bluuebunny/crossref_metadata_2025 huggingface dataset:
Sarcopenia prevalence and factors associated with sarcopenia in older people living in a nursing home in Ankara Turkey
Authors: Yalcin Ahmet , Aras Sevgi , Atmis Volkan , Cengiz Ozlem Karaarslan , Varli Murat , Cinar Esat , Atli Teslime
Published: August 2015

Aim

Sarcopenia is prevalent in older people, and is related to survival and disability. There are no data on sarcopenia evaluated according to European Working Group on Sarcopenia in Older People criteria for nursing home residents in Turkey. We aimed to evaluate the prevalence of sarcopenia according to European Working Group on Sarcopenia in Older People criteria and associated factors with sarcopenia among nursing home residents in Turkey.

Methods

The study cohort consisted of individuals aged over 65 years and living in the Seyranbağları Nursing Home and Rehabilitation Center in Ankara, Turkey. Besides demographic and medical data, Mini‐Mental State Examination, activities of daily living, Mini‐Nutritional Assessment, body mass index, calf circumference, gait speed and handgrip strength were also investigated. Muscle mass was evaluated by bioelectrical impedance analysis. Sarcopenia was diagnosed according to European Working Group on Sarcopenia in Older People criteria.

Results

A total of 141 older individuals were evaluated. Sarcopenia was found in 29% (n = 41) of the participants. Participants with sarcopenia were older and had low scores for activities of daily living, low body mass index, greater cognitive dysfunction, high malnutrition risk and low calf circumference. Body mass index and calf circumference were found to be associated with sarcopenia in multivariate logistic regression analysis.

Conclusions

Almost one‐third of older nursing home residents were diagnosed with sarcopenia according to European Working Group on Sarcopenia in Older People criteria in this study in Turkey. Calf circumference and body mass index were associated with increased risk of sarcopenia among nursing home residents. This is the first study evaluating sarcopenia using European Working Group on Sarcopenia in Older People criteria in Turkey. Geriatr Gerontol Int 2016; 16: 903–910.
Influence of comorbidities on the efficacy of pulmonary rehabilitation in patients with chronic obstructive pulmonary disease
Authors: Higashimoto Yuji , Yamagata Toshiyuki , Maeda Kazushige , Honda Noritsugu , Sano Akiko , Nishiyama Osamu , Sano Hiroyuki , Iwanaga Takashi , Chiba Yasutaka , Fukuda Kanji , Tohda Yuji
Published: August 2015

Aim

To evaluate the influence of comorbidities and aging on pulmonary rehabilitation (PR) efficacy in patients with chronic obstructive pulmonary disease (COPD).

Methods

This was a retrospective cohort study of patients with COPD attending an outpatient PR program. Comorbidity information was collected with the Charlson Index, BODE index and COPD‐specific comorbidity test, and also included other common conditions not included in these indexes. The efficacy of PR was defined as a 54‐m increase in 6‐min walk distance or a four‐point decrease in St. George's Respiratory Questionnaire score. Patients were divided into two age groups according to the median age of 72 years.

Results

A total of 21 of 52 patients (40%) showed a clinically significant benefit by the 6‐min walk distance, and 29 patients (55.8%) by the St. George's Respiratory Questionnaire score. PR efficacy was not different between the elderly group and the younger group by either parameter. A total of 98% of the patients had at least one chronic comorbidity. Hypertension was the most frequently reported comorbidity (28.5%). Higher body mass index, Hospital Anxiety and Depression Scale anxiety score and St. George's Respiratory Questionnaire total score were associated with a good response to PR by the 6‐min walk distance. None of the individual comorbidities or indexes were correlated with the efficacy of PR. Multiple logistic regression analysis showed that body mass index was independently associated with the response to PR.

Conclusions

PR is equally effective in elderly and younger patients with COPD, with efficacy influenced by body mass index and anxiety. Geriatr Gerontol Int 2016; 16: 934–941.
High prevalence of subclinical hypothyroidism and nodular thyroid disease in patients on hemodialysis
Authors: Da Costa Ana Beatriz B.A. , Pellizzari Caio , Carvalho Gisah A. , Sant'Anna Beatriz C. , Montenegro Rafaela L. , Zammar Filho Roberto G. , Mesa Junior Cleo O. , Hauck Prante Patrícia R. , Olandoski Marcia , Carvalho Mauricio
Published: August 2015

Chronic kidney disease has been known to affect thyroid hormone metabolism. Low serum levels of T3 and T4 are the most remarkable laboratorial findings. A high incidence of goiter and nodules on thyroid ultrasonography has been reported in patients with end‐stage renal disease (ESRD). Our objective is to evaluate the prevalence of laboratorial and morphologic alterations in the thyroid gland in a cohort of patients with ESRD on hemodialysis (HD). Sixty‐one patients with ESRD on HD were selected and compared with 43 healthy subjects matched by age, gender, and weight. Patients were submitted to thyroid ultrasonography. T3, free T4 (FT4), thyroid‐stimulating hormone, antithyroglobulin, and antithyroperoxidase antibodies were measured. The mean age of patients with ESRD was 47.4 ± 12.3 and 61% were women. ESRD was mainly caused by hypertensive nephrosclerosis and diabetic nephropathy. Mean thyroid volume, as determined by ultrasonography, was similar in both groups. Patients with ESRD had more hypoechoic nodules when compared with the control group (24.1% vs. 7.9%, P = 0.056). Mean serum FT4 and T3 levels were significantly lower in patients with ESRD, and subclinical hypothyroidism was more prevalent in patients with ESRD (21.82% vs. 7.14% control group, P = 0.04). Titers of antithyroid antibodies were similar in both groups. ESRD was associated with a higher prevalence of subclinical hypothyroidism and lower levels of T3 and FT4. Almost a quarter of patients showed thyroid nodules >10 mm. Periodic ultrasound evaluation and assessment of thyroid function are recommended in patients with ESRD on HD.
Is PEP prescribed appropriately?
Authors: Whitlock G , Nwokolo N , McOwan A
Published: August 2015

We describe the characteristics of HIV post‐exposure prophylaxis (PEP) recipients and PEP indications at 56 Dean Street, a central London sexual health clinic. PEP was prescribed on 577 occasions. Most (97%) was given for unprotected anal intercourse. Over a fifth of exposures involved recreational drug use. Of the patients prescribed PEP, 5.9% were given PEP more than once in this period. As a snapshot of HIV risk behaviour, we note the prevalence of drug use, sex without condom use and group sex among PEP recipients.
Malva verticillata seed extracts upregulate the Wnt pathway in human dermal papilla cells
Authors: Lee E. Y. , Choi E.‐J. , Kim J. A. , Hwang Y. L. , Kim C.‐D. , Lee M. H. , Roh S. S. , Kim Y. H. , Han I. , Kang S.
Published: August 2015

Synopsis

Objective

Mesenchymal–epithelial interactions are important in controlling hair growth and the hair cycle. The β‐catenin pathway of dermal papilla cells (DPCs) plays a pivotal role in morphogenesis and normal regeneration of hair follicles. Deletion of β‐catenin in the dermal papilla reduces proliferation of the hair follicle progenitor cells that generate the hair shaft and induces an early onset of the catagen phase. In this study, a modulator of the Wnt/β‐catenin activity was studied in oriental herb extracts on cultured human DPCs.

Methods

The effect of Malva verticillata (M. verticillata) seeds on human DPCs was investigated by a Wnt/β‐catenin reporter activity assay system (β‐catenin–TCF/LEF reporter gene) and cell proliferation analysis. The synthesis of the factors related to hair growth and cycling was measured at both the mRNA and the protein level by semi‐quantitative PCR and Western blot analysis, respectively.

Results

An extract from M. verticillata seeds increased Wnt reporter activity in a concentration‐dependent manner and also led to increased β‐catenin levels in cultured human DPCs. Myristoleic acid, identified as an effective compound of M. verticillata seeds, stimulated the proliferation of DPCs in a dose‐dependent manner and increased transcription levels of the downstream targets: IGF‐1, KGF, VEGF and HGF. Myristoleic acid also enhanced the phosphorylation of MAPKs (Akt and p38).

Conclusion

Overall, the data suggest that this extract of M. verticillata seeds could be a good candidate for treating hair loss by modulating the Wnt/β‐catenin pathway in DPCs.
Optimum aqueous extraction conditions for preparation of a phenolic‐enriched Davidson's plum (Davidsonia pruriensF. Muell) extract
Authors: Chuen Tiffany L.K. , Vuong Quan V. , Hirun Sathira , Bowyer Michael C. , Goldsmith Chloe D. , Scarlett Christopher J.
Published: August 2015

This study aimed to optimise aqueous extraction conditions for total phenolic compounds (TPC) from Davidson's plum (Davidsonia pruriens F. Muell) and to assess the physicochemical and antioxidant properties of the phenolic‐enriched extract. The results showed that temperature, time and ratio significantly affected the extraction of TPC. Optimization of extraction conditions was performed using response surface methodology (RSM) utilising a Box–Behnken design. Optimal extraction conditions were determined to be temperature: 90 °C, extraction time: 30 min and solvent to mass ratio: 20:1 mL g−1. The extracted solid obtained under these conditions had low‐moisture content, high water solubility and contained 45 mg GAE g−1 of TPC, 22 mg RUE g−1 of flavonoids, 3.2 mg CAE g−1 of proanthocyanidins, 2 mg CGE g−1 of anthocyanidins and 56 mg ACE g−1 vitamin C. The extract possessed potent antioxidant capacity, but was comparatively lower than those of vitamin E and BHT. Thus, Davidson's plum should be further investigated for its potential health promoting benefits and utilisation in the nutraceutical and food industries.
Association between abdominal fat distribution, adipocytokines and metabolic alterations in obese low‐birth‐weight children
Authors: Domínguez Hernández C. , Klünder Klünder M. , Huang F. , Flores Armas E. M. , Velázquez‐López L. , Medina‐Bravo P.
Published: August 2015

Background

In addition to obesity, low birth weight (LBW) has been proposed as another independent risk factor associated with cardiovascular disease and type 2 diabetes mellitus.

Objective

This study aimed to evaluate the influence of birth weight on abdominal fat distribution, adipocytokine levels and associated metabolic alterations in obese children.

Methods

A cross‐sectional study was conducted in 92 children. Children were divided into three groups according to their body mass index and birth weight. Glucose and insulin (0 and 120 min), lipid profile and adipocytokines were measured. Abdominal fat distribution was assessed by magnetic resonance imaging.

Results

Obese LBW children had higher fasting glucose (P = 0.054) and insulin (P < 0.001), and 120 min glucose (P < 0.001) and insulin levels (P < 0.001), such as increased HOMA‐IR (homeostasis model assessment of insulin resistance index) (P < 0.001). Obesity and LBW were associated with lower concentrations of high molecular weight (HMW) adiponectin (−2.38 [IC 95% −4.27; −0.42, P = 0.018]) and higher subcutaneous adipose tissue (SAT) (28.05 [IC 95% 0.40; 55.7, P = 0.047]) compared with NBW obese children, independent of age or sex.

Conclusions

LBW in obese children is associated with lower HMW adiponectin, increased insulin resistance and greater SAT.
Urethra‐sparing high‐intensity focused ultrasound for localized prostate cancer: Functional and oncological outcomes
Authors: Shoji Sunao , Nakano Mayura , Fujikawa Hiroshi , Endo Kazuyuki , Hashimoto Akio , Tomonaga Tetsuro , Terachi Toshiro , Uchida Toyoaki
Published: August 2015

Objectives

To evaluate longitudinal changes in urinary function and quality of life, and the oncological outcomes of patients treated with urethra‐sparing high‐intensity focused ultrasound for localized prostate cancer.

Methods

Patients with negative findings in the urethra and the anterior urethral zone using transrectal ultrasound‐guided targeted biopsies, and magnetic resonance imaging, received urethra‐sparing or whole‐gland high‐intensity focused ultrasound as the primary therapy for localized prostate cancer without transurethral resection of the prostate. Longitudinal changes in urinary function and quality of life, and the oncological outcomes of the patients were analyzed retrospectively.

Results

The median follow‐up times for urethra‐sparing and whole‐gland high‐intensity focused ultrasound were 36 and 30 months, respectively. Comparing the patients treated with urethra‐sparing high‐intensity focused ultrasound (n = 45) with those treated with whole‐gland high‐intensity focused ultrasound (n = 65), there were significant differences in the International Prostate Symptom Score (P = 0.014) at 3 months, International Prostate Symptom Score quality of life (P = 0.033) at 3 months, maximum urinary flow rate (mL/s; at 3 months, P = 0.010; at 6 months, P = 0.038) and residual urine volume (mL; at 3 months, P < 0.0001; at 6 months, P = 0.016; at 12 months, P = 0.028). For quality of life, there were significant differences in Functional Assessment of Cancer Therapy – General (at 3 months, P = 0.022) and Functional Assessment of Cancer Therapy – Prostate (at 3 months, P = 0.028; at 6 months, P = 0.034). There were no significant differences in oncological outcomes regarding negative biopsy rates on follow up (91% vs 92%; P = 0.8) or biochemical disease‐free survival rates (86.7% vs 89.2%; P = 0.7).

Conclusions

Urethra‐sparing high‐intensity focused ultrasound might prevent prolonged bladder outlet obstruction, and could be a treatment option for localized prostate cancer.
Predictors of trifecta outcomes in laparoscopic partial nephrectomy for clinical T1a renal masses
Authors: Osaka Kimito , Makiyama Kazuhide , Nakaigawa Noboru , Yao Masahiro
Published: August 2015

Objectives

To assess trifecta outcomes for laparoscopic partial nephrectomy for clinical T1a renal masses.

Methods

A total of 63 patients who underwent laparoscopic partial nephrectomy for clinical T1a renal masses by a single surgeon between January 2007 and December 2012 were evaluated. Demographic and perioperative data were collected and statistically analyzed. We retrospectively evaluated trifecta outcomes. Multivariable logistic regression models were used to analyze predictors of trifecta outcomes. Trifecta outcomes were defined as the combination of total ischemia time <25 min, negative surgical margins and no surgical complications.

Results

Of the 63 patients, 39 (62%) achieved trifecta. A total of 21 patients had total ischemia time ≥25 min, four patients had positive surgical margins and two patients had surgical complications. Tumor size (P < 0.001), distance from the urine collecting system or sinus (P < 0.001) and surgeon's learning curve (P < 0.01) were significantly different between the trifecta and no‐trifecta group. Multivariate analysis showed tumor size and surgeon's learning curve to be independent predictors of trifecta outcomes.

Conclusions

Tumor size and surgeon's learning curve seems to be strong predictors of trifecta outcomes after laparoscopic partial nephrectomy in T1a renal masses.
Patient Satisfaction in a One‐Stop Haematuria clinic and Urology Outpatients: A Comparison of Clinics
Authors: King Kathryn E.
Published: August 2015

One‐stop clinics have shown to improve the patient experience in early diagnosis of potentially life threatening conditions, although this service is less evident in Urology, where morbidity and mortality resulting from bladder cancers are increasing. This study will discuss whether or not one‐stop haematuria clinics improve patient satisfaction. A survey analysis comparing patient satisfaction for a one‐stop haematuria clinic and a traditional outpatient service was developed, based around the ‘Determinants and Components’ theory. A convenience sample of 102 haematuria patients attending either the one‐stop clinic (Route A) or an outpatient clinic within the Urology service (Route B), at an assigned National Health Service hospital, were invited to complete a ‘patient satisfaction’ questionnaire. Data were compared between clinic routes according to the patient satisfaction themes of: Time and Availability, Quality of Care, Environment, Accessibility and Convenience and Global Satisfaction. Response rate was 51%; with overall positive patient satisfaction levels for both clinics. Route A patients were most satisfied with Quality of Care; however, reported problems relating to prior information provision and appointment co‐ordination. For Route B, Availability and Time was a primary source of both satisfaction and dissatisfaction, receiving contradictory qualitative and quantitative responses respectively. Both groups rated Environment and Accessibility and Convenience highly overall, yet these were not a primary determinant of satisfaction. The majority of haematuria patients (82%), expressed a preference to attend a one‐stop clinic over several outpatient appointments. Practical recommendations for related service improvements are offered.
Outcomes of simultaneous heart–kidney and lung–kidney transplantations: the Australian and New Zealand experience
Authors: Ruderman I. , Sevastos J. , Anthony C. , Ruygrok P. , Chan W. , Javorsky G. , Bergin P. , Snell G. , Menahem S.
Published: August 2015

Background

Heart or lung transplantation alone in individuals with significant pre‐existing renal impairment results in high mortality and morbidity. Simultaneous heart–kidney (SHK) or simultaneous lung–kidney (SLK) transplantation may be considered in patients with dual organ failure not suitable for single organ transplantation.

Aim

We aimed to outline the Australian and New Zealand experience of SHK and SLK transplantations, focussing on patient characteristics and survival.

Methods

We analysed all SHK and SLK transplants performed in four centres across Australia and New Zealand between 1990 and 2014.

Results

Over the study period, 35 SHK and 3 SLK transplants were performed across 4 transplant centres. Mean age at transplantation for SHK transplants was 45 years, and for SLK transplant was 27 years. The most common aetiology of renal failure was glomerulonephritis. Most SHK transplant patients (77%) required renal replacement therapy prior to transplantation, with only one of the three patients undergoing SLK transplant, dialysis dependent. One‐year survival for the cohort was 79%, which is lower than reported for single organ transplantation. However, 5‐ and 10‐year survivals of 76% and 68%, respectively, were comparable. Isolated renal graft loss was seen in five patients, with only one patient successfully re‐transplanted and the rest commencing dialysis.

Conclusion

The Australian and New Zealand experience of SHK and SLK includes 38 patients with a high 1‐year mortality, but excellent 5‐ and 10‐year survivals. Based on this, it seems reasonable to continue to offer combined organ transplantation to select patients with dual organ failure.
The wide‐ranging clinical implications of the short telomere syndromes
Authors: Barbaro P. M. , Ziegler D. S. , Reddel R. R.
Published: August 2015

There is an increasing number of inherited disorders in which excessive telomere shortening underlies the molecular defect, with dyskeratosis congenita (DC) being the archetypal short telomere syndrome. DC is classically described as a mucocutaneous triad of oral leukoplakia, nail dystrophy and abnormal skin pigmentation. However, excessive telomere shortening can affect almost any organ system, so the clinical manifestations are protean, including developmental delay, cerebellar hypoplasia, exudative retinopathy, aplastic anaemia, acute myeloid leukaemia, idiopathic pulmonary fibrosis, idiopathic hepatic cirrhosis, head and neck cancer and dental abnormalities, and may be multi‐systemic. Undiagnosed patients may be seen by essentially any medical subspecialist. Correct diagnosis is important to ensure appropriate management, and for initiating investigations to identify affected family members. Treatment is often supportive, with transplantation offering cure for pulmonary fibrosis or bone marrow failure. Higher rates of mortality and morbidity with transplantation often require regimen alterations, underscoring the need for correct diagnosis. Short telomeres result from mutations in genes essential for telomere maintenance (e.g. genes encoding subunits of the telomerase enzyme complex). Disease severity reflects not only the severity of the defect, but also the inheritance of short telomeres, giving rise to incomplete penetrance and genetic anticipation. Attendees of the inaugural Australian Short Telomere Syndrome Conference were updated on the current scientific and clinical understanding of these disorders, and discussed the best approach for management of these patients in the Australian context. This review will include recommendations from the conference and aims to increase awareness of short telomere disorders.
1α,25‐dihydroxyvitamin D3 acts via transforming growth factor‐β to up‐regulate expression of immunosuppressive CD73 on human CD4+ Foxp3– T cells
Authors: Mann Elizabeth H. , Chambers Emma S. , Chen Yin‐Huai , Richards David F. , Hawrylowicz Catherine M.
Published: August 2015

Vitamin D deficiency is associated with increased incidence and severity of various immune‐mediated diseases. Active vitamin D (1α,25‐dihydroxyvitamin D3; 1,25(OH)2D3) up‐regulates CD4+ T‐cell expression of the purine ectonucleotidase CD39, a molecule that is associated with the generation of anti‐inflammatory adenosine. Here we aimed to investigate the direct impact of 1,25(OH)2D3 on expression of the downstream ecto‐5′‐nucleotidase CD73 by human CD4 T cells, and components of the transforming growth factor‐β (TGF‐β) pathway, which have been implicated in the modulation of CD73 by murine T cells. At 10−8 to 10−7 m, 1,25(OH)2D3 significantly increased expression of CD73 on peripheral human CD4+ T cells. Although 1,25(OH)2D3 did not affect the mRNA expression of latent TGF‐β1, 1,25(OH)2D3 did up‐regulate expression of TGF‐β‐associated molecules [latency‐associated peptide (LAP), glycophorin A repetitions predominant (GARP), GP96, neuropilin‐1, thrombospondin‐1 and αv integrin] which is likely to have contributed to the observed enhancement in TGF‐β bioactivity. CD73 was highly co‐expressed with LAP and GARP following 1,25(OH)2D3 treatment, but unexpectedly, each of these cell surface molecules was expressed primarily on CD4+ Foxp3– T cells, rather than CD4+ Foxp3+ T cells. Notably, neutralization of TGF‐β significantly impaired 1,25(OH)2D3‐mediated induction of CD73. Collectively, we show that 1,25(OH)2D3 enhances expression of CD73 on CD4+ Foxp3– T cells in a process that is at least partially TGF‐β‐dependent. These data reveal an additional contributing mechanism by which vitamin D may be protective in immune‐mediated disease.
Patients with pyoderma gangrenosum – analyses of the German DRG data from 2012
Authors: Jockenhöfer Finja , Klode Joachim , Kröger Knut , Roesch Alexander , Al Ghazal Philipp , Dissemond Joachim
Published: August 2015

Pyoderma gangrenosum (PG) is a rarely diagnosed non‐infectious neutrophil ulcerative dermatosis with only limited knowledge on the underlying auto‐inflammatory process. To unravel common cofactors and comorbidities in patients with PG we analysed Diagnosis Related Groups (DRG) cases of all inpatients diagnosed with PG in German hospitals in 2012. We received data of 1227 inpatient cases having PG as primary diagnosis and 985 inpatient cases with PG as secondary diagnosis. The ratio of women to men was 2:1, and the most often registered age was 75–79 years. Common comorbidities were arterial hypertension (50·3%), non‐insulin‐dependent diabetes mellitus (25·1%) and dysfunction of lipid metabolism (10·8%). In sum, 94·8% of the patients suffered from aspects of metabolic syndrome. Other comorbidities were Crohn's disease (4·5%), ulcerative colitis (4·2%), chronic polyarthritis (5·2%), monoclonal gammopathy or myelodysplastic syndrome (2·5%), leukaemia (1·1%) and lymphoma (0·4%). DRG data do not reflect individual patients, but rather patient cases. We described the worldwide largest PG population and confirmed a wide range of potentially relevant and partly not yet described cofactors and comorbidities such as metabolic syndrome.
Methods to assess area and volume of wounds – a systematic review
Authors: Jørgensen Line Bisgaard , Sørensen Jens A , Jemec Gregor BE , Yderstræde Knud B
Published: August 2015

Wound measurement is important in monitoring the healing process of chronic wounds and in evaluating the effect of treatment. The objective of this systematic review was to evaluate evidence from the literature on accuracy, agreement, reliability and feasibility of wound measurement techniques described since 1994. Studies were identified by searching the electronic databases PubMed, Embase and Cochrane Library. Of the 12 013 studies identified, 43 were included in the review. A total of 30 papers evaluated techniques for measuring wound area and 13 evaluated techniques for measuring wound volume. The six approaches for measuring wound area were simple ruler method (10 papers), mathematical models (5 papers), manual planimetry (10 papers), digital planimetry (16 papers), stereophotogrammetry (2 papers) and digital imaging method (20 papers). Of these studies, 10 evaluated accuracy, 15 agreement, 17 reliability and 25 mentioned feasibility. The number of wounds examined in the studies was highly variable (n = 3–260). Studies evaluating techniques for measuring wound volume included between 1 and 50 wounds and evaluated accuracy (4 studies), agreement (6 studies), reliability (8 studies) and feasibility (12 studies). Digital planimetry and digital imaging were considered the most accurate and reliable methods for area measurement, particularly in larger and irregularly shaped wounds. None of the three‐dimensional technologies have so far had a major impact, because of their low accuracy, high cost and complexity in handling the system set‐up.
Double deprivation: a phenomenological study into the experience of being a carer during a mental health crisis
Authors: Albert Rikke , Simpson Alan
Published: August 2015

Aim

To explore carers’ experience of caring during a mental health crisis.

Background

Community mental health care including crisis care relies increasingly on carers. The relationship between carers and professionals is at times fraught due to issues of what constitutes a crisis, confidentiality and a perception of lack of empathy. The caring experience can lead carers to feel isolated and neglected.

Design

A qualitative study with a phenomenological approach. Eight carers participated and were interviewed individually using a semi‐structured approach.

Method

Analysis used the Interpretive Phenomenological Analysis method including transcribing of interviews, initial noting, searching for connections and patterns across the transcripts and cases. The themes were checked with the participants for their views on the emerging themes. The data were collected from November 2011–May 2012.

Findings

Carers experienced ‘double deprivation’ by not receiving support from professionals and protecting their social network from the trauma of the crisis. The caring in crisis invoked complex feelings of guilt and loyalty which made discussing aggression difficult. Caring was described as a terrifying experience not just because of the aggression but also because of the perception of abandonment by professionals.

Conclusion

The experience was an overwhelmingly negative one with a wish for acknowledgement of the crisis and support from mental health services. For most of the participants the caring during crisis was traumatic which left the carer feeling isolated and unsupported. The study should be used to help educate professionals on the complexities of caring during a crisis.
Lessons from Law About Incomplete Commodification in the Egg Market
Authors: Krawiec Kimberly D.
Published: August 2015

This article seeks to illustrate egg donation's incompletely commodified status through an analysis of two cases of first impression, highlighting the tensions that arise from attempts to reconcile egg donation's reality as a robust commercial industry with the nonmarket norms that traditionally underlie reproduction. Antitrust and taxation litigation may seem unlikely sources for guidance in navigating the tensions in egg donation's uncertain place between the worlds of gift and market exchange. Nonetheless, this litigation forces an explicit consideration of how egg donation is perceived, talked about, and operationalized, and where along the gift‐market spectrum it fits. These cases also engage familiar questions of commodification, coercion, and exploitation, which are surprisingly central litigation issues.
Is There a Right to Surrogacy?
Authors: Straehle Christine
Published: August 2015

Access to surrogacy is often cast in the language of rights. Here, I examine what form such a right could take. I distinguish between surrogacy as a right to assisted procreation, and surrogacy as a contractual right. I find the first interpretation implausible: it would give rise to claims against the state that no state can fulfil, namely the provision of sufficient surrogates to satisfy the need. Instead, I argue that the right to surrogacy can only be plausibly understood as a contractual right. I then investigate two different sets of harms that are often employed to argue against such a contractual interpretation of the right to surrogacy: (1) harm to women's interests in a gendered society, and (2) harm to the sense of self of the surrogate. I assess both of these through the analytical lens of vulnerability. I find neither of them to be convincing arguments against surrogacy contracts. In conclusion, I agree that surrogacy contracts should be carefully regulated, but I disagree with those who call for prohibition of the right to surrogacy as a contractual right.
Colorblind or colorful? How diversity approaches affect cultural majority and minority employees
Authors: Jansen Wiebren S. , Vos Menno W. , Otten Sabine , Podsiadlowski Astrid , van der Zee Karen I.
Published: August 2015

We examined how perceived organizational diversity approaches (colorblindness and multiculturalism) relate to affective and productive work outcomes for cultural majority and minority employees. Using structural equation modeling on data collected in a panel study among 152 native Dutch majority and 77 non‐Western minority employees, we found that perceptions of a colorblind approach were most strongly related to work satisfaction and perceived innovation for majority members, while perceptions of a multicultural approach “worked best” for minority members. Moreover, these effects were fully mediated by the extent to which employees felt socially included in the organization. Thus, while inclusion is an important factor for both groups to enhance work outcomes, it is facilitated by different diversity approaches for majority and minority members.
Non‐surgical treatment of peri‐implant mucositis and peri‐implantitis at zirconia implants: a prospective case series
Authors: Schwarz Frank , John Gordon , Hegewald Andrea , Becker Jürgen
Published: August 2015

Objectives

To assess the efficacy of non‐surgical therapy for the management of peri‐implant diseases at a two‐piece zirconium implant system.

Material & Methods

Thirty‐four patients with 45 implants participated in this study. Seventeen patients (24 implants) were diagnosed with peri‐implant mucositis and received mechanical debridement + local antiseptic therapy using chlorhexidine digluconate (MD + CXH), while 17 patients (21 implants) diagnosed with peri‐implantitis were assigned to Er:YAG laser therapy. In both groups, post‐operative maintenance care included supramucosal plaque removal and local pocket irrigation using CHX. The primary endpoint was defined as disease resolution at 6 months (i.e. absence of bleeding upon probing (BOP) at mucositis sites/absence of BOP and probing pocket depths (PD) ≥6 mm at peri‐implantitis sites).

Results

Resolution of peri‐implant mucositis and peri‐implantitis was obtained in 9/17 (52.9%) (p = 0.001) and 5/17 (29.4%) (p = 0.02) of the patients respectively.

Conclusion

Non‐surgical treatment of either peri‐implant mucositis using MD + CHX or peri‐implantitis using ERL at zirconia implants was associated with significant short‐term clinical improvements. A complete disease resolution, however, was not achieved in the majority of the patients.
Practitioner Review: Borderline personality disorder in adolescence – recent conceptualization, intervention, and implications for clinical practice
Authors: Sharp Carla , Fonagy Peter
Published: August 2015

Background

The past decade has seen an unprecedented increase in research activity on personality disorders (PDs) in adolescents. The increase in research activity, in addition to major nosological systems legitimizing the diagnosis of borderline personality disorder (BPD) in adolescents, highlights the need to communicate new research on adolescent personality problems to practitioners.

Scope

In this review, we provide up‐to‐date information on the phenomenology, prevalence, associated clinical problems, etiology, and intervention for BPD in adolescents. Our aim was to provide a clinically useful practitioner review and to dispel long‐held myths about the validity, diagnostic utility, and treatability of PDs in adolescents.

Findings and conclusion

Alongside providing up‐to‐date information on the phenomenology, prevalence, and etiology, we also report on associated clinical problems and interventions for adolescent BPD. It is only through early active assessment and identification of youngsters with these problems that a lifetime of personal suffering and health system burden can be reduced or altogether avoided. A variety of evidence‐based approaches are now available to treat BPD and related clinical problems in young people. Future research should focus on establishing optimal precision in the diagnostic processes in different treatment settings.
Evolution of anuran brains: disentangling ecological and phylogenetic sources of variation
Authors: Liao W. B. , Lou S. L. , Zeng Y. , Merilä J.
Published: August 2015

Variation in ecological selection pressures has been implicated to explain variation in brain size and architecture in fishes, birds and mammals, but little is known in this respect about amphibians. Likewise, the relative importance of constraint vs. mosaic hypotheses of brain evolution in explaining variation in brain size and architecture remains contentious. Using phylogenetic comparative methods, we studied interspecific variation in brain size and size of different brain parts among 43 Chinese anuran frogs and explored how much of this variation was explainable by variation in ecological factors (viz. habitat type, diet and predation risk). We also evaluated which of the two above‐mentioned hypotheses best explains the observed patterns. Although variation in brain size explained on average 80.5% of the variation in size of different brain parts (supporting the constraint hypothesis), none of the three ecological factors were found to explain variation in overall brain size. However, habitat and diet type explained a significant amount of variation in telencephalon size, as well in three composite measures of brain architecture. Likewise, predation risk explained a significant amount of variation in bulbus olfactorius and optic tecta size. Our results show that evolution of anuran brain accommodates features compatible with both constraint (viz. strong allometry among brain parts) and mosaic (viz. independent size changes in response to ecological factors in certain brain parts) models of brain size evolution.
Connecting proximate mechanisms and evolutionary patterns: pituitary gland size and mammalian life history
Authors: Kamilar J. M. , Tecot S. R.
Published: August 2015

At the proximate level, hormones are known to play a critical role in influencing the life history of mammals, including humans. The pituitary gland is directly responsible for producing several hormones, including those related to growth and reproduction. Although we have a basic understanding of how hormones affect life history characteristics, we still have little knowledge of this relationship in an evolutionary context. We used data from 129 mammal species representing 14 orders to investigate the relationship between pituitary gland size and life history variation. Because pituitary gland size should be related to hormone production and action, we predicted that species with relatively large pituitaries should be associated with fast life histories, especially increased foetal and post‐natal growth rates. Phylogenetic analyses revealed that total pituitary size and the size of the anterior lobe of the pituitary significantly predicted a life history axis that was correlated with several traits including body mass, and foetal and post‐natal growth rates. Additional models directly examining the association between relative pituitary size and growth rates produced concordant results. We also found that relative pituitary size variation across mammals was best explained by an Ornstein–Uhlenbeck model of evolution, suggesting an important role of stabilizing selection. Our results support the idea that the size of the pituitary is linked to life history variation through evolutionary time. This pattern is likely due to mediating hormone levels but additional work is needed. We suggest that future investigations incorporating endocrine gland size may be critical for understanding life history evolution.
Colour pattern homology and evolution inVanessabutterflies (Nymphalidae:Nymphalini): eyespot characters
Authors: Abbasi R. , Marcus J. M.
Published: August 2015

Ocelli are serially repeated colour patterns on the wings of many butterflies. Eyespots are elaborate ocelli that function in predator avoidance and deterrence as well as in mate choice. A phylogenetic approach was used to study ocelli and eyespot evolution inVanessabutterflies, a genus exhibiting diverse phenotypes among these serial homologs. Forty‐four morphological characters based on eyespot number, arrangement, shape and the number of elements in each eyespot were defined and scored. Ocelli from eight wing cells on the dorsal and ventral surfaces of the forewing and hindwing were evaluated. The evolution of these characters was traced over a phylogeny ofVanessabased on 7750DNAbase pairs from 10 genes. Our reconstruction predicts that the ancestralVanessahad 5 serially arranged ocelli on all four wing surfaces. The ancestral state on the dorsal forewing and ventral hindwing was ocelli arranged in two heterogeneous groups. On the dorsal hindwing, the ancestral state was either homogenous or ocelli arranged in two heterogeneous groups. On the ventral forewing, we determined that the ancestral state was organized into three heterogeneous groups. InVanessa,almost all ocelli are individuated and capable of independent evolution relative to other colour patterns except for the ocelli in cells −1 and 0 on the dorsal and ventral forewings, which appear to be constrained to evolve in parallel. The genusVanessais a good model system for the study of serial homology and the interaction of selective forces with developmental architecture to produce diversity in butterfly colour patterns.
Housing bubbles and the increase of flood exposure. Failures in flood risk management on the Spanish south‐eastern coast (1975–2013)
Authors: Pérez‐Morales A. , Gil‐Guirado S. , Olcina‐Cantos J.
Published: August 2015

In recent decades, there has been a significant increase in economic losses caused by flood events on the coastal region of south‐eastern Spain. The increase of extreme rainfall events forecast by the climate change models is currently not reflected in the statistics which suggests that the principal cause is due to the exposure experienced within the past 40 years. Consequently, it is interesting to evaluate the effect of urban growth in flood‐prone areas and the role played by government institutions in mitigating the increase in exposure. For this study, the cadastral information and the hydrological modelling data for the return periods of 10, 50, 100 and 500 years were used. This allows high‐resolution spatial–temporal results to be obtained that show one of the most significant growths in exposure in Spain and Europe, as well as the low efficiency that risk mitigation measures have had.
Genotype of UGT1A1 and phenotype correlation between Crigler–Najjar syndrome type II and Gilbert syndrome
Authors: Maruo Yoshihiro , Nakahara Sayuri , Yanagi Takahide , Nomura Akitaka , Mimura Yu , Matsui Katsuyuki , Sato Hiroshi , Takeuchi Yoshihiro
Published: August 2015

Background and Aims:

Hereditary unconjugated hyperbilirubinemias, Crigler–Najjar syndrome type I, Crigler–Najjar syndrome type II (CN‐2), and Gilbert syndrome (GS) all result from mutations of the bilirubin uridine 5'‐diphosphate (UDP)‐glucuronosyltransferase gene (UGT1A1). Often, to distinguish between CN‐2 and GS is difficult because the borderline of the two syndromes is unclear. We analyzed the genotypes and phenotypes of 163 Japanese patients with CN‐2 or GS.

Methods:

Japanese patients (99 males and 64 females) with unconjugated hyperbilirubinemia were analyzed. Their serum bilirubin concentrations varied from 1.2 to 22.2 mg/dL (20 to 379 μM). Genetic analysis of UGT1A1 was performed by PCR‐amplified direct sequencing. Association between serum bilirubin concentrations and genotypes group (typical CN‐2, intermediate group, and typical GS) was studied.

Results:

Most patients had biallelic mutations of UGT1A1. Moreover, many of them (78.5%) had multiple mutations. The mutation in typical CN‐2 was a homozygous double missense mutation of p.[G71R:Y486D]. In typical GS group, four prevalent genotypes were detected: homozygous UGT1A1*28, UGT1A1*6/UGT1A1*28, and homozygous UGT1A1*6, and UGT1A1*27/UGT1A1*28. In the intermediate group, three genotypes, p.[G71R:Y486D]/UGT1A1*7, p.[G71R:Y486D]/UGT1A1*6, and homozygous UGT1A1*7, were detected. Serum bilirubin concentrations of typical CN‐2, intermediate group, and typical GS are respectively 12.9 ± 5.1, 5.2 ± 2.2, and 2.8 ± 1.1 mg/dL. Serum bilirubin concentration among the three groups is statistically different (P < 0.0001).

Conclusions:

The serum bilirubin concentration varied continuously from GS to CN‐2 depending on genotypes. Because of the combination of the mutations and polymorphisms, many patients showed intermediate serum bilirubin concentration between two syndromes. Clinically, it is difficult to distinguish clearly between the two syndromes.
Effects of esophageal capsaicin instillation on acid induced excitation of secondary peristalsis in humans
Authors: Liu Tso‐Tsai , Yi Chih‐Hsun , Lei Wei‐Yi , Hung Jui‐Sheng , Chen Chien‐Lin , Orr William C.
Published: August 2015

Background/Aim

Esophageal instillation of capsaicin or hydrochloric acid enhances secondary peristalsis. Our aim was to investigate whether intra‐esophageal capsaicin infusion can influence symptom perception and physiological alteration of secondary peristalsis subsequent to acid infusion.

Methods

Secondary peristalsis was induced by mid‐esophagus injections of air in 18 healthy subjects. Two different sessions including esophageal infusion of hydrochloric acid (0.1 N) following pretreatment with saline or capsaicin‐containing red pepper sauce were randomly performed at least one week apart. Symptoms of heartburn and secondary peristalsis were determined and compared between each study session.

Results

The intensity of heartburn symptom subsequent to acid infusion was significantly reduced after capsaicin infusion as compared with saline infusion (54 ± 3 vs 61 ± 3; P = 0.03). Capsaicin infusion significantly increased the threshold volume of secondary peristalsis to rapid air injections subsequent to esophageal acid infusion (8.0 ± 0.5 mL vs 4.4 ± 0.3 mL; P < 0.0001). The frequency of secondary peristalsis subsequent to acid infusion was significantly decreased after capsaicin infusion as compared to saline infusion (70% [60−82.5%] vs 80% [70−90%]; P = 0.03). Capsaicin infusion significantly decreased the pressure wave amplitude of secondary peristalsis subsequent to acid infusion during rapid air injections (90.6 ± 8.7 mmHg vs 111.1 ± 11.1 mmHg; P = 0.03).

Conclusions

Capsaicin appears to desensitize the esophagus to acid induced excitation of secondary peristalsis in humans, which is probably mediated by rapidly adapting mucosal mechanoreceptors. High capsaicin‐containing diet might attenuate normal physiological response to abrupt acid reflux by inhibiting secondary peristalsis.
Analysis of mitochondrial mechanical dynamics using a confocal fluorescence microscope with a bent optical fibre
Authors: LI YONGBO , HONDA SATOSHI , IWAMI KENTARO , OHTA YOSHIHIRO , UMEDA NORIHIRO
Published: August 2015

The cells in the cardiovascular system are constantly subjected to mechanical forces created by blood flow and the beating heart. The effect of forces on cells has been extensively investigated, but their effect on cellular organelles such as mitochondria remains unclear. We examined the impact of nano‐Newton forces on mitochondria using a bent optical fibre (BOF) with a flat‐ended tip (diameter exceeding 2 μm) and a confocal fluorescence microscope. By indenting a single mitochondrion with the BOF tip, we found that the mitochondrial elastic modulus was proportional to the (−1/2) power of the mitochondrial radius in the 9.6–115 kPa range. We stained the mitochondria with a potential‐metric dye (TMRE) and measured the changes in TMRE fluorescence intensity. We confirmed that more active mitochondria exhibit a higher frequency of repetitive transient depolarization. The same trend was observed at forces lower than 50 nN. We further showed that the depolarization frequency of mitochondria decreases under an extremely large force (nearly 100 nN). We conclude that mitochondrial function is affected by physical environmental factors, such as external forces at the nano‐Newton level.
A general model for resolution of digital holographic microscopy
Authors: WU XIUPIN , GAO WANRONG
Published: August 2015

For digital holographic microscopic imaging, the resolution in the reconstructed image is one of the most important parameters. To optimize the lateral resolution, a general model for the resolution of digital holographic microscopy (DHM) is proposed in this work, in which the effects of the sizes of each pixel, total area of the charge coupled device (CCD) and the microscopic objective lens are taken into account. Comparison between our model and others was carried out by calculating the point spread function (PSF) of DHM at different reconstruction distances and with different fill factors. It is shown that the effect of fill factors on the resolution of DHM becomes significant when the reconstruction distance is long. For high resolution DHM imaging the influence of fill factors must be taken into account when estimating the resolution of the reconstructed image. Furthermore, It is also demonstrated that the sidelobe of PSF can be cut effectively choosing appropriate values of the fill factors. Finally, the reconstructions of polyethylene microspheres have been implemented to demonstrate the theoretical analysis. These results obtained are helpful for estimation of the resolution and design of the DHM systems.