bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of hematological parameters in two different high altitudinal populations of Batrachuperus pinchonii (Amphibian: Urodela)
Authors: Xiong Jianli , Zhang Yanan , Sun Yuanye , Liu Qiangqiang , Fan Chaojie , Min Yao , Gou Jianping , Chen Wanguang
Published: January 2018

Hematological parameters are key to reflect the health status of animals and their physiological adaptation to the environment. However, few studies focused on the inter- and intra-specific variations of hematological parameters in hynobiid salamanders. Here, we examined the hematological parameters of the stream salamander, Batrachuperus pinchonii, originating from two different altitudinal populations to explore their intra-specific variation. Sexual dimorphism is only present in the erythrocyte count and males have higher mean values than females. The morphometric values of erythrocyte, hemoglobin concentration, and erythrocyte count of the high altitudinal (Jiajin) population were smaller than those of the lower altitudinal (Sandaoping) population; however, a significant difference between two populations was only revealed in the case of erythrocyte length via ANOVA. The results of linear regression showed that a significant relationship was present between body condition and erythrocyte length as well as the erythrocyte length to erythrocyte width ratio. Our findings suggest that the features of hematological parameters in B. pinchonii are reflected in the size of erythrocyte, and neither in erythrocyte count nor in hemoglobin concentration. These results provide a foundation for assessing and monitoring the health status of this salamander species, and furthermore, for understanding the physiological basis of altitudinal adaptation.
Dostoevsky’s Idea of the Golden Age
Authors: Horváth Géza S.
Published: January 2018

This article explores the semantic and intertextual ambience of the concept of the Golden Age as it appears in Stavrogin’s dream in the novel Demons. The motif of the Golden Age is considered a personal symbol deployed in Stavrogin’s dream and in his dualogue with the monk Tikhon. In At Tikhon’s, the originally unpublished chapter of the novel Demons, we can speak about three events and consequently three layers of time: 1/ the story of the little girl; 2/ the dream during the travels in Germany; 3/ the conversation with Tikhon. All together, the three time-layers can be read not only as a temporal structure, but also as three utterances, articulated in three different lan-guages, which are a realization of the meaning-paradigm constituted by the novel. Thus we conclude that the Golden Age reveals the grounding of a new “being-in-the-making” as a “new reality”, constituted by the novel-discourse.
Notes on scythridid moths in Habahu National Nature Reserves, with description of one new species (Lepidoptera: Scythrididae)
Authors: LOU KANG , YOU WANXUE , HUANG ZHILIN , LI HOUHUN
Published: January 2018

In a faunal study of insects in the Habahu National Nature Reserves of Ningxia, seven species of the genus Scythris of Scythrididae are recognized. One species, S. fustivalva Li, sp. nov., is described as new; five species are newly recorded in China: S. caballoides Nupponen, 2009, S. mikkolai Sinev, 1993, S. orientella Sinev, 2001, S. pallidella Passerin d'Entrèves et Roggero, 2006 and S. sinevi Nupponen, 2003. Photos of adults and genitalia are provided, and a list of Scythrididae in China is given.
On the taxonomy and biology of the clearwing moth Aegeria montis (Lepidoptera, Sesiidae)
Authors: YATA NAOKI , GORBUNOV OLEG G. , ARITA YUTAKA , AOKI YOSHICHIKA
Published: January 2018

The systematic position of Aegeria montis Leech, 1889 and Zhuosesia zhuoxiana Yang, 1977 is discussed. Having studied newly collected material, we transfer A. montis to the genus Chamaesphecia Spuler, 1910, subgenus Chamaesphecia s. str. The male of this species and its genitalia are illustrated for the first time. The host-plant of its larvae is assumed to be a species of Euphorbia (Euphorbiaceae).        Zhuosesia Yang, 1977, syn. nov., is shown to be a junior subjective synonym of Chamaesphecia Spuler, 1910 with the new combination of its type species, Chamaesphecia zhuoxiana (Yang, 1977), comb. nov.
Family Relations and Elder Care Among Arabs in the North of Israel
Authors: Ayalon Liat
Published: January 2018

The study examined family relations and elder care, in light of the modernization processes that are taking place in the Arab sector. Interviews with 25 older adults, 27 family members, and 5 paid home care workers of an Arab origin were conducted. Qualitative analysis consisted of constant comparisons and contrasts of relevant themes. Most Arabs reported that intergenerational solidarity is very strong in the Arab sector. Whereas many older adults and a few of their family members tended to favor paid care, the majority of Arab family members and fewer older adults stated that family care is preferred. Finally, a third theme outlined the desired properties of care, which consists of a true mix between formal and informal care. The study points to two sources of tension between (a) older adults and their family members and (b) perspectives on care held by the National Insurance Institute and the Arab sector.
Losing the Faith: Public Sector Work and the Erosion of Career Calling
Authors: Cohen Laurie , Duberley Joanne , Smith Pete
Published: January 2018

This article tells the story of Pete, a welfare rights adviser who worked his way up to be Assistant Director of Social Services in a Midlands local authority. Pete joined the public sector with a sense of calling and a belief that local government could create positive social change. Over the next 25 years, however, Pete’s calling was increasingly challenged as his job and the context in which he worked were transformed. This article focuses on the ways in which Pete navigated the system in an attempt to ‘keep the faith’, before eventually taking early retirement.
Fabrication of silver nanoparticles on glass substrate using low-temperature rapid thermal annealing
Authors: Barman Bidyut , Dhasmana Hrishikesh , Verma Abhishek , Kumar Amit , Singh DN , Jain VK
Published: January 2018

Metallic nanoparticle-based localized surface plasmon resonance phenomenon is of great interest in the field of solar cells and can increase efficiency via solar energy harvesting in the device due to their light trapping capabilities. In present research, rapid thermal annealing, a modern physical technique, has been employed for the fabrication of silver nanoparticles on glass substrates at lower temperature regime. The rapid thermal annealing is carried at temperatures 200, 250, and 300°C for annealing duration of 5, 10, 15, 20, and 30 min of as-sputtered silver clusters and then kept for natural cooling in inert ambient which has resulted into formation of silver nanoparticles on glass substrate. The surface morphological analysis of the grown silver nanoparticles shows average particle size minimization behavior with increase in rapid thermal annealing up to 15 min duration. Thereafter an increase in average size is observed with rapid thermal annealing time duration up to 30 min for all rapid thermal annealing temperatures. A growth mechanism is suggested to explain observed changes in silver nanoparticles size behavior under rapid thermal annealing conditions. The respective absorption peaks are lying in the wavelength range of 400–500 nm which confirms the formation of silver nanoparticles. The optical study for respective size of silver nanoparticles has also been analyzed and compared with that of theoretical calculations from Mie scattering theory.
Optimization of diesel engine input parameters for reducing hydrocarbon emission and smoke opacity using Taguchi method and analysis of variance
Authors: Muqeem Mohd , Sherwani Ahmad Faizan , Ahmad Mukhtar , Khan Zahid Akhtar
Published: January 2018

The aim of this paper is to optimize the input parameters of diesel engine with respect to hydrocarbon emission and smoke opacity through experimentation and Taguchi approach. Four parameters, namely, compression ratio, fuel injection timing, air temperature, and air pressure were varied at five different levels and their effect on hydrocarbon emission and smoke opacity under no load, half load, and full load conditions were recorded. The optimum combination of control/input parameters leading to the optimum values of performance parameters/response variables, were determined using signal-to-noise ratio, analysis of means, and analysis of variance. Confirmation tests were performed to check the validity of the results, which revealed good agreement between the predicted and the experimental values of the response variables at optimum combination of the input parameters.
Left ventricular thrombus and systemic embolism after painless myocardial infarction in a young female
Authors: Liao Shao-Feng , Lee Ching-Hsing , Wu Lung-Sheng , Li Chih-Huang , Chen Hsien-Yi
Published: January 2018

Oral contraceptives are widely used because of their reliability. Although oral contraceptives are known to increase the risk of thromboembolic events, there are extremely few reports of oral contraceptive–induced left ventricular thrombus. Herein, we report a 37-year-old non-smoking female, who had regularly taken oral contraceptives for 14 years, developed an anterior myocardial infarction concomitant with left ventricular thrombus, bilateral segmental renal infarctions, and lower limb ischemia. Medical treatment with a combination of dual antiplatelet therapy and anticoagulants completely relieved her symptoms.
Temperature and age–gender effects on out-of-hospital cardiac arrest cases
Authors: Low Chien Tat , Lai Poh Chin , Yeung Paul Sai Shun , Siu Axel Yuet Chung , Leung Kelvin Tak Yiu , Wong Paulina Pui Yun
Published: January 2018

Introduction:

Temperature is a key factor influencing the occurrence of out-of-hospital cardiac arrest, yet there is no equivalent study in Hong Kong. This study reports results involving a large-scale territory-wide investigation on the impacts of ambient temperature and age–gender differences on out-of-hospital cardiac arrest outcome in Hong Kong.

Methods:

This study included 25,467 out-of-hospital cardiac arrest cases treated by the Hong Kong Fire Services Department between December 2011 and November 2016 inclusive. Simple correlation and regression analyses were used to examine the relationships between out-of-hospital cardiac arrest cases and temperature, age and gender. Calendar charts were used to visualise temporal patterns of pre-hospital emergency medical services related to out-of-hospital cardiac arrest cases.

Results:

A strong negative curvilinear relationship was found between out-of-hospital cardiac arrest and daily temperature (r2 > 0.9) with prominent effects on elderly people aged ≥85 years. For each unit decrease in mean temperature in °C, there was a maximum of 5.6% increase in out-of-hospital cardiac arrest cases among all age groups and 7.3% increase in the ≥85 years elderly age group. Men were slightly more at risk of out-of-hospital cardiac arrest compared with women. The demand for out-of-hospital cardiac arrest–related emergency medical services was highest between 06:00 and 11:00 in the wintertime.

Conclusion:

This study provides the first local evidence linking weather and demographic effects with out-of-hospital cardiac arrest in Hong Kong. It offers empirical evidence to policymakers in support of strengthening existing emergency medical services to deal with the expected increase in out-of-hospital cardiac arrest in the wintertime and in regions with a large number of elderly population.
A rare adverse effect of energy drinks: Non-ST-elevation myocardial infarction
Authors: Levent Sevcan , Yolcu Sadiye
Published: January 2018

Energy drinks are increasingly used worldwide inspite of their side effects. These drinks has been linked to case reports that present with ST-elevation myocardial infarction, but in this case we report a case that presents with non-ST-elevation myocardial infarction after energy drink intake. The patient complained about chest pain after drinking two bottles of energy drink and vodka. Cardiac catheterization subsequently confirmed left anterior descending occlusion in this patient.
Pontine Tegmental Cap Dysplasia and Challenges in Facial Reconstructive Surgery
Authors: Aboutanos Sharline Z. , McAndrew Karen , Unkle John , Wornom Isaac L.
Published: January 2018

Pontine tegmental cap dysplasia (PTCD) is a rare condition that affects the brain stem and multiple cranial nerves, which can result in bilateral facial palsies, hearing loss, bilateral trigeminal nerve dysfunction, oculomotor apraxia, feeding difficulties, seizures, hypotonia, and undeveloped speech. We document a case in which a patient with PTCD presents with a challenging lip deformity and requires multidisciplinary treatment to improve reconstructive surgical success and treatment outcomes. An extensive literature review was conducted. This report serves to increase awareness of PTCD and the need for multidisciplinary teams to participate in reconstruction of facial defects in a complex medical setting.
An Evaluation of Alveolar Bone Grafting in the UK and Ireland
Authors: Jauhar Preeti , Macdonald Thomas , Patel Brijesh , Hay Norman
Published: January 2018

Objective:

To determine the main factors influencing the timing of alveolar bone grafting among cleft teams in the UK and Ireland, to assess the types of radiographs used to evaluate bone grafting sites pre- and postoperatively and the views of the profession on orthodontic expansion prior to grafting.

Design:

An online survey consisting of 24 questions was compiled and emailed to 53 orthodontists and surgeons in all 12 Cleft Hub Units in the UK and Ireland.

Results:

All units in the UK and Ireland responded with 51 responses, 39 complete and 12 partial responses, obtained from cleft surgeons and orthodontists. The majority of units are using dental criteria (75%) as a guide to timing alveolar bone grafting. Most units take a postoperative radiograph at 6 months but the view being taken varied. When asked if four cases were ready for grafting based on their radiographs, there was clear agreement by a significant majority for 3 cases but for 1 only a minimal majority (61%). The most common donor site chosen for the graft is the Iliac crest (92.9%). There was excellent agreement for 2 cases asking when to use expansion but poor agreement for one, 55% saying they would expand and 45% saying no.

Conclusion:

Overall there is good agreement among cleft teams in the UK and Ireland about management of alveolar bone grafting; however, a clearer consensus on preoperative orthodontic expansion may be needed.
A Tip for the Reconstruction of Larger Maxillary Defects in Complicated Cleft Patients
Authors: Oztel Mehmet , Rahmel Ben , Van Genechten Maarten , Batstone Martin D.
Published: January 2018

Residual alveolar cleft deficits can be difficult to treat. This is particularly the case in older and multiply operated patients as well as those with large oronasal defects and extensive scar tissue. In large and recalcitrant defects vascularized free tissue transfer should be considered as a definitive procedure. Vascularized free tissue transfer provides a 95% success rate and provides excellent bone for placement of osseointegrated implants for dental rehabilitation (Schwabegger et al., 2004). We feel that the scapula tip has a number of important advantages. These include reduced morbidity from the donor site, good bone quality and contour for implant placement, and a longer pedicle length.
Improving Mandatory Vaccination Against Influenza: Minimizing Anxiety of Employees to Maximize Health of Patients
Authors: Benin Andrea L. , Lockwood Gina , Creatore Tracy , Donovan Donna , Predmore Maggi , MacArthur Susan
Published: January 2018

The objective was to describe qualitatively the attitudes among employees toward mandatory vaccination against influenza to ultimately improve such programs and prevent hospital-acquired influenza. Qualitative interviews were conducted with 21 employees at a freestanding children’s hospital. Analysis of interview transcripts used grounded theory and the constant comparative method; codes were iteratively revised and refined as themes emerged. Themes emerged elucidating promoters and concerns. Promoters included a desire to protect self, family, and patients; perception of vaccination as part of professional responsibility; and free vaccination as a benefit from the organization. Concerns included negative feelings surrounding the forced nature and substantial anxiety about the physical injection. Participants expressed a strong desire for a private, compassionate, unhurried environment for the injection. Managing personal anxiety and a desire for privacy emerged as strong concerns among health care workers getting vaccinated at work. This information enabled future improvements in the mandatory vaccination campaign.
Operating characteristic information extraction of flood discharge structure based on complete ensemble empirical mode decomposition with adaptive noise and permutation entropy
Authors: Zhang Jianwei , Hou Ge , Ma Bin , Hua Weiwei
Published: January 2018

It remains a major issue to assess health condition and degree of vibration damage of flood discharge structure by working features in recent years. In the process of acquisition and transmission, because vibration signals are susceptible to interference from high-frequency white noise and low-frequency water flow noise, they are usually shown in the form of nonstationary random signals with low signal to noise ratio. Modal information is hard to be precisely recognized as the character of structural vibration is drowned into the strong noise. In order to remove the noise and preserve structural characteristic information, a new characteristic information extraction method based on complete ensemble empirical mode decomposition with adaptive noise (CEEMDAN) entropy (CEEMDAN-PE) is proposed. Firstly, the vibration signal is decomposed into a series of intrinsic mode functions (IMFs) by CEEMDAN, and then low-frequency water flow noise can be filtered out through spectrum analysis of each IMF component. Secondly, the noise degree of each IMF is determined by permutation entropy and high-frequency noise in IMFs is filtered out by singular value decomposition. Finally, the noise elimination IMFs are reconstructed to obtain the operating characteristic information of flood discharge structure. The effectiveness of the proposed method on characteristic information extraction is validated by a simulation experiment. Furthermore, the proposed method was applied to the 5th overflow section of Three Gorges Dam and the analysis results show that the CEEMDAN-PE method can effectively remove the noise and extract dominant frequencies of flood discharge structure, which provides foundation for health monitoring and damage identification of flood discharge structure with a strong engineering practicability.
Modified Tumescent Solution for Creating Working Space During Endoscopic Thyroidectomy
Authors: Zhang Li-Yong , Zhao Wen-Xin , Wang Bo , Yan Shou-Yi , Wen Jia
Published: January 2018

Objective. To study the feasibility of gas-liquid mixing tumescent solution for creating a working space (WS) in endoscopic thyroidectomy (ET). Materials and Methods. A prospective study was performed on 186 patients with thyroid tumor who had undergone ET via chest and breast approach. Patients were randomly divided into 2 groups to receive traditional tumescent solution as group A and modified tumescent solution (gas-liquid mixing tumescent solution) as group B. This study compares the following surgical outcome parameters between the 2 groups, including changes of blood pressure, heart rate, and oxygen saturation before and after creating a WS, time for creating a WS, operative time, hemorrhage volume for creating a WS, overall hemorrhage volume, overall postoperative drainage volume, postoperative pain score, postoperative hospitalization, number of retrieved lymph nodes, total serum calcium, serum parathyroid hormone, and cases of transient and permanent recurrent laryngeal nerve palsy. Results. No postoperative bleeding, permanent recurrent laryngeal nerve palsy, incision and surgical site infection, air embolism, flap injury occurred in both groups. The mean time for creating a WS and the whole operation in group B was significantly shorter than that in group A ( P < .05). There were no statistically significant differences in both groups in terms of other observation index ( P > .05). Conclusion. The clinical application of gas-liquid mixing tumescent solution can effectively reduce the time for creating a WS and whole operative time, and worthy of being widely used in ET as a safe and effective technique.
Cooperation between an unmanned aerial vehicle and an unmanned ground vehicle in highly accurate localization of gamma radiation hotspots
Authors: Lazna Tomas , Gabrlik Petr , Jilek Tomas , Zalud Ludek
Published: January 2018

This article discusses the highly autonomous robotic search and localization of radiation sources in outdoor environments. The cooperation between a human operator, an unmanned aerial vehicle, and an unmanned ground vehicle is used to render the given mission highly effective, in accordance with the idea that the search for potential radiation sources should be fast, precise, and reliable. Each of the components assumes its own role in the mission; the unmanned aerial vehicle (in our case, a multirotor) is responsible for fast data acquisition to create an accurate orthophoto and terrain map of the zone of interest. Aerial imagery is georeferenced directly, using an onboard sensor system, and no ground markers are required. The unmanned aerial vehicle can also perform rough radiation measurement, if necessary. Since the map contains three-dimensional information about the environment, algorithms to compute the spatial gradient, which represents the rideability, can be designed. Based on the primary aerial map, the human operator defines the area of interest to be examined by the applied unmanned ground vehicle carrying highly sensitive gamma-radiation probe/probes. As the actual survey typically embodies the most time-consuming problem within the mission, major emphasis is put on optimizing the unmanned ground vehicle trajectory planning; however, the dual-probe (differential) approach to facilitate directional sensitivity also finds use in the given context. The unmanned ground vehicle path planning from the pre-mission position to the center of the area of interest is carried out in the automated mode, similarly to the previously mentioned steps. Although the human operator remains indispensable, most of the tasks are performed autonomously, thus substantially reducing the load on the operator to enable them to focus on other actions during the search mission. Although gamma radiation is used as the demonstrator, most of the proposed algorithms and tasks are applicable on a markedly wider basis, including, for example, chemical, biological, radiological, and nuclear missions and environmental measurement tasks.
3D Printing: What Are the Hazards?
Authors: Randolph Susan A.
Published: January 2018

As the popularity of three-dimensional (3D) printers increases, more research will be conducted to evaluate the benefits and risks of this technology. Occupational health professionals should stay abreast of new recommendations to protect workers from exposure to 3D printer emissions.
In an Absolute State: Elevated Use of Absolutist Words Is a Marker Specific to Anxiety, Depression, and Suicidal Ideation
Authors: Al-Mosaiwi Mohammed , Johnstone Tom
Published: January 2018

Absolutist thinking is considered a cognitive distortion by most cognitive therapies for anxiety and depression. Yet, there is little empirical evidence of its prevalence or specificity. Across three studies, we conducted a text analysis of 63 Internet forums (over 6,400 members) using the Linguistic Inquiry and Word Count software to examine absolutism at the linguistic level. We predicted and found that anxiety, depression, and suicidal ideation forums contained more absolutist words than control forums ( ds > 3.14). Suicidal ideation forums also contained more absolutist words than anxiety and depression forums ( ds > 1.71). We show that these differences are more reflective of absolutist thinking than psychological distress. It is interesting that absolutist words tracked the severity of affective disorder forums more faithfully than negative emotion words. Finally, we found elevated levels of absolutist words in depression recovery forums. This suggests that absolutist thinking may be a vulnerability factor.
Transportation and Other Nonfinancial Barriers Among Uninsured Primary Care Patients
Authors: Kamimura Akiko , Panahi Samin , Ahmmad Zobayer , Pye Mu , Ashby Jeanie
Published: January 2018

Introduction:

Nonfinancial barriers are frequent causes of unmet need in health-care services. The significance of transportation barriers can weigh more than the issues of access to care. The purpose of this cross-sectional study was to examine transportation and other nonfinancial barriers among low-income uninsured patients of a safety net health-care facility (free clinic).

Methods:

The survey data were collected from patients aged 18 years and older who spoke English or Spanish at a free clinic, which served uninsured individuals in poverty in the United States.

Results:

Levels of transportation barriers were associated with levels of other nonfinancial barriers. Higher levels of nonfinancial barriers were associated with elevation in levels of stress and poorer self-rated general health. Higher educational attainment and employment were associated with an increase in other nonfinancial barriers.

Conclusion:

Focusing only on medical interventions might not be sufficient for the well-being of the underserved populations. Future studies should examine integrative care programs that include medical treatment and social services together and evaluate such programs to improve care for underserved populations.
Systemic multilineage engraftment in mice after in utero transplantation with human hematopoietic stem cells
Authors: Witt Russell G. , Kreger Emily M. , Buckman Laura B. , Moradi Patriss W. , Ho Phong T. , Derderian S. Christopher , Tsai Perry , Baker Chris , Schramm Nathaniel , Cleary Rachel , Garcia J. Victor , MacKenzie Tippi C.
Published: January 2018

Key Points

IUHCT of human cord blood–derived CD34+ cells into fetal NSG mice results in systemic multilineage engraftment with human cells. Preconditioning with in utero injection of an anti-c-Kit receptor antibody (ACK2) results in an improved rate of engraftment.
A randomised clinical trial of feedback on inhaler adherence and technique in patients with severe uncontrolled asthma
Authors: Sulaiman Imran , Greene Garrett , MacHale Elaine , Seheult Jansen , Mokoka Matshediso , D'Arcy Shona , Taylor Terence , Murphy Desmond M. , Hunt Eoin , Lane Stephen J. , Diette Gregory B. , FitzGerald J. Mark , Boland Fiona , Sartini Bhreathnach Aoife , Cushen Breda , Reilly Richard B. , Doyle Frank , Costello Richard W.
Published: January 2018

In severe asthma, poor control could reflect issues of medication adherence or inhaler technique, or that the condition is refractory. This study aimed to determine if an intervention with (bio)feedback on the features of inhaler use would identify refractory asthma and enhance inhaler technique and adherence.

Patients with severe uncontrolled asthma were subjected to a stratified-by-site random block design. The intensive education group received repeated training in inhaler use, adherence and disease management. The intervention group received the same intervention, enhanced by (bio)feedback-guided training. The primary outcome was rate of actual inhaler adherence. Secondary outcomes included a pre-defined assessment of clinical outcome. Outcome assessors were blinded to group allocation. Data were analysed on an intention-to-treat and per-protocol basis.

The mean rate of adherence during the third month in the (bio)feedback group (n=111) was higher than that in the enhanced education group (intention-to-treat, n=107; 73%versus63%; 95% CI 2.8%–17.6%; p=0.02). By the end of the study, asthma was either stable or improved in 54 patients (38%); uncontrolled, but poorly adherent in 52 (35%); and uncontrolled, but adherent in 40 (27%).

Repeated feedback significantly improved inhaler adherence. After a programme of adherence and inhaler technique assessment, only 40 patients (27%) were refractory and adherent, and might therefore need add-on therapy.
Effects of the “Living well with COPD” intervention in primary care: a comparative study
Authors: Steurer-Stey Claudia , Dalla Lana Kaba , Braun Julia , ter Riet Gerben , Puhan Milo A.
Published: January 2018

The pivotal objective of chronic obstructive pulmonary disease (COPD) self-management programmes is behaviour change to avoid moderate and severe exacerbations and improve health related quality of life.

In a prospectively planned, controlled study, COPD patients who participated in the “Living well with COPD” (LWWCOPD) self-management intervention were compared with usual care patients from the primary care COPD Cohort ICE COLD ERIC, who did not receive self-management intervention (NCT00706602) The primary outcome was behaviour change and disease-specific health related quality of life after 1 year. Secondary end-points included exacerbation rates. We calculated mixed linear, zero-inflated negative binomial and logistic regression models and used propensity scores to counteract confounding.

467 patients, 71 from the LWWCOPD and 396 from the usual care cohort, were included. The differences between intervention and control were 0.54 (95% CI 0.13−0.94) on the Chronic Respiratory Questionnaire domain “mastery”, 0.55 (95% CI 0.11−0.99) on “fatigue”, 0.54 (0.14−0.93) on “emotional function” and 0.64 (95% CI 0.14−1.14) on “dyspnoea”. The intervention considerably reduced the risk of moderate and severe exacerbations (incidence rate ratio 0.36, 95% CI 0.25−0.52).

Self-management coaching in primary care improves health-related quality of life and lowers exacerbation rates and health care use.
Service user perspectives on coercion and restraint in mental health
Authors: Rose Diana , Perry Emma , Rae Sarah , Good Naomi
Published: January 2018

Coercion remains a central aspect of many people's mental healthcare. It can include the use of legislation to restrict freedoms, the use of physical restraint, the restriction of freedom of movement and/or association, and the forced or covert administration of medication. There is good evidence that the use of such measures can traumatise service users. This article reports the findings of a survey of service users regarding their experiences of coercion and restraint and embeds this in the wider international and institutional environment.
Mental health and psychosocial support in Calais: a reflection on research in a challenging environment
Authors: Darwin Amy
Published: January 2018

This reflection focuses on research conducted in ‘The Jungle’ in Calais, an informal camp of approximately 6000 refugees (Help Refugees, 2016). My self-designed qualitative study aimed to assess the availability and nature of mental health and psychosocial support (MHPSS) by interviewing service providers about their role in MHPSS. The research questioned whether MHPSS was evidence-based (Tol et al, 2011), what types of MHPSS was available, what service providers envisaged to be the most immediate needs, and barriers and enabling factors in MHPSS.
An intracellular activation of Smoothened that is independent of Hedgehog stimulation in Drosophila
Authors: Jiang Kai , Liu Yajuan , Zhang Jie , Jia Jianhang
Published: January 2018

Smoothened (Smo), a GPCR family protein, plays a critical role in the reception and transduction of Hedgehog (Hh) signal. Smo is phosphorylated and activated on the cell surface; however, it is unknown whether Smo can be intracellularly activated. Here, we demonstrate that inactivation of the ESCRT-III causes dramatic accumulation of Smo in the ESCRT-III/MVB compartment, and subsequent activation of Hh signaling. In contrast, inactivation of ESCRTs 0–II induces mild Smo accumulation in the ESCRT-III/MVB compartment. We provide evidence that Kurtz (Krz), the Drosophila β-arrestin2, acts in parallel with the ESCRTs 0-II pathway to sort Smo to the multivesicular bodies and lysosome-mediated degradation. Additionally, upon inactivation of ESCRT-III, all active and inactive forms of Smo are accumulated. Endogenous Smo accumulated upon ESCRT-III inactivation is highly activated, which is induced by phosphorylation but not sumoylation. Taken together, our findings demonstrate a model for intracellular activation of Smo, raising the possibility for tissue overgrowth caused by an excessive amount, rather than mutation of Smo.
Negligible differences in metabolism and thermal tolerance between diploid and triploid Atlantic salmon (Salmo salar L.)
Authors: Bowden A. J. , Andrewartha S. J. , Elliott N. G. , Frappell P. B. , Clark T. D.
Published: January 2018

The mechanisms that underlie thermal tolerance in aquatic ectotherms remain unresolved. Triploid fish have been reported to exhibit lower thermal tolerance than diploids, offering a potential model organism to better understand the physiological drivers of thermal tolerance. Here, we compared triploid and diploid juvenile Atlantic salmon (Salmo salar) in freshwater to investigate the proposed link between aerobic capacity and thermal tolerance. We measured specific growth rates (SGR) and resting (aerobic) metabolic rates (RMR) in freshwater at 3, 7 and 9 weeks of acclimation to either 10, 14 or 18°C. Additionally, maximum metabolic rates (MMR) were measured at 3 and 7 weeks of acclimation, and critical thermal maxima (CTmax) were measured at 9 weeks. Mass, SGR, and RMR differed between ploidies across all temperatures at the beginning of the acclimation period, but all three metrics converged between ploidies by week 7. Aerobic scope (MMR – RMR) remained consistent across ploidies, acclimation temperatures, and time. At 9 weeks, CTmax was independent of ploidy, but correlated positively with acclimation temperature despite the similar aerobic scope between acclimation groups. Our findings suggest that acute thermal tolerance is not modulated by aerobic scope, and the altered genome of triploid Atlantic salmon does not translate to reduced thermal tolerance of juvenile fish in freshwater.
A review of the nomenclature of Cyclostigma (Cyclostigmatales: Cyclostigmataceae; fossil Isoetophyta)
Authors: Doweld Alexander B.
Published: January 2018

The complicated nomenclatural history of the extinct genus Cyclostigma Haught., established for arborescent trunks of presumably ancient isoetopsids (Isoetophyta: Cyclostigmatales), is reviewed and corrected with newly found bibliographic and historical data. The fossil name Cyclostigma, an illegitimate later homonym of two extant angiosperm genera, Cyclostigma Hochst. ex Endl. (Apocynaceae) nec Cyclostigma Klotzsch (Euphorbiaceae), was recently conserved and listed in App. III of ICN since the XVIII IBC in 2011. The fossil generic name Cyclostigma, associated with three species epithets and a distinct fossil family name Cyclostigmataceae (“Cyclostigmeae”), was invalidly published by Haughton in his series of works of 1859 and 1860 (reprinted several times), the genus lacking a description. Haughton’s family name based on his “Cyclostigma” and the species published in this genus were also not validly published. However, the generic name Cyclostigma was validly published in a little‐known publication by Haughton in 1859, not by Heer in 1871, as generally accepted in modern systematic palaeobotany, or Baily in 1861. In course of thorough nomenclatural analysis it has been shown that three fossil species names, which fell into oblivion still in the early works in the 19th century, Sigillaria dichotoma Haught. 1855, Lepidodendron griffithii Brongn. 1857 and L. minutum Haught. 1855 (non Sauveur) have priority over Cyclostigma kiltorkense Haught. 1859. Since C. kiltorkense has entered solidly into systematic palaeobotany and served as an index marker in historical geology, its retention through conservation is proposed. The nomenclature of the name Cyclostigmataceae is corrected as to be first validly published by Haughton in 1860.
An updated phylogeny and infrageneric classification of the genus Sisyrinchium (Iridaceae): Challenges of molecular and morphological evidence
Authors: Inácio Camila Dellanhese , Chauveau Olivier , Souza-Chies Tatiana T. , Sauquet Hervé , Eggers Lilian
Published: January 2018

Taxon delimitation and classification remains one of the fundamental bases of evolutionary studies and is especially challenging because processes by which new biological entities arise are complex and non‐linear over time, although continuous. Sisyrinchium (ca. 140 to 216 taxa) is one of the most species‐rich genera of Iridaceae, largely widespread in the Americas. Recent molecular phylogenetic studies have shown that the systematics of the genus is in need of substantial revision. Different data sources were investigated to establish an updated infrageneric classification based on phylogenetic principles. Monophyletic sections of Sisyrinchium were circumscribed using a new phylogenetic framework established from an increased sampling of taxa (107 species), and complementary approaches were combined to provide the most comprehensive infrageneric treatment of the genus proposed so far. Additionally, numerous molecular synapomorphies were identified to reinforce previous taxonomic treatments of tribe Sisyrinchieae (six genera) at the generic level. Major lineages of Sisyrinchium were concordantly resolved with mostly strong to full support by the DNA regions used in the study and ten sections characterized by unique combinations of molecular, morphological and geographical diagnostic characters were recognized. The phylogenetic trees respectively based on plastid + mitochondrial and nuclear ITS DNA regions were generally congruent except for two unplaced species (S. chilense, S. elegantulum) for which ancestral reticulation events were detected. New circumscriptions were provided for seven sections (sect. Cephalanthum, sect. Echthronema, sect. Hydastylus, sect. Segetia, sect. Sisyrinchium, sect. Spathirhachis, sect. Viperella) while three sections (sect. Morphanthus, sect. Rhizilineum, sect. Trichoparcus) were newly described. This work constitutes a robust contribution to elucidate the systematics of Sisyrinchium and emphasizes the need of integrative taxonomic approaches using multiple data sources, not only to improve the delimitation of taxa but also to investigate their evolutionary history.
Why Mahonia? Molecular recircumscription of Berberis s.l., with the description of two new genera, Alloberberis and Moranothamnus
Authors: Yu Chih-Chieh , Chung Kuo-Fang
Published: January 2018

Whether Mahonia should be recognized as a distinct genus or subsumed under Berberis has long been debated since its publication in 1818. Although recent molecular phylogenetic studies showed the paraphyly of Mahonia and some advocated a broadly defined Berberis to include Mahonia, the acceptance of Berberis s.l. is far from universal. Due to insufficient sampling and analytical issues of outgroup rooting, taxon misidentification, and the inclusion of a problematic GenBank DNA sequence, we argue that the phylogenetic status of Mahonia and consequently the circumscription of Berberis s.l. remains problematic. In particular, Berberis claireae and Mahonia sect. Horridae, taxa both inhabiting xeric habitats and characterized by a transitional morphology between Berberis s.str. and typical Mahonia (core Mahonia), have not been adequately sampled and well‐positioned phylogenetically. With the inclusion of these key species and an expanded sampling of core Mahonia, we re‐examine the phylogenetic relationships of Berberis s.l. using the internal transcribed spacer (ITS) of nrDNA, and three coding regions (accD, ndhF, rbcL) and one non‐coding region (psbA‐trnH) of the chloroplast genome. Our analyses reveal four clades within Berberis s.l., corresponding to Berberis s.str., B. claireae, core Mahonia, and Mahonia sect. Horridae, with the latter three (all compound‐leaved) forming a paraphyletic grade sister to simple‐leaved Berberis. Because of morphological and ecological distinctness of these four clades and their deep stem divergences equivalent to other genera of Berberidaceae, we propose a new classification of Berberis s.l. by applying a strict definition of Berberis (≡ Berberis s.str.), reinstating Mahonia (≡ core Mahonia), and proposing the two new genera Alloberberis nom. & stat. nov. (≡ Mahonia sect. Horridae) and Moranothamnus gen. nov. (≡ B. claireae). This revised classification is consistent with the traditional perception of Berberis and results in a monophyletic Mahonia, maintaining the stable usage of these two household names in both academic and non‐academic communities.
Species‐level phylogenetic analysis in the Relhania clade of “everlastings” and a new generic treatment of species previously assigned to Macowania and Arrowsmithia (Asteraceae: Gnaphalieae)
Authors: Bentley Joanne , Verboom G. Anthony , Bergh Nicola G.
Published: January 2018

The “Relhania clade” is a relatively species‐poor lineage that is sister to the remaining members of the paper daisy tribe Gnaphalieae. Although the monophyly of the Relhania clade is well established, previous molecular studies are based on fairly sparse sampling. Here, we explore clade membership and generic circumscription using plastid and nuclear DNA sequence data, and near‐complete species‐level sampling of all putative member genera. Two subclades are recovered within the Relhania clade: (i) clade I housing the genera Alatoseta, Athrixia, Pentatrichia and Phagnalon, all monophyletic as currently circumscribed; and (ii) clade II, containing the genera Antithirixia, Comborhiza, Oedera, Oreoleyesera, Relhania and Rosenia; the annual or otherwise “short‐lived” genera Leysera, Nestlera and Rhynchopsidium; as well as a subclade in which the monospecific Arrowsmithia is embedded within Macowania. A new taxonomic treatment involving 12 new combinations is proposed for the two latter genera. Only demonstrably monophyletic and diagnosable genera are recognised, involving the erection of a novel monospecific genus, Fluminaria, to house Macowania pinifolia, and the transfer of the remaining members of Macowania to Arrowsmithia. Updated descriptions and keys are provided.
Cocaine and its effects on pregnant women
Authors: Thow Sally Louise
Published: January 2018

Cocaine's popularity has escalated within the past decade and pregnant women from all socioeconomic, racial and cultural groups are among the burgeoning number of users. This article examines the pharmacological properties of this highly addictive, mood-altering drug and its profound effects on the pregnant woman and fetus.
Models of care to help midwives in decision making
Authors: Woods Anne
Published: January 2018

Using a case study approach, this article shows how a model of care may facilitate decision making. It identifies the issues facing midwives, and illustrates the value of relevant research, particularly in relation to episiotomy.
An anecdotal view of midwifery practice in Poland
Authors: Szczepinska Iris
Published: January 2018

This is a personal account of the different approaches to midwifery in Poland and England as seen through the eyes of two practitioners visiting one another's countries. Although differing widely, both midwives focus on the attitudes within each system towards the women in their care.
Hemiarthroplasty proximal femoral endoprostheses following tumour reconstruction
Authors: Stevenson J. D. , Kumar V. S. , Cribb G. L. , Cool P.
Published: January 2018

Aims

Dislocation rates are reportedly lower in patients requiring proximal femoral hemiarthroplasty than for patients undergoing hip arthroplasty for neoplasia. Without acetabular replacement, pain due to acetabular wear necessitating revision surgery has been described. We aimed to determine whether wear of the native acetabulum following hemiarthroplasty necessitates revision surgery with secondary replacement of the acetabulum after proximal femoral replacement (PFR) for tumour reconstruction.

Patients and Methods

We reviewed 100 consecutive PFRs performed between January 2003 and January 2013 without acetabular resurfacing. The procedure was undertaken in 74 patients with metastases, for a primary bone tumour in 20 and for myeloma in six. There were 48 male and 52 female patients, with a mean age of 61.4 years (19 to 85) and median follow-up of two years (interquartile range (IQR) 0.5 to 3.7 years). In total, 52 patients presented with a pathological fracture and six presented with failed fixation of a previously instrumented pathological fracture.

Results

All patients underwent reconstruction with either a unipolar (n = 64) or bipolar (n = 36) articulation. There were no dislocations and no acetabular resurfacings. Articular wear was graded using the criteria of Baker et al from 0 to 3, where by 0 is normal; grade 1 represents a narrowing of articular cartilage and no bone erosion; grade 2 represents acetabular bone erosion and early migration; and grade 3 represents protrusio acetabuli. Of the 49 patients with radiological follow-up greater than one year, six demonstrated grade 1 acetabular wear and two demonstrated grade 2 acetabular wear. The remainder demonstrated no radiographic evidence of wear. Median medial migration was 0.3 mm (IQR -0.2 to 0.7) and superior migration was 0.3 mm (IQR -0.2 to 0.6). No relationship between unipolar versus bipolar articulations and wear was evident.

Conclusion

Hemiarthroplasty PFRs for tumour reconstruction eliminate joint instability and, in the short to medium term, do not lead to native acetabular wear necessitating later acetabular resurfacing. Cite this article: Bone Joint J 2018;100B:101–8.
Wound irrigation does not affect health-related quality of life after open fractures: results of a randomized controlled trial
Authors: Sprague S. , Petrisor B. , Jeray K. , McKay P. , Heels-Ansdell D. , Schemitsch E. , Liew S. , Guyatt G. , Walter S. D. , Bhandari M.
Published: January 2018

Aims

The Fluid Lavage in Open Fracture Wounds (FLOW) trial was a multicentre, blinded, randomized controlled trial that used a 2 × 3 factorial design to evaluate the effect of irrigation solution (soap versus normal saline) and irrigation pressure (very low versus low versus high) on health-related quality of life (HRQL) in patients with open fractures. In this study, we used this dataset to ascertain whether these factors affect whether HRQL returns to pre-injury levels at 12-months post-injury.

Patients and Methods

Participants completed the Short Form-12 (SF-12) and the EuroQol-5 Dimensions (EQ-5D) at baseline (pre-injury recall), at two and six weeks, and at three, six, nine and 12-months post-fracture. We calculated the Physical Component Score (PCS) and the Mental Component Score (MCS) of the SF-12 and the EQ-5D utility score, conducted an analysis using a multi-level generalized linear model, and compared differences between the baseline and 12-month scores.

Results

We found no clinically important differences between irrigating solutions or pressures for the SF-12 PCS, SF-12 MCS and EQ-5D. Irrespective of treatment, participants had not returned to their pre-injury function at 12-months for any of the three outcomes (p < 0.001).

Conclusion

Neither the composition of the irrigation solution nor irrigation pressure applied had an effect on HRQL. Irrespective of treatment, patients had not returned to their pre-injury HRQL at 12 months post-fracture. Cite this article: Bone Joint J 2018;100-B:88–94.