bluuebunny/crossref_metadata_2025 huggingface dataset:
Identifying Consistent and Coherent Dimensions of Nursing Home Quality: Exploratory Factor Analysis of Quality Indicators
Authors: Xu Dongjuan , Kane Robert L. , Shippee Tetyana , Lewis Teresa M.
Published: December 2016

Background

There is a general belief that the markers of nursing home quality do not aggregate easily. Identifying consistent and coherent dimensions of quality that usefully summarize the multiplicity of nursing home quality measures is an important goal. It would simplify interpretation and help consumers, their families and advocates to choose nursing facilities.

Objectives

This study uses quality indicators (QIs) from a state nursing home report card to explore the dimensionality of quality in nursing homes and to determine whether aggregation at the resident versus facility level yields the same underlying dimensions.

Design

Cross‐sectional study.

Setting

382 Medicare‐ and/or Medicaid‐certified nursing homes in Minnesota.

Participants

Residents admitted to the nursing homes during 2011–2012.

Measurements

16 QIs obtained from the Minimum Data Set 3.0 assessment instrument between 2011 and 2012 were used in the exploratory factor analysis.

Results

Factor analysis results suggest four main factors or dimensions to characterize facility performance: continence care (including 4 QIs), restraints and behavioral symptoms (including 3 QIs), care for specific conditions (including 6 QIs), and physical functioning (including 3 QIs). The resident‐level and facility‐level results generally agreed for 11 QIs.

Conclusion

Nursing home quality of care can be captured in summary measures, which can be used by consumers, providers and researchers. Reporting at the resident or facility level will depend on the purpose. These summary measures can be used by policy‐makers to identify and reward high‐performing facilities and by families to choose nursing facilities for care.
A novel tomato SUMO E3 ligase, SlSIZ1, confers drought tolerance in transgenic tobacco
Authors: Zhang Song , Zhuang Kunyang , Wang Shiju , Lv Jinlian , Ma Na'na , Meng Qingwei
Published: December 2016

SUMOylation is an important post‐translational modification process that regulates different cellular functions in eukaryotes. SIZ/PIAS‐type SAP and Miz1 (SIZ1) proteins exhibit SUMO E3 ligase activity, which modulates SUMOylation. However, SIZ1 in tomato has been rarely investigated. In this study, a tomato SIZ1 gene (SlSIZ1) was isolated and its molecular characteristics and role in tolerance to drought stress are described. SlSIZ1 was up‐regulated by cold, sodium chloride (NaCl), polyethylene glycol (PEG), hydrogen peroxide (H2O2) and abscisic acid (ABA), and the corresponding proteins were localized in the nucleus. The expression of SlSIZ1 in Arabidopsis thaliana (Arabidopsis) siz1‐2 mutants partially complemented the phenotypes of dwarf, cold sensitivity and ABA hypersensitivity. SlSIZ1 also exhibited the activity of SUMO E3 ligase to promote the accumulation of SUMO conjugates. Under drought stress, the ectopic expression of SlSIZ1 in transgenic tobacco lines enhanced seed germination and reduced the accumulation of reactive oxygen species. SlSIZ1 overexpression conferred the plants with improved growth, high free proline content, minimal malondialdehyde accumulation and increased accumulation of SUMO conjugates. SlSIZ1 is a functional homolog of Arabidopsis SIZ1 with SUMO E3 ligase activity. Therefore, overexpression of SlSIZ1 enhanced the tolerance of transgenic tobacco to drought stress.
The National Anthem in Warao: Semiotic Ground and Performative Affordances of Indigenous Language Texts in Venezuela
Authors: Rodriguez Juan Luis
Published: December 2016

This paper analyzes how the translated text of the Venezuelan national anthem from Spanish to Warao has been put to new uses in Venezuela. It focuses on publicly available videos and written versions of the lyrics to understand how indigenous leaders and nonindigenous Spanish speakers use the anthem for new purposes. By analyzing the anthem as a text‐artifact, I argue that translation produced a change on the semiotic ground of interpretation for the anthem that also resulted in a break between types and tokens of the oral and written versions of the text. This break gave the anthem new performative affordances making possible new and sometimes contradictory ways of using it.
“Tapwaroro is true”: Indigenous Voice and the Heteroglossia of Methodist Missionary Translation in British New Guinea
Authors: Schram Ryan
Published: December 2016

In the semiotic ideology of many Christian discursive practices, it is assumed that any language can convey the same message of salvation, and any person is capable of true belief, no matter how it is expressed. Evangelism, especially by Western missions, thus centers on translating Christian texts into vernacular languages. This article considers these understandings and practices by examining the written discourse of Australian Methodist missionaries in the early colonial period in New Guinea. These missionaries desired an encounter with heathens in an unevangelized field, but they operated in a colonial terrain defined by the politics of past encounters between Australians and Melanesians. In their writings, missionary authors parody the voices of indigenous speakers and present a world in which missionary and native cannot arrive at a shared understanding of religion. Their parody usually involves quoting one term,taparoro,as a word used by natives for the mission and its activities. Having presented a world defined by a persistent gap in understanding, missionaries appropriate this particular sign of their own otherness to others as a basis for a new mission register into which they can translate Christian ideas. In so doing, they do not simply impose one dominant code as a metalinguistic standard, but fashion a new discourse out of available materials in a complex field of interlingualism.
The relationship between lip‐closing force and dental arch morphology in patient with Angle Class I malocclusion
Authors: Takehana Y. , Masuda Y. , Kageyama T. , Okazaki R. , Murakami M. , Yamada K.
Published: December 2016

Dental arch morphology and tooth position are affected by lip‐closing force (LCF). This study aimed to quantitatively evaluate the relationships between the horizontal or vertical balance of the LCF generated during maximum voluntary pursing‐like movements and dental arch length (DAL) or width (DAW) or the lingual inclination of the upper or lower 1st molars (LIUM, LILM) in patients with Angle Class I malocclusion. Sixteen subjects with Angle Class I malocclusion (median age: 23·4 ± 5·9 years) who had never undergone orthodontic treatment were randomly selected. LCF was measured in eight directions during maximum voluntary pursing‐like lip‐closing movements. Dental arch models were scanned and analysed to obtain DAW, DAL, LIUM and LILM measurements. Mandibular deviation was measured on posteroanterior cephalograms. A significant negative correlation was detected between maxillary DAL and upper LCF. Maxillary DAL, DAW and the DAL/DAW ratio displayed significant negative correlations with total LCF and upper LCF. However, no significant correlations were detected between any mandibular dental arch morphological parameter and LCF. The difference in the LIUM between the deviation and non‐deviation sides exhibited a significant positive correlation with the difference in upper LCF between the deviation and non‐deviation sides and was significantly negatively correlated with the difference in lower LCF between the deviation and non‐deviation sides. These results suggest that upper LCF is related to maxillary DAL, and the horizontal balance of the LCF of the upper and lower lips is related to the LIUM during pursing‐like lip‐closing movements in patients with Angle Class I malocclusion.
Prediction of chemical composition and peroxide value in unground pet foods by near‐infrared spectroscopy
Authors: De Marchi M. , Righi F. , Meneghesso M. , Manfrin D. , Ricci R.
Published: December 2016

The massive development of the pet food industry in recent years has lead to the formulation of hundreds of canine and feline complete extruded foods with the objective of meeting both the needs of the animals and numerous demands from pet owners. In the meantime, highly variable raw material compositions and the industry's new production techniques oblige manufacturers to monitor all phases of the extrusion process closely in order to ensure the targeted composition and quality of the products. This study aimed at evaluating the potential of infrared technology (visible and near‐infrared spectrophotometer; 570–1842 nm) in predicting the chemical composition and peroxide value (PV) of unground commercial extruded dog foods. Six hundred and forty‐nine commercial extruded dog foods were collected. For each product, an unground aliquot was analysed by infrared instrument while a second aliquot was sent to a laboratory for proximate analysis and PV quantification. The wide range of extruded dog food typologies included in the study was responsible for the wide variability observed within each nutritional trait, especially crude fibre and ash. The mean value of the 208 pet foods sampled for PV quantification was 17.49 mEq O2/kg fat (min 2.2 and max 94.10 mEq O2/kg fat). The coefficients of determination in cross‐validation of NIRS prediction models were 0.77, 0.97, 0.83, 0.86, 0.78 and 0.94 for moisture, crude protein, crude fat, crude fibre, ash and nitrogen‐free extract (NFE) respectively. PV prediction was less precise, as demonstrated by the coefficient of determination in cross‐validation (0.66). The results demonstrated the potential of NIRS in predicting chemical composition in unground samples, with lower accuracy for moisture and ash, while PV prediction models suggest use for screening purposes only.
Inference with the Whittle Likelihood: A Tractable Approach Using Estimating Functions
Authors: Jesus Joao , Chandler Richard E.
Published: December 2016

The theoretical properties of the Whittle likelihood have been studied extensively for many different types of process. In applications however, the utility of the approach is limited by the fact that the asymptotic sampling distribution of the estimator typically depends on third‐order and fourth‐order properties of the process that may be difficult to obtain. In this article, we show how the methodology can be embedded in the standard framework of estimating functions, which allows the asymptotic distribution to be estimated empirically without calculating higher‐order spectra. We also demonstrate that some aspects of the inference, such as the calculation of confidence regions for the entire parameter vector, can be inaccurate but that a small adjustment, designed for application in situations where a mis‐specified likelihood is used for inference, can lead to marked improvements.
The Effect of Inadequate Presample Blood Volume Withdrawal from Intravenous Catheter and Extension Sets on Measured Circulating L‐Blood Lactate Concentration in Horses Receiving Lactated Ringer's Solution
Authors: Marqués F.J. , Higgins S. , Chapuis R. , Waldner C.
Published: December 2016

Background

Circulating l‐lactate concentration is commonly measured in hospitalized horses by sampling from indwelling intravenous (IV) catheters. However, there are no published evidence‐based recommendations to prevent contamination by lactated Ringer's solution (LRS).

Hypothesis

Withdrawing 10 mL of blood from the LRS‐containing extension set connected to the IV catheter before obtaining the sample for analysis should be adequate to obtain accurate measurement of blood lactate concentration (BLC).

Animals

Thirty‐three adult hospitalized horses receiving constant rate infusion of LRS.

Methods

Immediately after disconnecting the LRS, 5 sequential 5 mL blood samples were obtained by aspiration from an extension set connected to an indwelling IV catheter, followed by 3 samples collected by direct venipuncture of the contralateral jugular vein. Samples were analyzed with 1 portable blood lactate analyzer. A linear mixed model was used to examine differences in lactate concentrations among samples collected from the catheter and by direct venipuncture.

Results

After considering differences in age, breed, sex, and reason for hospitalization, BLCs were higher (P < .001) in the first and second 5 mL samples collected through the extension set/catheter than in all other extension set/catheter samples or the direct venipuncture samples. The largest difference observed between the third and subsequent catheter or venipuncture samples was 0.34 mmol/L with an upper 95% CI of 1.12 mmol/L.

Conclusions and Clinical Importance

Withdrawing 15 mL of blood from a LRS‐containing extension set connected to an IV catheter (5.9 mL total volume capacity) before obtaining the sample for blood lactate analysis is suggested to optimize accuracy of BLC measurements.
Dynamics of Escherichia coli type I‐E CRISPR spacers over 42 000 years
Authors: Savitskaya Ekaterina , Lopatina Anna , Medvedeva Sofia , Kapustin Mikhail , Shmakov Sergey , Tikhonov Alexey , Artamonova Irena I. , Logacheva Maria , Severinov Konstantin
Published: December 2016

CRISPR‐Cas are nucleic acid‐based prokaryotic immune systems. CRISPR arrays accumulate spacers from foreign DNA and provide resistance to mobile genetic elements containing identical or similar sequences. Thus, the set of spacers present in a given bacterium can be regarded as a record of encounters of its ancestors with genetic invaders. Such records should be specific for different lineages and change with time, as earlier acquired spacers get obsolete and are lost. Here, we studied type I‐E CRISPR spacers of Escherichia coli from extinct pachyderm. We find that many spacers recovered from intestines of a 42 000‐year‐old mammoth match spacers of present‐day E. coli. Present‐day CRISPR arrays can be reconstructed from palaeo sequences, indicating that the order of spacers has also been preserved. The results suggest that E. coli CRISPR arrays were not subject to intensive change through adaptive acquisition during this time.
Historical processes and contemporary ocean currents drive genetic structure in the seagrass Thalassia hemprichii in the Indo‐Australian Archipelago
Authors: Hernawan Udhi E. , van Dijk Kor‐jent , Kendrick Gary A. , Feng Ming , Biffin Edward , Lavery Paul S. , McMahon Kathryn
Published: December 2016

Understanding spatial patterns of gene flow and genetic structure is essential for the conservation of marine ecosystems. Contemporary ocean currents and historical isolation due to Pleistocene sea level fluctuations have been predicted to influence the genetic structure in marine populations. In the Indo‐Australian Archipelago (IAA), the world's hotspot of marine biodiversity, seagrasses are a vital component but population genetic information is very limited. Here, we reconstructed the phylogeography of the seagrass Thalassia hemprichii in the IAA based on single nucleotide polymorphisms (SNPs) and then characterized the genetic structure based on a panel of 16 microsatellite markers. We further examined the relative importance of historical isolation and contemporary ocean currents in driving the patterns of genetic structure. Results from SNPs revealed three population groups: eastern Indonesia, western Indonesia (Sunda Shelf) and Indian Ocean; while the microsatellites supported five population groups (eastern Indonesia, Sunda Shelf, Lesser Sunda, Western Australia and Indian Ocean). Both SNPs and microsatellites showed asymmetrical gene flow among population groups with a trend of southwestward migration from eastern Indonesia. Genetic diversity was generally higher in eastern Indonesia and decreased southwestward. The pattern of genetic structure and connectivity is attributed partly to the Pleistocene sea level fluctuations modified to a smaller level by contemporary ocean currents.
No evidence for homosubtypic immunity of influenza H3 in Mallards following vaccination in a natural experimental system
Authors: Wille M. , Latorre‐Margalef N. , Tolf C. , Stallknecht D. E. , Waldenström J.
Published: December 2016

The Mallard (Anas platyrhynchos) is an important reservoir species for influenza A viruses (IAV), and in this host, prevalence and virus diversity are high. Studies have demonstrated the presence of homosubtypic immunity, where individuals are unlikely to be reinfected with the same subtype within an autumn season. Further, evidence for heterosubtypic immunity exists, whereby immune responses specific for one subtype offer partial or complete protection against related HA subtypes. We utilized a natural experimental system to determine whether homo‐ or heterospecific immunity could be induced following experimental vaccination. Thirty Mallards were vaccinated with an inactivated H3, H6 or a sham vaccine and after seroconversion were exposed to naturally infected wild conspecifics. All ducks were infected within 2 days and had both primary and secondary infections. Overall, there was no observable difference between groups; all individuals were infected with H3 and H10 IAV. At the cessation of the experiment, most individuals had anti‐NP antibodies and neutralizing antibodies against H10. Not all individuals had H3 neutralizing antibodies. The isolated H3 IAVs revealed genetic dissimilarity to the H3 vaccine strain, specifically substitutions in the vicinity of the receptor‐binding site. There was no evidence of vaccine‐induced homosubtypic immunity to H3, a likely result of both a poor H3 immune response in the ducks and H3 immune escape. Likewise, there was no observed heterosubtypic protection related to H6 vaccination. This study highlights the need for experimental approaches to assess how exposure to pathogens and resulting immune processes translates to individual and population disease dynamics.
Economic growth with demand saturation and “endogenous” demand creation
Authors: Murakami Hiroki
Published: December 2016

In this article, we present a model of economic growth through “demand creation” in the face of “demand saturation,” by representing demand saturation by an S‐shaped logistic function and reckoning the firm's R&D as an activity to determine the probability of product innovation, that is, of demand creation. By defining the parameter of birth rate of a new product as the probability that a new product is derived from an existing one and identifying the time path of this parameter with the firm's R&D plan, we derive the optimal R&D plan and examine the growth rate of the firm's expected total revenue along this optimal plan. We then find that the optimal birth rate of a new product is influenced positively by the speed of diffusion of demand and the initial level of demand but negatively by the unit cost of production and the interest rate and that the growth rate of the firm converges to the optimal birth rate of a new product.
Dynamics of the peptidoglycan biosynthetic machinery in the stalked budding bacterium Hyphomonas neptunium
Authors: Cserti Emöke , Rosskopf Sabine , Chang Yi‐Wei , Eisheuer Sabrina , Selter Lars , Shi Jian , Regh Christina , Koert Ulrich , Jensen Grant J. , Thanbichler Martin
Published: December 2016

Most commonly studied bacteria grow symmetrically and divide by binary fission, generating two siblings of equal morphology. An exception to this rule are budding bacteria, in which new offspring emerges de novo from a morphologically invariant mother cell. Although this mode of proliferation is widespread in diverse bacterial lineages, the underlying mechanisms are still incompletely understood. Here, we report the first molecular‐level analysis of growth and morphogenesis in the stalked budding alphaproteobacterium Hyphomonas neptunium. Peptidoglycan labeling shows that, in this species, buds originate from a stalk‐like extension of the mother cell whose terminal segment is gradually remodeled into a new cell compartment. As a first step toward identifying the machinery mediating the budding process, we performed comprehensive mutational and localization studies of predicted peptidoglycan biosynthetic proteins in H. neptunium. These analyses identify factors that localize to distinct zones of dispersed and zonal growth, and they suggest a critical role of the MreB‐controlled elongasome in cell morphogenesis. Collectively, our work shows that the mechanism of growth in H. neptunium is distinct from that in related, polarly growing members of the order Rhizobiales, setting the stage for in‐depth analyses of the molecular principles regulating the fascinating developmental cycle of this species.
Two regulatory RNA elements affect TisB‐dependent depolarization and persister formation
Authors: Berghoff Bork A. , Hoekzema Mirthe , Aulbach Lena , Wagner E. Gerhart H.
Published: December 2016

Bacterial survival strategies involve phenotypic diversity which is generated by regulatory factors and noisy expression of effector proteins. The question of how bacteria exploit regulatory RNAs to make decisions between phenotypes is central to a general understanding of these universal regulators. We investigated the TisB/IstR‐1 toxin‐antitoxin system of Escherichia coli to appreciate the role of the RNA antitoxin IstR‐1 in TisB‐dependent depolarization of the inner membrane and persister formation. Persisters are phenotypic variants that have become transiently drug‐tolerant by arresting growth. The RNA antitoxin IstR‐1 sets a threshold for TisB‐dependent depolarization under DNA‐damaging conditions, resulting in two sub‐populations: polarized and depolarized cells. Furthermore, our data indicate that an inhibitory 5′ UTR structure in the tisB mRNA serves as a regulatory RNA element that delays TisB translation to avoid inappropriate depolarization when DNA damage is low. Investigation of the persister sub‐population further revealed that both regulatory RNA elements affect persister levels as well as persistence time. This work provides an intriguing example of how bacteria exploit regulatory RNAs to control phenotypic heterogeneity.
High‐resolution mapping of the recombination landscape of the phytopathogen Fusarium graminearum suggests two‐speed genome evolution
Authors: Laurent Benoit , Palaiokostas Christos , Spataro Cathy , Moinard Magalie , Zehraoui Enric , Houston Ross D. , Foulongne‐Oriol Marie
Published: December 2016

Recombination is a major evolutionary force, increasing genetic diversity and permitting efficient coevolution of fungal pathogen(s) with their host(s). The ascomycete Fusarium graminearum is a devastating pathogen of cereal crops, and can contaminate food and feed with harmful mycotoxins. Previous studies have suggested a high adaptive potential of this pathogen, illustrated by an increase in pathogenicity and resistance to fungicides. In this study, we provide the first detailed picture of the crossover events occurring during meiosis and discuss the role of recombination in pathogen evolution. An experimental recombinant population (n = 88) was created and genotyped using 1306 polymorphic markers obtained from restriction site‐associated DNA sequencing (RAD‐seq) and aligned to the reference genome. The construction of a high‐density linkage map, anchoring 99% of the total length of the reference genome, allowed the identification of 1451 putative crossovers, positioned at a median resolution of 24 kb. The majority of crossovers (87.2%) occurred in a relatively small portion of the genome (30%). All chromosomes demonstrated recombination‐active sections, which had a near 15‐fold higher crossover rate than non‐active recombinant sections. The recombination rate showed a strong positive correlation with nucleotide diversity, and recombination‐active regions were enriched for genes with a putative role in host–pathogen interaction, as well as putative diversifying genes. Our results confirm the preliminary analysis observed in other F. graminearum strains and suggest a conserved ‘two‐speed’ recombination landscape. The consequences with regard to the evolutionary potential of this major fungal pathogen are also discussed.
Down‐regulation of cladofulvin biosynthesis is required for biotrophic growth of Cladosporium fulvum on tomato
Authors: Griffiths Scott , Mesarich Carl H. , Overdijk Elysa J. R. , Saccomanno Benedetta , de Wit Pierre J. G. M. , Collemare Jérôme
Published: December 2016

Fungal biotrophy is associated with a reduced capacity to produce potentially toxic secondary metabolites (SMs). Yet, the genome of the biotrophic plant pathogen Cladosporium fulvum contains many SM biosynthetic gene clusters, with several related to toxin production. These gene clusters are, however, poorly expressed during the colonization of tomato. The sole detectable SM produced by C. fulvum during in vitro growth is the anthraquinone cladofulvin. Although this pigment is not detected in infected leaves, cladofulvin biosynthetic genes are expressed throughout the pre‐penetration phase and during conidiation at the end of the infection cycle, but are repressed during the biotrophic phase of tomato colonization. It has been suggested that the tight regulation of SM gene clusters is required for C. fulvum to behave as a biotrophic pathogen, whilst retaining potential fitness determinants for growth and survival outside its host. To address this hypothesis, we analysed the disease symptoms caused by mutant C. fulvum strains that do not produce or over‐produce cladofulvin during the biotrophic growth phase. Non‐producers infected tomato in a similar manner to the wild‐type, suggesting that cladofulvin is not a virulence factor. In contrast, the cladofulvin over‐producers caused strong necrosis and desiccation of tomato leaves, which, in turn, arrested conidiation. Consistent with the role of pigments in survival against abiotic stresses, cladofulvin protects conidia against UV light and low‐temperature stress. Overall, this study demonstrates that the repression of cladofulvin production is required for C. fulvum to sustain its biotrophic lifestyle in tomato, whereas its production is important for survival outside its host.
Changes in turnover rather than production regulate biomass of ectomycorrhizal fungal mycelium across a Pinus sylvestris chronosequence
Authors: Hagenbo Andreas , Clemmensen Karina E. , Finlay Roger D. , Kyaschenko Julia , Lindahl Björn D. , Fransson Petra , Ekblad Alf
Published: December 2016

In boreal forest soils, ectomycorrhizal fungi are fundamentally important for carbon (C) dynamics and nutrient cycling. Although their extraradical mycelium (ERM) is pivotal for processes such as soil organic matter build‐up and nitrogen cycling, very little is known about its dynamics and regulation.

In this study, we quantified ERM production and turnover, and examined how these two processes together regulated standing ERM biomass in seven sites forming a chronosequence of 12‐ to 100‐yr‐old managed Pinus sylvestris forests. This was done by determining ERM biomass, using ergosterol as a proxy, in sequentially harvested in‐growth mesh bags and by applying mathematical models.

Although ERM production declined with increasing forest age from 1.2 to 0.5 kg ha−1 d−1, the standing biomass increased from 50 to 112 kg ha−1. This was explained by a drastic decline in mycelial turnover from seven times to one time per year with increasing forest age, corresponding to mean residence times from 25 d up to 1 yr.

Our results demonstrate that ERM turnover is the main factor regulating biomass across differently aged forest stands. Explicit inclusion of ERM parameters in forest ecosystem C models may significantly improve their capacity to predict responses of mycorrhiza‐mediated processes to management and environmental changes.
Fetuin‐A, serum amyloid A and tumor necrosis factor alpha levels in periodontal health and disease
Authors: Türer ÇC , Ballı U , Güven B
Published: December 2016

Objectives

This study is evaluating fetuin‐A, serum amyloid A (SAA) and tumor necrosis factor alpha (TNF‐α) levels in gingival crevicular fluid (GCF) and serum samples in periodontal health and disease.

Material and Methods

Sixty patients were divided into three groups: Group 1 periodontal health (n = 20), Group 2 gingivitis (n = 20) and Group 3 chronic periodontitis (CP) (n = 20). GCF and serum samples were evaluated using enzyme‐linked immunosorbent assay kit.

Results

SAA and TNF‐α levels in GCF and serum were significantly higher in patients with gingivitis and CP compared with controls (P < 0.016). Contrarily, fetuin‐A levels in GCF and serum were significantly higher in controls than in patients with gingivitis and CP (P < 0.016). In CP group, a significant correlation was observed between GCF‐SAA amount and the number of sites with 4 ≤ PPD ≤ 5 mm (P < 0.05). There was a significant correlation between GCF‐fetuin‐A levels and the number of sites with PPD ≥ 6 mm (P < 0.05). GCF‐TNF‐α was found to have a significant relationship with the number of sites with 4 ≤ PPD ≤ 5 mm and PPD ≥ 6 mm (P < 0.05).

Conclusions

In conclusion, serum and total levels of SAA significantly increased, whereas fetuin‐A levels significantly decreased, with increasing severity of PD.
Prevention of Cardiac Implantable Electronic Device Infections: Single Operator Technique with Use of Povidone‐Iodine, Double Gloving, Meticulous Aseptic/Antiseptic Measures and Antibiotic Prophylaxis
Authors: MANOLIS ANTONIS S. , MELITA HELEN
Published: December 2016

Background

Cardiac implantable electronic device (CIED) implantation is complicated by infection still at a worrisome rate of 2–5%. Since early on during device implantation procedures, we have adopted an infection‐preventive technique which has hitherto resulted in effective prevention of infections. Herein we present our results of applying this technique by a single operator in a prospective series of 762 consecutive patients undergoing device implantation.

Methods

A meticulous search for and treatment of active, occult, or smoldering infection was undertaken preoperatively. An aseptic/antiseptic technique was used for implantation of each device. Skin preparation is thorough with initial cleansing performed with alcohol followed by povidone‐iodine 10% solution, which is also used in the wound and inside the pocket. In addition, we routinely use double gloving, and IV antibiotic prophylaxis 1 hour before and for 48 hours afterwards followed by oral antibiotic for 2–3 days after discharge. The skin is closed with absorbable sutures. The study includes 382 patients having a new pacemaker (n = 333) or battery change, system upgrade or lead revision (n = 49), and 380 patients having a new implantable cardioverter‐defibrillator (ICD) (n = 296) or device replacement/upgrade/lead revision (n = 84).

Results

The pacemaker group, aged 70.2 ± 16.5 years, includes 18% VVI, 49% DDD, 29% VDD, and 4% cardiac resynchronization therapy (CRT) devices. The ICD group, aged 61.3 ± 13.0 years, with a mean ejection fraction of 36 ± 13%, includes 325 ICD and 55 CRT implants. Over 26.6 ± 33.4 months for the pacemaker group and 36.6 ± 38.3 months for the ICD group, infection occurred in one patient in each group (0.26%) having a device replacement.

Conclusion

A consistent and strict approach of aseptic/antiseptic technique with the use of double gloving and povidone‐iodine solution within the pocket plus a 4‐day regimen of antibiotic prophylaxis minimizes infections in CIED implants.
The Neutrophil‐to‐Lymphocyte Ratio Predicts All‐Cause Mortality in Patients with Implantable Cardioverter Defibrillators
Authors: HASHIMOTO NAOAKI , ARIMOTO TAKANORI , NARUMI TARO , IWAYAMA TADATERU , KUTSUZAWA DAISUKE , ISHIGAKI DAISUKE , KUMAGAI YU , TAMURA HARUTOSHI , NISHIYAMA SATOSHI , TAKAHASHI HIROKI , SHISHIDO TETSURO , MIYAMOTO TAKUYA , WATANABE TETSU , KUBOTA ISAO
Published: December 2016

Background

The relationship between the neutrophil‐to‐lymphocyte ratio (NLR) and outcome in patients with implantable cardioverter‐defibrillators (ICDs) is unclear.

Methods and Results

Consecutive patients with cardiomyopathy who had received an ICD (n = 120, mean age 64 ± 11 years) were prospectively enrolled. Blood samples were obtained on the morning of the day of implantation. Patients were followed for a median period of 61.2 months, to an endpoint of all‐cause mortality or appropriate ICD shock, which occurred in 35 (29%) and 28 (23%) patients, respectively. Multivariate Cox analysis revealed that secondary prevention was only associated with appropriate ICD shocks. The NLR, brain natriuretic peptide level, and estimated glomerular filtration rate were independent predictors of all‐cause mortality but not of appropriate ICD shocks. Subgroup analysis revealed that a high NLR (≥2.1) was valuable for anticipating all‐cause mortality among patients who had received ICDs for primary or secondary prevention. A high NLR was also associated with death prior to appropriate ICD shock.

Conclusion

Evaluating the NLR may be useful for predicting outcomes in patients with cardiomyopathy who have received ICDs.
FROM RED TAPE TO WHICH PERFORMANCE RESULTS? EXPLORING THE RELATIONSHIP BETWEEN RED TAPE AND VARIOUS DIMENSIONS OF PERFORMANCE IN HEALTHCARE WORK UNITS
Authors: VAN LOON NINA M.
Published: December 2016

Decades of research on red tape have still to provide final answers as to whether red tape reduces performance. This may be due to not distinguishing the different dimensions that public service performance consists of. Shifting the focus to rules and their characteristics, this study analyses how the degree of compliance burden and lack of functionality of rules relates to overall and dimensional public performance. Building upon the argument that red tape reduces resources and motivation and by doing so influences performance, hypotheses are put forward regarding the relationship to performance. Using red tape reports from employees in 49 work units and performance rated by the supervisor, this study shows that performance is at its lowest when the rules have a high compliance burden and lack functionality. Moreover, the dimensional analyses show that compliance burden may be most detrimental for output, whereas lack of functionality reduces responsiveness and democratic outcomes.
Maternal prenatal stress and child atopic dermatitis up to age 2 years: The Ulm SPATZ health study
Authors: Braig Stefanie , Weiss Johannes M. , Stalder Tobias , Kirschbaum Clemens , Rothenbacher Dietrich , Genuneit Jon
Published: December 2016

Background

Evidence linking maternal psychosocial stress during pregnancy to subsequent child atopic dermatitis (AD) is growing, but the definition of AD is diverse and results are inconsistent. We aimed to analyze the relationship between stress and AD using alternative measurements of stress and AD.

Methods

In the Ulm SPATZ Health Study, chronic stress and symptoms of anxiety and depression were assessed by standardized self‐reported questionnaires in 934 mothers of singletons following delivery in Ulm, Germany, from 04/2012‐05/2013. Maternal hair cortisol concentrations (HCCs, n = 626) at childbirth and the cumulative incidences of parent‐reported child AD symptoms, parent‐, and pediatrician‐reported AD diagnoses were assessed until age 2 years (n = 787). Overall, 205 dermatologic examinations were performed in 167 children showing AD symptoms. Crude and adjusted risk ratios (RR, aRR) with 95% confidence intervals were estimated.

Results

Maternal stress and anxiety were associated with child AD symptoms by trend (RR and aRR: 1.5 (1.0,2.3) for the highest vs. the lowest quarter of chronic stress; aRR: 1.4 (1.0,2.0) for possible anxiety symptoms vs. no symptoms). No relationship was found between stress or related constructs and AD diagnoses nor could we show consistent associations between maternal HCC and child AD. However, a higher RR of child AD was evident in families not yet affected by AD in siblings given maternal depressive symptoms, examined in the crude model.

Conclusions

Stress measurements or related constructs are linked to AD symptoms, but association with AD diagnoses is limited. The reason for this divergence still needs further research.
Validation of the Greek Version of the Fibromyalgia Rapid Screening Tool
Authors: Zis Panagiotis , Brozou Vassiliki , Stavropoulou Evmorfia , Argyra Erifilli , Siafaka Ioanna , Kararizou Evangelia , Bouhassira Didier , Perrot Serge , Zis Vassileios , Vadalouca Athina
Published: December 2016

Background and Aim

The Fibromyalgia Rapid Screening Tool (FiRST) is a brief, simple, and straightforward self‐administered questionnaire that was developed by Perrot et al. for the detection of fibromyalgia syndrome in patients with diffuse chronic pain. The aim of our study was to develop and validate the Greek version of FiRST.

Methods

The study was set up as a prospective observational study. The original French version of FiRST was adapted into Greek using forward and backward translation. Patients with chronic diffuse pain with a clinical diagnosis of fibromyalgia and osteoarthritis based on the criteria of the American College of Rheumatology were invited to participate to the study.

Results

Of the 101 patients who met our inclusion criteria, 42 were diagnosed with fibromyalgia and 59 with osteoarthritis. The 2 groups did not differ significantly regarding gender and pain characteristics (duration, intensity). Cronbach's alpha coefficient was 0.79. Receiver operating characteristic analysis showed an area under the curve of 89% (95% confidence interval = 83 to 95%; SE: 0.032, P < 0.001). At a cutoff score of ≥ 5, FiRST showed a sensitivity of 86%, a specificity of 83%, a positive predictive value of 78%, and a negative predictive value of 89%. The intraclass coefficient for the test–retest reliability was 0.96.

Conclusion

The Greek version of FiRST is a valid screening tool for fibromyalgia in daily practice.
Postoperative Pain Control Following Craniotomy: A Systematic Review of Recent Clinical Literature
Authors: Tsaousi Georgia G. , Logan Simon W. , Bilotta Federico
Published: December 2016

Background

Pain intensity after craniotomy is considered to be moderate to severe during the first 2 postoperative days. The ideal pain treatment to facilitate a rapid postoperative recovery and optimize outcome is unknown.

Objectives

This systematic review aims to report current clinical evidence related to pharmacological and adjuvant analgesic modalities for postcraniotomy pain control.

Design

Systematic review of randomized controlled trials (RCTs).

Data Sources

PubMed, EMBASE, and Cochrane Central Register of Controlled Trials (January 2011 to April 2016).

Eligibility Criteria

Original research involving the use of any analgesic drug, analgesic method, or nonpharmacological intervention for postcraniotomy pain relief, as assessed by pain scores up to 48 hours postoperatively, supplemental analgesic requirements, or occurence of adverse events.

Results

Nineteen RCTs enrolling a total of 1,805 patients were included. Most of the retrieved studies were of moderate‐to‐good methodological quality. Systemic pharmacological intervention was assessed in 14 RCTs. Opioids (5 RCTs) provided superior pain relief to other analgesics with no significant side effects, but the quality of studies was low. Diclofenac (3 RCTs) presented adequate craniotomy pain control without any adverse effects, while the use of parecoxib is not supported. Dexmedetomidine (3 RCTs) provided adequate transitional analgesia, but further research is needed. Data on the analgesic efficacy of gabapentin, pregabalin, and intravenous lidocaine are very limited (1 RCT for each). Scalp infiltration/block (3 RCTs) provided adequate analgesia in the early postoperative period, while more studies are needed to verify the analgesic benefit obtained from nonpharmacological interventions, such as multipoint electro‐acupuncture, in craniotomy surgery (2 RCTs).

Conclusions

No definite recommendations can be made based on this systematic review of pharamacological interventions following craniotomy due to significant divergence in the methodology of available studies. Limited evidence on scalp infiltration/block suggests an adequate analgesic effect in the early postoperative period. Analgesic efficacy of dexmedetomidine and multipoint electro‐acupuncture needs further evaluation.
Altering carbon allocation in hybrid poplar (Populus alba × grandidentata) impacts cell wall growth and development
Authors: Unda Faride , Kim Hoon , Hefer Charles , Ralph John , Mansfield Shawn D.
Published: December 2016

Galactinol synthase is a pivotal enzyme involved in the synthesis of the raffinose family of oligosaccharides (RFOs) that function as transport carbohydrates in the phloem, as storage compounds in sink tissues and as soluble metabolites that combat both abiotic and biotic stress in several plant species. Hybrid poplar (Populus alba × grandidentata) overexpressing the Arabidopsis thaliana GolS3 (AtGolS3) gene showed clear effects on development; the extreme overexpressing lines were stunted and had cell wall traits characteristic of tension wood, whereas lines with only moderate up‐regulation grew normally and had moderately altered secondary cell wall composition and ultrastructure. Stem cross‐sections of the developing xylem revealed a significant increase in the number of vessels, as well as the clear presence of a G‐layer in the fibres. Furthermore, AtGolS3‐OE lines possessed higher cellulose and lower lignin contents, an increase in cellulose crystallinity, and significantly altered hemicellulose‐derived carbohydrates, notably manifested by their mannose and xylose contents. In addition, the transgenic plants displayed elevated xylem starch content. Transcriptome interrogation of the transgenic plants showed a significant up‐regulation of genes involved in the synthesis of myo‐inositol, along with genes involved in sucrose degradation. The results suggest that the overexpression of GolS and its product galactinol may serve as a molecular signal that initiates metabolic changes, culminating in a change in cell wall development and potentially the formation of tension wood.
Correlates of sun protection behaviors among Hispanic children residing in a high UVR environment
Authors: Miller Kimberly A. , Huh Jimi , Unger Jennifer B. , Richardson Jean L. , Allen Martin W. , Peng David H. , Cockburn Myles G.
Published: December 2016

Background/Purpose

Rates of melanoma are rising in Hispanics in the United States. Excessive sun exposure in childhood increases the risk of melanoma in adulthood, and little is known about the factors motivating sun protection behaviors among Hispanic youth.

Methods

Correlates of sun protection were examined among Hispanic children residing in Los Angeles, California (N = 1891). Associations between multiple constructs (psychosocial, familial, and cultural) and sun protection outcomes (use of sunscreen, protective clothing, and shade seeking/sun avoidance) were examined.

Results

Family variables were associated with more frequent sun protection among Hispanic children across outcomes, as were perceived peer norms, perceived self‐efficacy, and fewer sun protection barriers. Skin cancer risk factors such as lighter skin and sunburn experience, and level of acculturation were not associated with greater sun protection.

Conclusion

Family sun protection habits are instrumental to Hispanic children's sun safe behaviors, and interventions that engage the family may be most effective. Increasing risk communication to high‐risk subgroups of Hispanic children (those with lighter, more sun reactive skin) is important when developing intervention strategies. However, there is overlap between Hispanic children's sun protection correlates and those observed among non‐Hispanic white children, suggesting that interventions to improve sun protection may generalize across cultural contexts.
Characterization and silencing of the fatty acid‐ and retinol‐binding Pp‐far‐1 gene in Pratylenchus penetrans
Authors: Vieira P. , Kamo K. , Eisenback J. D.
Published: December 2016

Fatty acid‐ and retinol‐binding proteins (FARs) are unique to nematodes, and are implicated in a wide range of metabolic and parasitic related functions. Along with the in silico analyses performed in this study, three different FAR members of this family were identified in Pratylenchus penetrans. The cDNA corresponding to the fatty acid‐ and retinol‐binding Pp‐far‐1 gene was cloned and herein characterized at the molecular level for the first time for this genus. The translated 185 amino acid sequence of P. penetrans FAR‐1 sequence, with a predicted molecular weight of 20.82 kDa and a pI of 5.49, shares highest sequence identity to FARs of other migratory nematodes of the Pratylenchidae family (90% to P. vulnus and 80% to Radopholus similis). In situ hybridization localizes Pp‐far‐1 transcripts in the hypodermis of the nematode. RT‐qPCR detected Pp‐far‐1 transcripts for all nematode developmental stages, with highest expression levels found in juveniles, adult females and adult males, respectively. Pp‐far‐1 is also highly expressed during infection and establishment of P. penetrans in roots of different host plants, such as corn, lily and soybean. The importance of Pp‐far‐1 was studied by in planta RNA interference (RNAi) assays using stable soybean hairy root lines. Targeting Pp‐far‐1 decreased expression of the nematode Pp‐far‐1 and significantly reduced the reproduction of nematodes, with a total of between 44% and 70% fewer nematodes in comparison to the average number of nematodes counted for control lines. The results indicate that suppressing the expression levels of Pp‐far‐1 can act as an effective target gene to control P. penetrans.
Light and temperature effects on photosynthetic activity of Eucheuma denticulatum and Kappaphycus alvarezii (brown and green color morphotypes) from Sulawesi Utara, Indonesia
Authors: Borlongan Iris Ann G. , Gerung Grevo S. , Nishihara Gregory N. , Terada Ryuta
Published: December 2016

Knowledge concerning the effects of several abiotic factors on the physiology of carrageenophytes is essential both in ecological and economic standpoints, to ensure their sufficient supply for the sustainability of seaweed‐based industries. This paper presents the photosynthetic characteristics of farmed carrageenophytes,
E

ucheuma denticulatum and
K

appaphycus alvarezii [brown (BRN) and green (GRN) color morphotypes] from Sulawesi Utara (Sulawesi Island), Indonesia, as determined by examining their photosynthetic response across different temperatures and irradiances using dissolved oxygen measurements and pulse‐amplitude modulated fluorometer. Net photosynthesis–irradiance (
P

–

E
) curves at 26°C revealed that net photosynthetic rates of the three seaweeds gradually increased until the estimated saturation irradiances (
E

k
) of 58 μmol photons m−
2 s−1 (49–68 μmol photons m−
2 s−1, 95% Bayesian prediction intervals; BPI) for
E

. denticulatum, and 158 and 143 μmol photons m−
2 s−1 (134–185 and 99–203 μmol photons m−
2 s−1, 95% BPI) for BRN and GRN K

. alvarezii, respectively; and that no photoinhibition was observed at the highest irradiance of 1000 μmol photons m−
2 s−1. All seaweed samples exhibited photosynthetic tolerance to high PAR as shown by their recovery in maximum quantum yields (Fv

/
Fm
) following chronic exposures; as well as tolerance over a broad range of temperature, which is from 19 to 33°C for
E

. denticulatum, 20–29°C for BRN K

. alvarezii, and 17–32°C for GRN K

. alvarezii. Temperature responses of these carrageenophytes indicated that they were well‐adapted to the annual seawater temperatures in the cultivation site; however, they are also likely close to threshold levels for thermal inhibition, given the decline in Fv

/
Fm
above 30°C.