exposure may contribute to abnormal LFT in a minority of cases, our study demonstrates that antibiotic‐induced liver injury is largely idiosyncratic and unpredictable.
The International Collaboration of Orthopaedic Nursing: advancing nursing through technology
Authors: Meehan A.J. , Maher A.B. , Hommel A.
Published: February 2015

Aim

To report on the International Collaboration of Orthopaedic Nursing, a mostly virtual network of orthopaedic nursing organizations across four continents.

Background

Formed by leaders of three national associations, the collaboration is based on recognition of patient problems and challenges shared by orthopaedic nurses globally.

Methods/Initiatives

The Collaboration provides a range of services including education, mentoring, and organizational development. Low cost internet‐based technologies, such as email and Skype, support global networking in real time.

Discussion/Implications for Nursing and Health Policy

The Collaboration is a cost effective example of how nurses can collaborate internationally to promote the highest standards of orthopaedic nursing.
Knowledge, attitudes and tobacco use among nursing and physiotherapy students
Authors: Fernández D. , Ordás B. , Álvarez M.J. , Ordóñez C.
Published: February 2015

Background

As future health educators, nursing and physiotherapy students will play an essential role in the prevention of smoking.

Aim

To determine the prevalence of smoking among students and to analyse their knowledge of and attitudes towards smoking.

Method

This was a descriptive cross‐sectional study using an anonymous questionnaire and conducted in a Spanish Faculty of Health Sciences in 2013.

Findings

247 nursing and physiotherapy students (82.33%) participated in the study. The global prevalence of smoking (18.2%) was lower compare with the general population group of the same age. We have observed statistical significance in relation to previous studies. Nursing and physiotherapy students showed a low nicotine dependence. We found a lack of knowledge about the harmful effects of cigarette consumption on health. Statistically significant results were also found in relation to degree courses (p < 0.01) as regards students' opinions about their knowledge of strategies and methods to help patients stop smoking.

Conclusion

Most students started smoking before commencing their university studies; consequently, interventions should focus on cessation programmes. An analysis of university curricula leading to the award of a degree in the health sciences could serve to identify educational deficiencies in order to implement the necessary modifications.

Implications for nursing and health policy

This paper presents an update in tobacco use characteristics amongst nursing and physiotherapy students. Those results have showed a need to improve the curricula in order to develop specific programmes to improve knowledge, attitudes and beliefs. Measures to prevent smoking must be taken at school.
Distribution of antibodies against influenza virus in pigs from farrow‐to‐finish farms in Minas Gerais state, Brazil
Authors: Dias Alessandra S. , Costa Érica A. , Rajão Daniela S. , Guedes Roberto M. C. , Ciacci Zanella Janice R. , Lobato Zélia I. P.
Published: February 2015

Background

Swine influenza virus (SIV) is the cause of an acute respiratory disease that affects swine worldwide. In Brazil, SIV has been identified in pigs since 1978. After the emergence of pandemic H1N1 in 2009 (H1N1pdm09), few studies reported the presence of influenza virus in Brazilian herds.

Objectives

The objective of this study was to evaluate the serological profile for influenza virus in farrow‐to‐finish pig farms in Minas Gerais state, Brazil.

Methods

Thirty farms with no SIV vaccination history were selected from the four larger pig production areas in Minas Gerais state (Zona da Mata, Triângulo Mineiro/Alto Paranaíba, South/Southwest and the Belo Horizonte metropolitan area). At each farm, blood samples were randomly collected from 20 animals in each production cycle category: breeding animals (sows and gilts), farrowing crate (2–3 weeks), nursery (4–7 weeks), grower pigs (8–14 weeks), and finishing pigs (15–16 weeks), with 100 samples per farm and a total of 3000 animals in this study. The samples were tested for hemagglutination inhibition activity against H1N1 pandemic strain (A/swine/Brazil/11/2009) and H3N2 SIV (A/swine/Iowa/8548‐2/98) reference strain.

Results

The percentages of seropositive animals for H1N1pdm09 and H3N2 were 26·23% and 1·57%, respectively, and the percentages of seropositive herds for both viruses were 96·6% and 13·2%, respectively.

Conclusions

The serological profiles differed for both viruses and among the studied areas, suggesting a high variety of virus circulation around the state, as well as the presence of seronegative animals susceptible to influenza infection and, consequently, new respiratory disease outbreaks.
Hot‐Pressing Kinetics and Densification Mechanisms of Boron Carbide
Authors: Du Xianwu , Zhang Zhixiao , Wang Yang , Wang Jilin , Wang Weimin , Wang Hao , Fu Zhengyi
Published: February 2015

The hot‐pressing kinetics of boron carbide at different stages in the hot‐pressing process was investigated. Based general densification equation and pore‐dragged creep model, the densification and grain growth kinetics were analyzed as a function of various parameters such as sintering temperature, sintering pressure and dwell time. Stress exponent of n ≈ 3 at the initial dwell stage suggests the plastic deformation may dominates the densification. The further TEM observations and the calculation based on effective stress and plastic yield stress also indicate that plastic deformation may occur and account for the large increase in density at the initial stage of sintering. Calculated grain size exponent of m ≈ 3 suggests that the grain‐boundary diffusion dominates the densification at the final stage. During the final stage of sintering, grain growth may be determined by evaporation/condensation and grain‐boundary migration.
Sintering of High‐Performance Silicon Nitride Ceramics Under Vibratory Pressure
Authors: Li Shuang , Xie Zhipeng , Xue Weijiang , Luo Xudong , An Linan
Published: February 2015

To improve mechanical behaviors of silicon nitride ceramics, here we introduced a novel external field—vibratory pressure into the sintering of Si3N4 ceramics with advantages of higher density, more uniform distribution of interfacial phase, higher sintering motivation in the width direction, and therefore more favorable mechanical properties than traditional sintering methods. Grain size and aspect ratio of the two ceramics were investigated with linear intercept method. Flexural strength of the vibratory‐assisted hot‐pressing (VAHP) specimen increased from 936 ± 27.2 MPa to 1247 ± 28.9 MPa, and an increase of 10% was achieved in fracture toughness. It is believed that such VAHP method can provide a universal approach and new opportunities for the fabrication of covalent‐bonded ceramics or composites with enhanced performances.
Less is more: the design of early‐warning scoring systems affects the speed and accuracy of scoring
Authors: Christofidis Melany J. , Hill Andrew , Horswill Mark S. , Watson Marcus O.
Published: February 2015

Aim

To evaluate the effect of early‐warning scoring system design on the speed and accuracy of scoring.

Background

Despite the widespread implementation of early‐warning scoring systems in hospitals, the speed and accuracy with which chart‐users determine patients' early‐warning scores has received minimal research attention.

Design

Within‐subjects, with scoring‐system design as the independent variable.

Methods

Forty‐seven novice chart‐users were presented with realistic vital sign observations recorded on charts with three different scoring‐system designs. The rows for recording individual vital sign scores were either: (1) grouped together beneath all of the vital sign rows; (2) separated, with each row presented immediately below the corresponding vital sign row; or (3) excluded altogether. Participants' response times and error rates for determining the overall scores were measured for 54 time‐points per design. Data were collected in December 2012–January 2013.

Results

Contrary to predictions, participants responded fastest and made the fewest errors when using the chart design without individual vital sign scoring‐rows. For the other two designs, participants were faster when the rows for scoring individual vital signs were separated (vs. grouped), but accuracy did not differ. For both of these designs, significantly more time‐points were affected by scoring errors compared with adding errors. Finally, data for patients with more serious derangements yielded greater response times and error rates on all three charts.

Conclusion

Early‐warning scoring systems may be more effective without individual vital sign scoring‐rows. Even when charts are designed by multi‐disciplinary teams of human factors specialists and clinicians, empirical evaluations are essential.
On the definition of element, chorotype and component in biogeography
Authors: Passalacqua Nicodemo G.
Published: February 2015

Terms such as element, chorotype and component are widely used to indicate biogeographical units. As a result of variation in approaches and methodologies, these terms do not have a single definitive meaning, and similar concepts have been defined under different labels. As originally defined, element denotes a group of species that occur in previously defined biogeographical areas, while chorotype denotes a group of species with a similar distribution. The term component is widely used in ecology to denote the biotic or abiotic constituent of an ecosystem; within biogeography it has typically been used as a synonym for element. Applying the original meanings, current usage within the tradition of systematic biogeography should regard element as referring to groups of taxa defined according to the biogeographical areas they occupy. Within quantitative and evolutionary biogeography, chorotype should be used to define patterns of distribution that can be used to generate hypotheses about their causes and origins. In this paper I argue that component expresses a generic concept rather than a chorological category and should be avoided in biogeography.
Prevalence of Hypertension and Associated Risk Factors in Western Alaska Native People: The Western Alaska Tribal Collaborative for Health (WATCH) Study
Authors: Jolly Stacey E. , Koller Kathryn R. , Metzger Jesse S. , Day Gretchen M. , Silverman Angela , Hopkins Scarlett E. , Austin Melissa A. , Boden‐Albala Bernadette , Ebbesson Sven O. E. , Boyer Bert B. , Howard Barbara V. , Umans Jason G.
Published: February 2015

Hypertension is a common chronic disease and a key risk factor in the development of cardiovascular disease. The Western Alaska Tribal Collaborative for Health study consolidates baseline data from four major cohorts residing in the Norton Sound and Yukon‐Kuskokwim regions of western Alaska. This consolidated cohort affords an opportunity for a systematic analysis of high blood pressure and its correlates in a unique population with high stroke rates over a wide age range. While the prevalence of hypertension among western Alaska Native people (30%, age‐standardized) is slightly less than that of the US general population (33%), cardiovascular disease is a leading cause of mortality in this rural population. The authors found that improvement is needed in hypertension awareness as about two thirds (64%) of patients reported awareness and only 39% with hypertension were controlled on medication. Future analyses assessing risk and protective factors for incident hypertension in this population are indicated.
Prognostic Significance of Visit‐to‐Visit Systolic Blood Pressure Variability: A Meta‐Analysis of 77,299 Patients
Authors: Tai Chenhui , Sun Yuxi , Dai Neng , Xu Dachun , Chen Wei , Wang Jiguang , Protogerou Athanase , van Sloten Thomas T. , Blacher Jacques , Safar Michel E. , Zhang Yi , Xu Yawei
Published: February 2015

In recent clinical investigations, visit‐to‐visit systolic blood pressure (SBP) variability was proven as a predictor of cardiovascular events and all‐cause mortality. However, inconsistent results exist in this association. A meta‐analysis of 13 prospective studies was conducted to evaluate the prognostic value of visit‐to‐visit SBP variability by different parameters in 77,299 patients with a mean follow‐up of 6.3 years. The pooled age‐ and mean SBP‐adjusted hazard ratios (HRs) for all‐cause mortality were 1.03 (95% confidence interval [CI], 1.02–1.04; P<.001) per 1‐mm Hg increase in SBP standard deviation (SD) and 1.04 (1.02–1.06, P<.001) per 1% in SBP coefficient of variation, and the corresponding values of cardiovascular mortality were 1.10 (1.02–1.17, P<.001) and 1.01 (0.99–1.03, P=.32), respectively. Moreover, a 1‐mm Hg increase in SD was significantly associated with stroke, with an HR of 1.02 (1.01–1.03, P<.001). Visit‐to‐visit SBP variability, independent of age and mean SBP, is a predictor of cardiovascular and all‐cause mortality and stroke.
ExplainingEUEffectiveness in Multilateral Institutions: The Case of the Arms Trade Treaty Negotiations
Authors: Romanyshyn Iulian
Published: February 2015

This article examines the EU's participation in multilateral institutions on the example of the UN Arms Trade Treaty. The central question of the study is to what extent and under what conditions the EU can be seen as an effective actor in multilateral security negotiations. It is argued that overall the EU was an effective player during the multilateral negotiations on the ATT, but the degree of its effectiveness varies along different dimensions. The EU was rather successful in the achievement of its goals and in maintaining external cohesion, but it scored relatively low in its efforts to commit the key stakeholders to sign up to the ATT. The EU's internal export control policy, together with the high level of institutional co‐ordination and Member States' interest convergence, facilitated the EU's effectiveness in the ATT negotiations, whereas the international context proved to be the major constraining factor.
Routine, empathic and compassionate patient care: definitions, development, obstacles, education and beneficiaries
Authors: Post Stephen G. , Ng Lauren E. , Fischel Janet E. , Bennett Mary , Bily Linda , Chandran Latha , Joyce Jeremiah , Locicero Briana , McGovern Kelly , McKeefrey Robyn L. , Rodriguez Jackie V. , Roess Michael W.
Published: February 2015

Rationale

We believe that this study represents an innovative approach to clarifying the definitions of routine, empathic and compassionate health care, as well as of sympathy. We emphasize the importance of affective empathy and its intensification in the context of patient suffering (compassion), without abandoning the ideal of clinical equanimity.

Methods

We develop a pedagogical model for clinicians and trainees who are weaker in their empathic skills that includes four levels of growth. We clarify representative obstacles to empathic and compassionate care in education and clinical practice. We summarize the four beneficiaries of empathic and compassionate care (clinicians, patients, trainees, institutions). We suggest areas for future research, including the development of a compassion scale and conclude with a statement on how the conceptual and professional confusion we address adversely impacts patients and trainees. The article represents the consensus work of a group of health care professionals and students at Stony Brook University Hospital and School of Medicine who have been engaged in this project for several years through the Center for Medical Humanities, Compassionate Care, and Bioethics, established in August of 2008.

Conclusions

We discern a shift away from concepts of clinical empathy and compassionate care that deny a significant place for an affective component and that idealize ‘detachment’.