bluuebunny/crossref_metadata_2025 huggingface dataset:
Reviving old antibiotics
Authors: Theuretzbacher Ursula , Van Bambeke Françoise , Cantón Rafael , Giske Christian G. , Mouton Johan W. , Nation Roger L. , Paul Mical , Turnidge John D. , Kahlmeter Gunnar
Published: June 2015

In the face of increasing antimicrobial resistance and the paucity of new antimicrobial agents it has become clear that new antimicrobial strategies are urgently needed. One of these is to revisit old antibiotics to ensure that they are used correctly and to their full potential, as well as to determine whether one or several of them can help alleviate the pressure on more recent agents. Strategies are urgently needed to ‘re-develop’ these drugs using modern standards, integrating new knowledge into regulatory frameworks and communicating the knowledge from the research bench to the bedside. Without a systematic approach to re-developing these old drugs and rigorously testing them according to today's standards, there is a significant risk of doing harm to patients and further increasing multidrug resistance. This paper describes factors to be considered and outlines steps and actions needed to re-develop old antibiotics so that they can be used effectively for the treatment of infections.
Expert guided natural language processing using one-class classification
Authors: Joffe Erel , Pettigrew Emily J , Herskovic Jorge R , Bearden Charles F , Bernstam Elmer V
Published: June 2015

Introduction Automatically identifying specific phenotypes in free-text clinical notes is critically important for the reuse of clinical data. In this study, the authors combine expert-guided feature (text) selection with one-class classification for text processing.

Objectives To compare the performance of one-class classification to traditional binary classification; to evaluate the utility of feature selection based on expert-selected salient text (snippets); and to determine the robustness of these models with respects to irrelevant surrounding text.

Methods The authors trained one-class support vector machines (1C-SVMs) and two-class SVMs (2C-SVMs) to identify notes discussing breast cancer. Manually annotated visit summary notes (88 positive and 88 negative for breast cancer) were used to compare the performance of models trained on whole notes labeled as positive or negative to models trained on expert-selected text sections (snippets) relevant to breast cancer status. Model performance was evaluated using a 70:30 split for 20 iterations and on a realistic dataset of 10 000 records with a breast cancer prevalence of 1.4%.

Results When tested on a balanced experimental dataset, 1C-SVMs trained on snippets had comparable results to 2C-SVMs trained on whole notes (F = 0.92 for both approaches). When evaluated on a realistic imbalanced dataset, 1C-SVMs had a considerably superior performance (F = 0.61 vs. F = 0.17 for the best performing model) attributable mainly to improved precision (p = .88 vs. p = .09 for the best performing model).

Conclusions 1C-SVMs trained on expert-selected relevant text sections perform better than 2C-SVMs classifiers trained on either snippets or whole notes when applied to realistically imbalanced data with low prevalence of the positive class.
Anosognosia and Metacognition in Alzheimer’s Disease
Authors: Ernst Alexandra , Moulin Chris J.A. , Souchay Celine , Mograbi Daniel C. , Morris Robin
Published: June 2015

While metacognition and anosognosia have long been studied as distinct concepts, more recently we have endeavored to construct a theoretical framework for exploring how metacognition can contribute to our understanding of anosognosia and vice versa. Following this approach, with a particular focus on Alzheimer’s disease (AD), this chapter first gives an overview of the key experimental findings and issues on metacognition in AD patients: in particular, overconfidence and absolute awareness; the sensitivity approach; the fractionation of metacognition in AD; the neural substrates of metacognition in the Alzheimer brain; and metacognitive control in these patients. Second, the chapter discusses the concept of anosognosia in AD patients from a cognitive neuropsychological viewpoint. It addresses models such as the cognitive awareness model and evidence from metacognition studies, and how they contribute to disentangle the issue of measuring anosognosia in AD patients. Finally, it develops the emerging concept of “implicit awareness” in AD patients.
Aesthetic Music Therapy
Authors: Lee Colin Andrew
Published: June 2015

This chapter provides an overview of a music-centered model of music therapy entitled Aesthetic Music Therapy (AeMT). AeMT was developed over many years of practice and theoretical reflection not only as a music-centered approach to therapeutic work, but also as a way to consider the myriad means by which humans experience the world of self and others. By placing AeMT within the framework of other present-day music therapy models, the need for music-centered thinking to be considered equal to those of medicine, community, and psychotherapy is endorsed. By expanding our knowledge and use of diverse musical cultures, music therapy will remain at the forefront of contemporary theories in both the field of health and the arts.
Concepts for the Development of a Customizable Checklist for Use by Patients
Authors: Fernando Rohesh J. , Shapiro Fred E. , Rosenberg Noah M. , Bader Angela M. , Urman Richard D.
Published: June 2015

Objectives

Checklists are tools that are developed to complete tasks by drawing on specific and relevant knowledge and supporting communication at critical times. If checklists were designed specifically for patient use, they could promote patient engagement, potentially leading to improved quality of care. Physicians of all specialties, nurses, patients, patient advocates, and administrators can take an active role in checklist development and dissemination.

Methods

Our method to investigate concepts in developing a customizable patient checklist included a literature search concerning existing checklists and resources currently available to patients. Literature containing expert opinion regarding checklists, professional organization statements, and patients and providers were consulted.

Results

A template for designing a patient checklist was developed incorporating methods from previous literature and resources regarding checklists. This template includes a development, drafting, and validation phase. Sample content for inclusion in potential checklists for patients with diabetes and patients undergoing anesthesia was devised.

Conclusions

Developed by physicians with input from patients and other involved health-care providers such as nurses, this relatively novel concept of a patient’s checklist creates a role for the patient to ensure their own safety. With increasing attention to high-quality and cost-effective health care, patient satisfaction surveys will be assessed to rate overall health care. Further development of checklists will need to be guided by specific medical conditions and acceptance by patients and providers. Providers can use these checklists as a method to gauge a patient’s understanding of an intervention, solidify the patient-doctor relationship, and improve patient safety.
Using genome-wide measures of coancestry to maintain diversity and fitness in endangered and domestic pig populations
Authors: Bosse Mirte , Megens Hendrik-Jan , Madsen Ole , Crooijmans Richard P.M.A. , Ryder Oliver A. , Austerlitz Frédéric , Groenen Martien A.M. , de Cara M. Angeles R.
Published: June 2015

Conservation and breeding programs aim at maintaining the most diversity, thereby avoiding deleterious effects of inbreeding while maintaining enough variation from which traits of interest can be selected. Theoretically, the most diversity is maintained using optimal contributions based on many markers to calculate coancestries, but this can decrease fitness by maintaining linked deleterious variants. The heterogeneous patterns of coancestry displayed in pigs make them an excellent model to test these predictions. We propose methods to measure coancestry and fitness from resequencing data and use them in population management. We analyzed the resequencing data of Sus cebifrons, a highly endangered porcine species from the Philippines, and genotype data from the Pietrain domestic breed. By analyzing the demographic history of Sus cebifrons, we inferred two past bottlenecks that resulted in some inbreeding load. In Pietrain, we analyzed signatures of selection possibly associated with commercial traits. We also simulated the management of each population to assess the performance of different optimal contribution methods to maintain diversity, fitness, and selection signatures. Maximum genetic diversity was maintained using marker-by-marker coancestry, and least using genealogical coancestry. Using a measure of coancestry based on shared segments of the genome achieved the best results in terms of diversity and fitness. However, this segment-based management eliminated signatures of selection. We demonstrate that maintaining both diversity and fitness depends on the genomic distribution of deleterious variants, which is shaped by demographic and selection histories. Our findings show the importance of genomic and next-generation sequencing information in the optimal design of breeding or conservation programs.
Numerical study of two dimensional unsteady flow of an anomalous Maxwell fluid
Authors: Wahab Abdul , Rasheed Amer , Nawaz Rab , Javaid Nazma
Published: June 2015

Purpose

– The purpose of this paper is to undertake an unsteady flow problem of an anomalous Maxwell fluid. The flow takes place between two side walls over a plate perpendicular to them and is driven by a sudden pressure force with constant gradient.

Design/methodology/approach

– A finite element method is invoked and is blended with a finite difference method for left Caputo fractional time derivatives in order to study the anomalous dynamics of the fluid.

Findings

– A numerical scheme for the constitutive equations of the prescribed flow in order to approximate the velocity field is designed. The graphical results to draw different physical conclusions on the flow problem are also presented.

Originality/value

– A rigorous mathematical exposition of the numerical scheme is provided and the results are valid for large values of the parameters.
Does the Relationship of the Proxy to the Target Person Affect the Concordance between Survey Reports and Medicare Claims Measures of Health Services Use?
Authors: Wehby George L. , Jones Michael P. , Ullrich Fred , Lou Yiyue , Wolinsky Fredric D.
Published: June 2015

Objectives

To compare concordance of survey reports of health service use versus claims data between self respondents and spousal and nonspousal relative proxies.

Data Sources

1995–2010 data from the Survey on Assets and Health Dynamics among the Oldest Old and 1993–2010 Medicare claims for 3,229 individuals (13,488 person‐years).

Study Design

Regression models with individual fixed effects were estimated for discordance of any hospitalizations and outpatient surgery and for the numbers of under‐ and over‐reported physician visits.

Principal Findings

Spousal proxies were similar to self respondents on discordance. Nonspousal proxies, particularly daughters/daughters‐in‐law and sons/sons‐in‐law, had less discordance, mainly due to reduced under‐reporting.

Conclusions

Survey reports of health services use from nonspousal relatives are more consistent with Medicare claims than spousal proxies and self respondents.
Screening for At‐Risk Drinking in a Population Reporting Symptoms of Depression: A Validation of the AUDIT, AUDIT‐C, and AUDIT‐3
Authors: Levola Jonna , Aalto Mauri
Published: June 2015

Background

Excessive alcohol use is common in patients presenting with symptoms of depression. The aim of this study was to evaluate how the Alcohol Use Disorders Identification Test (AUDIT) and its most commonly used abbreviated versions perform in detecting at‐risk drinking among subjects reporting symptoms of depression.

Methods

A subsample (n = 390; 166 men, 224 women) of a general population survey, the National FINRISK 2007 Study, was used. Symptoms of depression were measured with the Beck Depression Inventory–Short Form and alcohol consumption with the Timeline Follow‐back (TLFB). At‐risk drinking was defined as ≥280 g weekly or ≥60 g on at least 1 occasion in the previous 28 days for men, 140 and 40 g, respectively, for women. The AUDIT, AUDIT‐C, and AUDIT‐3 were tested against the defined gold standard, that is, alcohol use calculated from the TLFB. An optimal cutoff was designated as having a sensitivity and specificity of over 0.75, with emphasis on specificity. The AUDIT and its abbreviations were compared with carbohydrate‐deficient transferrin (CDT) and gamma‐glutamyltransferase.

Results

At‐risk drinking was common. The AUDIT and AUDIT‐C performed quite consistently. Optimal cutoffs for men were ≥9 for the AUDIT and ≥6 for AUDIT‐C. The optimal cut‐offs for women with mild symptoms of depression were ≥5 for the AUDIT and ≥4 for AUDIT‐C. Optimal cutoffs could not be determined for women with moderate symptoms of depression (specificity <0.75). A nearly optimal cutoff for women was ≥5 for the AUDIT. The AUDIT‐3 failed to perform in women, but in men, a good level of sensitivity and specificity was reached at a cutoff of ≥2. With standard threshold values, the biochemical markers demonstrated very low sensitivity (9 to 28%), but excellent specificity (83 to 98%).

Conclusions

Screening for at‐risk drinking among patients presenting with symptoms of depression using the full AUDIT is recommended, although the AUDIT‐C performed almost equally well. Cut‐offs should be adjusted according to gender, but not according to the severity of depressive symptoms. The AUDIT and its abbreviations were superior to biochemical markers.
Expression of Toll‐like receptors in nasal epithelium in allergic rhinitis
Authors: Renkonen Jutta , Toppila‐Salmi Sanna , Joenväärä Sakari , Mattila Pirkko , Parviainen Ville , Hagström Jaana , Haglund Caj , Lehtonen Mikko , Renkonen Risto
Published: June 2015

Toll‐like receptors (TLRs) are important in barrier homeostasis, but their role in airborne allergies is not fully understood. The aim was to evaluate baseline and allergen‐induced expression of TLR proteins in nasal epithelium during allergic rhinitis. Nineteen otherwise healthy non‐smoking volunteers both allergic to birch pollen and non‐allergic controls were enrolled. We took nasal biopsies before and after off‐seasonal intranasal birch pollen or diluent challenge. The expression of epithelial TLR1‐7, TLR9‐10, and MyD88 proteins was immunohistochemically evaluated from the nasal biopsies. The TLR1‐3 and TLR5‐10 mRNAs were observed by RNA‐microarray. Baseline epithelial expression of TLR proteins was wide and identical in controls and atopics. After off‐seasonal intranasal birch pollen challenge, a negative change in the expression score of TLR1 and TLR6 proteins was detected in the atopic group. TLR mRNA expression was not affected by birch pollen challenge. Nasal epithelium seems to express all known TLRs. The mechanisms by which TLR1, and TLR6 proteins could affect pollen allergen transport need further studies.
Latent growth curve analysis with dichotomous items: Comparing four approaches
Authors: Ye Feifei
Published: June 2015

A Monte Carlo study was used to compare four approaches to growth curve analysis of subjects assessed repeatedly with the same set of dichotomous items: A two‐step procedure first estimating latent trait measures using MULTILOG and then using a hierarchical linear model to examine the changing trajectories with the estimated abilities as the outcome variable; a structural equation model using modified weighted least squares (WLSMV) estimation; and two approaches in the framework of multilevel item response models, including a hierarchical generalized linear model using Laplace estimation, and Bayesian analysis using Markov chain Monte Carlo (MCMC). These four methods have similar power in detecting the average linear slope across time. MCMC and Laplace estimates perform relatively better on the bias of the average linear slope and corresponding standard error, as well as the item location parameters. For the variance of the random intercept, and the covariance between the random intercept and slope, all estimates are biased in most conditions. For the random slope variance, only Laplace estimates are unbiased when there are eight time points.
Hope and subjective well‐being among parents of children with special needs
Authors: Shenaar‐Golan Vered
Published: June 2015

The current study examined subjective well‐being (SWB) in parents who raise children with special needs. Previous studies that focused on parenting children with special needs stressed increased risk of depression. This study examined parental level of hope, the significance of being involved in a partner relationship and parental perception of the seriousness of their child's disability, each a factor that may influence parental SWB. A random sample of 92 parents raising children with special needs in Israel participated in the study. They completed three questionnaires, examining parent's perception of the severity of their child's disability, parental SWB and parents' level of hope. Results revealed that a high level of hope, being in a partnered relationship, and perception of the child's disability as having some positive influence on central aspects of the parents' life, are all significant contributors to raising parental SWB. Study findings show that ‘agency’, a component of the concept of ‘hope’, is a significant factor in predicting SWB in parents of a child with special needs. Perhaps awareness of how they can improve their SWB by using certain aspects of their lifestyle to their advantage can help improve quality of life for parents of children with special needs.
The Continuity of Metaphor: Evidence From Temporal Gestures
Authors: Walker Esther , Cooperrider Kensy
Published: June 2015

Reasoning about bedrock abstract concepts such as time, number, and valence relies on spatial metaphor and often on multiple spatial metaphors for a single concept. Previous research has documented, for instance, both future‐in‐front and future‐to‐right metaphors for time in English speakers. It is often assumed that these metaphors, which appear to have distinct experiential bases, remain distinct in online temporal reasoning. In two studies we demonstrate that, contra this assumption, people systematically combine these metaphors. Evidence for this combination was found in both directly elicited (Study 1) and spontaneous co‐speech (Study 2) gestures about time. These results provide first support for the hypothesis that the metaphorical representation of time, and perhaps other abstract domains as well, involves the continuous co‐activation of multiple metaphors rather than the selection of only one.
Assessment of Myocardial Function in Children before and after Autologous Peripheral Blood Stem Cell Transplantation
Authors: ElMarsafawy Hala , Matter Mohamed , Sarhan Mohamed , El‐Ashry Rasha , Al‐Tonbary Youssef
Published: June 2015

Background

Increased interest is focused on the long‐term adverse effects of bone marrow transplantation. Subclinical cardiac involvement appears common in adults, but only a few reports have examined pediatric patients.

Materials and Methods

A prospective case–control study of 19 children with normal cardiac function undergoing autologous hematopoietic stem cell transplantation (HSCT) was performed. Tissue Doppler imaging (TDI) and echocardiographic measurements were obtained according to the guidelines of the American Society of Echocardiography before and 3 months after HSCT.

Results

Lateral mitral annulus before HSCT showed significant reduced mitral systolic annular velocity (P < 0.0001), early diastolic annular velocity (P < 0.0001), late diastolic annular velocity (P = 0.02) and prolonged isovolumetric relaxation time (IRT) (P < 0.0001) compared with control. Significant reduced mitral systolic annular velocity (P < 0.0001), early diastolic annular velocity (P = 0.0005) and Em/Am ratio (P = 0.004), with higher late diastolic annular velocity (P = 0.02) and prolonged isovolumetric contraction time (ICT) (P = 0.003) and IRT (P = 0.002) after HSCT, were observed. Investigation of lateral tricuspid annulus showed nearly similar results as the lateral mitral annulus. LV and RV Tei indices were higher before HSCT compared with control and remained high after HSCT.

Conclusion

TDI detected subtle abnormalities in systolic and diastolic functions before and after HSCT, which suggests that a conditioning regimen may affect cardiac function.
Fatigue life estimation of tubular joints – a comparative study
Authors: Maheswaran J. , Siriwardane S. C.
Published: June 2015

In fatigue analysis, the structural detail of tubular joint has taken great attention among engineers. The DNV/GL‐RP‐0005 is covering this topic quite well for simple and clear joint cases. For complex joint and geometry, where joint classification is not available and there is limitation on validity range of non‐dimensional geometric parameters, the challenges become a fact among engineers. The classification of joint is an important factor to consider in fatigue analysis. These joint configurations are identified by the connectivity and the load distribution of tubular joints. To overcome these problems to some extent, this paper compares the fatigue life of tubular joints in offshore jacket according to the stress concentration factors (SCF) in DNV/GL‐RP‐0005 and finite element method employed in Abaqus/CAE. The paper presents the geometric details, material properties and load history of the considered jacket structure. It then describes the global structural analysis and identification of critical tubular joints for fatigue life estimation. Hence, fatigue life is determined based on the guidelines provided in design codes. Fatigue analysis of tubular joints is conducted using the finite element employed in Abaqus/CAE as the next major step. Finally, predicted SCFs and fatigue lives are compared, and these observations tend to conclude that even though the fatigue life, which is calculated based on code given SCFs, provides more realistic prediction to the simple uniplanar joints, there is a doubt for complex joints and geometry, where joint classification is not available. Also, the study emphasized that it is very important to preciously investigate SCFs by considering accurate geometry of complex tubular joints for a good judgement of fatigue life.
Ecosystem metabolism and nutrient dynamics in the main channel and backwaters of the Upper Mississippi River
Authors: Houser Jeffrey N. , Bartsch Lynn A. , Richardson William B. , Rogala James T. , Sullivan John F.
Published: June 2015

Photosynthesis and respiration are primary drivers of dissolved oxygen dynamics in rivers. We measured dissolved oxygen dynamics, aquatic ecosystem metabolism, algal abundance and nutrient concentrations at main channel and backwater sites on a reach of the Upper Mississippi River that borders the states of Wisconsin and Minnesota (U.S.A.). We asked (i) how ecosystem metabolism rates, dissolved oxygen dynamics and nutrient concentrations differed in the main channel and in backwaters, (ii) whether ecosystem metabolism relates to solar irradiance, nutrient concentration, algal abundance, temperature and river discharge and (iii) whether the relationships between ecosystem metabolism and these environmental factors differs between the main channel and backwaters.

The rates of aquatic ecosystem metabolism in the main channel were among the highest reported for large rivers. Mean daily gross primary production (GPP), ecosystem respiration (R) and net ecosystem production (NEP) in the main channel in the 2006 growing season were 10, 6 and 4 g O2 m2 d−1, respectively.

Solar irradiance, discharge and temperature, rather than nutrients, accounted for most temporal variability in gross primary production (GPP). Discharge was negatively associated with GPP in the main channel and temperature positively associated with GPP in backwaters.

Primary production consistently exceeded respiration in the main channel in summer, resulting in persistent oxygen supersaturation from late June to early August. Maximum chlorophyll concentrations (˜140 μg L−1) were observed in the main channel, rather than the backwaters.

Nitrogen and phosphorus exhibited contrasting temporal patterns in backwaters probably reflecting differences in their sources and sinks; N declined during the growing season while P increased.
Genetic footprints reveal geographic patterns of expansion in Fennoscandian red foxes
Authors: Norén Karin , Statham Mark J. , Ågren Erik O. , Isomursu Marja , Flagstad Øystein , Eide Nina E. , Berg Thomas Bjørneboe G. , Bech‐Sanderhoff Lene , Sacks Benjamin N.
Published: June 2015

Population expansions of boreal species are among the most substantial ecological consequences of climate change, potentially transforming both structure and processes of northern ecosystems. Despite their importance, little is known about expansion dynamics of boreal species. Red foxes (Vulpes vulpes) are forecasted to become a keystone species in northern Europe, a process stemming from population expansions that began in the 19th century. To identify the relative roles of geographic and demographic factors and the sources of northern European red fox population expansion, we genotyped 21 microsatellite loci in modern and historical (1835–1941) Fennoscandian red foxes. Using Bayesian clustering and Bayesian inference of migration rates, we identified high connectivity and asymmetric migration rates across the region, consistent with source‐sink dynamics, whereby more recently colonized sampling regions received immigrants from multiple sources. There were no clear clines in allele frequency or genetic diversity as would be expected from a unidirectional range expansion from south to north. Instead, migration inferences, demographic models and comparison to historical red fox genotypes suggested that the population expansion of the red fox is a consequence of dispersal from multiple sources, as well as in situ demographic growth. Together, these findings provide a rare glimpse into the anatomy of a boreal range expansion and enable informed predictions about future changes in boreal communities.
Application of geospatial technologies for understanding and predicting vector populations and vector‐borne disease incidence
Authors: DeGroote John P. , Larson Scott R. , Zhang Yanli , Sugumaran Ramanathan
Published: June 2015

Vector‐borne diseases inflict a heavy health burden. Numerous vector species have expanded their ranges while some vector‐borne diseases have emerged in new geographic areas or reemerged in former endemic areas, potentially due to global climate change. The continued health burden and the expansion in vector and vector‐borne disease ranges have led to an increased need for understanding and predicting in space and time the potential abundance and distribution of vectors and the transmission of vector‐borne diseases. Advances in computing technologies, increased spatial data availability, and greater understanding of ecological drivers have made it commonplace to attempt to understand and estimate, in time and space, vector populations and vector‐borne disease incidence. Although there have been great advances there are still limitations due to complex and varying ecologies and epidemiological contexts of vector‐borne diseases as well as data limitations. In this paper, we will provide an overview of and examine advances and limitations in the use of geospatial technologies for understanding and prediction of the drivers of vector populations and vector‐borne diseases.
Do family meals affect childhood overweight or obesity?: nationwide survey 2008–2012
Authors: Lee H. J. , Lee S. Y. , Park E. C.
Published: June 2015

Background

The prevalence of childhood obesity is increasing worldwide and this trend is no exception for South Korea. A multidisciplinary approach is needed for the prevention and management of childhood obesity. To do so, among many other strategies, managing the family unit can be a very effective strategy.

Objectives

The purpose of this study was to identify the relationship between frequency of family meals and overweight/obesity in elementary students and to suggest the management and prevention strategies of childhood obesity.

Methods

Data from a total of 2904 elementary students were analyzed from the 2008–2012 Korea National Health and Nutrition Examination Survey. Multiple logistic regression analysis was used to examine the association between overweight/obesity and family meals.

Results

Of the total 2904 elementary students, 573 (19.4%) were overweight or obese. The odds ratio of overweight or obese students who had family dinner only was 1.21 (95% CI: 0.89–1.64), that of those who had family breakfast only was 3.20 (95% CI: 1.70–6.02), and that of those who had neither family breakfast nor family dinner was 4.17 (95% CI: 1.98–8.78) compared with those who had both family breakfast and family dinner.

Conclusions

The frequency of family meals was strongly an inverse association with childhood overweight or obesity. Therefore, we suggest that the intervention of childhood obesity should include family meals.
Impact of obesity on outcomes of paediatric acute pancreatitis based on a national administrative database
Authors: Murata A. , Ohtani M. , Muramatsu K. , Kobori S. , Tomioka S. , Matsuda S.
Published: June 2015

Background

Insufficient information is available on the relationship between obesity and outcome of paediatric patients with acute pancreatitis.

Objectives

This study aimed to investigate the effect of obesity on outcomes of paediatric patients with acute pancreatitis based on a national administrative database.

Methods

A total of 500 cases in 416 paediatric patients with acute pancreatitis (aged 5–17 years) were referred from 260 hospitals between 2010 and 2012 in Japan. Patients were divided into two groups according to the presence of obesity: with obesity (n = 65) and without obesity (n = 435). Patient data were collected from the administrative database to compare the prevalence of severe acute pancreatitis, in‐hospital mortality, length of stay (LOS) and medical costs between the groups.

Results

Both prevalence of severe acute pancreatitis and in‐hospital mortality were significantly higher in paediatric patients with obesity than those without (36.9% vs. 16.3% and 3.1% vs. 0.0%; P < 0.001, respectively). Longer LOS and higher medical costs were also observed in paediatric patients with obesity (25.7 vs. 15.2 days, P < 0.001 and 14 169.5 vs. 7457.7 US dollars, P < 0.001, respectively).

Conclusion

This study demonstrated that obesity significantly influenced the outcomes of paediatric acute pancreatitis.
Georeferencing deaths from stroke in São Paulo: an intra-city stroke belt?
Authors: Kaup Alexandre O. , Santos Bento F. C. Dos , Victor Elivane S. , Cypriano Adriana S. , Lottenberg Claudio Luiz , Neto Miguel Cendoroglo , Silva Gisele S.
Published: June 2015

Background

The role of socioeconomic status in the worldwide stroke burden has been studied with various methods using vital statistics and research-generated data.

Aim

The objective of our study was to describe the stroke mortality rates and the stroke mortality distribution, and to evaluate the association between stroke mortality rates and geographical distribution with the human development index in São Paulo, Brazil.

Methods

This ecological study evaluated a historical series of stroke mortality in São Paulo, Brazil, from 2004 to 2010. Standard stroke mortality rate per 100 000 inhabitants at each year, the address of residence assumed as the place of living, and the human development index applied as a social indicator were used in order to evaluate if stroke mortality correlated with socioeconomic status.

Results

The mean standardized stroke mortality in São Paulo decreased from 66 to 46-7 per 100 000 inhabitants from 2004 to 2010. Stroke mortality differed according to human development index strata with an almost three times higher stroke mortality in the lowest when compared with the highest human development index stratum. Visual inspection of the map of the districts with high stroke mortality disclosed regional clusters with high mortality in the east, northwest, and south regions, a finding suggestive of the presence of a stroke belt inside the city of São Paulo.

Conclusions

In conclusion, between 2004 and 2010, stroke mortality rates decreased by 28-5% in São Paulo. A geographical pattern in stroke mortality could be observed, with considerable differences according the human development index level of the place of living.
Implications of Stroke for Caregiver Outcomes: Findings from the ASPIRE-S Study
Authors: Atteih Samar , Mellon Lisa , Hall Patricia , Brewer Linda , Horgan Frances , Williams David , Hickey Anne
Published: June 2015

Background

Informal caregivers are vital to the long-term care and rehabilitation of stroke survivors worldwide. However, caregiving has been associated with negative psychological outcomes such as anxiety and depression, which leads to concerns about caregiver as well as stroke survivor well-being. Furthermore, caregivers may not receive the support and service provision they require from the hospitals and community.

Aims

This study examines caregiver psychological well-being and satisfaction with service provision in the context of stroke.

Methods

Caregiver data were collected as part of the ASPIRE-S study, a prospective study of secondary prevention and rehabilitation which assessed stroke patients and their carers at six-months post stroke. Carer assessment included measurement of demographics, satisfaction with care (UK Healthcare Commission National Patient Survey of Stroke Care), psychological distress (Hospital Anxiety and Depression Scale), and vulnerability (Vulnerable Elders Scale). Logistic regression analyses and chi-squared tests were performed using STATA version 12.

Results

Analyses from 162 carers showed substantial levels of dissatisfaction (37·9%) with community and hospital services, as well as notable levels of anxiety (31·3%) and depressive symptoms (18·8%) among caregivers. Caregiver anxiety was predicted by stroke survivor anxiety (OR = 3·47, 95% CI 1·35–8·93), depression (OR = 5·17, 95% CI 1·83–14·58), and stroke survivor cognitive impairment (OR 2·35, 95% CI 1·00–5·31). Caregiver depression was predicted by stroke survivor anxiety (OR = 4·41, 95% CI 1·53–12·72) and stroke survivor depression (OR = 6·91, 95% CI 2·26–21·17).

Conclusion

Findings indicate that caregiver and stroke survivor well-being are interdependent. Thus, early interventions, including increased training and support programs that include caregivers, are likely to reduce the risk of negative emotional outcomes.
Novel gain of function mutation in the SLC40A1 gene associated with hereditary haemochromatosis type 4
Authors: Chen S.‐R. , Yang L.‐Q. , Chong Y.‐T. , Jie Y.‐S. , Wu Y.‐K. , Yang J. , Lin G.‐L. , Li X.‐H.
Published: June 2015

Here we report the case of a 69‐year‐old Chinese Han woman who presented with liver cirrhosis, diabetes mellitus, skin hyperpigmentation, hyperferritinaemia and high transferrin saturation. Subsequent genetic analyses identified a novel heterozygous mutation (p.Cys326Phe) in the SLC40A1 gene. This is the first report regarding a SLC40A1 mutation in the Chinese Han population and provides novel clinical evidence for the importance of p.Cys326 in SLC40A1 gene function.
Community‐based case management effectiveness in populations that abuse substances
Authors: Joo J.Y. , Huber D.L.
Published: June 2015

Background

The number of persons who are substance abusing has been increasing globally. A majority of them remain in their communities, untreated. Empirical studies have shown some positive impacts of case management on substance abuse. However, studies that systematically synthesize the effectiveness of community‐based case management with populations that abuse substances are limited.

Aim

To review evidence of the impact of case management in improving treatment of substance abuse among adults in community settings.

Methods

The Cochrane processes guided this systematic review. PubMed, CINAHL, PsycINFO, Ovid and the Web of Science were searched to retrieve primary studies published from 2000 to 2013. All randomized controlled trials were considered for review. The methodological quality of the studies was assessed.

Results

The initial unfiltered search identified 506 references. A total of seven randomized controlled trials were selected for review. Findings show that, compared with clinical case management and usual care, community‐based case management services significantly improved clients' ability to abstain from drug use, reduced social problems, supported unmet service needs and improved satisfaction. Studies also showed reduced use of healthcare services, but results were mixed.

Conclusions

There is an evidence base for practicing case management among adults who are substance abusing. In general, studies concluded that case management is an active and assertive method of care coordination for formal substance abuse treatment. Further research is needed to assess case management's cost‐effectiveness and the impact of dosage on client outcomes.

Implications for Nursing Policy

Because of the complexity of population health management across settings and over long time frames, evidence‐based strategies are required to achieve health improvements. Because it provides continuous and timely care, healthcare leaders and policymakers should consider community‐based case management as an important strategy for coordinating the care in populations that are substance abusing.
Applying the transtheoretical model to promote functional fitness of community older adults participating in elastic band exercises
Authors: Yang Hui‐Ju , Chen Kuei‐Min , Chen Ming‐De , Wu Hui‐Chuan , Chang Wen‐Jane , Wang Yueh‐Chin , Huang Hsin‐Ting
Published: June 2015

Aims

The transtheoretical model was applied to promote behavioural change and test the effects of a group senior elastic band exercise programme on the functional fitness of community older adults in the contemplation and preparation stages of behavioural change.

Background

Forming regular exercise habits is challenging for older adults. The transtheoretical model emphasizes using different strategies in various stages to facilitate behavioural changes.

Design

Quasi‐experimental design with pre‐test and post‐tests on two groups.

Methods

Six senior activity centres were randomly assigned to either the experimental or control group. The data were collected during 2011. A total of 199 participants were recruited and 169 participants completed the study (experimental group n = 84, control group n = 85). The elastic band exercises were performed for 40 minutes, three times per week for 6 months. The functional fitness of the participants was evaluated at baseline and at the third and sixth month of the intervention. Statistical analyses included a two‐way mixed design analysis of variance, one‐way repeated measures analysis of variance and an analysis of covariance.

Results

All of the functional fitness indicators had significant changes at post‐tests from pre‐test in the experimental group. The experimental group had better performances than the control group in all of the functional fitness indicators after three months and 6 months of the senior elastic band exercises.

Conclusion

The exercise programme provided older adults with appropriate strategies for maintaining functional fitness, which improved significantly after the participants exercising regularly for 6 months.
Genetic variation of the weaning weight of beef cattle as a function of accumulated heat stress
Authors: Santana M.L. , Bignardi A.B. , Eler J.P. , Ferraz J.B.S.
Published: June 2015

The objective of this study was to identify the genetic variation in the weaning weight (WW) of beef cattle as a function of heat stress. The WWs were recorded at approximately 205 days of age in three Brazilian beef cattle populations: Nelore (93 616), Brangus (18 906) and Tropical Composite (62 679). In view of the cumulative nature of WW, the effect of heat stress was considered as the accumulation of temperature and humidity index units (ACTHI) from the animal's birth to weaning. A reaction norm model was used to estimate the (co)variance components of WW across the ACTHI scale. The accumulation of THI units from birth to weaning negatively affected the WW. The definition of accumulated THI units as an environmental descriptor permitted to identify important genetic variation in the WW as a function of heat stress. As evidence of genotype by environment interaction, substantial heterogeneity was observed in the (co)variance components for WW across the environmental gradient. In this respect, the best animals in less stressful environments are not necessarily the best animals in more stressful environments. Furthermore, the response to selection for WW is expected to be lower in more stressful environments.
Characterization of microRNA profile in mammary tissue of dairy and beef breed heifers
Authors: Wicik Z. , Gajewska M. , Majewska A. , Walkiewicz D. , Osińska E. , Motyl T.
Published: June 2015

MicroRNAs (miRNAs) are small non‐coding RNAs that participate in the regulation of gene expression. Their role during mammary gland development is still largely unknown. In this study, we performed a microarray analysis to identify miRNAs associated with high mammogenic potential of the bovine mammary gland. We identified 54 significantly differentially expressed miRNAs between the mammary tissue of dairy (Holstein‐Friesian, HF) and beef (Limousin, LM) postpubertal heifers. Fifty‐two miRNAs had higher expression in the mammary tissue of LM heifers. The expression of the top candidate miRNAs (bta‐miR‐10b, bta‐miR‐29b, bta‐miR‐101, bta‐miR‐375, bta‐miR‐2285t, bta‐miR‐146b, bta‐let7b, bta‐miR‐107, bta‐miR‐1434‐3p) identified in the microarray experiment was additionally evaluated by qPCR. Enrichment analyses for targeted genes revealed that the major differences between miRNA expression in the mammary gland of HF versus LM were associated with the regulation of signalling pathways that are crucial for mammary gland development, such as TGF‐beta, insulin, WNT and inflammatory pathways. Moreover, a number of genes potentially targeted by significantly differentially expressed miRNAs were associated with the activity of mammary stem cells. These data indicate that the high developmental potential of the mammary gland in dairy cattle, leading to high milk productivity, depends also on a specific miRNA expression pattern.
Clindamycin phosphate 1.2% / tretinoin 0.025%: a novel fixed‐dose combination treatment for acne vulgaris
Authors: Ochsendorf F.
Published: June 2015

The Global Alliance to Improve Outcomes in Acne Group recommends retinoid‐based combination therapy as first‐line therapy and the preferred treatment approach for almost all acne patients except those with the most severe disease. Clindamycin 1% (as clindamycin phosphate 1.2%)/tretinoin 0.025% (Clin‐RA) is a new fixed‐dose retinoid‐based combination therapy. The aqueous‐based gel formulation of Clin‐RA was designed to minimize skin irritation and optimize adherence with the therapy. It contains both solubilized and crystalline tretinoin which allows the retinoid to be slowly released onto the skin surface and decreases the potential for cutaneous irritation. A pooled analysis of three pivotal studies involving 4550 acne patients showed that Clin‐RA is well tolerated and effective at treating both inflammatory and non‐inflammatory acne lesions. The onset of action of Clin‐RA is rapid occurring within 2 weeks of treatment initiation. It is not associated with acne flaring or an increase in clindamycin‐resistant Propionibacterium acnes counts. Clin‐RA is considered as effective as adapalene 0.1%/benzoyl peroxide (BPO) 2.5%, whereas Clin‐RA has a more favourable tolerability profile. Clin‐RA may be more effective than clindamycin 1%/BPO 5% at treating non‐inflammatory acne lesions since the latter does not contain a retinoid to target comedones. Clin‐RA is also easy for patients to handle and apply, and has the advantage of not containing BPO which can bleach hair and fabrics. Taken together, the profile of Clin‐RA suggests Clin‐RA to be a first‐line treatment for patients with facial acne.
Effect of adapalene 0.1%/benzoyl peroxide 2.5% topical gel on quality of life and treatment adherence during long‐term application in patients with predominantly moderate acne with or without concomitant medication – additional results from the non‐interventional cohort study ELANG
Authors: Gollnick H.P.M. , Friedrich M. , Peschen M. , Pettker R. , Pier A. , Streit V. , Jöstingmeyer P. , Porombka D. , Rojo Pulido I. , Jäckel A.
Published: June 2015

Background

In addition to physical long‐lasting effects such as permanent scarring and disfigurement, acne has acute and long‐term psychosocial effects that affect the individual's quality of life. As with other chronic diseases, treatment success is often compromised by poor adherence.

Objective

Two main objectives of this non‐interventional study were to assess the long‐term effect of the fixed‐dose combination adapalene 0.1%/benzoyl peroxide 2.5% (adapalene‐BPO gel) on quality of life and treatment adherence.

Methods

Patients with moderate to severe facial acne receiving adapalene‐BPO alone or in combination with other drugs were enrolled in this non‐interventional study. Data were documented at baseline and after 3 and 9 months of adapalene‐BPO treatment. The secondary outcomes reported here include quality of life determined by the Cardiff Acne Disability Index (CADI), treatment adherence assessed by the ECOB (Elaboration d'un outil d'evaluation de l'observance des traitements medicamenteux) questionnaire, and patient satisfaction.

Results

In total, 5131 patients were included in the efficacy evaluation. After 9 months, mean (±SD) quality of life (CADI) improved significantly from 5.9 ± 3.0 to 2.4 ± 2.7 (P < 0.0001). Patients with more severe acne at baseline tended to achieve a greater improvement in quality of life. Long‐term adherence was found to be good in 83.9% of patients. Adherence had a significant effect on efficacy and quality of life (P < 0.0001 respectively). The vast majority of patients (92.1%) reported subjective improvement at the interim analysis. Accordingly, most patients (84.8%) were satisfied or very satisfied with adapalene‐BPO by the end of the observation period.

Conclusion

The clinical improvement of the disease led to an increase in quality of life among acne patients. The treatment success may be a motivation factor for patients to stay adherent over the long‐term treatment course, indicating the qualification of adapalene‐BPO topical gel as an appropriate medication also in the long‐term usage.