bluuebunny/crossref_metadata_2025 huggingface dataset:
Impacts of urban stream pollution: A comparative spatial hedonic study of high‐rise residential buildings in Guangzhou, south China
Authors: Chen Wendy Y. , Li Xun
Published: April 2018

Urban streams are scarce natural elements in compact cities, and suffer from pollution in the course of city expansion and densification, especially in developing nations like China. They may offer the amenity of a riverscape view, but also the dis‐amenity associated with water pollution. Yet whether and how polluted urban streams affect high‐rise residential property values remain under‐investigated. Based on a total of 315 transaction records of apartment sales in two residential precincts located near two typical urban streams in Guangzhou, south China, this study attempts to assess the impacts of urban river pollution, in terms of view and proximity, at a neighbourhood level. A novel “cube contiguity”, consisting of a three‐dimensional spatial weighting matrix, is developed to incorporate the effect of property height in hedonic price models. Comparison of the spatial hedonic analysis of the two selected residential precincts reveals that views of heavily polluted urban streams fail to command a premium, and the impacts of proximity to urban streams vary considerably in high‐rise, compact urban contexts, when micro‐level landscape variations are carefully represented in hedonic modelling. This could be associated with the hydro‐morphological features and riverine landscape, as well as with homebuyers’ subjective perception of river pollution. Assessing the impacts of urban stream pollution could provide a basis for understanding the negative externalities of urban river pollution, establishing priorities for restoring polluted urban streams, and planning the provision of multi‐functional green‐blue spaces with respect to homebuyers’ demand for environmental amenities in mid‐ and high‐rise housing markets in both developed and developing nations.
An unusual cause of gastrointestinal bleeding in a hemodialysis patient
Authors: Aron Julien , Couturier Aymeric , Sinayoko Leila , Duedal Viviane , Ridel Christophe , Touzot Maxime
Published: April 2018

Iron deficiency caused by gastrointestinal (GI) bleeding is a common cause of anemia in hemodialysis patient. Herein, we report the case of an 89‐year‐old hemodialysis patient who presented with acute anemia and melena. Endoscopy found gastritis and diverticulosis without active bleeding. A capsule endoscopy (CE) was then performed and revealed multiple vascular lesions that lead to the diagnosis of Blue Rubber Bleb Nevus syndrome (BRBNS). This rare disease is associated with multiple venous malformations in the skin and the GI tract, usually observed in children. The patient developed 4 months latter 2 skin lesions compatible with BRBNS. Treatment included blood transfusion and intravenous iron supplementation. We reported an unusual presentation of venous malformation BRBS which differs from angioectasia, in an adult hemodialysis patient. Overall prognosis is good
A discontinuity in the late Pleistocene alluvial deposits, Hwacheon‐ri, Gyeongju, Korea: Occurrences and paleoenvironmental implication
Authors: Lee Hoil , Paik In Sung , Kim Hyun Joo , Kang Hee‐Cheol , Seol Won Gyeong , Lee Jin‐Young
Published: April 2018

A sedimentary discontinuity is present in the late Pleistocene alluvial deposits exposed along the cliff in stream side, Gyeongju, Korea. Sedimentological study, Optically Stimulated Luminescence (OSL) age dating, and X‐ray diffraction (XRD), and X‐ray fluorescence spectrometer (XRF) analyses were conducted in order to interpret the origin of the discontinuity surface. Based on the sedimentological study, these deposits can be divided into three distinct stages, in ascending order: (Stage 1) development of a braided stream flowing from south to north and deposition by debris flows from the mountain aside the stream during and/or after deposition of the braided stream; (Stage 2) deposition by intermittent events during a state of stagnation after the abandonment or migration of the previously existed braided stream; and (Stage 3) deposition of gravels from debris flows from the mountain aside the stream. Hornfelsic gravels are common in Stage 1, whereas andesitic gravels are predominant in Stage 3, suggesting the provenance change from Stage 1 to Stage 3. The discontinuity surface is laterally extensive and marked by a distinct carbonaceous dark grey horizon between Stage 2 and Stage 3. It is characteristic that rootlets mineralized by vivianite are present, and iron‐oxide crusts are cutting across irregularly below the discontinuity surface. It is thus interpreted that the shift of depositional environment from an alluvial plain (Stage 2) (125 ka) to an alluvial fan (Stage 3) (94–55 ka) was an alluvial response to sea level change from the interglacial to the glacial. The development of iron‐oxide crusts and diagenetic vivianite in the discontinuity surface suggests humid condition persisted during the paleoclimatic shift from the last interglacial to the last glacial stages.
Evaluation of substantivity of hypochlorous acid as an antiplaque agent: A randomized controlled trial
Authors: Lafaurie GI , Zaror C , Díaz‐Báez D , Castillo DM , De Ávila J , Trujillo TG , Calderón‐Mendoza J
Published: April 2018

Background

Hypochlorous acid (HOCl) is a non‐antibiotic antimicrobial substance with significant effects on pathogenic oral micro‐organisms. The effects of HOCl as an antiplaque agent have not been studied.

Objective

The aim of this study was to evaluate the substantivity of HOCl mouthwashes compared with chlorhexidine (CHX) rinses and a placebo.

Materials and Methods

A double‐blind randomized controlled trial with 75 participants was conducted. Participants were divided into five groups using block randomization: 0.025% HOCl, 0.05% HOCl, 0.12% CHX, 0.2% CHX, and sterile water as a placebo. Participants were instructed to use each rinse solution for 30 seconds after dental prophylaxis. Samples of saliva were taken at baseline and after 30 seconds, 1, 3, 5 and 7 hours to assess substantivity, and bacterial viability was established by the fluorescence method. Visible plaque in all participants was assessed with the Turesky index at baseline and at 7 hours, and adverse events were also assessed.

Results

HOCl led to a 33% reduction in bacterial counts in the saliva after 30 seconds compared with a 58% reduction by CHX. HOCl has no substantivity, and bacterial counts returned to baseline after 1 hour. Placebo treatment led to the highest plaque count after 7 hours compared with the CHX and HOCl groups, although the differences were not significant. HOCl rinsing induced the highest percentages of unpleasant taste and dryness sensations.

Conclusions

HOCl rinses have an initial effect on bacterial viability in saliva but have no substantivity. Other mechanisms may explain its antiplaque effect.
Effectiveness of a telephone follow‐up nursing intervention in postsurgical patients
Authors: Santana Rosimere Ferreira , Pereira Shimmenes Kamacael , do Carmo Thalita Gomes , Freire Vanessa Emille Carvalho de Sousa , Soares Thais da Silva , do Amaral Dayana Medeiros , Vaqueiro Raquel Dantas
Published: April 2018

Background

Surgical recovery can be defined as the days required to initiate activities that maintain life, health, and well‐being.

Aim

The main study objective was to compare the effectiveness of telephone versus conventional follow‐up in postsurgical older adult patients.

Methods

This is a quasi‐experimental study with random sampling. Postsurgical patients over 60 years old who had undergone gastrectomy and colectomy were selected from 2 hospitals and randomly divided into intervention group (22 patients) and control group (21 patients). Data collection was performed from January to September 2014. The differences in surgical recovery between the control and intervention groups were measured at 48 hours, 4 weeks, and 8 weeks after surgery.

Results

Patients in the control group took significantly longer duration in the length of surgical recovery from the first to the second (P = .007) and to the third evaluation time points (P = .013). Patients in the intervention group had significant less impaired mobility (P = .003), need for assistance for self‐care (P = .009), fatigue (P = .048), and time required for recuperation (P = .048).

Conclusion

Telephone follow‐up reduced the occurrence of delayed surgical recovery.
Frontline workers' competency in activation work
Authors: Sadeghi Talieh , Fekjær Silje Bringsrud
Published: April 2018

Frontline workers play a crucial role in implementing activation policies. Nevertheless, research on what competencies are required for activation work is limited. We explored activation competency based on a survey of 1,735 frontline workers in the Norwegian labour and welfare administration. Factor analysis revealed two distinct underlying dimensions in activation competency: market competency and user‐oriented competency. We found that the social workers in the study viewed themselves as having significantly less market competency and slightly more user‐oriented competency than non‐social workers have, but the differences were small. The results also indicate that these effects are partially mediated by attitudes towards conditionality. The results give reason to treat activation competencies as twofold and raise the question of whether social work education improves frontline workers' competency in activation work compared with frontline workers with other educational backgrounds.
Between Enforcement and Precarity: Externalization and Migrant Deaths at Sea
Authors: Williams Kira , Mountz Alison
Published: April 2018

Much scholarship on border enforcement and loss of life asserts the relationship between enforcement and precarity. Little research attempts to correlate the two: enforcement operations and loss of life. In this article, we statistically analyse the relationship between increased border enforcement operations at sea and migrant losses of life around the EU between 2006 and 2015, and find them to be significantly and positively correlated. We also find evidence that increased enforcement leads to rerouting of migrant journeys to ‘weak spots’ in relation to borders. These findings bring empirical support to the commonly‐asserted claim by social scientists that externalization creates greater loss of life. We argue that, although discourse about interception and externalization has shifted to humanitarian rescue narratives, offshore enforcement by any other name continues to be highly correlated with migrant deaths. We then construct two datasets documenting migrant boats lost at sea and state interdiction operations since 1980. These data serve as the basis of our statistical analysis.
On the nonlinear behavior of Young's modulus of carbon‐bonded alumina at high temperatures
Authors: Luchini Bruno , Grabenhorst Joern , Fruhstorfer Jens , Pandolfelli Victor C. , Aneziris Christos G.
Published: April 2018

The origin of the nonlinear behavior of the Young's modulus (E) of carbon‐bonded alumina at high temperatures was addressed, based on the microstructural changes observed during processing and their thermo‐mechanical properties. Impulse excitation technique, thermogravimetric analysis, porosity measurement, and scanning electron microscopy were conducted in order to highlight and explain the E behavior. The finite element model of a virtual microstructure was simulated and the results attained are in good agreement with the experimental data. The tests revealed that the Young's modulus of a cured sample heated from room temperature up to 500°C was governed by the release of volatiles. Above this temperature, the thermal expansion mismatch among alumina, graphite, and the carbon matrix is dominant resulting in an increase in the effective Young's modulus. During cooling, crack networks and gaps between alumina particles and the carbon matrix were developed. The former were induced by volatile release and by the graphite's highly anisotropic thermal expansion. The latter was derived by the thermal expansion mismatch between the alumina and the carbon matrix. The closure of the gaps and cracks governed the expansion behavior during the second heating cycle and a nonlinear effective Young's modulus increase as a function of temperature was observed.
Historical Emissions and the Carbon Budget
Authors: Moss Jeremy , Kath Robyn
Published: April 2018

How should the world's remaining carbon budget be divided among countries? We assess the role of a fault‐based principle in answering this question. Discussion of the role of historical emissions in dividing the global carbon budget has tended to focus on emissions before 1990. We think that this is in part because 1990 seems so recent, and thus post‐1990 emissions seem to constitute a lesser portion of historical emissions. This point of view was undoubtedly warranted in the early 1990s, when discussion of fault‐based principles in this context began. While this view still has some intuitive force, we find that it and the associated focus on pre‐1990 emissions are now out of date. Emissions since 1990 in fact constitute a large and rapidly increasing proportion of emissions since 1750 – approximately half of the carbon emissions due to fossil fuel use and cement production, at the time of writing. We show that a restricted fault‐based principle, according to which emissions should be divided among countries on the basis of their emissions since 1990, is both viable and powerful. We consider standard objections to a fault‐based principle in this context, how such a principle might more concretely be applied, and its likely implications.
Comparisons of self and proxy report on health‐related factors in people with intellectual disability
Authors: Scott Haleigh M. , Havercamp Susan M.
Published: April 2018

Background

The intellectual disability field has learned about the lives of people with intellectual disabilities (ID), largely from the perspective of their family and caregivers. Information from caregivers has been critical to scientific advancement, especially when caregivers are engaged on behalf of individuals with significant language impairment. On the other hand, the perspective of individuals with ID themselves is critical for internal subjective content such as thoughts and feelings.

Methods

Participants were 90 adults with ID and a proxy of their choosing.

Results

Overall, self and caregiver report were significantly related for subjective health but varied for physical activity, social support and stress.

Conclusions

These findings add to the growing literature establishing the importance of considering the self‐report of adults with ID, particularity when the subject matter focuses on internal thoughts or feelings. Clinical considerations for the use of self and proxy report are discussed.
When distributive justice and gender stereotypes coincide: Reactions to equity and equality violations
Authors: Caleo Suzette
Published: April 2018

The current study explores how prescriptive gender stereotypes shape reactions to resource allocations. Starting from the premise that the equity norm necessitates stereotypically male behavior and the equality norm necessitates stereotypically female behavior, I propose that men and women face differing consequences for violating equity and equality. These ideas were tested in two experiments, with participants reviewing how a manager divided resources between subordinates. Results partially supported the hypotheses. Although findings indicate that decision makers were evaluated negatively for using equality in a situation that called for equity, men received less favorable ratings and were viewed as less agentic than women for this violation. This work suggests that distributive justice norms and prescriptive gender stereotypes can exert a combined effect on reactions to allocation decisions.
Teaching self‐regulation strategies via an intelligent tutoring system (TuinLECweb): Effects for low‐skilled comprehenders
Authors: Serrano M.‐Á. , Vidal‐Abarca E. , Ferrer A.
Published: April 2018

The use of documents to perform tasks is a continuous task demand in the current knowledge‐based society that involves making a series of decisions to self‐regulate the use of text information. Low‐skilled comprehenders have serious problems monitoring and self‐regulating their decisions in these task‐oriented reading situations, which has a negative impact on performance and merits instructional interventions in school settings. Intelligent tutoring systems have emerged as effective tools to teach strategic skills. Herein, we present TuinLECweb, an intelligent tutoring system that teaches monitoring and self‐regulation strategies to young adolescents. Study 1 explores whether high‐skilled and low‐skilled comprehenders respond to the intervention with TuinLECweb differently in terms of task‐oriented reading performance and monitoring accuracy of nonsearch decisions. The results show that the intervention with TuinLECweb primarily benefits low‐skilled comprehenders. Study 2 compares the efficacy of TuinLECweb over a classroom intervention for low‐skilled comprehenders. The results reveal that TuinLECweb training improves monitoring accuracy of nonsearch decisions over and above classroom instruction. Both studies also reveal that low‐skilled comprehenders use the strategies learned beyond the time of training. Our results provide arguments in favour of using computer‐assisted programs in strategy instruction.
Prediction of ventricular tachyarrhythmia in Brugada syndrome by right ventricular outflow tract conduction delay signs
Authors: Ragab Ahmed A.Y. , Houck Charlotte A. , van der Does Lisette J.M.E. , Lanters Eva A.H. , Muskens Agnes J.Q.M. , de Groot Natasja M.S.
Published: April 2018

Background

Brugada syndrome (BrS) is an autosomal dominant disease responsible for sudden cardiac death in young individuals without structural anomalies. The most critical part in the management of this channelopathy is identification of high‐risk patients, especially asymptomatic subjects. Prior studies have shown that conduction delay in the right ventricular outflow tract (RVOT) is the main mechanism for developing ventricular tachyarrhythmia (VTA) in BrS patients. The aim of this study was to investigate the significance of electrocardiographic RVOT conduction delay parameters as predictors for development of VTA in patients with BrS.

Methods and results

We retrospectively analyzed electrocardiograms obtained from 147 BrS patients (43 ± 15 years, 65% men) and assessed the following electrocardiographic parameters: (1) Tzou criteria (V1R > 0.15 mV, V6S > 0.15 mV, and V6S:R > 0.2), (2) prominent S wave in lead I, lead II, and lead III, (3) SII > SIII, and (4) prominent Q wave in lead III as possible predictors of VTA occurrences during follow‐up. Prominent SI, SII, SIII, SII > SIII, QIII, and +ve Tzou criteria occurred more frequently in patients who either presented with VTA or developed VTA during the follow‐up of 56 (IQR: 40–76) months. SII > SIII has the highest area under the curve for prediction of VTA (AUC: 0.84, sensitivity: 80%, specificity: 89%). Multivariable regression analysis showed that prominent S waves in lead I, SII > SIII and +ve Tzou criteria are independent predictors for VTA in BrS patients.

Conclusion

Prominent S in lead I, SII > SIII and +ve Tzou criteria can be used as effective signs for predicting VTA in patients with BrS.
Relationship between vitamin D receptor gene polymorphism and susceptibility to chronic kidney disease and periodontal disease in community‐dwelling elderly
Authors: Yoshihara Akihiro , Kaneko Noboru , Iwasaki Masanori , Nohno Kaname , Miyazaki Hideo
Published: April 2018

Objectives

The aim of this study was to investigate the possible correlation between vitamin D receptor (VDR) gene polymorphism and susceptibility to chronic kidney disease (CKD) and periodontal disease.

Material and Methods

This study analysed 345 participants, who were all 79 years of age. Kidney function levels were determined based on the estimated glomerular filtration rate (eGFR; non‐reduced function: ≥60 and reduced function: <60 ml min−1 1.73 m−2). VDR TaqI genotyping was also studied. We calculated the periodontal inflamed surface area (PISA). After classifying participants into quartile groups according to eGFR or PISA values, the subjects were then split into two groups (highest quartile versus the other three groups combined). Multiple logistic regression analysis was performed to evaluate the odds ratios between the eGFR and VDR TaqI genotype with the different PISA groups. The eGFR was set as the dependent variable while the VDR TaqI genotype, HbA1C, gender, smoking habits and body mass index were defined as independent variables.

Results

A significant association was observed between the VDR TaqI genotype and eGFR in the PISA high group (odds ratio = 3.97, p = .027).

Conclusion

Study results suggest that VDR TaqI genotype might be associated with CKD during inflammatory conditions caused by periodontal disease.
Drug fever and acute inflammation from hypercytokinemia triggered by dipeptidyl peptidase‐4 inhibitor vildagliptin
Authors: Anno Takatoshi , Kaneto Hideaki , Kawasaki Fumiko , Shigemoto Ryo , Aoyama Yumi , Kaku Kohei , Okimoto Niro
Published: April 2018

A 69‐year‐old man started taking the dipeptidyl peptidase‐4 inhibitor, vildagliptin. One week later, C‐reactive protein and plasma immunoglobulin E levels were markedly elevated, and the vildagliptin was stopped. After the patient's laboratory findings were normalized, we decided to restart vildagliptin with the patient's agreement. The next day, he had a high fever, and C‐reactive protein and procalcitonin levels were elevated. Although we failed to find a focus of infection, we started antibiotics therapy. Two days later, the high fever had improved, and the C‐reactive protein level had decreased. A drug lymphocyte stimulation test showed a positive result for vildagliptin. We examined various kinds of cytokine and infection markers just before and after the treatment with vildagliptin. Finally, we diagnosed the patient with vildagliptin‐induced drug fever, probably based on the increase of various inflammatory cytokine levels and the response to this. Taken together, we should be aware of the possibility of vildagliptin inducing drug fever and/or acute inflammation.
Advance Care Planning in Frail Older Adults: A Cluster Randomized Controlled Trial
Authors: Overbeek Anouk , Korfage Ida J. , Jabbarian Lea J. , Billekens Pascalle , Hammes Bernard J. , Polinder Suzanne , Severijnen Johan , Swart Siebe J. , Witkamp Frederika E. , van der Heide Agnes , Rietjens Judith A.C.
Published: April 2018

Objectives

To determine the effectiveness of advance care planning (ACP) in frail older adults.

Design

Cluster randomized controlled trial.

Setting

Residential care homes in the Netherlands (N=16).

Participants

Care home residents and community‐dwelling adults receiving home care (N=201; n=101 intervention; n=100 control). Participants were 75 years and older, frail, and capable of consenting to participation.

Intervention

Adjusted Respecting Choices ACP program.

Measurements

The primary outcome was change in patient activation (Patient Activation Measure, PAM‐13) between baseline and 12‐month follow‐up. Secondary outcomes included change in quality of life (SF‐12), advance directive (AD) completion, and surrogate decision‐maker appointment. Use of medical care in the 12 months after inclusion was also assessed. Multilevel analyses were performed, controlling for clustering effects and differences in demographics.

Results

Seventy‐seven intervention participants and 83 controls completed the follow‐up assessment. There were no statistically significant differences between the intervention (–0.26±11.2) and control group (–1.43±10.6) in change scores of the PAM (p=.43) or the SF‐12. Of intervention group participants, 93% completed an AD, and 94% appointed a decision‐maker. Of control participants, 34% completed an AD, and 67% appointed a decision‐maker (p<.001). No differences in the use of medical care were found.

Conclusions

ACP did not increase levels of patient activation or quality of life but did increase completion of ADs and appointment of surrogate decision‐makers. It did not affect use of medical care.
Interdisciplinary Home Visits for Individuals with Advanced Parkinson's Disease and Related Disorders
Authors: Fleisher Jori , Barbosa William , Sweeney Meghan M. , Oyler Sarah E. , Lemen Amy C. , Fazl Arash , Ko Mia , Meisel Talia , Friede Naomi , Dacpano Geraldine , Gilbert Rebecca M. , Di Rocco Alessandro , Chodosh Joshua
Published: April 2018

Parkinson's disease (PD) is a complex, multisymptom, neurodegenerative disease affecting primarily older adults. With progression, many individuals become homebound and removed from coordinated, expert care, resulting in excess morbidity, mortality, and healthcare expenditures in acute care settings and institutions. Home visit care models have achieved the triple aim of improving individual and population health while reducing costs in many frail, community‐dwelling geriatric cohorts. This study details a novel, interdisciplinary home visit program specifically designed for individuals with PD and related disorders and their family caregivers built upon best practice principles in the care of multimorbid older adults. At each quarterly home visit, a movement disorders–trained neurologist, social worker, and nurse work in parallel with the individual and caregiver to complete a history, physical, detailed medication reconciliation, psychosocial needs assessment, and home safety assessment. A comprehensive, person‐centered plan is agreed upon, referrals to community resources are made, standardized documentation is shared, and follow‐up communication is instituted. In the first 2 years, 272 visits were conducted with 85 individuals who represent one of the oldest, most disabled PD populations reported. Satisfaction with and retention in the program were high. This study represents the first translation of the success of interdisciplinary and home‐based geriatric care models to a population with a specific neurological disease. Preliminary evidence supports the need for such programs in vulnerable populations. Future studies will prospectively assess person‐centered outcomes, the effect of using telemedicine on sustainability, and cost effectiveness.
Motor and Cognitive Trajectories Before Dementia: Results from Gait and Brain Study
Authors: Montero‐Odasso Manuel , Speechley Mark , Muir‐Hunter Susan W. , Sarquis‐Adamson Yanina , Sposato Luciano A. , Hachinski Vladimir , Borrie Michael , Wells Jennie , Black Alanna , Sejdić Ervin , Bherer Louis , Chertkow Howard ,   The Canadian Gait and Cognition Network
Published: April 2018

Objectives

To compare the trajectories of motor and cognitive decline in older adults who progress to dementia with the trajectories of those who do not. To evaluate the added value of measuring motor and cognitive decline longitudinally versus cross‐sectionally for predicting dementia.

Design

Prospective cohort study with 5 years of follow‐up.

Setting

Clinic based at a university hospital in London, Ontario, Canada.

Participants

Community‐dwelling participants aged 65 and older free of dementia at baseline (N=154).

Measurements

We evaluated trajectories in participants' motor performance using gait velocity and cognitive performance using the MoCA test twice a year for 5 years. We ascertained incident dementia risk using Cox regression models and attributable risk analyses. Analyses were adjusted using a time‐dependent covariate.

Results

Overall, 14.3% progressed to dementia. The risk of dementia was almost 7 times as great for those whose gait velocity declined (hazard ratio (HR)=6.89, 95% confidence interval (CI)=2.18–21.75, p=.001), more than 3 times as great for those with cognitive decline (HR=3.61, 95% CI=1.28–10.13, p=.01), and almost 8 times as great in those with combined gait velocity and cognitive decline (HR=7.83, 95% CI=2.10–29.24, p=.002), with an attributable risk of 105 per 1,000 person years. Slow gait at baseline alone failed to predict dementia (HR=1.16, 95% CI=0.39–3.46, p=.79).

Conclusion

Motor decline, assessed according to serial measures of gait velocity, had a higher attributable risk for incident dementia than did cognitive decline. A decline over time of both gait velocity and cognition had the highest attributable risk. A single time‐point assessment was not sufficient to detect individuals at high risk of dementia.
Heart Rate and Bone Mineral Density in Older Women with Hypertension: Results from the Korea National Health and Nutritional Examination Survey
Authors: Jung Mi‐Hyang , Youn Ho‐Joong , Ihm Sang‐Hyun , Jung Hae Ok , Hong Kyung‐Soon
Published: April 2018

OBJECTIVES

To determine whether high heart rate is associated with low bone mineral density (BMD) in older women with hypertension.

DESIGN

Retrospective cohort study.

SETTING

Population‐based study conducted in Korea (Korea National Health and Nutritional Examination Survey 2009–10).

PARTICIPANTS

Postmenopausal women aged 60 and older with hypertension (N=981) divided into 2 groups according to resting heart rate, with a cut‐off value of 80 bpm, which has been found to be associated with osteoporosis.

MEASUREMENTS

BMD profiles and clinical and laboratory data were collected. Osteoporosis was defined as a T‐score of –2.5 or less, according to World Health Organization criteria.

RESULTS

BMD was significantly lower in participants with a high heart rate, even after adjustment for age, diabetes mellitus, white blood cell count, and fasting glucose and triglyceride levels. The prevalence of osteoporosis was also significantly higher in those participants. In multivariate logistic regression analysis, the group with high heart rate was 1.7 times as likely (95% confidence interval=1.2–2.3) to have osteoporosis as those with a lower heart rate, independent of age, body mass index, comorbidities, and laboratory findings.

CONCLUSION

High heart rate is independently associated with lower BMD in older women with hypertension; proactive surveillance of BMD could be helpful when managing older women with hypertension and a high heart rate.
Pattern of antibiotic prescription among dentists in Riyadh, Saudi Arabia
Authors: Baskaradoss Jagan K. , Alrumaih Abdulaziz , Alshebel Abdulrahman , Alfaqih Ahmed , Aleesa Mohammed , Alkhashan Saleh , Altuwaijri Mohamad
Published: April 2018

Aim

The aim of the present study was to investigate the pattern of antibiotic prescription and dentists' awareness about the recent guidelines for antibiotic prescription.

Methods

This cross‐sectional study was conducted among 282 dentists practicing in Riyadh, Saudi Arabia. The data were collected from 20 randomly‐selected dental clinics from each of the five administrative blocks in Riyadh. In addition, data were also collected from four tertiary care centers and three academic universities. The questionnaire measured the antibiotic prescription pattern of the dentists and their choice of antibiotics for various dental conditions.

Results

Amoxicillin was the most commonly prescribed antibiotic. More than 70% of dentists prescribed antibiotics for dental patients with various cardiac conditions. Bivariate analysis showed that female dentists had significantly higher mean scores for ideal prescription pattern (P = .04) compared to male dentists. Saudi nationals, especially those working in the government sector were found to have better prescription pattern compared with others (P = .02). Dentists with higher educational qualifications (board certificate and above) had a more ideal prescription pattern than other dentists (P = .04).

Conclusion

Inappropriate antibiotic prescription practice was highly prevalent in this population.
Risk factors and topographies for self‐injurious behaviour in a sample of adults with intellectual developmental disorders
Authors: Folch A. , Cortés M. J. , Salvador‐Carulla L. , Vicens P. , Irazábal M. , Muñoz S. , Rovira L. , Orejuela C. , Haro J. M. , Vilella E. , Martínez‐Leal R.
Published: April 2018

Background

Self‐injurious behaviour (SIB) is a prevalent form of challenging behaviour in people with intellectual developmental disorders (IDD). Existing research has yielded conflicting findings concerning the major risk factors involved, and in addition, SIB shows multiple topographies and presentations. Although presence of autism spectrum disorders (ASD) and severity of intellectual disability (ID) are known risk factors for SIB, there are no studies comparing SIB topographies by severity degrees of ID and ASD. The purpose of the present paper has been to identify risk factors and topographies for SIB in a representative, stratified and randomised sample of adults with IDD.

Method

This study was conducted on the basis of data collected by the POMONA‐ESP project, in a sample of 833 adults with IDD. Data concerning demographic and health information, ASD symptoms, psychopathology and ID, have been analysed to determine the presence of risk factors for SIB among participants and to explore the occurrence and topographies of SIB across different severity levels of ID and ASD symptoms.

Results

Self‐injurious behaviour prevalence in the sample was 16.2%. Younger age, oral pain, greater severity of ID, presence of dual diagnosis, psychiatric medication intake and higher scores on Childhood Autism Rating Scale were risk factors for SIB among participants, whereas number of areas with functioning limitations, place of residence, diagnosis of epilepsy and sex were not. SIB was more frequent in participants with ASD symptoms regardless of its severity level, and they displayed a higher number of different topographies of SIB. People with profound ID without co‐morbid ASD symptoms showed similar results concerning SIB prevalence and topographies.

Conclusions

Knowledge on risk factors and topographies of SIB might play a vital role in the development of prevention strategies and management of SIB in people with IDD. The mere presence of ASD symptoms, regardless of its severity level, can be a crucial factor to be taken into account in assessing SIB. Accordingly, the presence of SIB in people with ID, especially when presented with a varied number of topographies, might provide guidance on ASD differential diagnosis.
Comparisons of the topographic characteristics and electrical charge distributions among Babesia‐infected erythrocytes and extraerythrocytic merozoites using AFM
Authors: SCUDIERO L. , MERCADO‐ROJANO W. DE J. , RUDOLPH A. , WANG J. , LAUGHERY J.M. , SUAREZ C.E.
Published: April 2018

Tick‐borne Babesia parasites are responsible for costly diseases worldwide. Improved control and prevention tools are urgently needed, but development of such tools is limited by numerous gaps in knowledge of the parasite–host relationships. We hereby used atomic force microscopy (AFM) and frequency‐modulated Kelvin probe potential microscopy (FM‐KPFM) techniques to compare size, texture, roughness and surface potential of normal and infected Babesia bovis, B. bigemina and B. caballi erythrocytes to better understand the physical properties of these parasites. In addition, AFM and FM‐KPFM allowed a detailed view of extraerythrocytic merozoites revealing shape, topography and surface potential of paired and single parasites. B. bovis‐infected erythrocytes display distinct surface texture and overall roughness compared to noninfected erythrocytes. Interestingly, B. caballi‐infected erythrocytes do not display the surface ridges typical in B. bovis parasites. Observations of extraerythrocytic B. bovis, B. bigemina and B. caballi merozoites using AFM revealed differences in size and shape between these three parasites. Finally, similar to what was previously observed for Plasmodium‐infected erythrocytes, FM‐KPFM images reveal an unequal electric charge distribution, with higher surface potential above the erythrocyte regions that are likely associated with Babesia parasites than over its remainder regions. In addition, the surface potential of paired extraerythrocytic B. bovis Mo7 merozoites revealed an asymmetric potential distribution. These observations may be important to better understand the unique cytoadhesive properties of B. bovis‐infected erythrocytes, and to speculate on the role of differences in the distribution of surface charges in the biology of the parasites.
The Global Landscape of Nursing and Genomics
Authors: Calzone Kathleen A. , Kirk Maggie , Tonkin Emma , Badzek Laurie , Benjamin Caroline , Middleton Anna
Published: April 2018

Purpose

Nurses have a pivotal role in bringing the benefits of genomics and precision medicine to everyday health care, but a concerted global effort is needed to transform nursing policy and practice to address widely acknowledged deficits in nurses’ genomic literacy. The purpose was to conduct a global country and organization review of nursing engagement with genomics, informing a landscape analysis to assess readiness for integration of genomics into nursing.

Design

Global nursing leaders and nursing organizations were recruited using a purposive sampling strategy to complete an online survey that assessed the scope of genomic integration in practice and education, challenges and barriers, and priorities for action.

Methods

The survey was administered online following an orientation webinar. Given the small numbers of nurse leaders globally, results were analyzed and presented descriptively.

Findings

Delegates consisted of 23 nurse leaders from across the world. Genomic services were offered predominantly in specialty centers consisting mostly of newborn screening (15/18) and prenatal screening (11/18). Genomic literacy and infrastructure deficits were identified in both practice and education settings, with only one country reporting a genetic/genomic knowledge and skill requirement to practice as a general nurse.

Conclusions

These data provide insights into the commitment to and capacity for nursing to integrate genomics, revealing common themes and challenges associated with adoption of genomic health services and integration into practice, education, and policy. Such insights offer valuable context and baseline information to guide the activities of a new Global Genomics Nursing Alliance (G2NA). The G2NA will use the landscaping exercise as a springboard to explore how to accelerate the integration of genomics into nursing healthcare.

Clinical Relevance

Genomics is relevant to all healthcare providers across the healthcare continuum. It provides an underpinning for understanding health, risks for and manifestations of disease, therapeutic decisions, development of new therapies, and responses to interventions. Harnessing the benefits of genomics to improve health and care outcomes and reduce costs is a global nursing challenge.
Ischemic oculomotor nerve palsy due to hyaluronic acid filler injection
Authors: Bae In Ho , Kim Min Sung , Choi Hoon , Na Chan Ho , Shin Bong Seok
Published: April 2018

Hyaluronic acid (HA) is the most popular agent today for intradermal injections to improve wrinkles and other cosmetic defects. Ischemic necrosis due to injection of HA is one of the serious complications. Because there are many vascular branches around the nose, caution and care should be given during facial filler injection. Although the incidence is rare, blindness and permanent visual loss may occur. We describe a 29‐year‐old woman presented with painful erythematous swelling with violaceous patch on right periocular area and glabella after HA filler injection. After injecting the filler, she felt pain and dizziness, and her vision became blurred. She immediately received hyaluronidase around the HA filler inject area and during hospitalized for 10 days, she was successfully treated with systemic steroid, vasodilator, prophylactic antibiotics, and LLLT (low‐level laser therapy) without any defects.
Anti‐Hu antibody‐mediated limbic encephalitis associated with cervical cancer: A case report
Authors: Shin Kyong Jin , Ji Yong Il
Published: April 2018

A 55‐year‐old postmenopausal and multiparous woman presented to our department with recent memory disturbances associated with rapidly progressive positive Anti‐Hu antibodies. She was subsequently diagnosed with anti‐Hu antibody‐related paraneoplastic limbic encephalitis. Clinical examination and imaging studies revealed a bulky cervical tumor with both parametrial and vaginal fornix extension; biopsy confirmed the tumor as cervical squamous cell carcinoma. In this case, we encountered a patient with anti‐Hu‐mediated paraneoplastic limbic encephalitis with a subsequent diagnosis of cervical cancer.
Ultrasonographic prediction of antepartum deterioration of growth‐restricted fetuses after late preterm
Authors: Yamamoto Ryo , Ishii Keisuke , Nakajima Erika , Sasahara Jun , Mitsuda Nobuaki
Published: April 2018

Aim

To examine the predictive value of ultrasound parameters for antepartum non‐reassuring fetal status (NRFS) in fetal growth restriction (FGR) cases after late preterm.

Methods

Retrospective review of singleton FGR cases before 37 weeks gestation who delivered after 34 weeks gestation was performed. The association between ultrasound parameters that was assessed from 34 to 36 weeks gestation and the development of antepartum NRFS that was diagnosed by nonstress test and biophysical profile was analyzed by using multivariate Cox proportional hazards analyses.

Results

A total of 214 patients were included in final data analyses. Antepartum NRFS occurred in 23 cases (10.7%) including five cases of placental abruption. Lower standard deviation (SD) of estimated fetal weight (EFW), lower cerebroplacental ratio (CPR) and the presence of oligohydramnios were independently associated with antepartum NRFS. The prevalence of antepartum NRFS was highest (50.4%) in the group of EFW ≤−2.5 SD with CPR ≤1.45.

Conclusion

Ultrasound parameters of lower SD of EFW, lower CPR and oligohydramnios were predictive for antepartum NRFS in FGR after late preterm.
Diagnostic value of signal peptide‐CUB‐EGF domain‐containing protein 1 as an early and late biochemical marker in the ovarian torsion rat model
Authors: Uzun Özgür , Kaban Işık , Midi Ahmet , Uysal Hande , Boran Ahmet B. , Bacanakgil Besim H. , Tarbaghia Marwa
Published: April 2018

Aims

Signal peptide‐CUB‐EGF (epidermal growth factor‐like protein) domain‐containing protein 1 (SCUBE1) is an experimental marker of ischemia that has been previously studied both in rat models and humans. In this study, we aim to investigate the importance of SCUBE1 levels in ovarian torsion using an ovarian torsion model in rats.

Methods

A total of 18 Sprague–Dawley rats were equally divided into three groups. Group 1 (n = 6) was the Sham group and was only given a laparotomy procedure. Group 2 (n = 6) underwent bilateral ovarian torsion and ovarian ischemia lasting 8 h. Group 3 (n = 6) was subjected to bilateral ovarian torsion and ischemia lasting 24 h. Blood samples were collected from all three groups after the operations, and SCUBE1 levels were studied. Ovarian samples were collected, and microscopic evaluation was performed. The correlation of SCUBE1 levels and histopathological findings were investigated.

Results

The mean SCUBE1 level of group 3 was statistically higher than other groups (P < 0.01). Follicular degeneration and infiltration of inflammatory cells were, respectively, statistically significant in groups 2 and 3 (P = 0.002 and P = 0.045, respectively).

Conclusion

SCUBE1 can be useful in diagnosing ovarian torsion during the first 24 h, but more randomized controlled studies are necessary in order to implement it in clinical settings.
Incidence and Etiology of Microinfarcts in Patients with Ischemic Stroke
Authors: Oliveira‐Filho Jamary , Ay Hakan , Shoamanesh Ashkan , Park Kwang Yeol , Avery Ross , Sorgun Mine , Kim Gyeong‐Moon , Cougo Pedro T. , Greenberg Steven M. , Gurol M. Edip
Published: April 2018

BACKGROUND AND PURPOSE

Cerebral microinfarcts (CMI) are associated with intracerebral hemorrhage due to small vessel disease (SVD) in studies not including an ischemic etiologic workup. We aimed to determine their incidence and potential causes in a large ischemic stroke (IS) cohort.

METHODS

Consecutive patients with MRI‐confirmed IS within 72 hours of onset were enrolled. Subjects had either single high‐risk embolic source (cardioembolic or large vessel disease) or no embolic source. CMIs were classified by their relationship to the primary infarct as within or outside the same vascular territory. White matter hyperintensities (WMH) and microbleeds were markers SVD severity. Multivariable regression tested the association between CMIs and potential etiologies.

RESULTS

We analyzed 946 IS patients, mean age 69 ± 15 years, 46% female. We detected CMI (≤5 mm) on diffusion‐weighted imaging in 269 (28%) subjects, 190 (71%) within the vascular territory of the primary infarct. Large‐vessel atherosclerosis (P <.001), cardioembolic source (P <.001), higher WMH (P = .032) and lower systolic blood pressure (SBP, P = .024) were independently associated with the presence of CMI. While SBP was associated with CMI in any location (P <.05), WMH was only associated with CMI outside the territory of the primary infarct (P = .033), and large vessel atherosclerosis with CMI within the primary infarct territory (P = .004).

CONCLUSIONS

CMIs occurring within the vascular territory of a larger infarct are more likely embolic, but those occurring outside are probably related to SVD. Our findings suggest a role for SVD in pathogenesis of CMIs and emphasize the importance of etiologic workup to identify alternate etiologies.
Analgesic effect of S (+)-flurbiprofen plaster in a rat model of knee arthritis: analysis of gait and synovial fluid prostaglandin E2 levels
Authors: Fukumoto Ayaka , Tajima Kyoko , Hori Miyuki , Toda Yoshihisa , Kaku Shinsuke , Matsumoto Hideo
Published: April 2018

Objectives

We developed S (+)-flurbiprofen plaster (SFPP), a novel NSAID patch containing S (+)-flurbiprofen (SFP), a potent cyclooxygenase (COX) inhibitor. The purpose of this study was to assess efficacy of SFPP by analysing its effect on the gait disturbance and measuring the prostaglandin E2 (PGE2) production in synovial fluid in a rat model of knee arthritis.

Methods

Knee inflammation was induced in rats by intra-articular injection of a yeast suspension. Subsequently, an NSAID patch containing SFP, ketoprofen or loxoprofen was applied over the affected knee. Gait was assessed at 2, 4 and 6 h after application of the patch. The PGE2 concentration in the synovial fluid was measured after the gait assessment.

Key findings

Application of SFPP (0.125, 0.25, 0.5 or 1 mg/sheet) was followed by a decrease in the visual gait score at all the doses examined. In the case of the other two NSAID patches, only the ketoprofen patch (1 or 2 mg/sheet) and loxoprofen patch (5 mg/sheet) produced a decrease in the visual gait score. All of the NSAID patches decreased the PGE2 production in the synovial fluid.

Conclusions

These results suggest the potential usefulness of SFPP as an analgesic patch in patients with inflammatory joint pain.