bluuebunny/crossref_metadata_2025 huggingface dataset:
The subgingival microbiome, systemic inflammation and insulin resistance: The Oral Infections, Glucose Intolerance and Insulin Resistance Study
Authors: Demmer Ryan T. , Breskin Alexander , Rosenbaum Michael , Zuk Aleksandra , LeDuc Charles , Leibel Rudolph , Paster Bruce , Desvarieux Moïse , Jacobs David R. , Papapanou Panos N.
Published: December 2016

Background

Inflammation might link microbial exposures to insulin resistance. We investigated the cross‐sectional association between periodontal microbiota, inflammation and insulin resistance.

Methods

The Oral Infections, Glucose Intolerance and Insulin Resistance Study (ORIGINS) enrolled 152 diabetes‐free adults (77% female) aged 20–55 years (mean = 34 ± 10). Three hundred and four subgingival plaque samples were analysed using the Human Oral Microbe Identification Microarray to measure the relative abundances of 379 taxa. C‐reactive protein, interleukin‐6, tumour necrosis factor‐α and adiponectin were assessed from venous blood and their z‐scores were summed to create an inflammatory score (IS). Insulin resistance was defined via the HOMA‐IR. Associations between the microbiota and both inflammation and HOMA‐IR were explored using multivariable linear regressions; mediation analyses assessed the proportion of the association explained by inflammation.

Results

The IS was inversely associated with Actinobacteria and Proteobacteria and positively associated with Firmicutes and TM7 (p‐values < 0.05). Proteobacteria levels were associated with insulin resistance (p < 0.05). Inflammation explained 30–98% of the observed associations between levels of Actinobacteria, Proteobacteria or Firmicutes and insulin resistance (p‐values < 0.05). Eighteen individual taxa were associated with inflammation (p < 0.05) and 22 with insulin resistance (p < 0.05). No findings for individual taxa met Bonferroni‐adjusted statistical significance.

Conclusion

Bacterial measures were related to inflammation and insulin resistance among diabetes‐free adults.
Immediate versus delayed implant placement after anterior single tooth extraction: the timing randomized controlled clinical trial
Authors: Tonetti Maurizio S. , Cortellini Pierpaolo , Graziani Filippo , Cairo Francesco , Lang Niklaus P. , Abundo Roberto , Conforti Gian Paolo , Marquardt Siegfried , Rasperini Giulio , Silvestri Maurizio , Wallkamm Beat , Wetzel Anton
Published: December 2016

Aim

To compare need for bone augmentation, surgical complications, periodontal, radiographic, aesthetic and patient reported outcomes in subjects receiving implant placement at the time of extraction (Immediate Implant) or 12 weeks thereafter.

Methods

Subjects requiring single tooth extraction in the anterior and premolar areas were recruited in seven private practices. Implant position and choice of platform were restoratively driven. Measurements were performed by calibrated and masked examiners.

Results

IMI was unfeasible in 7.5% of cases. One hundred and 24 subjects were randomized. One implant was lost in the IMI group. IMI required bone augmentation in 72% of cases compared with 43.9% for delayed (p = 0.01), while wound failure occurred in 26.1% and 5.3% of cases, respectively (p = 0.02). At 1 year, IMI had deeper probing depths (4.1 ± 1.2 mm versus 3.3 ± 1.1 mm, p < 0.01). A trend for greater radiographic bone loss was observed at IMI over the initial 3‐year period (p‐trend < 0.01). Inadequate pink aesthetic scores were obtained in 19% of delayed and in 42% of IMI implant cases (p = 0.03). No differences in patient reported outcomes were observed.

Conclusions

Immediate implant placement should not be recommended when aesthetics are important, IMI should be limited to selected cases. Longer follow‐up is needed to assess differences in complication rates.
Impact of postprandial hyperglycemia at clinic visits on the incidence of cardiovascular events and all‐cause mortality in patients with type 2 diabetes
Authors: Takao Toshiko , Suka Machi , Yanagisawa Hiroyuki , Iwamoto Yasuhiko
Published: December 2016

Aims/Introduction

We evaluated the impact of postprandial hyperglycemia at clinic visits on the incidence of cardiovascular diseases (CVD) and all‐cause mortality independently of mean glycosylated hemoglobin in type 2 diabetes patients in a real‐world setting.

Materials and Methods

The present retrospective observational cohort study included 646 type 2 diabetes patients. All of the participants had their initial consultations at the Institute for Diabetes Care and Research, Asahi Life Foundation affiliated Marunouchi Hospital, Tokyo, Japan, during the period from 1995 to 1996, visited the clinic ≥4 times, had their 2‐h post‐breakfast blood glucose (2h‐PBBG) levels measured and were followed up for ≥1 year. The 646 patients were followed up for survival. Of the 646 patients, 618 had no history of CVD at the first visit and had measured 2h‐PBBG until the first CVD onset or censorings. These two cohorts were followed up through June 2012, and subsequently questionnaires were mailed. Multivariate Cox proportional hazard models were used to evaluate the risk of CVD incidence and death.

Results

CVD occurred in 78 patients, and 56 patients died. The median follow‐up periods of the CVD cohort and the mortality cohort were 15.6 and 15.9 years, respectively. The mean 2h‐PBBG is a significant predictor of the CVD incidence and all‐cause mortality after adjusting for the mean glycosylated hemoglobin, the number of 2h‐PBBG measurements, age, sex and classical risk factors.

Conclusions

Postprandial hyperglycemia represented by the mean level of 2h‐PBBG at clinic visits is associated with CVD incidence and all‐cause mortality independently of the mean glycosylated hemoglobin level in type 2 diabetes patients. Prospective interventional trials are warranted to confirm the present findings.
A systematic review on the role of imiquimod in lentigo maligna and lentigo maligna melanoma: need for standardization of treatment schedule and outcome measures
Authors: Tio D. , van der Woude J. , Prinsen C.A.C. , Jansma E.P. , Hoekzema R. , van Montfrans C.
Published: December 2016

Lentigo maligna (LM) is an in situ variant of melanoma. Our objective was to systematically review clinical and histological clearance and recurrence rates of imiquimod treatment of LM with emphasis on progression to lentigo maligna melanoma (LMM). PubMed, EMBASE and the Cochrane library were searched from inception to May 2015. Articles were included if they described histologically proven LM treated with imiquimod 5% monotherapy or combined with another topical therapy. Analysed outcomes were clinical and histological clearance, recurrence rates and number of LMM. The quality was assessed using the GRADE‐like checklist, and results were reported according to the PRISMA Statement. Twenty‐six case reports, 11 retrospective studies, three prospective studies and one randomized controlled trial were included. One case report of poor quality was excluded. Complete clinical clearance was seen in 369 of 471 patients (78.3%). Histological clearance was present in 285 of 370 (77%) patients. LMM was diagnosed in nine (1.8%) patients 3.9 months (range 0–11 months) post‐treatment. Univariate multinominal logistic regression showed that 6–7 applications/week had a 6.47 greater odds (P = 0.017) of resulting in complete clinical clearance compared to 1–4 applications/week. An intensity of 6–7 applications/week showed a 8.85 greater odds (P = 0.003) of resulting in histological clearance compared to 1–4 applications. Applying imiquimod >60 times during a treatment period of 12 weeks (range 4–36) showed a 7.75 greater odds (P = 0.001) of resulting in histological clearance compared to <60 total applications. In conclusion, a treatment schedule using imiquimod 6–7 applications per week, with at least 60 applications, shows the greatest odds of complete clinical and histological clearance of LM. Imiquimod is an option for patients unfit for or not willing to undergo surgery or radiotherapy. Nine cases of LM progressed to LMM shortly after treatment. Our hypothesis is that these LMM may have been present before starting imiquimod.
The evolution of cooperation by negotiation in a noisy world
Authors: Ito K. , McNamara J. M. , Yamauchi A. , Higginson A. D.
Published: December 2016

Cooperative interactions among individuals are ubiquitous despite the possibility of exploitation by selfish free riders. One mechanism that may promote cooperation is ‘negotiation’: individuals altering their behaviour in response to the behaviour of others. Negotiating individuals decide their actions through a recursive process of reciprocal observation, thereby reducing the possibility of free riding. Evolutionary games with response rules have shown that infinitely many forms of the rule can be evolutionarily stable simultaneously, unless there is variation in individual quality. This potentially restricts the conditions under which negotiation could maintain cooperation. Organisms interact with one another in a noisy world in which cooperative effort and the assessment of effort may be subject to error. Here, we show that such noise can make the number of evolutionarily stable rules finite, even without quality variation, and so noise could help maintain cooperative behaviour. We show that the curvature of the benefit function is the key factor determining whether individuals invest more or less as their partner's investment increases, investing less when the benefit to investment has diminishing returns. If the benefits of low investment are very small then behavioural flexibility tends to promote cooperation, because negotiation enables cooperators to reach large benefits. Under some conditions, this leads to a repeating cycle in which cooperative behaviour rises and falls over time, which may explain between‐population differences in cooperative behaviour. In other conditions, negotiation leads to extremely high levels of cooperative behaviour, suggesting that behavioural flexibility could facilitate the evolution of eusociality in the absence of high relatedness.
Molecular Phylogeny of Paraphelidium letcheri sp. nov. (Aphelida, Opisthosporidia)
Authors: Karpov Sergey A. , Torruella Guifré , Moreira David , Mamkaeva Maria A. , López‐García Purificación
Published: December 2016

Aphelids remain poorly known parasitoids of algae and have recently raised considerable interest due to their phylogenetic position at the base of Holomycota. Together with Cryptomycota (Rozellosporidia) and Microsporidia, they have been recently re‐classified as the Opisthosporidia, which constitutes the sister group to the fungi within the Holomycota. Molecular environmental studies have revealed a huge diversity of aphelids, but only four genera have been described: Aphelidium, Amoeboaphelidium, Paraphelidium, and Pseudaphelidium. Here, we describe the life cycle of a new representative of Aphelida, Paraphelidium letcheri sp. nov., and provide the 18S rRNA gene sequence for this species. Molecular phylogenetic analysis indicates that P. letcheri is sister to Paraphelidium tribonemae and together they form a monophyletic cluster which is distantly related to both, Aphelidium, with flagellated zoospores, and Amoebaphelidium, with amoeboid zoospores.
The effect of environmental colour on the growth, metabolism, physiology and skin pigmentation of the carnivorous freshwater catfish Lophiosilurus alexandri
Authors: Costa D. C. , Mattioli C. C. , Silva W. S. , Takata R. , Leme F. O. P. , Oliveira A. L. , Luz R. K.
Published: December 2016

The growth, physiology and skin pigmentation of pacamã Lophiosilurus alexandri juveniles were evaluated in an experiment using different tank colours (white, yellow, green, blue, brown and black) over an 80 day period. The tank colours did not cause significant differences to final body mass, total length, survival rate, carcass composition (moisture, crude protein, ash, ether extract, calcium, phosphorus, energy), or to plasma protein, triglyceride and cholesterol values. Haematocrit values, however, were highest for fish kept in white tanks (ANOVA P < 0·05), while the greatest haemoglobin levels were recorded for fish kept in blue and brown tanks (P < 0·01). The concentrations of cortisol (P < 0·001) and glucose (P < 0·01) were the most in fish in the black tanks. Tank colour affected skin pigmentation significantly, with fish in white tanks having the highest values of L* (brightness) and the lowest values in blue and black tanks. L*, however, decreased in all treatments throughout the experiment. C*ab increased significantly over the course of the experiment in fish kept in white tanks. Similar increases of C*ab were recorded in the other treatments but to a lesser extent. The use of black tanks during the cultivation of L. alexandri caused stress and should be avoided. Cultivation in white and yellow tanks produced individuals with a pale skin colour, while cultivation in blue and black tanks resulted in juveniles with a darker and more pigmented skin.
Lake sturgeon Acipenser fulvescens and shovelnose sturgeon Scaphirhynchus platorynchus environmental life history revealed using pectoral fin‐ray microchemistry: implications for interjurisdictional conservation through fishery closure zones
Authors: Phelps Q. E. , Hupfeld R. N. , Whitledge G. W.
Published: December 2016

This study inferred that the majority of shovelnose sturgeon Scaphirhynchus platorynchus captured in the upper Mississippi River probably originated from locations outside the upper Mississippi River (Missouri River, middle Mississippi River); whereas, lake sturgeon Acipenser fulvescens exhibit infrequent movement outside of the upper Mississippi River, but may move throughout these interconnected large rivers at various life stages. By using pectoral fin‐ray microchemistry (a non‐lethal alternative to using otoliths), it is suggest that interjurisdictional cooperation will probably be needed to ensure sustainability of the S. platorynchus commercial fishery and the success of A. fulvescens reintroduction in the upper Mississippi River. Additionally, fin‐ray microchemistry can provide invaluable data to make informed management decisions regarding large river fishes, that cross jurisdictional boundaries or that move outside of closure zones, without causing further mortality to compromised fish populations (e.g. threatened and endangered species).
Adenosine triphosphate induces P2Y2 activation and interleukin‐8 release in human esophageal epithelial cells
Authors: Wu Liping , Oshima Tadayuki , Fukui Hirokazu , Watari Jiro , Miwa Hiroto
Published: December 2016

Background and Aim

Immune‐mediated mucosal inflammation characterized by the release of interleukin (IL)‐8 is associated with gastroesophageal reflux disease. ATP released by human esophageal epithelial cells (HEECs) mediates the release of cytokines through P2 nucleotide receptors that are present on various cells, including HEECs. This study characterized and identified human esophageal epithelial P2 receptors that are responsible for ATP‐mediated release of IL‐8 by using a human esophageal stratified squamous epithelial model.

Methods

Primary HEECs were cultured with the use of an air‐liquid interface (ALI) system. The ATP analogue adenosine 5′‐O‐3‐thiotriphosphate (ATP‐γ‐S) was added to the basolateral compartment, and IL‐8 release was measured. Involvement of the P2Y2 receptor was assessed with the use of selective and non‐selective receptor antagonists and a P2Y2 receptor agonist. Expression of the P2Y2 receptor was assessed using western blotting and immunohistochemistry.

Results

Adenosine triphosphate‐γ‐S induced IL‐8 release through the P2Y2 receptor. A P2Y2 receptor antagonist but not a P2X3 receptor antagonist or a P2Y1 receptor antagonist blocked ATP‐γ‐S‐mediated IL‐8 release. Conversely, a P2Y2 receptor agonist induced IL‐8 release. Western blotting and immunohistochemistry of the P2Y2 receptor showed strong expression of the P2Y2 receptor on ALI‐cultured HEECs and in human esophagus. Inhibition of extracellular signal‐regulated kinase but not of protein kinase C blocked the ATP‐mediated release of IL‐8. ATP‐γ‐S induced phosphorylation of extracellular signal‐regulated kinase, and a P2Y2 receptor antagonist blocked this phosphorylation.

Conclusions

Interleukin‐8 release after purinergic stimulation in ALI‐cultured HEECs is mediated through P2Y2 receptor activation. ATP‐induced IL‐8 release maybe involved in the pathogenesis of refractory gastroesophageal reflux disease.
Serologic antibodies in relation to outcome in postoperative Crohn's disease
Authors: Hamilton Amy L , Kamm Michael A , De Cruz Peter , Wright Emily K , Selvaraj Fabiyola , Princen Fred , Gorelik Alexandra , Liew Danny , Lawrance Ian C , Andrews Jane M , Bampton Peter A , Sparrow Miles P , Florin Timothy H , Gibson Peter R , Debinski Henry , Gearry Richard B , Macrae Finlay A , Leong Rupert W , Kronborg Ian , Radford‐Smith Graham , Selby Warwick , Bell Sally J , Brown Steven J , Connell William R
Published: December 2016

Background and Aim

Disease recurs frequently after Crohn's disease resection. The role of serological antimicrobial antibodies in predicting recurrence or as a marker of recurrence has not been well defined.

Methods

A total of 169 patients (523 samples) were prospectively studied, with testing peri‐operatively, and 6, 12 and 18 months postoperatively. Colonoscopy was performed at 18 months postoperatively. Serologic antibody presence (perinuclear anti‐neutrophil cytoplasmic antibody [pANCA], anti‐Saccharomyces cerevisiae antibodies [ASCA] IgA/IgG, anti‐OmpC, anti‐CBir1, anti‐A4‐Fla2, anti‐Fla‐X) and titer were tested. Quartile sum score (range 6–24), logistic regression analysis, and correlation with phenotype, smoking status, and endoscopic outcome were assessed.

Results

Patients with ≥ 2 previous resections were more likely to be anti‐OmpC positive (94% vs 55%, ≥ 2 vs < 2, P = 0.001). Recurrence at 18 months was associated with anti‐Fla‐X positivity at baseline (49% vs 29%; positive vs negative, P = 0.033) and 12 months (52% vs 31%, P = 0.04). Patients positive (n = 28) for all four antibacterial antibodies (anti‐CBir1, anti‐OmpC, anti‐A4‐Fla2, and anti‐Fla‐X) at baseline were more likely to experience recurrence at 18 months than patients negative (n = 32) for all four antibodies (82% vs 18%, P = 0.034; odds ratio 6.4, 95% confidence interval 1.16–34.9). The baseline quartile sum score for all six antimicrobial antibodies was higher in patients with severe recurrence (Rutgeert's i3‐i4) at 18 months, adjusted for clinical risk factors (odds ratio 1.16, 95% confidence interval 1.01–1.34, P = 0.039). Smoking affected antibody status.

Conclusions

Anti‐Fla‐X and presence of all anti‐bacterial antibodies identifies patients at higher risk of early postoperative Crohn's disease recurrence. Serologic screening pre‐operatively may help identify patients at increased risk of recurrence.
Potentially Avoidable Readmissions of Patients Discharged to Post‐Acute Care: Perspectives of Hospital and Skilled Nursing Facility Staff
Authors: Vasilevskis Eduard E. , Ouslander Joseph G. , Mixon Amanda S. , Bell Susan P. , Jacobsen J. Mary Lou , Saraf Avantika A. , Markley Daniel , Sponsler Kelly C. , Shutes Jill , Long Emily A. , Kripalani Sunil , Simmons Sandra F. , Schnelle John F.
Published: December 2016

Background

Hospital readmissions from skilled nursing facilities (SNFs) are common. Previous research has not examined how assessments of avoidable readmissions differ between hospital and SNF perspectives.

Objectives

To determine the percentage of readmissions from post‐acute care that are considered potentially avoidable from hospital and SNF perspectives.

Design

Prospective cohort study.

Setting

One academic medical center and 23 SNFs.

Participants

We included patients from a quality improvement trial aimed at reducing hospital readmissions among patients discharged to SNFs. We included Medicare patients who were discharged to one of 23 regional SNFs between January 2013 and January 2015, and readmitted to the hospital within 30 days.

Measurements

Hospital‐based physicians and SNF‐based staff performed structured root‐cause analyses (RCA) on a sample of readmissions from a participating SNF to the index hospital. RCAs reported avoidability and factors contributing to readmissions.

Results

The 30‐day unplanned readmission rate to the index hospital from SNFs was 14.5% (262 hospital readmissions of 1,808 discharges). Of the readmissions, 120 had RCA from both the hospital and SNF. The percentage of readmissions rated as potentially avoidable was 30.0% and 13.3% according to hospital and SNF staff, respectively. Hospital and SNF ratings of potential avoidability agreed for 73.3% (88 of the 120 readmissions), but readmission factors varied between settings. Diagnostic problems and improved management of changes in conditions were the most common avoidable readmission factors by hospitals and SNFs, respectively.

Conclusion

A substantial percentage of hospital readmissions from SNFs are rated as potentially avoidable. The ratings and factors underlying avoidability differ between hospital and SNF staff. These data support the need for joint accountability and collaboration for future readmission reduction efforts between hospitals and their SNF partners.
Gender Bias and Credit Access
Authors: ONGENA STEVEN , POPOV ALEXANDER
Published: December 2016

We extract an exogenous measure of gender bias from survey responses by descendants of U.S. immigrants on questions about the role of women in society. We then use data on around 6,000 small business firms from 17 countries and find that in high‐gender‐bias countries, female entrepreneurs are more likely to opt out of the loan application process and to resort to informal finance, even though banks do not appear to actively discriminate against them. These results are not driven by credit risk differences between female‐ and male‐owned firms or by any idiosyncrasies in the set of countries in our sample.
Corridor System and Interest Rates: Volatility and Asymmetry
Authors: LEE JIHO
Published: December 2016

The corridor system in its current form is believed to reduce the volatility of overnight interest rates and to eliminate any chance of persistent upward or downward bias. The model presented here serves to highlight two main findings: one is that a central bank can further reduce the volatility of overnight interest rates by allowing banks some flexibility to meet their reserve targets within a small range, as observed in the UK data. The second is that a seemingly symmetric corridor may be asymmetric in practice due to several distortions, as the UK and euro area data suggest.
Glucocorticoid Effects on Cerebellar Development in a Chicken Embryo Model: Exploring Changes in PAX6 and Metalloproteinase‐9 After Exposure to Dexamethasone
Authors: Austdal L. P. E. , Bjørnstad S. , Mathisen G. H. , Aden P. K. , Mikkola I. , Paulsen R. E. , Rakkestad K. E.
Published: December 2016

The developing cerebellum is vulnerable to effects of glucocorticoids and cerebellar dysfunction is associated with neurodevelopmental disorders (e.g. autism). Transcription factor PAX6 and matrix metalloproteinase‐9 (MMP‐9) are critical for normal cerebellar development and are highly expressed in migrating neurones. Alterations in MMP‐9 and PAX6 are associated with altered cerebellar development. In the present study, we characterised the growth rate and development of the cortical layers, and further investigated how the levels of PAX6 and MMP‐9, as well as glucocorticoid receptor (GR) and proliferating cell nuclear antigen (PCNA), change in the cerebellum during the foetal period [embryonic day (E)12–21] in chicken, which corresponds to the human perinatal period. Dexamethasone (DEX) was administered in ovo at E13 and E16, aiming to investigate how prenatal exposure to glucocorticoids interferes with normal development. DEX reduced foetal and cerebellar weight at E17 in a dose‐dependent manner linked to a reduced level of PCNA and, over time, down‐regulation of GR. We report that promoter activity of PAX6 and MMP‐9 increased as a result of GR‐stimulation in vitro. Prenatal DEX increased the protein level of PAX6 in a transient manner. PAX6 is reduced in mature granule neurones, and this occurred earlier in embryos exposed to DEX than in non‐exposed controls. DEX exposure also led to a slow‐onset down‐regulation of MMP‐9. Taken together, these findings indicate that excess prenatal glucocorticoid stimulation disturbs normal development of the cerebellum through mechanisms associated with reduced proliferation and accelerated maturation where PAX6 and MMP‐9 play important roles.
The Road to Unintended Consequences Is Paved with Motivational Apps
Authors: Austin Caroline Graham , Kwapisz Agnieszka
Published: December 2016

Myriad automated interventions have been designed to help consumers set and achieve behavioral goals. Firms and governments are making significant investments in applications that help consumers manage their behavior. However, scant evidence demonstrates their effectiveness. Are such interventions effective? Are they worth our time and money? Might they do more harm than good? This study presents the results of an exploratory experiment using Self Determination Theory to test the efficacy of one type of motivational aid used in many apps—the automated prompt. We examine how effective this approach is at helping people make long‐term behavioral changes. We also test whether providing people with motivational wisdom—i.e., “it takes three weeks to form a habit”—has an effect on behavioral change. In addition to practical implications for consumers' health, productivity, and happiness, and policy implications, our project contributes to the literature on consumers' motivation and goal pursuit.
A new tool to improve delivery of patient‐engaged care and satisfaction in facial treatments: the Aesthetic Global Ranking Scale
Authors: Jain Ravi , Huang Peter , Ferraz Rodrigo M.
Published: December 2016

Background

Physicians face the challenge of individualizing aesthetic treatments in order to match the aesthetic needs of patients with their expectations.

Objective

To review issues underlying patient satisfaction with minimally invasive aesthetic treatment and to present a patient‐centric assessment tool (the Global Ranking Scale [GRS]) designed to set higher standards for patient consultation and treatment experience; ensure a comprehensive patient‐centric aesthetic consultation process; and raise patient satisfaction with facial rejuvenation treatment.

Methods

A review of the design and content of the GRS and its use as part of the wider Galderma Harmony Program. Results of a small survey of clinicians who have switched to the GRS, and case studies of patients who have used the tool, are also presented.

Results

The GRS is used in ~500 clinics around the world. In a small survey, physicians who have used the GRS report that it has changed the way that patients are assessed and treated. While no patient survey was conducted, anecdotal evidence suggests that patients are satisfied with the GRS procedure and the outcomes of treatment.

Conclusions

The GRS is a new patient assessment tool that is designed as a guide for clinicians to help ensure consistency in the quality of patient assessment and consultation in their clinics offering minimally invasive facial cosmetic procedures. Qualitative research suggests that it gives patients a better chance to achieve results aligned with their needs resulting in a higher level of satisfaction with aesthetic treatments, but this needs to be confirmed in a formal patient survey.
Evaluation of a formal care worker educational intervention on pressure ulceration in the community
Authors: Cross Carol , Hindley Jenny , Carey Nicola
Published: December 2016

Aims and objectives

To develop and evaluate an educational intervention for formal care workers on pressure ulceration in the community.

Background

Pressure ulcers are a major burden to health care and with an ageing population likely to increase. Formal care workers are ideally placed to identify high risk but lack standardised educational provision.

Design

An insider approach to action research in one provider organisation, November 2014–May 2015.

Methods

Number and categorisation of pressure ulcers, within three community nursing teams before and four months after intervention was delivered to a purposive sample (n = 250) of formal care workers, were assessed and the taught element evaluated using a questionnaire and verbal feedback.

Results

Total number of pressure ulcers reduced from 28–20, category II, 19–11, III unchanged at 6 and IV from 2–0 following the educational intervention. Key risk factors included impaired mobility (71%), urinary incontinence (61%) and previous pressure damage (25%), and 71% had formal care worker input. The intervention was highly rated 4·95/5 by 215 (86%) formal care workers in the evaluation questionnaire.

Conclusions

Formal care workers receive little, if any, education on pressure ulceration. An educational intervention can have a positive effect within community care, with the potential to reduce direct costs of care. However, a standardised approach to education is required; an urgent review of the education provision to formal care workers, in the UK and around the world, is therefore essential if the potential that formal care workers offer is to be realised.

Relevance to clinical practice

Formal care workers are ideally placed to help identify and alert healthcare professionals about patients at high risk of developing pressure ulcers. If this potential is to be realised, a standardised approach to education is required.
Conservative management of post‐partum hemorrhage secondary to placenta previa–accreta with hypogastric artery ligation and endo‐uterine hemostatic suture
Authors: Rauf Melekoglu , Ebru Celik , Sevil Eraslan , Selim Buyukkurt
Published: December 2016

Aim

The aim of this study was to investigate maternal and neonatal outcomes of conservative management of post‐partum hemorrhage due to placenta previa–accreta using hypogastric artery ligation and endo‐uterine hemostatic suture to lower uterine segment.

Methods

The records of 38 patients who were managed conservatively with hypogastric artery ligation and endo‐uterine hemostatic suture to control post‐partum hemorrhage secondary to placenta previa–accreta between April 2014 and January 2016, were reviewed retrospectively. Placenta previa–accreta was diagnosed according to gray‐scale, color and 3‐D power Doppler ultrasonography in addition to the intraoperative findings based on fragmentary or difficult separation of the placenta. In the case of conservative treatment protocol failure, cesarean hysterectomy was performed.

Results

Of these patients, 55.2% were between 25 and 35 years old; 97.5% were multiparous; 71.2% had two or more previous cesarean section and 68.5% had preterm delivery. Women with placenta accreta had a median estimated blood loss of 450 mL; 57.8% of patients had blood transfusion (mean intraoperative transfusion, 2 units packed red blood cells; range, 0–9 units). Median duration of operation was 112.5 min (range, 45–305 min) and 32 patients (84.3%) with placenta accreta did not undergo cesarean hysterectomy.

Conclusion

Conservative treatment of post‐partum hemorrhage secondary to placenta previa–accreta with hypogastric artery ligation and endo‐uterine hemostatic sutures to the lower segment of the uterus is associated with lower hysterectomy rate compared with the other conservative methods reported in the literature.
Evaluation of ovarian reserve using anti‐müllerian hormone and antral follicle count in Sjögren's syndrome: Preliminary study
Authors: Karakus Savas , Sahin Ali , Durmaz Yunus , Aydin Huseyin , Yildiz Caglar , Akkar Ozlem , Dogan Mansur , Cengiz Ahmet , Cetin Meral , Cetin Ali
Published: December 2016

Aim

The aim of this study was to determine ovarian reserve status using anti‐müllerian hormone (AMH) level and antral follicle count (AFC) in patients with Sjögren's syndrome (SS).

Methods

Twenty‐four women with SS diagnosed according to the classification criteria proposed by the American–European Consensus Group and 25 healthy women as controls were enrolled in this study. Ovarian reserve was assessed on clinical findings, AFC, and serum AMH and reproductive hormone levels.

Results

Compared with the healthy controls, in the SS patients, the duration of menstrual cycle was significantly shorter (P = 0.043); serum AMH (P = 0.001) and AFC (P = 0.001) were significantly lower, and serum luteinizing hormone (LH) was significantly higher (P = 0.019). The right (P = 0.555) and left ovarian (P = 0.386) volumes were also lower but this did not reach statistical significance. Serum follicle‐stimulating hormone (P = 0.327), estradiol (P = 0.241), and prolactin (P = 0.55) were similar between the two groups.

Conclusions

Ovarian reserve may be reduced in SS patients. For the assessment of ovarian reserve, serum AMH and ovarian AFC with serum LH may be useful. Further studies with long‐term follow‐up are required to determine the course of ovarian reserve abnormalities and best possible biomarkers of reduced ovarian reserve in SS patients.
Intimate Partner Violence and Children's Attachment Representations During Middle Childhood
Authors: Gustafsson Hanna C. , Brown Geoffrey L. , Mills‐Koonce W. Roger , Cox Martha J. ,   The Family Life Project Key Investigators
Published: December 2016

Despite long‐standing hypotheses that intimate partner violence (IPV) may undermine children's ability to form secure attachment representations, few studies have empirically investigated this association. Particularly lacking is research that examines IPV and attachment during middle childhood, a time when the way that children understand, represent, and process the behavior of others becomes particularly important. Using data from a sample of African American children living in rural, low‐income communities (N = 98), the current study sought to address this gap by examining the association between physical IPV occurring early in children's lives and their attachment security during the first grade. Results indicate that, even after controlling for child‐ and family‐level covariates, physical IPV was associated with a greater likelihood of being rated insecurely attached. This effect was above and beyond the influence of maternal parenting behaviors, demonstrating a unique effect of physical IPV on children's attachment representations during middle childhood.
Stuck in Limbo: Motivational Antecedents and Consequences of Experiencing Action Crises in Personal Goal Pursuit
Authors: Holding Anne C. , Hope Nora H. , Harvey Brenda , Marion Jetten Ariane S. , Koestner Richard
Published: December 2016

Objective

Action crises describe the intrapsychic conflicts individuals experience when they feel torn between further goal pursuit and goal disengagement. The present investigation introduces autonomous and controlled motivation as independent predictors of action crisis severity, beyond known personality‐level predictors (action orientation) and novel personality‐level predictors (Neuroticism and Conscientiousness).

Method

Using a multi‐wave prospective longitudinal design and multilevel modeling (MLM), we followed students pursuing three personal goals across an academic semester (N = 425 undergraduates; 76% female; 57% Caucasian; Mage = 20.2, SD = 2.3). In two follow‐up surveys, participants reported on the severity of their action crises, goal progress, and symptoms of depression.

Results

Results suggest that autonomous motivation shields individuals from experiencing action crises, whereas controlled motivation represents a risk factor for developing action crises beyond personality‐level predictors. Furthermore, MLM revealed that autonomous motivation is a significant predictor of action crisis severity at both the within‐ and between‐person levels of analysis. Action crises mediate both the relationship between autonomous motivation and goal progress, and the relationship between controlled motivation and symptoms of depression.

Conclusions

The implications of these findings for the prevention of action crises and motivation research are discussed.
Innovative Egg Custard Formulation Reduced Rearing Period and Improved Survival of Giant Freshwater Prawn, Macrobrachium rosenbergii, Larvae
Authors: Nik Sin Nik Nurhusna , Shapawi Rossita
Published: December 2016

This study was conducted to determine the performance of new egg custard formula to replace Artemia sp. on the growth and survival of the giant freshwater prawn, Macrobrachium rosenbergii, larvae. Five experimental diets were tested with triplicate treatments: ART (Artemia sp.), ART‐MIX (Artemia sp. + egg custard MIX: a mixture of shrimp, squid, and bivalve meal‐based egg custard, with palm oil), ART‐PBM (Artemia sp. + PBM, poultry byproduct meal‐based egg custard with fish oil), egg custard MIX only, and egg custard PBM only. All experimental diets were tested after 9 d (stage VI) of feeding Artemia sp. to prawn larvae. The stocking density was set at 100 larvae/L in a clear water tank culture system. Results indicated that the highest survival was recorded in the treatment of ART‐PBM (46.07 ± 0.84%) and the lowest was in the MIX treatment (8.87 ± 0.51%). ART‐PBM and ART‐MIX diets successfully reduced the rearing period and improved survival from larval to postlarval stage by 19 and 65%, respectively, compared with the ART diet. However, the use of MIX and PBM alone increased the rearing period up to 11%. The feeding regime of ART‐PBM and ART‐MIX has provided nutritional advantages and can be successfully practiced in the hatchery of M. rosenbergii larvae. The innovative approach of using PBM and palm oil in the egg custard formulation in this study can provide prawn hatchery operators with more options in terms of dietary ingredients and cost‐effective solutions.
Inactivation of foodborne pathogenic and spoilage micro-organisms using ultraviolet-A light in combination with ferulic acid
Authors: Shirai A. , Watanabe T. , Matsuki H.
Published: December 2016

The low energy of UV-A (315–400 nm) is insufficient for disinfection. To improve UV-A disinfection technology, we evaluated the effect of ferulic acid (FA) addition on disinfection by UV-A light-emitting diode (LED) (350-385 nm) against various food spoilers and pathogens (seven bacteria and four fungi species). Photoantimicrobial assays were performed at FA concentrations below the MIC. The MIC of the isomerized FA, consisting of 93% cis-form and 7% trans-form, was very similar to that of the commercially available FA (trans-form). Irradiation with UV-A (1·0 J cm−2) in the presence of 100 mg l−1 FA resulted in enhanced reducing of all of the tested bacterial strains. A combination of UV-A (10 J cm−2) and 1000 mg l−1 FA resulted in enhanced reducing of Saccharomyces cerevisiae and one of the tested filamentous fungi. These results demonstrated that the combination of a short-term application of UV-A and FA at a low concentration yielded synergistic enhancement of antimicrobial activity, especially against bacteria.

Significance and Impact of the Study

Microbial contamination is one of the most serious problems for foods, fruit and sugar thick juices. UV light is suitable for the nonthermal decontamination of food products by inactivating the contaminating micro-organisms. However, UV-A exposure is insufficient for disinfection. This study demonstrates that the combination of UV-A LED light (350–385 nm), which is not hazardous to human eyes and skin, and ferulic acid (FA), a known phytochemical and food additive, provides synergistic antimicrobial activity against foodborne pathogenic and spoilage micro-organisms. Therefore, FA addition to UV-A light treatment may be useful for improvement of UV-A disinfection technology to prevent food deterioration.
A Public International Law approach to safeguard nationality for surrogate-born children
Authors: Ghráinne Bríd Ní , McMahon Aisling
Published: December 2016

International surrogacy agreements involve a child born to a surrogate mother who is of a different nationality to the commissioning parent(s) in a state other than that of which the commissioning parent(s) are nationals or reside. Many of these arrangements lead to children being born stateless, which deprives that child of many rights that are directly linked to one's nationality as well as causing significant practical problems, such as difficulty in obtaining a passport. In undertaking the first Public International Law analysis of nationality and international surrogacy agreements, we map out how various provisions can be used to guarantee protections against statelessness. Accordingly, we argue that the drafting of a proposed new convention is not the ideal solution in this respect, and should not be to the detriment of the ratification and implementation of the relevant conventions that we identify; in particular, the 1989 Convention on the Rights of the Child. We argue that these protections offer the most meaningful protection in the short term and should be used to inform any future protections under the proposed Convention. We conclude by encouraging the advancement of Public International Law arguments when petitioning in a domestic context on behalf of stateless international surrogate children.
Experimental assessment ofPosidonia oceanica‐associated gastropods grazing on an early‐successional biofilm community: nutrient availability and species‐specific effects
Authors: Castejón‐Silvo Inés , Terrados Jorge
Published: December 2016

Although grazing is considered an essential process controlling epiphyte biomass on seagrass leaves, there is still a lack of fundamental knowledge about the species‐specific consumption rates of the most common grazers in Mediterranean meadows. This study experimentally assessed the effect ofPosidonia oceanica‐associated gastropod grazing on early successional biofilm and the species‐specific relationship between biofilm consumption rates and biofilm biomass. Two biofilms on artificial substrata, both developedin situ(in aP. oceanicameadow), one under ambient conditions and the other under nutrient‐enriched conditions, were offered in aquaria assays to nine species of grazers found inP. oceanicameadows. Biofilm consumption rates and their association with biofilm biomass were assessed. It was found that: (i) there was a positive association between biofilm consumption and biofilm biomass up to 20 mg Chla·m−2forBittium reticulatum,Gibbula ardens,Jujubinus exasperatusandTricolia pullus; (ii)Alvania montagui,B. reticulatumandJujubinus striatusshowed the highest consumption rates and are thus expected to be amongst the leading consumers in early‐successional epiphytic communities; (iii) there was not an increase of consumption rate when a substratum colonized under nutrient‐enriched conditions was offered to any of the nine studied species. This study provides species‐specific consumption rates knowledge that is useful for the assessment of the strength of grazer–epiphyte interactions and trophic fluxes inP. oceanicameadows.
Mitochondrial DNA variation reveals distinct lineages in Penaeus semisulcatus (Decapoda, Penaeidae) from the Indo‐West Pacific Ocean
Authors: Alam M. M. Mahbub , de Croos M. D. S. T. , Pálsson Snæbjörn
Published: December 2016

Penaeus semisulcatus, the green tiger prawn, is an ecologically and economically important penaeid shrimp in the Indo‐West Pacific region, especially in rice‐shrimp farming and capture fisheries in Bangladesh and Sri Lanka, respectively. Genetic variation and phylogeography of samples of this species from Bangladesh and Sri Lanka were studied utilizing different mitochondrial DNA markers, i.e. cytochrome oxidase subunit 1 (CO1), control region (CR) and 16S rRNA genes. No evidence of population structure was observed in Bangladesh, but distinct variations were found among the Sri Lankan samples (ΦST = 0.04, p = .002; FST = 0.07, p = .001), with the western sample differing from the northwestern and southern samples. The Bangladesh population had lower genetic diversity than two of the three Sri Lanka populations. The phylogeography of P. semisulcatus revealed two distinct mitochondrial DNA (mtDNA) lineages, one in the Western Pacific Ocean and second in the Indian Ocean. The Bangladesh samples showed highest levels of similarity with samples from Sri Lanka, India and Malaysia, with the Bangladesh and Sri Lanka populations sharing the most common recent ancestry. Among the Indian Ocean samples, high levels of variation were observed in the samples from Iran, indicating admixture of two distinct mtDNA lineages, one shared by the populations from the Bay of Bengal and the other possibly originating from Eastern Africa. The genetic and phylogeographic information obtained in this study will be useful in appropriate planning for management and conservation of shrimp fisheries in Bangladesh and Sri Lanka, and in the Indo‐West Pacific region.
Topological redundancy and ‘small‐world’ patterns in a food web in a subtropical ecosystem of Brazil
Authors: Bornatowski Hugo , Barreto Rodrigo , Navia Andrés F. , de Amorim Alberto Ferreira
Published: December 2016

According to graph theory, the frequency distribution of trophic interactions within a food web has deep structural implications, as it can highlight the presence of patterns associated with the web and indicate whether the properties of the web are independent of its size. A hypothesis is that ‘small‐world’ food webs are sensitive to the loss of species with the highest values. Therefore, the present work aimed to evaluate the degree to which a subtropical food web in Southern Brazil displays small‐world patterns and their resistance. As part of the assessment, we evaluated the topological redundancy values of species in the food web and then we simulated the exclusion of these species (such as sharks and sea birds), and also the exclusion of high centrality species (such as squids Loligo sp., portunid swimming crabs and the cutlassfish Trichiurus lepturus). The food web showed a ‘broad‐scale’ distribution of connections by node, and a small‐world pattern. As expected, a simplification of the network was observed after elimination of some species with high centrality. However, the food web was resistant to the loss of species with low topological redundancy, probably because these species occupy a high trophic level and do not participate in lots of routes within the food web. We highlight however, the importance of the application of multiple analyses to evaluate the importance of components in food webs, and fisheries management plans should consider both species of high centrality values and species with low topological redundancy.
Using Twins to Resolve the Twin Problem of Having a Bad Job and a Low Wage
Authors: Böckerman Petri , Ilmakunnas Pekka , Vainiomäki Jari
Published: December 2016

We use twin data linked to register‐based information on earnings to examine the long‐standing puzzle of nonexistent compensating wage differentials. The use of twin data with a panel dimension allows us to alleviate the impact of otherwise unobserved productivity differences that have been the prominent reason for estimation bias in prior studies. Using a twin design, we find some evidence for positive compensation of adverse working conditions in the labor market.