bluuebunny/crossref_metadata_2025_split huggingface dataset:
ECOWAS and Regional Integration in West Africa: From State to Emerging Private Authority
Authors: Oloruntoba Samuel O 
Published: July 2016

AbstractThe Economic Community of West African States was established in 1975 due to the leadership initiative of Nigeria and Togo as well as the cooperation of other Heads of State and Governments in the subregion. It was established within the framework of the consciousness of the need to develop a regional platform for cooperation and development. Since inception various institutions have been established, treaties and protocols have been signed and deadlines have been set for realising the objective conditions for which the subregional body was set up. Integration and regionalism in Africa have seen some twists and turns depending on the prevailing socio‐economic and ideological conditions both at the domestic and international environments. Various efforts have been made towards building regionalism in West Africa, especially within the context of neoliberal economic paradigm in which removal of barriers to market access and other factors of production is the main concern. Despite some successes, the effectiveness of the subregional body has been hampered through both domestic and external factors. News actors in form of private authority of indigenous multinational companies and other non‐state actors are emerging which could facilitate integration in the sub‐region in a more sublime and functional sense than the approach taken by political elites over the past 50 years. This paper discusses these new trends in integration within the theoretical prisms of networked political economy, private authority and regional identity. I also examine the institutional developments that have taken place since it was formed about 40 years ago.
A case study of the introduction of the International Classification for Nursing Practice® in Poland
Authors: Kilańska D. , Gaworska‐Krzemińska A. , Grabowska H. , Gorzkowicz B. 
Published: July 2016

IntroductionThe development of a nursing practice, improvements in nurses’ autonomy, and increased professional and personal responsibility for the medical services provided all require professional documentation with records of health status assessments, decisions undertaken, actions and their outcomes for each patient. The International Classification for Nursing Practice is a tool that meets all of these needs, and although it requires continuous evaluation, it offers professional documentation and communication in the practitioner and researcher community.AimThe aim of this paper is to present a theoretical critique of an issue related to policy and experience of the current situation in Polish nursing – especially of the efforts to standardize nursing practices through the introduction and development of the Classification in Poland.DiscussionDespite extensive promotion and training by International Council of Nurses members worldwide, there are still many countries where the Classification has not been implemented as a standard tool in healthcare facilities. Recently, a number of initiatives were undertaken in cooperation with the local and state authorities to disseminate the Classification in healthcare facilities.ConclusionsThanks to intense efforts by the Polish Nurses Association and the International Council of Nurses Accredited Center for ICNP® Research & Development at the Medical University of Łódź, the Classification is known in Poland and has been tested at several centres. Nevertheless, an actual implementation that would allow for national and international interoperability requires strategic governmental decisions and close cooperation with information technology companies operating in the country.Implications for nursing & health policyDiscussing the barriers to the implementation of the Classification can improve understanding of it and its use. At a policy level, decision makers need to understand that use Classification in eHealth services and tools it is necessary to achieve interoperability.
Hybrid dynamics in a species group of swallowtail butterflies
Authors: Dupuis J. R. , Sperling F. A. H. 
Published: July 2016

AbstractHybrid zones provide unique natural laboratories for studying mechanisms of evolution. But identification and classification of hybrid individuals (F1, F2, backcross, etc.) can be complicated by real population changes over time as well as by use of different marker types, both of which challenge documentation of hybrid dynamics. Here, we use multiple genetic markers (mitochondrial DNA, microsatellites and genomewide single nucleotide polymorphisms) to re‐examine population structure in a hybrid zone between two species of swallowtail butterflies in western Canada, Papilio machaon and P. zelicaon. Our aim was to test whether their hybrid dynamics remain the same as found 30 years ago using morphology and allozymes, and we compared different genetic data sets as well as alternative hybrid identification and classification methods. Overall, we found high differentiation between the two parental species, corroborating previous research from the 1980s. We identified fewer hybrid individuals in the main zone of hybridization in recent years, but this finding depended on the genetic markers considered. Comparison of methods with simulated data sets generated from our data showed that single nucleotide polymorphisms were more powerful than microsatellites for both hybrid identification and classification. Moreover, substantial variation among comparisons underlined the value of multiple markers and methods for documenting evolutionarily dynamic systems.
Otolith shape lends support to the sensory drive hypothesis in rockfishes
Authors: Tuset V. M. , Otero‐Ferrer J. L. , Gómez‐Zurita J. , Venerus L. A. , Stransky C. , Imondi R. , Orlov A. M. , Ye Z. , Santschi L. , Afanasiev P. K. , Zhuang L. , Farré M. , Love M.S. , Lombarte A. 
Published: July 2016

AbstractThe sensory drive hypothesis proposes that environmental factors affect both signalling dynamics and the evolution of signals and receivers. Sound detection and equilibrium in marine fishes are senses dependent on the sagittae otoliths, whose morphological variability appears intrinsically linked to the environment. The aim of this study was to understand if and which environmental factors could be conditioning the evolution of this sensory structure, therefore lending support to the sensory drive hypothesis. Thus, we analysed the otolith shape of 42 rockfish species (Sebastes spp.) to test the potential associations with the phylogeny, biological (age), ecological (feeding habit and depth distribution) and biogeographical factors. The results showed strong differences in the otolith shapes of some species, noticeably influenced by ecological and biogeographical factors. Moreover, otolith shape was clearly conditioned by phylogeny, but with a strong environmental effect, cautioning about the use of this structure for the systematics of rockfishes or other marine fishes. However, our most relevant finding is that the data supported the sensory drive hypothesis as a force promoting the radiation of the genus Sebastes. This hypothesis holds that adaptive divergence in communication has significant influence relative to other life history traits. It has already been established in Sebastes for visual characters and organs; our results showed that it applies to otolith transformations as well (despite the clear influence of feeding and depth), expanding the scope of the hypothesis to other sensory structures.
Factors Associated With Ineligibility for PCI Differ Between Inpatient and Outpatient ST‐Elevation Myocardial Infarction
Authors: Jaski Brian E. , Grigoriadis Christopher E. , Dai Xuming , Meredith Richard D. , Ortiz Bryan C. , Stouffer George A. , Thomas Lorie , Smith Sidney C. 
Published: July 2016

ObjectivesWithout early revascularization, both inpatient and outpatient STEMIs have poor outcomes. Reasons for denying PCI for STEMI, however, remain uncertain. This single‐center retrospective cohort study compares factors and outcomes associated with ineligibility for PCI between inpatients and outpatients following ST‐elevation myocardial infarction (STEMI).MethodsA total of 1,759 STEMI patients between June 2009 and January 2015 were assessed. Individual medical records were reviewed to obtain reasons for PCI ineligibility for STEMI patients who did not receive reperfusion therapy.ResultsCompared to outpatients with STEMI (n = 1,688), inpatients (n = 71) were less likely to receive coronary angiography (60.6% vs 95.9%; P < 0.001) or PCI (50.7% vs 80.9%; P < 0.001), with longer ECG/door to first device activation times (97 [78, 131] vs 63 [49, 78] minutes; P < 0.001). When coronary angiography was performed, however, similar rates of PCI and procedural success were seen in both groups. Principal contraindication for PCI was risk of bleeding within the inpatient population and complex coronary artery disease within the outpatient population. Total in‐hospital mortality was higher in inpatient STEMIs compared to outpatients (42.2% vs 10.0%; P < 0.001), but lower for patients eligible for PCI in both groups.ConclusionsReasons for PCI ineligibility differ between inpatient and outpatient STEMIs. Inpatients have increased risks of bleeding, lower coronary angiography and PCI use, and higher in‐hospital mortality. Especially for inpatients, specific PCI STEMI protocols that anticipate and overcome types of ineligibility and delay for cardiac catheterization may improve outcomes.
OLDER PEOPLE WITH CHRONIC KIDNEY DISEASE: DEFINITION, AND INFLUENCE OF BIOMARKERS AND MEDICATIONS UPON CARDIOVASCULAR AND RENAL OUTCOMES
Authors: Raman Maharajan , Green Darren , Middleton Rachel J. , Kalra Philip A. 
Published: July 2016

SUMMARYBackgroundChronic kidney disease (CKD) is a global problem. With an ageing population the burden on the health services has increased due to the growing number of older people with CKD. This group of individuals is far different to the younger CKD population and their risk of cardiovascular death is far greater than the risk of progressing to end stage kidney disease (ESKD).ObjectiveIn this review we explore the role of certain biomarkers and medications in predicting the risk of progression to ESKD and death in old people with CKD.MethodsAn electronic literature search of EMBASE and MEDLINE databases was performed using Healthcare Databases Advanced Search (HDAS) in December 2014.ResultsAlbuminuria is a key biomarker in predicting the risk of death and progression to ESKD. Cystatin C appears to be superior in predicting the risk of cardiovascular and non‐cardiovascular death compared to GFR or creatinine. Several inflammatory biomarkers can be used to predict the risk of death and progression to CKD but measuring and monitoring them in routine clinical practice will be expensive and impractical. The effects of long‐term RAAS inhibition in older people are not well established. Older people especially those with CKD receive suboptimal secondary preventive measures. Due to multiple comorbidities older people with CKD are usually receiving a number of medications. This can potentially lead to significant adverse drug events (ADE) due to drug interactions.ConclusionNovel non‐traditional risk factors like albuminuria, Cystatin C and inflammatory biomarkers play an important role in predicting their risk of death and progression to ESKD. The efficacy and safety of medications in older people with CKD is not well established and requires more extensive, focused study.
NURSE STAFFING AND RENAL ANAEMIA OUTCOMES IN HAEMODIALYSIS CARE
Authors: Erlingmark Julia , Hedström Mariann , Lindberg Magnus 
Published: July 2016

SUMMARYBackgroundCurrent trends in renal anaemia management place greater emphasis, and thus increased workload, on the role of the nurse in haemodialysis settings. However, there is little evidence that demonstrates the relationship between nurse staffing and patient outcomes.ObjectivesTo describe nurse staffing in haemodialysis settings, its relationship with target levels of renal anaemia management and to describe target level achievement for different ways of organising anaemia management.DesignCross‐sectional audit.ParticipantsForty (out of 78) haemodialysis centres in Sweden reported quality assurance data.MeasurementsThe numbers of bedside registered nurses, licensed nurse assistants and patients undergoing haemodialysis during a predefined morning shift; type of anaemia management and achieved target levels of anaemia management.ResultsThe mean patient:registered nurse ratio was 2.4 and the mean patient:nurse assistant ratio was 12.8. There were no significant relationships between registered nurse staffing and target level achievement. On average, 45.6% of the patients had haemoglobin within the target levels at centres applying nurse‐driven anaemia management, compared with 47.3% at physician‐driven centres.ConclusionsThese cross‐sectional data suggest that renal anaemia outcomes are unrelated to the patient:registered nurse ratio. There is, however, room for improvement in renal anaemia management in the units included in this study, particularly the achievement of target levels of haemoglobin and transferrin saturation.
Ellagic acid confers protection against gentamicin-induced oxidative damage, mitochondrial dysfunction and apoptosis-related nephrotoxicity
Authors: Sepand Mohammad Reza , Ghahremani Mohammad Hossein , Razavi-Azarkhiavi Kamal , Aghsami Mehdi , Rajabi Jalil , Keshavarz-Bahaghighat Hedieh , Soodi Maliheh 
Published: July 2016

Abstract

Objectives
The aim of this study was to investigate the possible protective effect of ellagic acid (EA) against gentamicin (GEN)-induced nephrotoxicity using biochemical, molecular and histopathological approaches.

Methods
Rats (n = 24) were divided into four groups: control, GEN (100 mg/kg, i.p.), EA (10 mg/kg, p.o.) and GEN plus EA. The regimes were administered for 10 successive days. 24 h after last treatment, kidney and blood samples were collected.

Key findings
Ellagic acid treatment significantly reduced plasma creatinine and urea levels, which were initially increased due to GEN administration. Also, EA significantly ameliorated oxidative stress markers including lipid peroxidation, catalase (CAT) and superoxide dismutase (SOD) enzyme activity as well as glutathione (GSH) content in kidney tissue. Activation of caspase-3 and increase in the ratio of Bcl-2/Bax expression observed in GEN-treated group were significantly ameliorated by EA treatment. EA also protected GEN-induced mitochondrial damages as indicated by decreasing the mitochondrial ROS content, preventing of mitochondrial membrane potential (MMP) loss, reducing mitochondrial swelling and decreasing cytochrome c release. In addition, histopathological findings revealed that EA ameliorates GEN-induced kidney injury.

Conclusions
Our findings suggest that EA treatment attenuates GEN-induced nephrotoxicity, which may be ascribed to its antioxidant and anti-apoptotic properties.
Chlorogenic acid inhibits cholestatic liver injury induced by α-naphthylisothiocyanate: involvement of STAT3 and NFκB signalling regulation
Authors: Tan Zhen , Luo Min , Yang Julin , Cheng Yuqing , Huang Jing , Lu Caide , Song Danjun , Ye Meiling , Dai Manyun , Gonzalez Frank J , Liu Aiming , Guo Bin 
Published: July 2016

Abstract

Objectives
Chlorogenic acid (CGA) is one of the most widely consumed polyphenols in diets and is recognized to be a natural hepatoprotective agent. Here, we evaluated the protective effect and the potential mechanism of CGA against ɑ-naphthylisothiocyanate (ANIT)-induced cholestasis and liver injury.

Methods
Twenty-five male 129/Sv mice were administered with CGA, and ANIT challenge was performed at 75 mg/kg on the 4th day. Blood was collected and subjected to biochemical analysis; the liver tissues were examined using histopathological analysis and signalling pathways.

Key findings
Chlorogenic acid almost totally attenuated the ANIT-induced liver damage and cholestasis, compared with the ANIT group. Dose of 50 mg/kg of CGA significantly prevented ANIT-induced changes in serum levels of alanine aminotransferase, alkaline phosphatases, total bile acid, direct bilirubin, indirect bilirubin (5.3-, 6.3-, 18.8-, 158-, 41.4-fold, P&lt;0.001) and aspartate aminotransferase (4.6-fold, P&lt;0.01). Expressions of the altered bile acid metabolism and transport-related genes were normalized by cotreatment with CGA. The expressions of interleukin 6, tumour necrosis factor-α and suppressor of cytokine signalling 3 were found to be significantly decreased (1.2-fold, ns; 11.0-fold, P&lt;0.01; 4.4-fold, P&lt;0.05) in the CGA/ANIT group. Western blot revealed that CGA inhibited the activation and expression of signal transducer and activator of transcription 3 and NFκB.

Conclusions
These data suggest that CGA inhibits both ANIT-induced intrahepatic cholestasis and the liver injury. This protective effect involves down-regulation of STAT3 and NFκB signalling.
The influence of non-ionisable excipients on precipitation parameters measured using the CheqSol method
Authors: Etherson Kelly , Halbert Gavin , Elliott Moira 
Published: July 2016

Abstract

Objectives
The aim of this study was to determine the influence of non-ionisable excipients hydroxypropyl-β-cyclodextrin (HPβCD) and poloxamers 407 and 188 on the supersaturation and precipitation kinetics of ibuprofen, gliclazide, propranolol and atenolol induced through solution pH shifts using the CheqSol method.

Methods
The drug's kinetic and intrinsic aqueous solubilities were measured in the presence of increasing excipient concentrations using the CheqSol method. Experimental data rate of change of pH with time was also examined to determine excipient-induced parachute effects and influence on precipitation rates.

Key findings
The measured kinetic and intrinsic solubilities provide a determination of the influence of each excipient on supersaturation index, and the area under the CheqSol curve can measure the parachute capability of excipients. The excipients influence on precipitation kinetics can be measured with novel parameters; for example, the precipitation pH or percentage ionised drug at the precipitation point, which provide further information on the excipient-induced changes in precipitation performance.

Conclusion
This method can therefore be employed to measure the influence of non-ionisable excipients on the kinetic solubility behaviour of supersaturated solutions of ionisable drugs and to provide data, which discriminates between excipient systems during precipitation.
Oral delivery of insulin for treatment of diabetes: status quo, challenges and opportunities
Authors: Wong Chun Y , Martinez Jorge , Dass Crispin R 
Published: July 2016

Abstract

Objectives
Diabetes mellitus is characterised by progressive β-cell destruction and loss of function, or loss of ability of tissues to respond to insulin. Daily subcutaneous insulin injection is standard management for people with diabetes, although patient compliance is hard to achieve due to the inconvenience of injections, so other forms of delivery are being tested, including oral administration. This review summarises the developments in oral insulin administration.

Methods
The PubMed database was consulted to compile this review comparing conventional subcutaneous injection of insulin to the desired oral delivery.

Key findings
Oral administration of insulin has potential benefits in reducing pain and chances of skin infection, improving the portal levels of insulin and avoiding side effects such as hyperinsulinemia, weight gain and hypoglycaemia. Although oral delivery of insulin is an ideal administration route for patients with diabetes, several physiological barriers have to be overcome. An expected low oral bioavailability can be attributed to its high molecular weight, susceptibility to enzymatic proteolysis and low diffusion rate across the mucin barrier.

Conclusions
Strategies for increasing the bioavailability of oral insulin include the use of enzyme inhibitors, absorption enhancers, mucoadhesive polymers and chemical modification for endogenous receptor-mediated absorption. These may help significantly increase patient compliance and disease management.
Diabetes may affect the expression of matrix metalloproteinases and their inhibitors more than smoking in chronic periodontitis
Authors: Bastos M. F. , Tucci M. A. , de Siqueira A. , de Faveri M. , Figueiredo L. C. , Vallim P. C. , Duarte P. M. 
Published: July 2016

Background and ObjectiveNo previous study has directly compared the levels of matrix metalloproteinases (MMPs) and tissue inhibitor of metalloproteinases (TIMPs) between smokers and individuals with diabetes mellitus (DM) with periodontitis. Therefore, the aim of this study was to evaluate the gene expression of MMP‐1, MMP‐2, MMP‐8, MMP‐9, TIMP‐1 and TIMP‐2 in tissues with chronic periodontitis (ChP) of smokers and individuals with type 2 DM.Material and MethodsGingival biopsies were harvested from: non‐smokers and non‐diabetic individuals with ChP (n = 18) (ChP group); non‐diabetic smokers (≥ 10 cigarettes per day for at least the past 5 years) with ChP (n = 18) (SChP group); non‐smoking individuals with type 2 diabetes (glycated hemoglobin levels ≥ 7.5%) and ChP (n = 18) (DMChP group). The tissue levels of mRNA of MMP‐1, MMP‐2, MMP‐8, MMP‐9, TIMP‐1 and TIMP‐2 were evaluated by quantitative real‐time polymerase chain reaction.ResultsThe MMP‐8 expression was the lowest in the ChP group (p < 0.05). The DMChP group presented increased mRNA levels of MMP‐2 and MMP‐9, when compared to the SChP group (p < 0.05). MMP‐1 expression and the MMP‐1/TIMP‐1, MMP‐2/TIMP‐1, MMP‐8/TIMP‐1, MMP‐9/TIMP‐1, MMP‐1/TIMP‐2 and MMP‐2/TIMP‐2 ratios were higher in the DMChP group than in the ChP and SChP groups (p < 0.05). The DMChP group presented lower mRNA levels of TIMP‐1 than the ChP group (p < 0.05). The MMP‐8/TIMP‐2 ratio was the highest in the SChP group (p < 0.05).ConclusionUncontrolled type 2 DM upregulates the ratio of MMP/TIMPs in sites with ChP more than smoking, which may contribute to a greater extracellular matrix degradation and periodontal breakdown in DM‐related periodontitis.
Experiences of Korean adolescent renal transplant recipients
Authors: Kim Sumi , Choi Heeseung 
Published: July 2016

AbstractPurposeTo understand the experiences of Korean adolescents who have undergone a renal transplant.Design and MethodsNine adolescents aged 12–18 who received a renal transplant participated in this qualitative descriptive study. Using content analysis, we analyzed in‐depth interview data from individual adolescents.ResultsThe main themes extracted were “being different from others,” “not being invited as a decision maker,” “becoming one of them,” “still being different from others,” “having mixed feeling toward mothers,” and “coping with new circumstances.”Practice ImplicationsInterventions designed to improve adolescent renal transplant recipients’ sense of autonomy and belongingness are needed.