bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of prebiotic (fructooligosaccharide) on uremic toxins of chronic kidney disease patients: a randomized controlled trial
Authors: Ramos Christiane Ishikawa , Armani Rachel Gatti , Canziani Maria Eugenia Fernandes , Dalboni Maria Aparecida , Dolenga Carla Juliana Ribeiro , Nakao Lia Sumie , Campbell Katrina Louise , Cuppari Lilian 
Published: May 2018

AbstractBackgroundMicrobial-derived uremic toxins, p-cresyl sulfate (PCS), indoxyl sulfate (IS) and indole 3-acetic acid (IAA), have been associated with the burden of chronic kidney disease (CKD). Prebiotics have emerged as an alternative to modulate the gut environment and to attenuate toxin production. This trial aims to investigate the effect of a prebiotic fructooligosaccharide (FOS) on uremic toxins of non-dialysis-dependent CKD (NDD-CKD) patients.MethodsA double-blind, placebo-controlled, randomized trial was conducted for 3 months. In all, 50 nondiabetic NDD-CKD patients [estimated glomerular filtration rate (eGFR) <45 mL/min/1.73 m2], aged 18–80 years, were allocated to prebiotic (FOS, 12 g/day) or placebo (maltodextrin, 12 g/day) groups. Primary outcomes were changes in serum (total and free) and urinary (total) PCS. Secondary outcomes included changes in IS, IAA, serum markers of intestinal permeability (zonulin), gut-trophic factors (epidermal growth factor and glucagon-like peptide-2), eGFR, inflammation (high sensitive c-reactive protein and interleukin-6), homeostatic model assessment-insulin resistance, lipid profile and gastrointestinal symptoms.ResultsFrom 50 participants (54% men, 57.3 ± 14.6 years and eGFR 21.4 ± 7.6 mL/min/1.73 m2), 46 completed the follow-up. No changes in dietary intake or gastrointestinal symptoms were observed. There was a trend in the difference of serum total ΔPCS (treatment effect adjusted for baseline levels: −12.4 mg/L; 95% confidence interval (−5.6 to 0.9 mg/L; P = 0.07) and serum-free Δ%PCS [intervention −8.6 (−41.5 to 13.9%) versus placebo 3.5 (−28.8 to 85.5%); P = 0.07] between the groups. The trend in the difference of serum total ΔPCS was independent of eGFR and dietary protein:fiber ratio intake. No difference was found in urinary PCS. Aside from the decreased high-density lipoprotein cholesterol in the intervention, no differences were observed in the change of IS, IAA or other secondary outcome between the groups.ConclusionsOur result suggests the potential of FOS in reducing serum total and free PCS in nondiabetic NDD-CKD patients.
An Analysis of the On-Call Clinical Experience of a Junior Neurosurgical Resident
Authors: Gordon William E , Gienapp Andrew J , Jones Morgan , Michael L Madison , Klimo Paul 
Published: May 2018

Abstract
The process of transforming a medical student to a competent neurosurgeon is becoming increasingly scrutinized and formalized. However, there are few data on resident workload.
We sought to quantify the workload and educational experience of a junior resident while “on-call.”
A single resident's on-call log was reviewed from the period of July 1, 2014 to June 30, 2016, corresponding to that resident's postgraduate years 2 and 3. For each patient encounter (ie, consult or admission), information pertaining to the patient's demographics, disease or reason for consult, date/time/location of consult, and need for any neurosurgical intervention within the first 24 hours was collected.
In total, 1929 patients were seen in consultation. The majority of patients were male (62%) with a median age of 50 years (range, day of life 0-102 years) and had traumatic diagnoses (52%). The number of consults received during the 16:00 to 17:00 and 17:00 to 18:00 hours was +1.6 and +2.5 standard deviations above the mean, respectively. The busiest and slowest months were May and January, respectively. Neurosurgical intervention performed within the first 24 hours of consultation occurred in 330 (17.1%) patients: 221 (11.4%) major operations, 69 (3.6%) external ventricular drains, and 40 (2.1%) intracranial pressure monitors.
This is the first study to quantify the workload and educational experience of a typical neurosurgical junior resident while “on-call” (ie, carrying the pager) for 2 consecutive years. It is our hope that these findings are considered by neurosurgical educators when refining resident education.
Effectiveness of and User Experience With Web-Based Interventions in Increasing Physical Activity Levels in People With Multiple Sclerosis: A Systematic Review
Authors: Dennett Rachel , Gunn Hilary , Freeman Jennifer A 
Published: May 2018

Abstract

Background
Supporting people with multiple sclerosis (MS) to achieve and maintain recommended levels of physical activity is important but challenging. Web-based interventions are increasingly being used to deliver targeted exercise programs and promote physical activity.

Purpose
The purpose of this study was to systematically review current evidence regarding the effectiveness and user experience of web-based interventions in increasing physical activity in people with MS.

Data Sources
MEDLINE, EMBASE, CINAHL, AMED, PEDro, PsychInfo, Web of Sciences, The Cochrane Library, and gray literature were searched from 1990 to September 2016.

Study Selection
English language articles reporting the use of web-based interventions to increase physical activity in adults with MS were included. Eligible quantitative studies were of any design and reported a measure of physical activity. Qualitative studies exploring users’ experiences in any context were included. Of the 881 articles identified, 9 met the inclusion criteria.

Data Extraction
Two reviewers independently assessed methodological quality and extracted data using standardized critical appraisal and data extraction tools from the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI).

Data Synthesis
Meta-analysis of self-reported physical activity questionnaire data from 4 studies demonstrated a standardized mean difference of 0.67 (95% CI = 0.43–0.92), indicating a positive effect in favor of the web-based interventions. Narrative review of accelerometry data from 3 studies indicated increases in objectively measured physical activity. No qualitative studies met the inclusion criteria.

Limitations
In the 9 included articles, only 2 different interventions (used with people who were ambulant) were reported.

Conclusions
Web-based interventions had a short-term positive effect on self-reported physical activity in people who had MS and were ambulant. Evidence is not currently available to support or refute their use in the long-term or with people who are not ambulant.
Community Business in Scotland: An Alternative Vision of ‘Enterprise Culture’, 1979–97
Authors: Murray Gillian 
Published: May 2018

Abstract
The force and coherency with which Margaret Thatcher and her inner circle outlined their vision for ‘enterprise culture’, like so many aspects of Thatcherism, have masked the complexity of its origins and the histories of alternative responses. This article provides a history of an alternative vision for enterprise culture by examining the community business movement in Scotland, the largest experiment of its kind in the UK in the 1980s and a forerunner of social enterprise. Working across Scotland, but with a hub of activity in the Strathclyde region, practitioners worked with local people to find ways to develop their neighbourhood economy while improving their environment, creating jobs, and developing services needed in their area. This article outlines the origins of the movement, the shared values of its founding members, and how their training in community development informed the community business model. It analyses how practitioners put their ideas into practice and the reasons behind the fragmentation of the movement in the 1990s. It argues that although at face value the concept of community business may appear to chime with the dominant political rhetoric of Thatcher’s ‘enterprise culture’, the history of the movement provides a signpost to an alternative, if unrealised, vision for Scotland’s recovery from social and economic depression. Where previous historical research has focused on the political consequences of Thatcher’s policies in Scotland, this research connects this discussion to the transformation of Scotland’s civic society in the wake of deindustrialization.
The Influence of Nurse Manager Leadership Style on Staff Nurse Work Engagement
Authors: Manning Jennifer 
Published: May 2018

BACKGROUND:
Nursing literature supports the importance of an engaged nursing workforce as a means to positively influence performance. Nurse manager leadership style plays a critical role in engaging staff nurses. These relationships have been minimally studied in nurse managers and staff nurses.

OBJECTIVE:
The aim of this study is to evaluate the influence of nurse manager leadership style factors on staff nurse work engagement.

METHODS:
Using a descriptive correlational research design, 441 staff nurses working in 3 acute care hospitals were surveyed. Survey instruments included the Utrecht Work Engagement Scale and the Multifactorial Leadership Questionnaire 5X short form.

RESULTS:
Transactional and transformational leadership styles in nurse managers positively influenced staff nurse work engagement. Passive-avoidant leadership style in nurse managers negatively influenced staff nurse work engagement.

CONCLUSIONS:
Nurse managers who provide support and communication through transformational and transactional leadership styles can have a positive impact on staff nurse work engagement and ultimately improve organizational outcomes.
A Metasynthesis Exploring Nurses and Women on Governing Boards
Authors: Sundean Lisa J. , McGrath Jacqueline M. 
Published: May 2018

OBJECTIVE:
The purpose of this article is to present the results of a metasynthesis addressing significant issues relating to board appointments for nurses and women.

BACKGROUND:
Nurses are rarely engaged as voting board members even though they are positioned to add value. When nurses and women are appointed to boards, their experiences reflect the struggles associated with traditional patriarchal board norms.

METHOD:
A metasynthesis of qualitative studies was conducted. Seven studies from nursing and business literature were analyzed using the meta-ethnography methodology.

RESULTS:
Proving worth is the central issue of nurses and women on boards.

CONCLUSION:
Boardroom parity for nurses and women is an important social agenda with implications for strategic decision making in healthcare and business.
Utility of Postoperative Mandibulomaxillary Fixation After Rigid Internal Fixation of Isolated Mandibular Fractures
Authors: Diaconu Silviu C. , McNichols Colton H.L. , Liang Yuanyuan , Orkoulas-Razis Dennis , Woodall Jhade , Rasko Yvonne M. , Grant Michael P. , Nam Arthur J. 
Published: May 2018

Purpose:
The utility of postoperative mandibulomaxillary fixation (MMF) after open reduction and internal fixation (ORIF) of mandible fractures is debated. The purpose of this study is to analyze if patients undergoing ORIF with postoperative MMF have improved outcome compared with those treated with ORIF alone.

Methods:
A retrospective study was performed on patients who underwent ORIF of isolated mandibular fractures. Patients were divided into those placed in MMF postoperatively (ORIF with MMF) and those who were not (ORIF only). Postoperative complications and follow-up compliance were compared.

Results:
A total of 238 patients were identified. Of these, 204 had sufficient follow-up with 94 patients in the ORIF with MMF group and 107 patients in the ORIF only group. Both groups had similar minor complication rates (13% vs 12%, P = 0.83) and major complication rates (16% vs 13%, P = 0.69). After adjusting for potential confounders, the use of postoperative MMF did not reduce the risk of minor (P = 0.34) or major complications (P = 0.57). Patients with postoperative MMF had a 5% lost to follow-up rate compared to 20% in the ORIF only group.

Conclusion:
Postoperative MMF does not improve clinical outcome after ORIF in patients with isolated mandible fractures but has the potential benefit of improving follow-up compliance.
Anatomy of a glacial meltwater discharge event in an Antarctic cove
Authors: Meredith Michael P. , Falk Ulrike , Bers Anna Valeria , Mackensen Andreas , Schloss Irene R. , Ruiz Barlett Eduardo , Jerosch Kerstin , Silva Busso Adrián , Abele Doris 
Published: May 2018

Glacial meltwater discharge from Antarctica is a key influence on the marine environment, impacting ocean circulation, sea level and productivity of the pelagic and benthic ecosystems. The responses elicited depend strongly on the characteristics of the meltwater releases, including timing, spatial structure and geochemical composition. Here we use isotopic tracers to reveal the time-varying pattern of meltwater during a discharge event from the Fourcade Glacier into Potter Cove, northern Antarctic Peninsula. The discharge is strongly dependent on local air temperature, and accumulates into an extremely thin, buoyant layer at the surface. This layer showed evidence of elevated turbidity, and responded rapidly to changes in atmospherically driven circulation to generate a strongly pulsed outflow from the cove to the broader ocean. These characteristics contrast with those further south along the Peninsula, where strong glacial frontal ablation is driven oceanographically by intrusions of warm deep waters from offshore. The Fourcade Glacier switched very recently to being land-terminating; if retreat rates elsewhere along the Peninsula remain high and glacier termini progress strongly landward, the structure and impact of the freshwater discharges are likely to increasingly resemble the patterns elucidated here.
This article is part of the theme issue ‘The marine system of the West Antarctic Peninsula: status and strategy for progress in a region of rapid change’.
A simplified method to estimate the run-off in Periglacial Creeks: a case study of King George Islands, Antarctic Peninsula
Authors: Falk Ulrike , Silva-Busso Adrián , Pölcher Pablo 
Published: May 2018

Although the relationship between surface air temperature and glacial discharge has been studied in the Northern Hemisphere for at least a century, similar studies for Antarctica remain scarce and only for the past four decades. This data scarcity is due to the extreme meteorological conditions and terrain inaccessibility. As a result, the contribution of glacial discharge in Antarctica to global sea-level rise is still attached with great uncertainties, especially from partly glaciated hydrological basins as can be found in the Antarctic Peninsula. In this paper, we propose a simplified model based on the Monte Carlo method and Fourier analysis for estimating discharge in partly glaciated and periglacial hydrological catchments with a summer melt period. Our model offers the advantage of scarce data requirements and quick recognition of periglacial environments. Discharge was found to be highly correlated with surface air temperature for the partially glaciated hydrological catchments on Potter Peninsula, King George Island (Isla 25 Mayo). The model is simple to implement and requires few variables to make most versatile simulations. We have obtained a monthly simulated maximum flow estimates between 0.74 and 1.07 m
3
s
−1
for two creeks (South and North Potter) with a very good fit to field observations. The glacial mean monthly discharge during summer months was estimated to 0.44±0.02 m
3
s
−1
for South Potter Creek and 0.55±0.02 m
3
s
−1
for North Potter Creek.

This article is part of the theme issue ‘The marine system of the West Antarctic Peninsula: status and strategy for progress in a region of rapid change’.
Macronutrient and carbon supply, uptake and cycling across the Antarctic Peninsula shelf during summer
Authors: Henley Sian F. , Jones Elizabeth M. , Venables Hugh J. , Meredith Michael P. , Firing Yvonne L. , Dittrich Ribanna , Heiser Sabrina , Stefels Jacqueline , Dougans Julie 
Published: May 2018

The West Antarctic Peninsula shelf is a region of high seasonal primary production which supports a large and productive food web, where macronutrients and inorganic carbon are sourced primarily from intrusions of warm saline Circumpolar Deep Water. We examined the cross-shelf modification of this water mass during mid-summer 2015 to understand the supply of nutrients and carbon to the productive surface ocean, and their subsequent uptake and cycling. We show that nitrate, phosphate, silicic acid and inorganic carbon are progressively enriched in subsurface waters across the shelf, contrary to cross-shelf reductions in heat, salinity and density. We use nutrient stoichiometric and isotopic approaches to invoke remineralization of organic matter, including nitrification below the euphotic surface layer, and dissolution of biogenic silica in deeper waters and potentially shelf sediment porewaters, as the primary drivers of cross-shelf enrichments. Regenerated nitrate and phosphate account for a significant proportion of the total pools of these nutrients in the upper ocean, with implications for the seasonal carbon sink. Understanding nutrient and carbon dynamics in this region now will inform predictions of future biogeochemical changes in the context of substantial variability and ongoing changes in the physical environment.
This article is part of the theme issue ‘The marine system of the West Antarctic Peninsula: status and strategy for progress in a region of rapid change’.
Evidences of strong sources of DFe and DMn in Ryder Bay, Western Antarctic Peninsula
Authors: Bown Johann , van Haren Hans , Meredith Michael P. , Venables Hugh J. , Laan Patrick , Brearley J. Alexander , de Baar Hein J. W. 
Published: May 2018

The spatial distribution, biogeochemical cycling and external sources of dissolved iron and dissolved manganese (DFe and DMn) were investigated in Ryder Bay, a small coastal embayment of the West Antarctic Peninsula, during Austral summer (2013 and 2014). Dissolved concentrations were measured throughout the water column at 11 stations within Ryder Bay. The concentration ranges of DFe and DMn were large, between 0.58 and 32.7 nM, and between 0.18 and 26.2 nM, respectively, exhibiting strong gradients from the surface to the bottom. Surface concentrations of DFe and DMn were higher than concentrations reported for the Southern Ocean and coastal Antarctic waters, and extremely high concentrations were detected in deep water. Glacial meltwater and shallow sediments are likely to be the main sources of DFe and DMn in the euphotic zone, while lateral advection associated with local sediment resuspension and vertical mixing are significant sources for intermediate and deep waters. During summer, vertical mixing of intermediate and deep waters and sediment resuspension occurring from Marguerite Trough to Ryder Bay are thought to be amplified by a series of overflows at the sills, enhancing the input of Fe and Mn from bottom sediment and increasing their concentrations up to the euphotic layer.
This article is part of the theme issue ‘The marine system of the West Antarctic Peninsula: status and strategy for progress in a region of rapid change’.
Icebergs, sea ice, blue carbon and Antarctic climate feedbacks
Authors: Barnes David K. A. , Fleming Andrew , Sands Chester J. , Quartino Maria Liliana , Deregibus Dolores 
Published: May 2018

Sea ice, including icebergs, has a complex relationship with the carbon held within animals (blue carbon) in the polar regions. Sea-ice losses around West Antarctica's continental shelf generate longer phytoplankton blooms but also make it a hotspot for coastal iceberg disturbance. This matters because in polar regions ice scour limits blue carbon storage ecosystem services, which work as a powerful negative feedback on climate change (less sea ice increases phytoplankton blooms, benthic growth, seabed carbon and sequestration). This resets benthic biota succession (maintaining regional biodiversity) and also fertilizes the ocean with nutrients, generating phytoplankton blooms, which cascade carbon capture into seabed storage and burial by benthos. Small icebergs scour coastal shallows, whereas giant icebergs ground deeper, offshore. Significant benthic communities establish where ice shelves have disintegrated (giant icebergs calving), and rapidly grow to accumulate blue carbon storage. When 5000 km2giant icebergs calve, we estimate that they generate approximately 106tonnes of immobilized zoobenthic carbon per year (t C yr−1). However, their collisions with the seabed crush and recycle vast benthic communities, costing an estimated 4 × 104 t C yr−1. We calculate that giant iceberg formation (ice shelf disintegration) has a net potential of approximately 106 t C yr−1sequestration benefits as well as more widely known negative impacts.This article is part of the theme issue ‘The marine system of the West Antarctic Peninsula: status and strategy for progress in a region of rapid change’.
Mechanics of CaMKII-actin networks
Authors: Khan Shahid , Downing Kenneth H. , Molloy Justin E. 
Published: May 2018

AbstractCalcium calmodulin dependent kinase (CaMKII) has an important role in dendritic spine remodelling upon synaptic stimulation. Using fluorescence video microscopy and image analysis, we investigated the architectural dynamics of rhodamine-phalloidin stabilized F-actin networks cross-linked by CaMKII. We used automated image analysis to identify F-actin bundles and cross-over junctions and developed a dimensionless metric to characterize network architecture. Similar networks were formed by three different CaMKII species with ten-fold length difference in the linker region between the kinase domain and holoenzyme hub; implying linker length is not a primary determinant of F-actin binding. Electron micrographs showed that, at physiological molar ratios, single CaMKII holoenzymes cross-linked multiple F-actin filaments in random networks, whereas at higher CaMKII / F-actin ratios filaments bundled. Light microscopy established that random networks resisted macromolecular crowding, with polyethylene glycol mimicking cytoplasmic osmolarity, and blocked ATP-powered compaction by myosin-2 mini-filaments. Importantly, the networks disassembled following addition of calcium calmodulin and were then rapidly spaced into compacted foci by myosin motors or, more slowly, aggregated by crowding. Single molecule TIRF microscopy showed CaMKII dissociation from surface-immobilized G-actin exhibited a mono-exponential dwell-time distribution, whereas CaMKII bound to F-actin networks had a long-lived fraction, trapped at cross-over junctions. Release of CaMKII from F-actin, triggered by calcium calmodulin did not require ATP (hence phosphorylation) and was too rapid to measure with video-rate imaging. The residual bound-fraction was reduced substantially upon addition of an NMDA receptor peptide analogue. These results provide mechanistic insights to CaMKII-actin interactions at the collective network and single molecule level. Our findings argue that CaMKII-actin networks in dendritic spines are stable enough to protect the basal network architecture against physical stress but once CaMKII is disengaged by calcium calmodulin and sequestered by receptors at the synapse; F-actin compaction by myosin motors stabilizes the expanded spine compatible with the recorded times.