bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence and correlates of diabetes distress, perceived stress and depressive symptoms among adults with early‐onset Type 2 diabetes: cross‐sectional survey results from the Danish DD2 study
Authors: Bo A. , Pouwer F. , Juul L. , Nicolaisen S. K. , Maindal H. T.
Published: July 2019

Aims

To establish the prevalence of diabetes distress, perceived stress and depressive symptoms among adults with early‐onset Type 2 diabetes, and to examine their association with socio‐demographic and clinical characteristics.

Methods

A cross‐sectional survey was performed among individuals with Type 2 diabetes aged 20‐45 years who were included in the Danish nationwide Danish Center for Strategic Research in Type 2 Diabetes cohort between 2010 and 2016. The survey assessed diabetes distress (20‐item Problem Areas in Diabetes Scale), perceived stress (10‐item Perceived Stress Scale) and depressive symptoms (10‐item short form of the Center for Epidemiological Studies Depression Scale Revised), as well as socio‐demographic characteristics. Clinical data were collected from national health registers.

Results

In total, 216/460 (47%) individuals (48% women) with Type 2 diabetes completed the survey. The median (IQR) age was 42 (38–44) years and the diabetes duration was 5 (3–7) years. In total, 24% of respondents reported high diabetes distress (Problem Areas in Diabetes Scale ≥ 40), 46% reported high perceived stress (Perceived Stress Scale ≥ 18) and 41% reported elevated symptoms of depression (Center for Epidemiological Studies Depression Scale Revised ≥ 10). The prevalence of emotional problems was higher among women than men. Diabetes distress was higher among those prescribed non‐insulin glucose‐lowering drugs (vs. no glucose‐lowering drugs), but was not associated with other clinical or socio‐demographic characteristics. High perceived stress was associated with being unemployed and using antidepressant medication, and elevated depressive symptoms were associated with low education level, unemployment, living alone, having a psychiatric disorder and using antidepressant medication.

Conclusion

We found a high prevalence of emotional problems among adults with early‐onset Type 2 diabetes in Denmark. Health care for this group should focus on both physical health and psychosocial circumstances and should also address general as well as diabetes‐specific emotional problems.
Coping with the cold: energy storage strategies for surviving winter in freshwater fish
Authors: Fernandes Timothy , McMeans Bailey C.
Published: July 2019

For many ectothermic animals, the acquisition, storage and depletion of lipids is integral to successfully coping with reduced metabolic rates and activity levels associated with cold, winter periods. In fish, lipids are crucial for overwinter survival and successful reproduction. The timing and magnitude of seasonal lipid storage should therefore vary predictably among fish with different thermal preferences and spawn times. Small‐ and large‐bodied fish should also face different constraints associated with season that influence lipid cycling. However, much work to date has been species‐ and location‐specific and a general conceptual model for the seasonal energy budgets of freshwater fish is lacking. Here, we conducted a comprehensive literature review of seasonal lipid levels in freshwater fishes. We predicted that warm and cool water species would be more likely to demonstrate peak lipid levels during warm months than cold water species, and expected a larger magnitude of annual lipid cycling in warm and cool water compared to cold water fish. We also expected dampened lipid cycling in larger fish due to their lower mass‐specific metabolic rates. Observed patterns in the timing and magnitude of lipid storage contradicted our prediction because lipid cycling was widespread across species, despite thermal guild, with peak lipid levels commonly occurring during warmer months, even in cold water fish. For body size effects, larger bodied fish species had dampened seasonal lipid cycling, as predicted. We developed a conceptual framework describing how the ‘scope’ for variation in annual lipid cycling changes with body size both among and within species in order to guide future work. Together, our findings suggest that energy acquired during warm months is broadly important for overwinter survival and reproduction in fishes, and provide a new perspective on the differential constraints and physiological responses to seasonality among freshwater fish. Improving our understanding of these dynamics is especially pressing given that a changing global climate is anticipated to alter existing seasonal signals.
Diamondback moth egg susceptibility to rainfall: effects of host plant and oviposition behavior
Authors: Rahman Md Mahbubur , Zalucki Myron P. , Furlong Michael J.
Published: July 2019

Oviposition patterns of the diamondback moth (DBM), Plutella xylostella L. (Lepidoptera: Plutellidae), differ between common cabbage (Brassica oleracea L. var. capitata) and Chinese cabbage (Brassica rapa L. var. pekinensis) (Brassicaceae) host plants. This study shows that the moth prefers to oviposit on adaxial rather than abaxial leaf surfaces and petioles of both host plants. More eggs were laid in leaf veins than on leaf laminas of both host plants, especially in Chinese cabbage, where 94.6% of eggs were laid in veins. On Chinese cabbage, very few eggs were laid in clusters (≥2 eggs), whereas on common cabbage approximately 30% of eggs were laid in groups of 2 or more eggs. Removal of wax from common cabbage leaves dramatically increased the number of eggs laid singly on the leaf lamina of treated plants, suggesting that leaf waxes affect how eggs are distributed by ovipositing DBM. Eggs were most susceptible to removal by rainfall from the plant surface immediately (<1 h) after oviposition and when close to hatching (>72h old) whereas they were least susceptible 24 h after oviposition. Eggs laid on common cabbage plants were more susceptible to simulated rainfall than eggs laid on Chinese cabbage plants. On common cabbage plants, egg susceptibility to rainfall on different plant parts ranked adaxial leaf surfaces>petioles = abaxial leaf surfaces>stem, but there was no difference in egg susceptibility to rainfall on the various plant parts of Chinese cabbage. Furthermore, on common cabbage plants, eggs laid on both adaxial and abaxial leaf surfaces were afforded significant protection from the effects of rainfall by leaves higher in the plant canopy. On common cabbage plants, oviposition patterns reduce the potential impact of rainfall on eggs, possibly reducing the effect of this important abiotic mortality factor in the field.
Dominant soil bacteria and their ecological attributes across the deserts in northern China
Authors: Feng Wei , Zhang Yuqing , Yan Ru , Lai Zongrui , Qin Shugao , Sun Yanfei , She Weiwei , Liu Zhen
Published: July 2019

Soils harbour highly diverse bacterial communities that are essential for nutrient cycling and carbon storage. However, this diversity impedes the efforts to characterize individual taxa and their ecological attributes. In particular, comprehensive assessments of soil bacterial communities in drylands in China are limited. In this study, soil samples were collected across 12 deserts, covering four climatic regions (dry sub‐humid, semi‐arid, arid and hyper‐arid) in northern China to examine the dominant phylotypes, and their environmental preferences and functional traits. Only 3.2% of the bacterial phylotypes (913 phylotypes) were dominant. These dominant phylotypes can be grouped into six major ecological clusters based on high pH, high elevation, low aridity index, high aridity index, low mean annual temperature and low soil water content, each with multiple phyla. Based on the association between diversity indexes for dominant and subdominant phylotypes, these dominant bacteria might be the drivers or indicators of key soil processes across desert soils in northern China. Genes involved in carbon fixation and decomposition and nitrogen metabolism varied across desert soils, suggesting functional differences. These findings provide deeper insights into soil bacterial communities, which are critical for forecasting the ecological consequences of ongoing global environmental change and for a better mechanistic understanding of the biogeochemical cycle.

Highlights

3.2% of the bacterial phylotypes were dominant across 12 deserts in northern China.

The dominant phylotypes were grouped into six major ecological clusters.

Carbon fixation, decomposition and nitrogen metabolism genes varied across desert soils.

Some northern China desert soils might undergo nitrogen and carbon loss in the near future.
Causes of maladaptation
Authors: Brady Steven P. , Bolnick Daniel I. , Angert Amy L. , Gonzalez Andrew , Barrett Rowan D.H. , Crispo Erika , Derry Alison M. , Eckert Christopher G. , Fraser Dylan J. , Fussmann Gregor F. , Guichard Frederic , Lamy Thomas , McAdam Andrew G. , Newman Amy E.M. , Paccard Antoine , Rolshausen Gregor , Simons Andrew M. , Hendry Andrew P.
Published: July 2019

Evolutionary biologists tend to approach the study of the natural world within a framework of adaptation, inspired perhaps by the power of natural selection to produce fitness advantages that drive population persistence and biological diversity. In contrast, evolution has rarely been studied through the lens of adaptation's complement, maladaptation. This contrast is surprising because maladaptation is a prevalent feature of evolution: population trait values are rarely distributed optimally; local populations often have lower fitness than imported ones; populations decline; and local and global extinctions are common. Yet we lack a general framework for understanding maladaptation; for instance in terms of distribution, severity, and dynamics. Similar uncertainties apply to the causes of maladaptation. We suggest that incorporating maladaptation‐based perspectives into evolutionary biology would facilitate better understanding of the natural world. Approaches within a maladaptation framework might be especially profitable in applied evolution contexts – where reductions in fitness are common. Toward advancing a more balanced study of evolution, here we present a conceptual framework describing causes of maladaptation. As the introductory article for a Special Feature on maladaptation, we also summarize the studies in this Issue, highlighting the causes of maladaptation in each study. We hope that our framework and the papers in this Special Issue will help catalyze the study of maladaptation in applied evolution, supporting greater understanding of evolutionary dynamics in our rapidly changing world.
Current Issues in the Practice of Integrative Couple and Family Therapy
Authors: Lebow Jay L.
Published: July 2019

This paper provides an overview of current issues in integration in couple and family therapy. It summarizes the evolution of integration in couple and family therapy, the various traditions in integration, the strengths of integrative approach, and the possible pitfalls involved. It highlights the extent to which most couple and family therapy is now integrative practice. It concludes with a consideration of an emerging trend toward methods of practice centered on modules of intervention that have been identified as effective with certain presenting phenomena. The example of therapy for high conflict divorce is utilized to illustrate how various components can be brought together to create a maximally effective intervention.
Modeling fatigue crack and spalling for rolling die under hot milling
Authors: Tolcha Mesay Alemu , Altenbach Holm , Shunki Tibba Getachew
Published: July 2019

In hot milling process, rolling die is subjected to nonsteady conditions which can rise the combinations of fatigue and spalling damage mechanism. An understanding about the failure mechanism of the rolling die is essential under hot rolling process. Fatigue crack growth and spalling process are governed by highly concentrated strain and stress in the crack tip region. Based on the theory of elastic‐plastic fracture mechanics, an analytical model are presented in this paper to determine the elliptical crack growth rate and spalling damage mechanism. The model includes new proposed constitutive equations for fatigue and spalling crack growth. To verify the models, finite element simulation and experimental data are considered. The results show good agreement with finite element simulation and experimental data.
Observations of fatigue crack behaviour in proton‐irradiated 304 stainless steel
Authors: Spencer Rory P. , Patterson Eann A.
Published: July 2019

Thermoelastic stress analysis (TSA) has been used to monitor fatigue crack growth in compact tension (CT) specimens, made from 304 grade austenitic stainless steel, that have been subject to proton irradiation. Several specimens had a 10 × 10 mm area ahead of a 1‐mm precrack irradiated with a 1.6 MeV proton beam up to 0.216C to 0.648C of accumulated charge prior to fatigue testing. Subsequently, specimens were loaded sinusoidally at 20 Hz with an R ratio of 0.5, and TSA data were collected both at the loading frequency and its second harmonic. Irradiation appears to cause an increase in the fatigue life, with a reduction in crack growth rate observed in the irradiated specimens compared with the unirradiated control specimens. Irradiation damage caused a moderately linear change in both the parameters of the Paris law with accumulated charge from the irradiation.
Stochastic fatigue damage assessment of metro switch blade
Authors: Lu Chun , Meléndez Juan , Martínez‐Esnaola José Manuel
Published: July 2019

Stochastic fatigue damage of a metro switch blade is studied with a combination of explicit finite element model (FEM), multiaxial fatigue criterion, and statistical analysis. The explicit FEM is used to reproduce dynamic procedure and to provide detailed stress/strain state variation. A multiaxial fatigue criterion proposed recently is extended to 3D conditions for fatigue prediction. The influence of stochastic impact position is considered by statistical analysis. After analysis, the formation of the serious unstable crack (continuous bites) on the switch blade can be revealed. From the perspective of service life, increasing traction coefficient and decreasing friction coefficient between wheel flange and switch blade gauge surface are beneficial but not significant. However, a speed increase from 36 to 54 km/h can lead to 40% reduction in service life. This work enhances the cognition of damage mechanism on switch blade and provides theoretical foundation for service life design and maintenance operation.
Open science and meta‐analysis allow for rapid advances in ecology: A response to Menegotto et al. (2019)
Authors: Kinlock Nicole L. , Prowant Lisa , Herstoff Emily M. , Foley Catherine M. , Akin‐Fajiye Morodoluwa , Bender Nicole , Umarani Mihir , Ryu Hae Yeong , Şen Bilgecan , Gurevitch Jessica
Published: July 2019

Menegotto and colleagues’ (2019) commentary on our paper (Kinlock et al., 2018) does not negate our findings, but by recategorizing and reanalysing a portion of our data set, advances our knowledge of the latitudinal diversity gradients (LDGs) in marine ecosystems, particularly emphasizing different findings for benthic LDGs as a result of the recategorization of the data. Furthermore, we see the contribution by Menegotto et al. (2019) as highlighting the importance of scientific transparency; we believe that this insight into the nature of LDGs in marine systems would have been delayed, if not unobtainable, had we not provided fully transparent methods and complete data in our paper.
Daily sleep duration and the risk of incident disability among younger elderly Japanese adults in the New Integrated Suburban Seniority Investigation Project: A prospective study using competing event analysis
Authors: Zhang Lin , Ukawa Shigekazu , Zhao Wenjing , Okabayashi Satoe , Ando Masahiko , Wakai Kenji , Tsushita Kazuyo , Kawamura Takashi , Tamakoshi Akiko
Published: July 2019

Aim

This study aimed to investigate the association between daily sleep duration and incident disability among younger elderly individuals in Japan.

Methods

We carried out a prospective cohort study, the New Integrated Suburban Seniority Investigation Project, including 1895 (962 men and 933 women) Japanese physically and socially independent individuals aged ≥65 years. Information on daily sleep duration, demographic, lifestyle characteristics and medical status were collected by questionnaire and health checkup every year from 1996 through 2005. Dates of incident disability were confirmed using the certification for the long‐term care insurance in Japan. We treated censored cases due to death as competing events. A competing risk model was used to calculate the hazard ratio and 95% confidence interval for incident disability.

Results

During a median of 12.7 years of follow up, 256 participants (114 men and 142 women) reported incident disability. Compared with a sleep duration of 7–7.9 h/day, sleeping <6 h/day showed an increased risk of incident disability (hazard ratio 1.64, 95% confidence interval 1.13–2.38 for total; hazard ratio 1.90, 95% confidence interval 1.19–3.03 for women).

Conclusions

The present findings suggest that shorter sleep duration was associated with a higher risk of incident disability among older Japanese people. Geriatr Gerontol Int 2019; 19: 945–949.
Mobility hub or hollow? Cross‐border travelling in the Mediterranean, 1995–2016
Authors: DEUTSCHMANN EMANUEL , RECCHI ETTORE , BICCHI FEDERICA
Published: July 2019

The Mediterranean is often portrayed as a hub of human mobility. In this article, we test this widespread view by exploring the structure of travel flows in the region over the last two decades (1995–2016). We find that mobility is much higher and increasing more strongly along the northern than along the southern shore, thus creating a growing mobility divide. South–north and north–south movements are even scarcer and stagnate or even decline over time. With a Gini coefficient of .87, mobility flows are distributed extremely unequally across country pairs in the Mediterranean. Community detection algorithms reconfirm that mobility predominantly takes place in disparate clusters around the Mediterranean, not across it. These findings imply that a ‘neo‐Braudelian’ view of the Mediterranean as a mobility hub is less justified than a ‘Rio Grande’ perspective that conceives of the Mediterranean as a mobility hollow. Multivariate regression models for network data suggest that geographical distance and, to a lesser extent, political visa regulations, explain the unequal mobility structure better than differences in economic well‐being.
Marstacimab, a tissue factor pathway inhibitor neutralizing antibody, improves coagulation parameters of ex vivo dosed haemophilic blood and plasmas
Authors: Patel‐Hett Sunita , Martin Erika J. , Mohammed Bassem M. , Rakhe Swapnil , Sun Pengling , Barrett John C. , Nolte Melinda E. , Kuhn Janice , Pittman Debra D. , Murphy John E. , Brophy Donald F.
Published: July 2019

Introduction

Tissue factor pathway inhibitor (TFPI) is an endogenous inhibitor of the extrinsic pathway that negatively regulates thrombin production during coagulation. Under haemophilic conditions, where the intrinsic coagulation pathway is impaired, inhibition of TFPI may improve clotting.

Aim

We investigated the ex vivo effects of a human TFPI neutralizing antibody, marstacimab (previously PF‐06741086), in coagulation assays including rotational thromboelastometry (ROTEM), thrombin generation assay (TGA) and the dilute prothrombin time (dPT) assay, performed in haemophilic whole blood and plasmas. We compared the effects of marstacimab to the effects of recombinant coagulation factors and investigated the reproducibility of marstacimab in restoring haemostasis by comparing its effect in whole blood collected from the same study participants on differing days.

Methods

Citrated whole blood and plasmas obtained from haemophilia participants were supplemented ex vivo with vehicle, marstacimab, recombinant FVIII (rFVIII) or recombinant factor IX (rFIX) and analysed in ROTEM, TGA and the dPT assay using low tissue factor concentrations to trigger coagulation.

Results

Marstacimab induced pro‐coagulant responses in ROTEM parameters including reduction in clotting times and increases in angle. Similarly, participant plasmas supplemented with marstacimab exhibited improvements in TGA parameters, including reduced lag times, increased peak thrombin concentrations and reductions in dPT clotting time. Concentrations of marstacimab tested showed activity comparable to addition of rFVIII or rFIX and were reproducible.

Conclusions

These studies show the ex vivo potency of marstacimab in restoring haemostasis in whole blood and plasmas from haemophilia participants and comparability to ex vivo reconstitution with recombination coagulation factors.
PERSPECTIVES: Stroke survivors' views on the design of an early‐phase cell therapy trial for patients with chronic ischaemic stroke
Authors: Nagpal Anjali , Hillier Susan , Milton Austin G. , Hamilton‐Bruce Monica A. , Koblar Simon A.
Published: July 2019

Background

Stem cell research holds the potential for a paradigm shift in the management of diseases such as stroke. Patient and public involvement in research (PPIR) can bring a focus to issues of clinical relevance and accelerate translation to real‐world clinical practice.

Objective

A qualitative thematic analysis of the perspectives of stroke survivors regarding the conduct and design aspects of a proposed phase I clinical cell therapy study in stroke.

Design

Twelve stroke survivors were purposively recruited in July 2016–August 2017 and participated in semi‐structured, face‐to‐face interviews for input into the design of a proposed phase I clinical study of autologous dental pulp stem cells. Concurrent thematic analysis was conducted until data saturation was achieved.

Discussion and conclusions

Participants conveyed that the most relevant outcomes to them were regaining participation, decreased dependence on caregivers and improvement in cognition, memory, mood, pain and fatigue. The perception of risk vs. benefit was likely influenced by the time elapsed since stroke, with participants being more willing to accept a higher level of risk early in the post‐stroke disease course. They believed that all stroke survivors should be given an opportunity to participate in research, irrespective of their cognitive capacity. A relatively small sample population of 12 stroke survivors was studied as thematic saturation was achieved. PERSPECTIVES study applied principles of PPIR to early‐phase cell research. Incorporation of outcomes relevant to patients' need within the study design is critical to generate data that will enable personalized application of regenerative medicine in stroke.
Role of Cu/S ratio and Mg doping on modification of structural and optical characteristics of nano CuS
Authors: Mohamed Mohamed Bakr , Abdel‐Kader Mohamed H. , Almarashi Jamal Q. M.
Published: July 2019

Nano CuS with different Cu to S ratio and also Mg‐doped nano CuS are prepared using a thermolysis procedure under nitrogen flows. The effect of changing copper to sulfur ratio in preparation of CuS under flowing nitrogen and also Mg‐doped CuS on the lattice parameters and crystallite size is studied using X‐ray diffraction data by applying the Rietveld profile method. Scanning electron microscope mapping is used to verify the distribution of different elements over undoped and doped CuS samples. Fourier transforms infrared spectroscopy spectra confirm that the structure of CuS is not altered by doping or changing of the Cu to S ratio. In order to examine the effect of changes of Cu to S or Mg doping on the absorption behavior of nano CuS, ultraviolet spectroscopy is used. The energy gaps of different samples are determined using Tauc’s relation. The photoluminescence spectroscopy reveals that all samples exhibit violet and blue sub‐emissions except a CuS with Cu:S ratio 1:4 which also emits green sub‐emission.
Water holding capacity of sodium‐reduced chicken breast myofibrillar protein gel as affected by combined CaCl2 and high‐pressure processing
Authors: Wang Yu , Zhou Ying , Wang Xi‐xi , Li Pei‐jun , Xu Bao‐cai , Chen Cong‐gui
Published: July 2019

The water holding capacity (WHC) of sodium‐reduced (0.3 m sodium chloride, corresponding to the salt percentage (w/v) of 1.755%) myofibrillar protein (MP) gel in response to combined calcium chloride (CaCl2, 20, 60, 100 mm) and high‐pressure processing (HPP, 200 MPa, 10 min) was investigated. The results showed that 200 MPa + 20 mm CaCl2 synergistically increased the WHC of MP gel via reducing particle size of MP solutions, strengthening hydrogen‐bonding and disulphide‐bonding, promoting formation of β‐sheet and uncoiling of α‐helix, exposing tryptophan residues, enhancing hydrophobic interactions of aliphatic residues and forming a compact and continuous networked gel structure. However, high concentrations (≥60 mm) of CaCl2 could attenuate the enhancing effects of HPP on the WHC by inducing decreased hydrogen bonds, fewer tryptophan residues exposed and coarser and aggregated gel structures with large cavities. Therefore, a combined moderate HPP and low concentration of CaCl2 is a potential alternative for developing sodium‐reduced meat products.
Predictors of a long length of stay in the emergency department for older people
Authors: Sweeny Amy , Keijzers Gerben , O'Dwyer John , Arendts Glenn , Crilly Julia
Published: July 2019

Background

Dedicated geriatric models of care are becoming more prevalent due to the complexity of, and increase in, acute healthcare presentations for older patients. For older people, a long stay in the emergency department (ED) may reflect the complexity of their presentation, or deficiencies in systems that manage these complexities.

Aims

To identify predictors of a long ED length of stay (LLoS) for patients ≥65 years old.

Methods

Linked hospital information systems data from a large, public Australian ED were analysed in this retrospective cohort study. LLoS was defined as the 75th percentile (617 min). Multivariate regression identified LLoS predictors for admissions and discharges separately.

Results

Of 16 791 ED presentations made by older people, 4192 experienced a LLoS; 55% were admitted. Increasing age was associated with an increasing ED LoS. Factors most predictive of LLoS for both admitted and discharged patients included: investigations (both pathology and imaging), less urgent Australasian triage scale categories and after‐hours arrival. Ambulance arrival did not increase the risk of a LLoS for patients eventually admitted, but conferred nearly a twofold increased risk for a LLoS for discharged older persons (adjusted odds ratios = 1.9; 95% confidence interval 1.5–2.4).

Conclusions

This study assists clinicians and decision‐makers to identify reasons why older persons have a LLoS, whether admitted or discharged. Interventions to streamline care for older patients arriving after‐hours and who require imaging and pathology are required. LoS targets should consider age distribution. The use of ED LoS as a quality of care indicator should be assessed for admissions and discharges, separately.
CD93 is a cell surface lectin receptor involved in the control of the inflammatory response stimulated by exogenous DNA
Authors: Nativel Brice , Ramin‐Mangata Stéphane , Mevizou Rudy , Figuester Audrey , Andries Jessica , Iwema Thomas , Ikewaki Nobunao , Gasque Philippe , Viranaïcken Wildriss
Published: July 2019

Bacterial DNA contains CpG oligonucleotide (ODN) motifs to trigger innate immune responses through the endosomal receptor Toll‐like receptor 9 (TLR9). One of the cell surface receptors to capture and deliver microbial DNA to intracellular TLR9 is the C‐type lectin molecule DEC‐205 through its N‐terminal C‐type lectin‐like domain (CTLD). CD93 is a cell surface protein and member of the lectin group XIV with a CTLD. We hypothesized that CD93 could interact with CpG motifs, and possibly serve as a novel receptor to deliver bacterial DNA to endosomal TLR9. Using ELISA and tryptophan fluorescence binding studies we observed that the soluble histidine‐tagged CD93‐CTLD was specifically binding to CpG ODN and bacterial DNA. Moreover, we found that CpG ODN could bind to CD93‐expressing IMR32 neuroblastoma cells and induced more robust interleukin‐6 secretion when compared with mock‐transfected IMR32 control cells. Our data argue for a possible contribution of CD93 to control cell responsiveness to bacterial DNA in a manner reminiscent of DEC‐205. We postulate that CD93 may act as a receptor at plasma membrane for DNA or CpG ODN and to grant delivery to endosomal TLR9.
Allergic sensitization in patients with rhinitis and bronchial asthma in Ningxia region of China
Authors: Di Ling‐Ling , Wang Li‐Xin , Ma Xiao , Wen Wu‐Lin , Gao Xiao‐Ping
Published: July 2019

Background

Allergic rhinitis and bronchial asthma are common allergic diseases. The pattern of dominant allergens depends on the degree of urbanization and the geographic region. The present study characterized the allergens of patients with allergic rhinitis and bronchial asthma in Ningxia region of China.

Methods

A total of 309 patients were enrolled in this study. Western blotting assays were performed of the serum samples to evaluate allergen‐specific IgE antibody for inhaled and ingested allergens. Statistical analysis was performed to compare the positive rate among different subgroups.

Results

Among the 309 patients, 221 of them had positive test results. There were 157 positive cases for ingested allergens and 174 positive cases for inhaled allergens. No significant differences in positive rates were found between the ingested and inhaled allergens. Among the inhaled allergens, Artemisia was the most frequent allergen, followed by fungi and dog hair. Cashew was the most common ingested allergen, followed by crab, mango, and beef. Further analysis showed no significant differences in positive rate between males and females. However, significant differences in positive rate of inhaled and ingested allergens were found between children (1‐13 years old) and adults (above 18 years old) (P < .05), while no significant differences were found between the children and teenagers (14‐18 years old). For the comparison between teenagers and adults, significant difference in positive rate was found only in the ingested allergen.

Conclusion

This study provided the characteristics of allergens in Ningxia population, providing clinical and epidemiological data for prevention and treatment of the diseases in the region.
Pharmacist‐led medication review in community‐dwelling older patients using the GheOP3S‐tool: General practitioners' acceptance and implementation of pharmacists' recommendations
Authors: Foubert Katrien , Mehuys Els , Maesschalck Joris , De Wulf Isabelle , Wuyts Joke , Foulon Veerle , Lelubre Mélanie , De Vriese Carine , Somers Annemie , Petrovic Mirko , Boussery Koen
Published: July 2019

Rationale, aims, and objectives

The Ghent Older People's Prescriptions community Pharmacy Screening (GheOP3S)‐tool was recently developed as an explicit screening tool to detect drug‐related problems (DRPs) and to help in performing medication reviews. In this study, we aimed (a) to describe the characteristics of the detected DRPs and the subsequent pharmacists' recommendations with their acceptance and implementation rate resulting from a pharmacist‐led medication review using the GheOP3S‐tool and (b) to assess the potential impact of the intervention.

Method

Prospective observational study in community‐dwelling older patients (70 years or older, using five or more medications). Community pharmacists performed medication reviews resulting in the documentation of “GheOP3S‐related DRPs” and “other DRPs” with corresponding pharmacists' recommendations. Acceptance was recorded during face‐to‐face pharmacist‐general practitioner (GP) meetings. Implementation was assessed after a 3‐month follow‐up by consulting the electronic pharmacy record, the patient, and/or GP. The potential impact on the number of medications, the number of “GheOP3S‐related DRPs”, the anticholinergic and sedative burden quantified by the Drug Burden Index (DBI), and medication costs was assessed by a pre‐post comparison of the patients' medication lists.

Results

Twenty‐one pharmacists detected 470 DRPs with a median (IQR) of 6 (4‐8) per patient in 75 patients (about half “GheOP3S‐related DRPs” and half “other DRPs”). Most prevalent recommendations were stopping (22.9%) and substituting (18.9%) medication. Overall acceptance was 66.9%. At follow‐up, 42.9% of all recommendations were implemented. The number of GheOP3S‐criteria (P < .001) and the DBI scores (P = .033) significantly differed from baseline. This was not the case for the number of chronic medications and medication costs.

Conclusions

This study demonstrates a relatively high acceptance of pharmacists' recommendations, although implementation could be improved. Pharmacist‐led medication reviews with multidisciplinary meetings using the GheOP3S‐tool can have a potential impact on the number of DRPs and the anticholinergic and sedative burden of patients.
Perceptions of patient‐centred care among providers and patients in the orthopaedic department of a tertiary care hospital in Karachi, Pakistan
Authors: Rahman Rahbel , Matthews Elizabeth B. , Ahmad Alizeh , Rizvi Syeda Mahnoor , Salama Umme , Samad Lubna , Khan Mansoor
Published: July 2019

Objective

This study examined the perspectives of 18 health care providers (nurses, consultant doctors, residents, radiologists, and physiotherapists) and 18 patients regarding best practices for patient‐centred care (PCC) in a free private hospital in Pakistan, studying the congruence between provider and patient perspectives.

Methods

Six focus group interviews (FGIs) were conducted from January to March 2017: three with providers and three with patients. Focus group interviews were audio‐recorded and transcribed verbatim. A deductive approach was used to analyse the data using the key dimensions of Scholl's framework, which was then complemented with constant comparison analysis to explore variability and similarity among participants across the six focus groups.

Results

Findings indicated that providers and patients acknowledged maintaining a collaborative relationship with patients by using empathy. Patients and providers agreed that providers allocated time to counsel the patient and alleviated their fears. Family involvement was seen as a key indicator in decision making for patients. Some discrepancies were found between patient and provider perceptions of inhibitors to PCC, notably a lack of teamwork exhibited by providers and continuity of care offered postdischarge.

Conclusions

We recommend practices of PCC that are congruent with non‐Western settings where religion and family play a primary role in matters dealing with patients' illnesses. Our findings suggest the need for recurrent training to improve teamwork among providers; questioning the implicit agreement of patients who may be vulnerable to decision making of authoritarian figures in their family; and the inclusion of peer‐support workers or community health workers to offer aftercare support to patients in their home.
Nbseptin2 Expression Pattern and Its Interaction with NbPTP1 during Microsporidia Nosema bombycis Polar Tube Extrusion
Authors: Liu Fangyan , Chen Jie , Dang Xiaoqun , Meng Xianzhi , Wang Rong , Bao Jialing , Long Mengxian , Li Tian , Ma Qiang , Huang Jun , Pan Guoqing , Zhou Zeyang
Published: July 2019

Nosema bombycis (Nb) is a deadly species of microsporidia capable of causing pébrine, leading to heavy losses in sericulture. Germination is an important biological event in the invasion process of microsporidia. Septins, a family of membrane‐associated proteins, play a critical role in tissue invasion and have been recognized as a virulence factor in numerous pathogens. Previous work in our laboratory has shown that Nosema bombycis septin2 (Nbseptin2) interacts with subtilisin‐like protease 2 (NbSLP2). Herein, we found that Nbseptin2 was mainly associated with the plasma membrane in spores. Following spore germination, Nbseptin2 was found to co‐localize with polar tube protein 1 (NbPTP1) at the polar cap and proximal zone of the polar tube. Co‐immunoprecipitation and yeast two‐hybrid analysis further confirmed that Nbseptin2 interacted with NbPTP1. The translocation and interaction of Nbseptin2 in the spores suggest that Nbseptin2 may play a significant role in microsporidia polar tube extrusion process. Our findings improve understanding of the mechanisms underlying microsporidia germination.
Prediction of 28‐day mortality in acute decompensation of cirrhosis through the presence of multidrug‐resistant infections at admission
Authors: Gupta Tarana , Lochan Dibya , Verma Nipun , Rathi Sahaj , Agrawal Swastik , Duseja Ajay , Taneja Sunil , Chawla Yogesh K , Dhiman Radha K
Published: July 2019

Background and Aim

The aim of this study is to evaluate the epidemiology and impact of bacterial infections at admission in patients with acute decompensation (AD) of cirrhosis.

Methods

A cohort with AD of cirrhosis (European Association for the Study of the Liver criteria) admitted at a tertiary center was evaluated between 2013 and 2014 for the presence of bacterial infections at admission. Clinical, demographic, and microbiological data were collected prospectively till death, transplant, or 90 days.

Results

Of 179 patients with AD, 102 (56.9%) had bacterial infections at admission. The commonest infections were spontaneous bacterial peritonitis (SBP) (n = 65; 63.7%), spontaneous bacteremia (n = 10; 9.8%), pneumonia (n = 9; 8.8%), urinary tract infection (n = 8; 7.8%), spontaneous bacterial empyema (n = 4; 3.9%), and cellulitis (n = 2; 1.9%). The commonest source was community acquired (n = 85; 83.3%). Serum albumin and sodium levels were lower in infected as compared with non‐infected cohort (P = 0.015; for both). Escherichia coli was the commonest organism isolated from SBP (n = 14; 21.5%), urinary tract infection (n = 5; 45.5%), and bacteremia (n = 3; 20%). There was a trend toward higher 28‐day mortality in infected cohort as compared with non‐infected cohort (48 [52.7%] vs 28 [32%]; P = 0.152). Multidrug‐resistant organisms (MDROs) were isolated in 63% of all culture‐positive infections. The presence of MDRO was an independent predictor of 28‐day mortality.

Conclusions

Infections are the leading reason for the occurrence of AD; SBP is the most common infection, and E. coli is the commonest microorganism based on this single‐center study of Indian patients with AD of cirrhosis. There is a high prevalence of MDROs among culture‐positive infections that independently predict 28‐day mortality in AD of cirrhosis.
Doppler ultrasonography: A non‐invasive method used to diagnose and follow up patients with chronic hepatitis C
Authors: da Silva Franco Karen Margarete Vieira , Vieira Waldonio Brito , Dias Apio Ricardo Nazareth , Falcão Aline Semblano Carreira , Falcão Luiz Fábio Magno , Quaresma Juarez Antônio Simões
Published: July 2019

Background and Aim

This study aimed to investigate the association between the findings of Doppler ultrasonography and transient elastography using FibroScan and to determine the cut‐off points, sensitivity, and specificity of resistance indices, and pulsatility of the hepatic vessels to predict significant hepatic fibrosis.

Methods

This is a transversal, observational, and analytical study that includes 30 patients with chronic hepatitis C who were admitted at a public referral hospital. Transient elastography and ultrasonographic data were collected, and the linear association between these methods was evaluated using the Pearson test. Various Doppler velocimetric indices were compared according to the presence/absence of significant (≥ F2) fibrosis.

Results

There was a moderate‐strong linear association between the FibroScan data and the Doppler velocimetric indices and splenic index in the hepatic vessels; the mean values of the indices differed between groups with absent/mild (F0/F1) and significant (≥ F2) hepatic fibrosis. There was an association between the monophasic and biphasic wave pattern of the suprahepatic veins and the stratification of hepatic fibrosis estimated by the values of kilopascal in FibroScan.

Conclusion

Doppler ultrasonography is a non‐invasive method used to evaluate liver fibrosis, and it presents acceptable sensitivity/specificity for the prediction of fibrosis ≥ F2 in patients with chronic hepatitis C.
Factors Associated With Becoming Edentulous in the US Health and Retirement Study
Authors: Weintraub Jane A. , Orleans Brian , Fontana Margherita , Phillips Ceib , Jones Judith A.
Published: July 2019

BACKGROUND/OBJECTIVE

To determine factors associated with older adults becoming edentulous (complete tooth loss).

DESIGN

Longitudinal study over a 6‐year period.

SETTING

United States, 2006, 2012.

PARTICIPANTS

Nationally representative US sample of adults, aged 50 years and older (n = 9982), participating in the Health and Retirement Study in 2006 and 2012. At the outset, they were dentate and not institutionalized.

INTERVENTION

None.

MEASUREMENTS

Self‐report of being dentate or edentulous, demographic variables, dental utilization and other health behaviors, self‐rated general health, and incidence between 2006 and 2012 of comorbid medical conditions, functional limitations, and disabilities.

RESULTS

From 2006 to 2012, 563 individuals (5%) became edentulous and 9419 (95%) remained dentate. Adults who became edentulous by 2012 were more likely than those who remained dentate to be black/African American compared to white, to be less educated, were current smokers, had diabetes, and reported poorer self‐rated general health, more functional limitations and disabilities, and fewer dental visits (all P < .0001), among other factors. Of those with regular dental visits (at least once every 2 years during the 6‐year period), 2.3% became edentulous compared to 9.9% among those without regular dental visits. After adjusting for age and other potential confounders, there was a strong association with poor dental attendance and smoking. Nonregular dental attenders were more likely than regular attenders to become edentulous (odds ratio [OR] = 2.74; 95% confidence interval [CI] = 2.12‐3.53), and current smokers were more likely than never smokers to become edentulous (OR = 2.46; 95% CI = 1.74‐3.46).

CONCLUSION

Although more contemporaneous data are needed to determine causality, regular dental utilization and smoking are modifiable factors that could prevent edentulism, even when many other comorbid conditions are present. J Am Geriatr Soc, 1–7, 2019. J Am Geriatr Soc 67:2318–2324, 2019
Eating behaviour patterns are associated with excessive weight gain after liver transplantation
Authors: Ferreira S. C. , Penaforte F. R. O. , Cardoso A. S. R. , da Silva M. V. T. , Lima A. S. , Correia M. I. T. D. , Anastácio L. R.
Published: July 2019

Background

Weight gain and obesity are important issues in liver transplant (LTx) recipients. Although dietary habits are probably related to excessive weight gain after LTx, some studies have failed to demonstrate these associations. The present study aimed to assess eating behaviour and verify its association with weight gain and excessive weight among LTx recipients.

Methods

The investigation comprised a cross‐sectional study. Post‐LTx patients, aged >18 years were evaluated about their eating behaviour [Three Factor Eating Questionnaire–R21 (TFEQ‐R21)]. The scores of the TFEQ‐R21 [uncontrolled eating (UE), cognitive restraint (CR) and emotional eating (EE)] were determined. Excessive weight was classified as body mass index ≥25 kg/m² and obesity ≥30 kg/m².

Results

In total, 270 patients (age 58.0 years; range 20.0–77.0 years; 64.1% men) were assessed. Average weight gain was 8.0 kg (range −16.0 to 41.0 kg). Of the patients, 64.1% (n = 173) had excessive weight and 23.3% (n = 63) were obese. Post‐LTx weight gain was significantly correlated with UE (r = 0.311, P < 0.001) and EE (r = 0.287, P < 0.001). Patients with excessive weight had significantly higher scores than others: CR (61.0; range 0–122.0 versus 44.0; range 0–116.0) (P = 0.003) and EE (11.0; range 0–100.0 versus 0.0; range 0–100.0) (P = 0.030). Patients with obesity had higher scores than non‐obese UE (22.0; range 0–77.0 versus 14.0; range 0–85.0; P = 0.028), CR (55.0; range 11.0–116.0 versus 50.0; range 0–122.0) (P = 0.017) and EE (16.0; range 0–100.0 versus 5.0; range 0–100.0) individuals (P < 0.001). The greatest quartiles of weight gain had higher scores on the eating behaviours of UE and EE, especially those with weight gain ≥14 kg. UE was associated with weight gain. CR was associated with being overweight. EE was associated with obesity.

Conclusions

Uncontrolled eating is associated with weight gain, CR was associated with excessive weight and EE was associated with obesity after LTx.
Inhibition of SERPINA3N‐dependent neuroinflammation is essential for melatonin to ameliorate trimethyltin chloride–induced neurotoxicity
Authors: Xi Yu , Liu Mengyu , Xu Shuzhen , Hong Huihui , Chen Mengyan , Tian Li , Xie Jia , Deng Ping , Zhou Chao , Zhang Lei , He Mindi , Chen Chunhai , Lu Yonghui , Reiter Russel J. , Yu Zhengping , Pi Huifeng , Zhou Zhou
Published: July 2019

Trimethyltin chloride (TMT) is a potent neurotoxin that causes neuroinflammation and neuronal cell death. Melatonin is a well‐known anti‐inflammatory agent with significant neuroprotective activity. Male C57BL/6J mice were intraperitoneally injected with a single dose of melatonin (10 mg/kg) before exposure to TMT (2.8 mg/kg, ip). Thereafter, the mice received melatonin (10 mg/kg, ip) once a day for another three consecutive days. Melatonin dramatically alleviated TMT‐induced neurotoxicity in mice by attenuating hippocampal neuron loss, inhibiting epilepsy‐like seizures, and ameliorating memory deficits. Moreover, melatonin markedly suppressed TMT‐induced neuroinflammatory responses and astrocyte activation, as shown by a decrease in inflammatory cytokine production as well as the downregulation of neurotoxic reactive astrocyte phenotype markers. Mechanistically, serine peptidase inhibitor clade A member 3N (SERPINA3N) was identified as playing a central role in the protective effects of melatonin based on quantitative proteome and bioinformatics analysis. Most importantly, melatonin significantly suppressed TMT‐induced SERPINA3N upregulation at both the mRNA and protein levels. The overexpression of Serpina3n in the mouse hippocampus abolished the protective effects of melatonin on TMT‐induced neuroinflammation and neurotoxicity. Melatonin protected cells against TMT‐induced neurotoxicity by inhibiting SERPINA3N‐mediated neuroinflammation. Melatonin may be a promising and practical agent for reducing TMT‐induced neurotoxicity in clinical practice.