bluuebunny/crossref_metadata_2025 huggingface dataset:
Comments on the neglected nymphs of mud crickets in the genus Mirhipipteryx (Caelifera: Tridactyloidea: Ripipterygidae)
Authors: BAENA-BEJARANO NATHALIE , HEADS SAM W. , TAYLOR STEVEN J.
Published: September 2018

Mud crickets (family Ripipterygidae) comprise a small family of orthopterans distributed throughout much of the Neotropics, but knowledge of this groups' biology, ecology and distribution remains poor in comparison to most orthopteran taxa. Here we review the state of knowledge of nymphs in the genus Mirhipipteryx Günther 1969 and report the genus from Belize for the second time in 86 years. Because information about nymphs in this family is so scarce and nymphs are often neglected in species descriptions, we include comments on the coloration of nymphs for Mirhipipteryx pulicaria (Saussure 1896). Caution is suggested for the use of adult characters for the identification of immatures stages in the group. Nymphs of Mirhipipteryx pulicaria pulicaria are similar in coloration patterns to the adults, but lighter. Mirhipipteryx lobata Günther 1977 is designated a nomen nudum.
A new species of Dignomus Wollaston (Coleoptera: Ptinidae) from Eocene Baltic amber
Authors: BUKEJS ANDRIS , BELLÉS XAVIER , ALEKSEEV VITALII I.
Published: September 2018

Dignomus francescovitalii sp. nov. is described and illustrated based on a well-preserved specimen from Eocene Baltic amber. This new extinct species is placed into D. irroratus species-group. The distribution of the genus Dignomus including fossil records is mapped.
On the Choice of Momentum Control Variables and Covariance Modeling for Mesoscale Data Assimilation
Authors: Xu Qin
Published: September 2018

For mesoscale variational data assimilation with high-resolution observations, there has been an issue concerning the choice of momentum control variables and related covariance modeling. This paper addresses the theoretical aspect of this issue. First, relationships between background error covariance functions for differently chosen momentum control variables are derived, and different choices of momentum control variables are proven to be theoretically equivalent in the sense that they lead to the same optimally analyzed incremental wind field in the limit of infinitely high spatial resolution provided their error covariance functions satisfy the derived relationships. It is then shown that when the velocity potential χ and streamfunction ψ are used as momentum control variables with their background error autocovariance functions modeled by single-Gaussian functions, the derived velocity autocovariance functions contain significant negative sidelobes. These negative sidelobes can represent background wind error structures associated with baroclinic waves on the synoptic scale but become unrepresentative on the mesoscale. To reduce or remove these negative sidelobes for mesoscale variational data assimilation, Gaussian functions are used with two types of modifications to model the velocity covariance functions in consistency with the assumed homogeneity and isotropy in variational data assimilation. In this case, the random (χ, ψ) background error fields have no classically valid homogeneous and isotropic covariance functions, but generalized (χ, ψ) covariance functions can be derived from the modified velocity covariance functions for choosing (χ, ψ) as momentum control variables. Mathematical properties of generalized covariance functions are explored with physical interpretations. Their important implications are discussed for mesoscale data assimilation.
A Tropical Stochastic Skeleton Model for the MJO, El Niño, and Dynamic Walker Circulation: A Simplified GCM
Authors: Thual Sulian , Majda Andrew J. , Chen Nan
Published: September 2018

A simple dynamical stochastic model for the tropical ocean atmosphere is proposed that captures qualitatively major intraseasonal to interannual processes altogether including El Niño–Southern Oscillation (ENSO), the Madden–Julian oscillation (MJO), the associated wind bursts, and the background dynamic Walker circulation. Such a model serves as a prototype “skeleton” for general circulation models (GCMs) that solve similar dynamical interactions across several spatiotemporal scales but usually show common and systematic biases in representing tropical variability as a whole. The most salient features of ENSO, the wind bursts, and the MJO are captured altogether including their overall structure, evolution, and fundamental interactions in addition to their intermittency, diversity, and energy distribution across scales. Importantly, the intraseasonal wind bursts and the MJO are here solved dynamically, which provides their upscale contribution to the interannual flow as well as their modulation in return in a more explicit way. This includes a realistic onset of El Niño events with increased wind bursts and MJO activity starting in the Indian Ocean to the western Pacific and expanding eastward toward the central Pacific, as well as significant interannual modulation of the characteristics of intraseasonal variability. A hierarchy of cruder model versions is also analyzed in order to highlight fundamental concepts related to the treatment of multiple time scales, main convective nonlinearities, and the associated stochastic convective parameterizations. The model developed here also should be useful to diagnose, analyze, and help eliminate the strong tropical biases that exist in current operational models.
Using the variance function to generalize Bland–Altman analysis
Authors: Sadler William A
Published: September 2018

Background

Bland–Altman analysis is a popular and widely used method for assessing the level of agreement between two analytical methods. An important assumption is that paired method differences exhibit approximately constant (homogeneous) scatter when plotted against pair means. This allows estimation of limits of agreement which retain validity across the entire range of mean values. In practice, pair differences often increase systematically with the mean and Bland and Altman used log transformed data to achieve approximately homogeneous scatter. Unfortunately, a logarithmic transformation fails when data are located near the detection limit of an assay (a region that is often of considerable clinical importance).

Methods

Simulated thyrotropin data are used to illustrate how a variance function, estimated from pair differences, can be used to transform problematic data into a form suitable for traditional Bland–Altman analysis. Simulated and real data sets are used in a supplementary file to illustrate and offer practical solutions to potential problems.

Results

Following transformation by variance function, Bland–Altman results can be readily interpreted by back-transformation either to the original measurement scale or as percentage values. Limits of agreement are no longer horizontal straight lines, but their shapes simply reflect error characteristics which are (or should be) thoroughly familiar to laboratory analysts.

Conclusions

The method is completely general and in principle requires only the estimation of a variance function that reliably describes the relationship between the variances of pair differences and their mean values. A computer program is available which performs the necessary calculations.
A Novel Auditory Display for Neonatal Resuscitation: Laboratory Studies Simulating Pulse Oximetry in the First 10 Minutes After Birth
Authors: Zestic Jelena , Brecknell Birgit , Liley Helen , Sanderson Penelope
Published: September 2018

Objective:

We tested whether enhanced sonifications would improve participants’ ability to judge the oxygen saturation levels (SpO2) of simulated neonates in the first 10 min after birth.

Background:

During the resuscitation of a newborn infant, clinicians must keep the neonate’s SpO2 levels within the target range, however the boundaries for the target range change each minute during the first 10 min after birth. Resuscitation places significant demand on the clinician’s visual attention, and the pulse oximeter’s sonification could provide eyes-free monitoring. However, clinicians have difficulty judging SpO2 levels using the current sonification.

Method:

In two experiments, nonclinicians’ ability to detect SpO2 range and direction—while performing continuous arithmetic problems—was tested with enhanced versus conventional sonifications. In Experiment 1, tremolo signaled when SpO2 had deviated below or above the target range. In Experiment 2, tremolo plus brightness signaled when SpO2 was above target range, and tremolo alone when SpO2 was below target range.

Results:

The tremolo sonification improved range identification accuracy over the conventional display (81% vs. 63%, p < .001). The tremolo plus brightness sonification further improved range identification accuracy over the conventional display (92% vs. 62%, p <.001). In both experiments, there was no difference across conditions in arithmetic task accuracy ( p >.05).

Conclusion:

Using the enhanced sonifications, participants identified SpO2 range more accurately despite a continuous distractor task.

Application:

An enhanced pulse oximetry sonification could help clinicians multitask more effectively during neonatal resuscitations.
The Effect of Workplace Inspections on Worker Safety
Authors: Li Ling , Singleton Perry
Published: September 2018

The US Occupational Safety and Health Administration (OSHA) enforces safety regulations through workplace inspections. The authors estimate the effect of inspections on worker safety by exploiting a feature of OSHA’s Site-Specific Targeting plan. The program targeted establishments for inspection if their baseline case rate exceeded a cutoff. This approach generated a discontinuous increase in inspections, which the authors exploit for identification. Using the fuzzy regression discontinuity model, they find that inspections decrease the rate of cases that involve days away from work, job restrictions, and job transfers in the calendar year immediately after the inspection cycle. They find no effect for other case rates or in subsequent years. Effects are most evident in manufacturing and less evident in health services, the largest two-digit industries represented in the data.
The offence/defence of infanticide: A view from two perspectives
Authors: Howard Helen
Published: September 2018

This article asks whether the time is right for abolition of the offence/defence of infanticide. To this end, a two-pronged approach is taken, examining infanticide initially as an offence, and then as a defence. In terms of the offence of infanticide, consideration is given both to the concept of the ‘infanticidal mother’ and to the status of infants below the age of 12 months. When considering the defence of infanticide, examination is made of the exclusive nature of the defence and of the scope for an individual to be a ‘partial’ moral agent. The contradictory nature of infanticide, being both inculpatory and exculpatory, suggests the need for a theoretical rationale that justifies disallowing the offence/defence to, inter alia, those women who kill their own children over 12 months and to men who suffer similar ‘environmental’ postnatal depression. It is suggested that women who kill their children while suffering from the ‘after-effects’ of childbirth are either, depending on the severity of mental disorder, fully competent and therefore criminally responsible (although perhaps entitled to a lesser sentence due to a reduction in culpability) or fully incompetent, therefore incurring no criminal responsibility at all. This proposal can be achieved by recognising that there is a place for reduced culpability or a complete absence of responsibility to fall within the current defence of diminished responsibility or within the Law Commission’s recommended alternative to the insanity defence of ‘not criminally responsible by reason of recognised medical condition’.
The Duality of Human Experience: Perspectives From Psychosocial Adaptation to Chronic Illness and Disability—Empirical Observations and Conceptual Issues
Authors: Livneh Hanoch , McMahon Brian T. , Rumrill Phillip D.
Published: September 2018

The authors examine the current views on the duality of the human experience as portrayed within the process of coping with traumatic life events. Emphasis is placed on those views associated with the onset or diagnosis of chronic illnesses and disabilities (CID). In a companion article, the authors reviewed experiential dualities focusing on (a) modes of psychosocial adaptation to CID, such as coping versus succumbing, disabled and nondisabled selves; (b) models of denial; and (c) models of personal growth following adversity and traumatic events, such as the onset or diagnosis of CID. Discussion then focused on the dualities espoused by the latter models, which typically dichotomize human functioning following traumatic experiences. In the present article, the authors discuss (a) the main factors, considered by the various theoretical models, that have been found to exert influence on the genuineness of personal growth, with a special emphasis on post-CID psychological growth; (b) pertinent empirical findings that, directly and indirectly, address the perceived dualities of personal growth in the context of psychosocial adaptation to CID; and (c) theoretical and research implications associated with the study of the dual nature of post-CID growth, including recommendations for investigating the veracity of this reported personal growth.
An infection cocktail: malaria, dengue, chikungunya and Japanese encephalitis
Authors: Dev Nishanth
Published: September 2018

Vector-borne diseases cause a significant burden on healthcare facilities. An increasing number of cases reported with multiple co-infections only add to the ordeal. The presence of co-infection may modify clinical and laboratory parameters significantly making diagnosis and treatment a challenge. Cases of malaria and dengue with other infections such as chikungunya, leptospirosis and hepatitis have been reported previously. We report a case of acute febrile illness with altered sensorium which was eventually diagnosed to have quadruple infection with malaria, dengue, chikungunya and Japanese encephalitis. This may be the first case with four concurrent vector-borne infections, all of which are transmitted by mosquitoes.
Effectiveness of interventions to increase participation in advance care planning for people with a diagnosis of dementia: A systematic review
Authors: Bryant Jamie , Turon Heidi , Waller Amy , Freund Megan , Mansfield Elise , Sanson-Fisher Rob
Published: September 2018

Background:

Advance care planning involves considering, discussing and documenting future wishes in case a person is unable to make or communicate decisions. Given people with dementia are at high risk of future decisional incapacity, it is critical that advance care planning occurs early in the illness trajectory.

Aim:

To determine (1) the number of intervention studies published between 1997 and July 2017 that aimed to increase advance care planning for persons with dementia, (2) the methodological quality of studies and (3) the effectiveness of interventions in increasing advance care planning for persons with dementia.

Design:

Systematic review.

Data sources:

Medline, Cochrane, EMBASE, PsycINFO and CINAHL were searched for articles published from 1997 to July 2017. Studies were included if they utilised a methodologically robust study design and reported on an intervention designed to increase participation in advance care planning for persons with dementia that was targeted at the person with dementia and/or a carer/family member. Methodological quality was assessed independently by two authors.

Results:

Four studies met the criteria for inclusion. Methodological quality was variable. Two studies did not report analyses comparing advance care planning outcomes for intervention and control participants. A third study found no effect for a nurse-facilitator intervention. The fourth study found that a structured conversation about end-of-life care with a family member increased the likelihood of advance care orders being listed in residents’ records.

Conclusion:

There is little evidence about effective strategies to improve participation in advance care planning for persons with dementia. Methodologically rigorous intervention trials are needed to test interventions that encourage timely participation.
Clinical pharmacokinetics, pharmacodynamics, safety, and tolerability of JNJ-54175446, a brain permeable P2X7 antagonist, in a randomised single-ascending dose study in healthy participants
Authors: Timmers Maarten , Ravenstijn Paulien , Xi Liwen , Triana-Baltzer Gallen , Furey Maura , Van Hemelryck Sandy , Biewenga Jeike , Ceusters Marc , Bhattacharya Anindya , van den Boer Maarten , van Nueten Luc , de Boer Peter
Published: September 2018

Background:

Central nervous system-derived interleukin-1β plays a role in mood disorders. P2X7 receptor activation by adenosine-triphosphate leads to the release of interleukin-1β.

Aims:

This first-in-human study evaluated safety, tolerability, pharmacokinetics and pharmacodynamics of a novel central nervous system-penetrant P2X7 receptor antagonist, JNJ-54175446, in healthy participants.

Methods:

The study had three parts: an ascending-dose study in fasted participants (0.5–300 mg JNJ-54175446); an ascending-dose study in fed participants (50–600 mg); and a cerebrospinal fluid study (300 mg). Target plasma concentrations were based on estimated plasma effective concentration (EC)50 (105 ng/mL) and EC90 (900 ng/mL) values for central nervous system P2X7 receptor binding.

Results:

Seventy-seven participants received a single oral dose of JNJ-54175446 ( n=59) or placebo ( n=18). Area under the curve of concentration time extrapolated to infinity (AUC∞) increased dose-proportionally; maximum concentration (Cmax) of plasma (Cmax,plasma) increased less than dose-proportionally following single doses of JNJ-54175446. Because food increases bioavailability of JNJ-54175446, higher doses were given with food to evaluate safety at higher exposures. The highest Cmax,plasma reached (600 mg, fed) was 1475±163 ng/mL. JNJ-54175446 Cmax in cerebrospinal fluid, a proxy for brain penetration, was seven times lower than in total plasma; unbound Cmax,plasma and Cmax,CSF were comparable (88.3±35.7 vs 114±39 ng/mL). JNJ-54175446 inhibited lipopolysaccharide/3′-O-(4-benzoylbenzoyl)-ATP-induced interleukin-1β release from peripheral blood in a dose-dependent manner (inhibitory concentration (IC)50:82 ng/mL; 95% confidence interval: 48–94). Thirty-three of 59 (55.9%) participants reported at least one treatment-emergent adverse event; the most common adverse event being headache (11/59, 18.6%).

Conclusion:

Plasma exposure of JNJ-54175446 was dose-dependent. No serious adverse events occurred. Single-dose administration of JNJ-54175446>10 mg attenuated ex-vivo lipopolysaccharide-induced interleukin-1β release in peripheral blood. Passive brain penetration of JNJ-54175446 was confirmed.
Optical coherence tomography findings predictive of response to treatment in diabetic macular edema
Authors: Cho Young Joo , Lee Dong Hyun , Kim Min
Published: September 2018

Objective

To evaluate the short-term efficacy of intravitreal bevacizumab (IVB) and posterior sub-tenon triamcinolone injections (PSTI) on the basis of spectral-domain optical coherence tomography (SD-OCT) patterns in diabetic macular edema (DME).

Methods

We retrospectively reviewed 73 eyes of 73 patients with DME. Based on the presence of serous retinal detachment (SRD), eyes were categorized into two groups, and either IVB or PSTI treatment was performed. Central macular thickness (CMT) and the degree of SRD were assessed preoperatively and 1 month postoperatively. The severity of intraretinal edema was approximated based on the distance from the external limiting membrane to the internal limiting membrane.

Results

In eyes with SRD, reduction of SRD was greater with IVB than with PSTI. Moreover, reduction of intraretinal edema was greater with PSTI than with IVB. In eyes without SRD, PSTI achieved greater CMT reduction, compared with IVB.

Conclusions

In DME patients with SRD, IVB achieved greater reduction of SRD, compared with PSTI; however, intraretinal edema responded more favorably to PSTI, regardless of the presence of SRD. Our results suggest that the classification of DME based on OCT findings may be useful to predict responses to IVB or PSTI treatments.
Hematoma block for distal radius fractures – prospective, randomized comparison of two different volumes of lidocaine
Authors: Orbach Hagay , Rozen Nimrod , Rinat Barak , Rubin Guy
Published: September 2018

Objective

This study aimed to compare analgesic efficacy and safety of different volumes of lidocaine injected into a fracture hematoma (hematoma block [HB]) for reducing distal radius fractures.

Methods

Patients were randomly divided into two groups. Group A included patients in whom 10 mL of 2% lidocaine was injected into the fracture site and group B included patients in whom 20 mL of 1% lidocaine was injected. The fracture was manipulated after 15 minutes and the Visual Analogue Scale (VAS) score was recorded during manipulation. Patients were followed up for approximately 1 hour and complications were recorded.

Results

Twenty patients were enrolled in the study (12 women and eight men), with a mean age of 57 years (range, 32–87 years). Demographic findings were similar between the groups. The mean VAS score of group A was 5.50 ± 3.57 and that in group B was 3.09 ± 2.33, with no significant difference between the groups.

Conclusion

VAS scores between HB with 20 mL of 1% lidocaine and HB with 10 mL of 2% lidocaine are not significantly different. However, our study suggests that HB with 20 mL of 1% lidocaine has a better analgesic effect than HB with 10 mL of 2% lidocaine.
Toward More Sustainable Behavior: A Systematic Review of the Impacts of Involuntary Workplace Relocation on Travel Mode Choice
Authors: Zarabi Z. , Lord S.
Published: September 2018

Daily home–work travel is a habitual behavior that can be disrupted when the location of work, as one of the behavioral contexts, changes. It is then likely that individuals will reconsider their travel behavior more intentionally and choose alternative transport modes. To identify motivations and barriers to incorporating the use of sustainable modes into the individual’s daily travel, this article systematically reviews the literature on the impacts of involuntary workplace relocation on commuting behavior. Effective measures that incentivize sustainable commuting behavior are also discussed. This study on involuntary workplace relocation informs considerations of changes in travel behavior related to other contextual changes.
Dyeing Ramie Fabrics With Curcumin in NaOH/Urea Solution at Low Temperature
Authors: Li Sijun , Lu Ming , Hu Ruimin , Tang Tian , Hou Keru , Liu Yiping
Published: September 2018

To improve dyeing properties of ramie fabrics, sodium hydroxide/urea (NaOH/urea) was used as curcumin solvent and ramie-fiber swelling solvent. Ramie fabrics were dyed with curcumin in NaOH/urea aqueous solution at low temperature without using any mordants. The color depth (K/S) value, washing fastness, ultraviolet–visible spectrophotometry were measured to investigate dyeing properties of the ramie with curcumin in NaOH/urea solution at low temperature. Meanwhile, X-ray diffraction and breaking strength were used to determine the structure of the ramie in NaOH/urea solution. Curcumin could be dissolved completely in NaOH/urea solution, and crystallinity of ramie fiber was decreased a little. The K/S value of dyed ramie fabrics in NaOH/urea solution increased around 4-fold compared to dyed ramie fabrics in water. The dyed ramie fabrics in NaOH/urea solution displayed good washing fastness. In addition, dyed ramie fabrics in NaOH/urea solution revealed anti-ultraviolet properties.
Positive Caregiving Characteristics as a Mediator of Caregiving Burden and Satisfaction With Life in Caregivers of Older Adults
Authors: Fauziana Restria , Sambasivam Rajeswari , Vaingankar Janhavi Ajit , Abdin Edimansyah , Ong Hui Lin , Tan Min-En , Chong Siow Ann , Subramaniam Mythily
Published: September 2018

Background:

Satisfaction with life is recognized to be a factor in alleviating burden in stressful caregiving duties. However, the mechanism underlying this relationship is indistinct. Positive aspects of caregiving (PAC) may help to regulate caregiving burden among caregivers of older adults. The study aims to examine whether positive caregiving characteristics mediate the effect between satisfaction with life and burden of care.

Methods:

Participants were 285 caregivers of older adults (aged 60 and above) in Singapore and were recruited in a cross-sectional, self-report study (mean [M] = 47.0 years; 64.6% females). Measures included in the study were the Zarit Burden Interview (ZBI), Positive Aspects of Caregiving (PAC), and the Satisfaction with Life Scale (SWLS). Mediation analyses were used to study the indirect effects of life satisfaction on caregiver burden through features of PAC.

Results:

Mean scores for the ZBI, PAC, and SWLS scales were M = 23.15 (standard deviation [SD] = 15.98), M = 34.55 (SD = 8.19), and M = 23.56 (SD = 6.62) respectively. Results from the mediation analysis revealed that the association between life satisfaction and caregiving burden was significantly mediated by the PAC ( P < .001).

Discussion:

Positive aspects of caregiving may be a mechanism that links satisfaction with life and caregiver burden. Findings may represent attempts to manage caregiving duties as well as maintaining a positive attitude toward their responsibilities.
Psychological Resilience and Its Downstream Effects for Business Survival in Nascent Entrepreneurship
Authors: Chadwick Ingrid C. , Raver Jana L.
Published: September 2018

While scholars frequently argue that nascent entrepreneurs will be more successful if they are resilient, this assumption remains untested and the mechanisms for its potential benefits are unknown. To establish the utility of this psychological construct, we draw from Fredrickson's broaden-and-build theory (1998 ) to develop and test theory on the processes through which psychological resilience influences first-time entrepreneurs' business survival. Results of a time-lagged study of nascent entrepreneurs followed over a 2-year period support this theory, highlighting the cognitive and behavioral ways in which psychological resilience helps nascent entrepreneurs become less vulnerable to their stressful circumstances.
Innovation Motives in Family Firms: A Transgenerational View
Authors: Diaz-Moriana Vanessa , Clinton Eric , Kammerlander Nadine , Lumpkin G. T. , Craig Justin B.
Published: September 2018

Drawing on the transgenerational entrepreneurship perspective, we employ a multiple case study approach to investigate why multigenerational family firms innovate. The data collection process drew upon five in-depth cases comprising 42 semistructured interviews, 25 participant observations, and several thousand pages of historical data dating from 1916 to 2017. We find patterns on how the firms’ long-term view—embracing both the past and the future—influences the innovation motives of these firms. Specifically, we identify three innovation patterns: conserving, persisting and legacy-building. We introduce a set of propositions and a framework linking long-term orientation dimensions to innovation motives and innovation outcomes. Our research thus contributes to a more fine-grained understanding of innovation behavior in family firms.
Factors Associated With the Concomitant Use of Cardiovascular Drugs and Dietary Herbal Products: A Cross-Sectional Study
Authors: Aykan Duygun Altıntaş , Aykan Ahmet Cağrı
Published: September 2018

Introduction:

Dietary herbal products taken together with prescription medicines may have harmful effects. In this study, we evaluated the use of dietary herbal supplements and identified factors that predict the concomitant use of these supplements in patients taking drugs prescribed for chronic cardiovascular diseases.

Methods:

We performed a cross-sectional study with 343 patients with cardiovascular diseases. Data regarding the sociodemographic status, medical condition, number of prescription drugs, and use of herbal supplements were collected using a self-administered questionnaire.

Results:

Regular use of dietary herbal supplements was reported by 82.5% of patients. The most commonly consumed herbal supplement was garlic (71.2%), followed by onion (67.1%), and walnut (63.6%). Consumption of herbal supplements was commonly observed in patients with hypertension (53.6%). Among the patients in the study, 21.3% patients reported consumption of herbal supplements to the physician. Results of multivariable analysis showed that body mass index (odds ratio [OR] = 0.890, 95% confidence interval [CI] = 0.826-0.960), heart failure (OR = 0.325, 95% CI = 0.142-0.742), coronary artery disease (OR = 0.162, 95% CI = 0.069-0.379), smoking (OR = 3.852, 95% CI = 1.194-12.433), hypertension (OR = 10.584, 95% CI = 4.648-24.103), and dysrhythmia (OR = 9.339, 95% CI = 2.035-42.853) were associated with the use of dietary herbal supplements.

Conclusions:

Our results showed that dietary herbal supplements were commonly used by patients with chronic cardiovascular diseases. Therefore, understanding the interactions between the herbal supplements and drugs is necessary for minimizing adverse reactions.
Posaconazole–digoxin drug–drug interaction mediated by inhibition of P-glycoprotein
Authors: Shumaker Abby C , Bullard Heather M , Churpek Jane , Knoebel Randall W
Published: September 2018

Drug–drug interactions between digoxin and the triazole antifungal agents, mediated via various cytochrome P450 isozymes, have been described in the literature. Posaconazole is not extensively metabolized by these isozymes but is both a p-glycoprotein (P-gp) substrate and inhibitor. To our knowledge, there have been no published cases of clinically significant posaconazole-digoxin drug–drug interactions. We report an interaction between posaconazole (300 mg by mouth daily) and digoxin (0.25 mg by mouth daily, Monday through Friday) resulting in atrial fibrillation with slow ventricular response and degenerating into polymorphic ventricular tachycardia.
Effectiveness of zolpidem and sleep hygiene counseling in the treatment of insomnia in solid tumor patients
Authors: Asok Amrita , Sreekumar Sreelakshmi , TK Radhika , CC Anagha , P Uma Devi , K Pavithran
Published: September 2018

Objective

To study the effectiveness of zolpidem and sleep hygiene counseling in managing insomnia in solid tumor patients.

Methods

Cancer patients with a Pittsburgh Sleep Quality Index score ≥ 5 were grouped into two. Both groups received treatment for insomnia in the form of either zolpidem 5 mg for 7 days or sleep hygiene counseling.

Result

At baseline, zolpidem and counseling group had a mean Pittsburgh Sleep Quality Index score of 14.82 ± 2.61 and 11.67 ± 3.32, respectively. The difference in mean Pittsburgh Sleep Quality Index score was found to be 4.03 in patients using zolpidem and 1.5 in counseled patients (p = 0.003). The components of Pittsburgh Sleep Quality Index namely difficulty falling asleep within 30 min (sleep latency), overall sleep quality, trouble staying awake during daytime and trouble staying motivated to get things done showed statistically significant improvement after treatment with zolpidem. Following sleep hygiene counseling, the proportion of patients with sleep latency > 30 min reduced considerably. Waking up to use the bathroom was the most common problem reported by approximately 94% patients in both groups before treatment which remained the most prevalent problem even after treatment. Night or early morning awakenings seemed to decrease significantly in patients taking zolpidem (p = 0.039) while it did not show any improvement with counseling. Counseling seemed to get patients to sleep within 30 min.

Conclusion

Patients on zolpidem showed a reduction in their Pittsburgh Sleep Quality Index scores thereby suggesting it as a treatment for insomnia in solid tumor patients. Sleep hygiene counseling, though not as effective as zolpidem, made a slight difference in the overall sleep.
Does right ventricle dysfunction represent cardiac frailty in critically ill trauma patients?
Authors: Flaubert Mark , Lauerman Margaret H , Haase Daniel , Fatima Syeda , Galvagno Samuel , Scalea Thomas M , Stein Deborah M , Murthi Sarah
Published: September 2018

Introduction

Cardiac function includes left ventricle ejection fraction, right ventricle function, diastolic function, and multiple markers of cardiac outflow. Markers of cardiac function associated with mortality are unknown. The purpose of this study was to determine markers of cardiac function associated with mortality in the elderly which represent cardiac frailty and the relative importance of these many measurements of cardiac function when compared with each other.

Methods

A retrospective review of patients who underwent focused rapid echocardiographic evaluations was performed from 2009 to 2014. Focused rapid echocardiographic evaluations are echocardiographic exams focusing on cardiac function rather than structure.

Results

Overall, 513 trauma patients received focused rapid echocardiographic evaluations. In elderly patients, mortality increase of 33.9% was seen with left ventricle ejection fraction less than 30% (p = 0.05), 28.5% with moderate right ventricle dysfunction (p = 0.03), and 18.5% with velocity time integral less than 18 cm (p = 0.02). Any level of diastolic dysfunction, cardiac output of less than 4 l/min, and cardiac index less than 2.5 l/min/m2 was not significantly associated with increased mortality in the elderly (not significant [NS] for all). In younger patients, a mortality increase of 68.1% was seen with grade 3–4 diastolic dysfunction (p<0.001) and 14.6% with velocity time integral less than 18 cm (p = 0.02), with right ventricle dysfunction, decreased left ventricle ejection fraction, cardiac output less than 4 l/min, and cardiac index less than 2.5 l/min/m2 not associated with mortality (NS for all). In logistic regression for elderly patients, only moderate right ventricle dysfunction was associated with mortality (odds ratio 4.321, 95% confidence interval 1.451–12.866, p = 0.009).

Conclusions

Markers of cardiac function associated with mortality vary with age. Right ventricle dysfunction may represent cardiac frailty, while diastolic dysfunction and left ventricle ejection fraction likely do not.
The Cretan Aging Cohort: Cohort Description and Burden of Dementia and Mild Cognitive Impairment
Authors: Zaganas Ioannis V. , Simos Panagiotis , Basta Maria , Kapetanaki Stefania , Panagiotakis Symeon , Koutentaki Irini , Fountoulakis Nikolaos , Bertsias Antonios , Duijker George , Tziraki Chariklia , Scarmeas Nikolaos , Plaitakis Andreas , Boumpas Dimitrios , Lionis Christos , Vgontzas Alexandros N.
Published: September 2018

Our aim was to explore the burden of dementia in the Cretan Aging Cohort, comprised of 3140 persons aged ≥60 years (56.8% women, 5.8 ± 3.3 years formal education, 86.2% living in rural areas) who attended selected primary health-care facilities on the island of Crete, Greece. In the first study phase, a formal diagnosis of dementia had been reached in 4.0% of the participants. However, when selected 505 participants underwent thorough neuropsychiatric evaluation in the second phase of this study (344 with Mini-Mental State Examination [MMSE] <24 and 161 with MMSE ≥24), and results were extrapolated to the entire cohort, the prevalence of dementia and mild cognitive impairment was estimated at 10.8% (9.7%-11.9%) and 32.4% (30.8%-34.0%), respectively. Using both the field diagnostic data and the extrapolated data, the highest dementia prevalence (27.2%) was found in the 80- to 84-year-old group, who also showed the lowest educational level, apparently due to lack of schooling during World War II.
Effect of two different participant information sheets on recruitment to a falls trial: An embedded randomised recruitment trial
Authors: Witham Miles D , Band Margaret M , Price Rosemary J G , Fulton Roberta L , Clarke Clare L , Donnan Peter T , Soiza Roy L , Cvoro Vera
Published: September 2018

Background/Aims

Recruitment to trials of intervention for older people who fall is challenging. Evidence suggests that the word falls has negative connotations for older people, and this may present a barrier to engaging with trials in this area. We therefore tested whether a participant information sheet that minimised reference to falls could improve recruitment rates.

Methods

We conducted a study within a trial, embedded within a randomised controlled trial of vitamin K versus placebo to improve postural sway in patients aged 65 and over with a history of falls. Potential participants were identified from primary care lists in 14 practices and were randomised to receive either a standard participant information sheet or an information sheet minimising use of the word falls, instead focussing on maintenance of health, fitness and balance. The primary outcome for this embedded trial was the proportion of responses expressing interest in participating received in each arm. Secondary outcomes were the proportion of those contacted attending a screening visit, consenting at screening, and the proportion contacted who were randomised into the main trial.

Results

In all, 4145 invitations were sent, with an overall response rate of 444 (10.7%). In all, 2148 individuals received the new information sheet (minimising reference to falls); 1997 received the standard information sheet. There was no statistically significant difference in response rate between those individuals sent the new information sheet and those sent the standard information sheet (10.1% vs 11.4%; difference 1.3% (95% confidence interval −0.6% to 3.2%); p = 0.19). Similarly, we found no statistically significant difference between the percentage of those who attended and consented at screening in the two groups (2.1% vs 2.7%; difference 0.6% (95% confidence interval: –0.4% to 1.6%); p = 0.20), and no statistically significant difference between the percentage randomised in the two groups (2.0% vs 2.6%; difference 0.6% (95% confidence interval −0.4% to 1.6%); p = 0.20)

Conclusions

Use of a participant information sheet minimising reference to falls did not lead to a greater response rate in this trial targeting older people with a history of falls.
A Central African Perspective on Delegated Protected Area Management
Authors: Scholte Paul , Agnangoye Jean-Pierre , Chardonnet Bertrand , Eloma Henri-Paul , Nchoutpouen Chouaibou , Ngoga Telesphore
Published: September 2018

In recent years, there has been a trend for African states to delegate protected area management to private partners. Central Africa is confronted with rapidly declining wildlife populations, with scarce funding and poor incentives as root causes. This raises the question as to whether management delegation can counter this trend. However, our understanding of the efficiency of such partnerships and how they need to be handled is poor. Based on hands-on experiences and external evaluations, we developed best practices of delegated management partnerships in Central Africa. This triggered the development of the here presented Central African perspective, enriching a debate that is biased toward other parts of the continent and dominated by private conservation partners. In particular, we emphasize that in Central Africa, (a) protected areas with delegated management are among the most prestigious ones, albeit with serious management challenges; (b) it is the importance of the protected area that justifies its inclusion in formal development cooperation agreements—the dominant source of funding; (c) lack of legal provisions has been an obstacle to initiate delegated management partnerships for some countries and its wider use in others; (d) increasingly, foundations are being created as implementing national entities; and (e) raising national capacities in handling delegated management should be at the forefront of partnerships. We conclude by highlighting the importance of the new regional best practices that are based on the four stages: identification, preparation, negotiation, and implementation, of which the first three have often been neglected by Central African governments.
Assessing Human–Wildlife Interactions in a Forest Settlement in Sathyamangalam and Mudumalai Tiger Reserves
Authors: Karanth Krithi K. , Ranganathan Priya
Published: September 2018

India, a megabiodiversity nation, is home to 4,800 species and 1.3 billion people. The proximity of people and wildlife produces a wide variety of human–wildlife interactions particularly with forest-dwelling communities embedded deep within protected areas (PAs). We evaluated people–park relationships through the 421 families in Thengumarahada located between Sathyamangalam and Mudumalai Tiger Reserves in India. This settlement was originally granted land rights in 1948 but has been subleased many times over. We examined attitudes toward wildlife, PA, experiences of conflict, and challenges faced by people. Logistic regression models evaluated the factors associated with household losses and their attitudes. Thirty-four percent of households reported crop loss and 10% reported livestock predation. Crop loss was associated with growing rice and bananas and negatively with forest cover. Depredation was primarily associated with 87% of households grazing livestock in the forest. Usage of mitigation measures was not significantly associated with reducing conflict. Despite conflict losses and government pressure, only 34% of families expressed an interest in settling outside the reserved forest. People’s motivations to remain in the forest hamlets included free resource availability (28%) and tradition-familiar livelihoods (29%). People’s mistrust of the forest department was heightened by the lack of awareness about (29%) and payment of compensation (3%). Given the frequency of conflict, the lack of infrastructure, inadequate compensation payments, and limited interest in relocation, balancing people–wildlife relationships in the forests of Sathyamangalam and Mudumalai Tiger Reserves remains a formidable task.
Antiepileptic Drug Management in Hospitalized Epilepsy Patients With Nil Per Os Diets: A Retrospective Review
Authors: Bank Anna M. , Lee Jong Woo , Ehlert Alexa N. , Berkowitz Aaron L.
Published: September 2018

Background and Purpose:

Antiepileptic drug (AED) management in patients with epilepsy who cannot take their usual oral medications is a common neurologic dilemma in the hospital setting. Strategies to maintain seizure control in patients with nil per os (NPO, nothing by mouth) diet orders include continuation of oral AEDs despite NPO nutrition orders, administration of intravenous AED(s), or temporary administration of benzodiazepines. The frequency with which these strategies are used and their effectiveness in preventing in-hospital seizures is unknown.

Methods:

We conducted a retrospective cohort study to determine AED management strategies and seizure frequency in hospitalized epilepsy patients with NPO diet status admitted to an academic medical center between 2001 and 2016. Clinical documentation was reviewed. Antiepileptic drug selection (medication and route of administration) and presence or absence of seizures were recorded.

Results:

We identified 199 admissions during which epilepsy patients had NPO diet orders. Antiepileptic drug management strategies included continuation of oral medications (50.3% of admissions), intravenous AED monotherapy (22.1%), intravenous AED polytherapy (12.6%), benzodiazepines (1.0%), holding AEDs (4.5%), or a combination (9.5%). Seizures occurred during 14 admissions. Treatment with AED polytherapy prior to admission and changing the patient’s AED regimen during admission were associated with increased odds of seizures during admission ( P = .0028; P = .0114).

Conclusions:

These results suggest that patients’ home oral AED regimens should be continued when possible in order to minimize the frequency of seizures during hospitalizations.
Sharing the Same Political Ideology Yet Endorsing Different Values: Left- and Right-Wing Political Supporters Are More Heterogeneous Than Moderates
Authors: Hanel Paul H. P. , Zarzeczna Natalia , Haddock Geoffrey
Published: September 2018

Members of extreme political groups are usually perceived as more homogeneous than moderates. We investigated whether members of the general public who share the same political ideology would exhibit different levels of heterogeneity in terms of human values across 20 European countries and Israel. We directly compared the variability across moderate-, left-, and right-wing groups. Our findings suggest that the values of more extreme (left-wing or right-wing) supporters are usually more heterogeneous than those with more moderate views. We replicated this finding for politics-related variables such as attitudes toward immigrants and trust in (inter)national institutions. We also found that country-level variables (income, religiosity, and parasite stress level) did not moderate the pattern of value variability. Overall, our results suggest that endorsing the same political ideology is not necessarily associated with sharing the same values, especially in the case of common citizens holding extreme political attitudes.
A hypothesis on the economic nature of labour law
Authors: Bavaro Vincenzo , Pietrogiovanni Vincenzo
Published: September 2018

This article aims to introduce in the scientific debate on the future of EU labour law and its relationship with human and fundamental rights, a redefinition of the collective labour rights in terms of ‘collective labour freedoms’. This redefinition is undertaken in different steps and initiates from the so-called ‘Laval doctrine’ that has emancipated the economic freedoms (mainly referred to as the freedoms of the employers) from the social rights (mainly referred to as the rights of workers and trade unions): collective labour freedoms do not question the outcome of the balance struck by the CJEU but the possibility of balancing per se. In order to do so, this contribution proposes a different methodology that synthesises a socio-historical analysis of social rights as materially considered and acted by social partners with a positive reading of fundamental charters and constitutions in which the freedom of association, the right to collective bargaining and industrial action are recognised as tools to regulate the interests of a social and economic nature (in form of an inseparable hendiadys) pursued by both sides of the labour market, employers and employees. Collective labour freedoms underline the inherent economic nature of labour law and, in line with the theoretical framework (but opposite in terms of political goals) with the German ordoliberals, they do not deny the freedom of market; moreover, they are valuable entitlements to achieve the social market economy as enshrined in Art. 3(3) of TEU. The article finally presents a possible outcome of the proposed methodology with an example taken from a pivotal case from the Italian Supreme Court on the limits to the exercise of the right to strike in non-standard forms.
Should we use the oral selective IP receptor agonist selexipag off‐label in children with pulmonary arterial hypertension?
Authors:   European Pediatric Pulmonary Vascular Disease Network, Koestenberger Martin , Hansmann Georg
Published: September 2018

We discuss the currently available data on the use of the prostacyclin mimetic selexipag in children and adolescents with pulmonary arterial hypertension (PAH). Future indications may include transitioning from intravenous prostacyclin/prostacyclin analog to oral selexipag, and vice versa, or adding selexipag as a third oral PAH‐targeted agent in children not responding well to dual PAH therapy.