bluuebunny/crossref_metadata_2025 huggingface dataset:
Teaching Assistants Talking
Authors: McLachlan Benita
Published: October 2016

Local Authorities (LAs) in Britain traditionally employ Visual Impairment (VI) teams as integrative statutory Special Educational Needs and Inclusion (SENI) provision. Teaching Assistants (TAs) work alongside Qualified Teachers (QTs) in VI teams to support children and young people (CYP) with VI. The VI TA has a broad role in covering early years, primary, secondary and special school settings and their key duties can include implementing visual targets, providing sensory support, delivering touch typing lessons, to name a few. Based on systemic and work‐based learning theories, this article explores the learning stories of seven VI TAs who volunteered to participate in professional development focus group discussions between September 2014 and November 2015. The seven participants all work in the VI team of one LA in Cambridgeshire. The focus of the fortnightly focus group discussions were to explore the impact which eye conditions had on the education and learning of CYP. Participants were encouraged to engage in reflective writing about their new knowledge and how this may have changed their VI practice. Findings from qualitative data generated for analysis and interpretation demonstrated that most participants did improve their knowledge and understanding of specific eye conditions. Some participants benefited and changed their practice based on their newly acquired knowledge whereas some were not aware of any impact on their practice. Themes also highlighted constructive comments on how future professional learning for TAs can be improved. There are currently no mandatory training requirements for specialist VI TAs.
Writing readiness and children with Down Syndrome in an Irish context
Authors: Patton Sandra , Hutton Eve
Published: October 2016

There is a dearth of studies investigating writing readiness in children with Down Syndrome (DS) and limited information on appropriate interventions. This article reports on a study conducted in the Republic of Ireland. An uncontrolled pretest‐posttest design was implemented using writing readiness measures specifically adapted/developed from the literature to collect data on the writing readiness skills of 28 school‐aged children with DS attending mainstream schools in the Republic of Ireland. Teacher/parent perspectives were also gathered during focus groups. The children presented with complex needs in relation to posture, pencil grasp, copying basic shapes, name/letter copying. Teacher and parent reports highlighted the need for collaborative intervention with occupational therapy. Findings from the study support the need for targeted early collaborative syndrome‐specific intervention to support the development of writing readiness in children with DS as an important part of school readiness. Intervention should include adopting a broader emergent literacy approach, teacher education regarding writing readiness and parental involvement in intervention.
Intrauterine balloon tamponade for management of severe postpartum haemorrhage in a perinatal network: a prospective cohort study
Authors: Revert M , Cottenet J , Raynal P , Cibot E , Quantin C , Rozenberg P
Published: October 2016

Objective

To evaluate the effectiveness of intrauterine balloon tamponade (IUBT) for management of severe postpartum haemorrhage (PPH). To identify the factors predicting IUBT failure.

Design

Prospective cohort study.

Setting

Ten maternity units in a perinatal network.

Population

Women treated by IUBT from July 2010 to March 2013.

Methods

The global IUBT success rate was expressed as the number of women with severe PPH who were successfully treated by IUBT divided by the total number treated by IUBT. IUBT failure was defined as the need for arterial embolisation or surgery. Logistic regression analysis was used to estimate factors predicting IUBT failure.

Main outcome measures

Global IUBT success rate. Factors associated with IUBT failure.

Results

Intrauterine balloon tamponade was attempted in 226 women: 171 after vaginal delivery (VD) (75.7%) and 55 during or after caesarean delivery (CD) (24.3%). The global success rate was 83.2% (188/226) and was significantly higher after VD (152/171, 88.9%) than CD (36/55, 65.5%, P < 0.01). The percentage of CD was significantly higher in the failure group (50.0 versus 19.1%, P < 0.01), as was mean (SD) estimated blood loss before IUBT: 1508 ± 675 ml versus 1064 ± 476, P < 0.01. Coagulopathy was significantly more frequent in the failure group (50.0% versus 17.2%, P < 0.01). CD [Odds ratio (OR) 3.5; 95% CI 1.6–7.6], estimated blood loss before IUBT (OR 3.2; 95% CI 1.5–6.8) and coagulopathy (OR 5.6; 95% CI 2.5–13.0) were predictive of IUBT failure.

Conclusion

Intrauterine balloon tamponade is an effective method for treating severe PPH. Early balloon deployment before the development of coagulopathy increases its success rate.

Tweetable abstract

Intrauterine balloon tamponade is effective for achieving haemostasis in intractable postpartum haemorrhages.
Case Outcomes in a Communication‐and‐Resolution Program in New York Hospitals
Authors: Mello Michelle M. , Greenberg Yelena , Senecal Susan K. , Cohn Janet S.
Published: October 2016

Objective

To determine case outcomes in a communication‐and‐resolution program (CRP) implemented to respond to adverse events in general surgery.

Study Setting

Five acute‐care hospitals in New York City.

Study Design

Following CRP implementation, hospitals recorded information about each CRP event for 22 months.

Data Collection Methods

Risk managers prospectively collected data in collaboration with representatives from the hospital's insurer. External researchers administered an online satisfaction survey to clinicians involved in CRP events.

Principal Findings

Among 125 CRP cases, disclosure conversations were carried out in 92 percent, explanations were conveyed in 88 percent, and apologies were offered in 72.8 percent. Three quarters of events did not involve substandard care. Compensation offers beyond bill waivers were deemed appropriate in 9 of 30 of cases in which substandard care caused harm and communicated in six such cases. In 44 percent of cases, hospitals identified steps that could be taken to improve safety. Clinicians had low awareness of the workings of the CRP, but high satisfaction with their experiences.

Conclusions

The bulk of CRPs' work is in investigating and communicating about events not caused by substandard care. These CRPs were quite successful in handling such events, but less consistent in offering compensation in cases involving substandard care.
Graphic Depictions: Portrayals of Mental Illness in Video Games
Authors: Shapiro Samuel , Rotter Merrill
Published: October 2016

Although studies have examined portrayals of mental illness in the mass media, little attention has been paid to such portrayals in video games. In this descriptive study, the fifty highest‐selling video games in each year from 2011 to 2013 were surveyed through application of search terms to the Wikia search engine, with subsequent review of relevant footage on YouTube. Depiction categories were then assigned based on the extent of portrayal and qualitative characteristics compared against mental illness stereotypes in cinema. Twenty‐three of the 96 surveyed games depicted at least one character with mental illness. Forty‐two characters were identified as portraying mental illness, with most characters classified under a “homicidal maniac” stereotype, although many characters did not clearly reflect cinema stereotypes and were subcategorized based on the shared traits. Video games contain frequent and varied portrayals of mental illness, with depictions most commonly linking mental illness to dangerous and violent behaviors.
The Issue of Age Estimation in a Modern Skeletal Population: Are Even the More Modern Current Aging Methods Satisfactory for the Elderly?,
Authors: Cappella Annalisa , Cummaudo Marco , Arrigoni Elena , Collini Federica , Cattaneo Cristina
Published: October 2016

The main idea behind age assessment in adults is related to the analysis of the physiological degeneration of particular skeletal structures with age. The main issues with these procedures are due to the fact that they have not been tested on different modern populations and in different taphonomic contexts and that they tend to underestimate the age of older individuals. The purpose of this study was to test the applicability and the reliability of these methods on a contemporary population of skeletal remains of 145 elderly individuals of known sex and age. The results show that, due to taphonomic influences, some skeletal sites showed a lower survival. Therefore, the methods with the highest percentage of applicability were Lovejoy (89.6%) and Rougé‐Maillart (81.3%), followed by Suchey‐Brooks (59.3%), and those with the lowest percentage of applicability were Beauthier (26.2%) and Iscan (22.7%). In addition, this research has shown how for older adults the study of both acetabulum and auricular surface may be more reliable for aging. This is also in accordance with the fact that auricular surface and the acetabulum are the areas more frequently surviving taphonomic insult.
Gastrointestinal Functionality of Aquatic Animal (Oreochromis niloticus) Carcass in Water Allows Estimating Time of Death
Authors: Hahor Waraporn , Thongprajukaew Karun , Yoonram Krueawan , Rodjaroen Somrak
Published: October 2016

Postmortem changes have been previously studied in some terrestrial animal models, but no prior information is available on aquatic species. Gastrointestinal functionality was investigated in terms of indices, protein concentration, digestive enzyme activity, and scavenging activity, in an aquatic animal model, Nile tilapia, to assess the postmortem changes. Dead fish were floated indoors, and samples were collected within 48 h after death. Stomasomatic index decreased with postmortem time and correlated positively with protein, pepsin‐specific activity, and stomach scavenging activity. Also intestosomatic index decreased significantly and correlated positively with protein, specific activity of trypsin, chymotrypsin, amylase, lipase, and intestinal scavenging activity. In their postmortem changes, the digestive enzymes exhibited earlier lipid degradation than carbohydrate or protein. The intestine changed more rapidly than the stomach. The findings suggest that the postmortem changes of gastrointestinal functionality can serve as primary data for the estimation of time of death of an aquatic animal.
Malondialdehyde–Acetaldehyde‐Adducted Surfactant Protein Alters Macrophage Functions Through Scavenger Receptor A
Authors: Sapkota Muna , Kharbanda Kusum K. , Wyatt Todd A.
Published: October 2016

Background

Reactive aldehydes such as acetaldehyde and malondialdehyde generated as a result of alcohol metabolism and cigarette smoke exposure lead to the formation of malondialdehyde–acetaldehyde‐adducted proteins (MAA adducts). These aldehydes can adduct to different proteins such as bovine serum albumin and surfactant protein A or surfactant protein D (SPD). Macrophages play an important role in innate immunity, but the effect of MAA adducts on macrophage function has not yet been examined. Because macrophage scavenger receptor A (SRA; CD204) mediates the uptake of modified proteins, we hypothesized that the effects of MAA‐modified proteins on macrophage function are primarily mediated through SRA.

Methods

We tested this hypothesis by exposing SPD‐MAA to macrophages and measuring functions. SPD‐MAA treatment significantly stimulated pro‐inflammatory cytokine tumor necrosis factor‐alpha (TNF‐α) release in the macrophage cell line, RAW 264.7.

Results

A significant reduction in phagocytosis of zymosan particles was also observed. SPD‐MAA stimulated a significant dose‐dependent increase in TNF‐α and interleukin (IL)‐6 release from peritoneal macrophages (PMs) of wild‐type (WT) mice. But significantly less TNF‐α and IL‐6 were released from PMs of SRA−/− mice. We observed a significant reduction in phagocytosis of zymosan particles in PMs from WT mice treated with SPD‐MAA. No further SPD‐MAA‐induced reduction was seen in PMs from SRA−/− mice. SPD‐MAA treatment significantly increased SRA mRNA expression, but had no effect on surface receptor protein expression. Protein kinase C alpha inhibitor and NF‐κB inhibitor significantly reduced pro‐inflammatory cytokine release in response to SPD‐MAA.

Conclusions

In conclusion, our data demonstrate that SRA is important for MAA‐adducted protein‐mediated effect on macrophage functions.
Minimally Circulatory‐Assisted On‐Pump Beating Coronary Artery Bypass Grafting for Patients With Complex Conditions for Off‐Pump Surgery
Authors: Mizuno Tomohiro , Egi Koso , Sakai Kenji , Oi Keiji , Hachimaru Tsuyoshi , Makita Tohru , Oishi Kiyotoshi , Arai Hirokuni
Published: October 2016

Off‐pump coronary artery bypass grafting (OPCAB) in patients with acute myocardial infarction (AMI) is difficult because of circulatory deterioration during displacement of the heart. At our institution, we performed minimally circulatory‐assisted on‐pump beating coronary artery bypass grafting (MICAB) in these patients. During MICAB, support flow was controlled at a minimal level to maintain a systemic blood pressure of approximately 100 mm Hg and a pulmonary arterial systolic pressure of <30 mm Hg, providing optimal pulsatile circulation for end‐organ perfusion and prevention of heart congestion. From September 2006 to March 2012, MICAB was performed in 37 patients. Either emergent or urgent MICAB was performed in 27 patients following AMI because of hemodynamic instability during reconstruction. Elective MICAB was performed in the remaining 10 patients because of dilated left ventricle (LV) or small target coronary arteries. The details of bypass grafts, perioperative renal function, and early and mid‐term morbidity and mortality were compared between the patients who received MICAB and the 37 consecutive patients who underwent OPCAB during the study period at our hospital. The assist flow indices (actual support flow/body surface area) during anastomosis to the left anterior descending artery, left circumflex artery, and right coronary artery were 0.95 ± 0.48 L/min/m2, 1.32 ± 0.53 L/min/m2, and 1.15 ± 0.47 L/min/m2, respectively, in the emergent and urgent patients following AMI, and 0.44 ± 0.39 L/min/m2, 1.25 ± 0.39 L/min/m2, and 1.14 ± 0.43 L/min/m2, respectively, in the elective patients with either dilated LVs or small target vessels. The lowest mixed venous oxygen saturation during pump support in the MICAB group was significantly higher than that in the OPCAB group (83.8 ± 10.8%, 71.6 ± 7.5%, P < 0.001). Comparing MICAB and OPCAB, the median number of distal bypass grafts for both groups was 4 (25th, 75th percentile: 3, 4) (P = 0.558); the complete revascularization rates were 94.6 and 97.3%, respectively (not significant [NS]); the acute patency rates were 98.9 and 99.2%, respectively (NS); and the 30‐day mortality rates were 2.7 and 0%, respectively (NS). No instances of either cerebrovascular complications or newly occurring postoperative renal failure were noted in either group. There were no statistically significant differences between the groups with respect to early and mid‐term results (freedom from all‐cause death: 82.9 vs. 86.5%, respectively, and freedom from cardiac events at 3 years: 96.4 vs. 96.4%, respectively). MICAB is a safe alternative to OPCAB, particularly in patients with AMI and dilated LV. MICAB is associated with high rates of complete revascularization and acute graft patency, adequate preservation of end‐organ function, and early and mid‐term results comparable with those observed following OPCAB.
Topographic, tomographic and biomechanical corneal changes during pregnancy in patients with keratoconus: a cohort study
Authors: Naderan Mohammad , Jahanrad Ali
Published: October 2016

Purpose

This study aimed at evaluating the effect of pregnancy on topographic, tomographic and biomechanical parameters of patients with keratoconus (KC) in comparison with non‐pregnant patients with KC.

Method

In a cohort study, patients with KC, whose disease was stable for at least 2 years, were evaluated before pregnancy, at their third trimester of pregnancy (34th week of pregnancy) and 6 months after pregnancy. As the control group, an equivalent number of age‐ and severity‐matched non‐pregnant female patients with KC were evaluated at the corresponding times. All subjects were evaluated with respect to central and thinnest corneal thickness (CCT and TCT), keratometry values, and maximum anterior and posterior elevation measurements (AE and PE) by Pentacam. Furthermore, corneal biomechanical properties including corneal hysteresis (CH) and corneal resistance factor (CRF) were measured using the ocular response analyser.

Results

Twenty‐two eyes of 11 patients were equally enrolled in each group. The results revealed that there was a statistically significant difference between the means of all measurements during the course of study (p < 0.001, repeated measures analysis of variance). The values of CCT, TCT, CH, CRF, IOPg and IOPcc were significantly decreased; however, keratometry values, AE, PE and refraction measurements were significantly increased during the study period (p < 0.001). In contrast, no significant differences were observed regarding the study variables in the control group (p > 0.05). According to the Amsler–Krumeich classification, severity of KC increased during the pregnancy and postpregnancy periods (p = 0.038).

Conclusion

The obtained results revealed that KC progressed during the pregnancy period and continued to the post‐partum period, indicating that pregnancy may be a risk factor for KC progression. Patients with KC, who intend to become pregnant, may consider corneal cross‐linking treatment in an attempt to stop KC progression.
Context and Scope of Social Work Interventions in Perinatal Mental Health Settings in India
Authors: Ragesh G , Sajitha K , Hamza Ameer
Published: October 2016

The perinatal period may not be a happy time for all mothers. During this period, some may develop psychiatric complications, which have both biological and psychosocial etiology, and such illness may affect the whole family. Psychosocial aspects may trigger the illness and act as risk and maintaining factors. Social workers need to intervene in this context for optimal functioning of women with perinatal mental health issues and her family. A biopsychosocial framework may be adopted for social work assessment and intervention. Individual, familial, group, and community level intervention is required to address this complex issue, along with other mental health clinicians.
Is Food Insecurity Associated with Depressive Symptoms in South Korea?
Authors: Kim Youngmi , Park Aely , Huang Jin
Published: October 2016

Emerging studies have suggested a possible link between food hardship and depression; however, empirical knowledge is limited. In South Korea, more public discussion has been conducted regarding the prevalence and consequences of food insecurity on mental health. To begin to address the knowledge gap, we applied family stress theory and investigated the association of food insecurity with depression in South Korea. We employed observational data from the Korea Welfare Panel Study, the first data to draw on food insecurity information from a nationally representative sample in Korea. Our sample consisted of 744 non‐elderly household heads. The independent variable “food insecurity” was measured using a six‐item scale adapted from the United States Department of Agriculture Food Security Scale. The dependent variable “depression” was measured using 11 questions from the Center for Epidemiologic Studies Depression Scale adapted for Koreans. After controlling for income, material hardship, and other factors, our ordinary least squares regression findings show that food insecurity significantly predicts depression. Our findings are consistent whether food insecurity is measured on a continuum or in categorical groups. More research and empirical evidence should be shared to provide legitimate grounds for policy interventions that address and prevent food insecurity and mental health issues.
Who is Jobless? A Comparison of Joblessness in Rural and Urban Areas in China
Authors: Yao Jianping
Published: October 2016

Since market‐oriented economic reform was launched in China in the 1980s, unemployment has been recognized by the government. This paper focuses on the differences in joblessness in rural and urban areas between rural migrant workers, peasants, and urban citizens. The results indicate that people in rural areas frequently lose their jobs, which differs from the traditional perception. There is a significantly lower jobless rate in urban areas. In contrast to the results of previous studies, the employment situation of rural migrant workers is closer to urban citizens rather than peasants. Logistic regression results show that the elderly, women, and less educated citizens have a higher likelihood of joblessness, both in urban and rural areas. Minorities have a lower likelihood of joblessness in rural areas and a higher likelihood in urban areas. Chinese Communist Party members and people without dependent children have a lower likelihood of joblessness in urban areas.
Pathology of Guillain–Barré syndrome
Authors: Nakano Yuta , Kanda Takashi
Published: October 2016

Guillain–Barré syndrome (GBS), a disease affecting the peripheral nervous system, is now well known. However, the disease concept has evolved over successive periods. For example, for approximately nine decades from the first report of GBS, it was considered to have a spinal cord origin. After the first clinical report, the accumulation of detailed clinicopathological data showed that GBS is composed of two distinct clinicopathological entities: acute inflammatory demyelinating polyneuropathy, and acute motor axonal neuropathy or acute motor and sensory axonal neuropathy. Acute inflammatory demyelinating polyneuropathy is characterized by the patchy distribution of demyelinative foci throughout the peripheral nervous system, whereas acute motor axonal neuropathy/acute motor and sensory axonal neuropathy shows primary axonal degeneration in the peripheral nervous system, which is particularly accentuated at the spinal nerve roots. The purpose of the present article was to provide an overview of the previous publications regarding the pathology of GBS and to thereby elucidate the pathological mechanisms of this still threatening disorder from a pathological viewpoint. The critical pathological feature of acute inflammatory demyelinating polyneuropathy is the complement–macrophage‐induced cytotoxic damage on the plasmalemma of the Schwann cells, whereas that of acute motor axonal neuropathy/acute motor and sensory axonal neuropathy is the antibody–complement‐mediated immune attack on the axolemma at the nodes of Ranvier.
Magnetic resonance imaging based correlation analysis between calcarine sulcus development and isolated fetal ventriculomegaly
Authors: Li Hehong , Liang Huiying , Wu Huiying
Published: October 2016

Fetal ventriculomegaly development leads to neurological, motor, and/or cognitive impairment, and is presently diagnosed based on the width of the atrium in the lateral ventricle. But in this study, we have tried to assess the relationship between the development of calcarine sulcus and width of fetal lateral ventricles, to assess if calcarine sulcus can also be used for fetal ventriculomegaly diagnosis. We conducted a retrospective analysis of the magnetic resonance imaging (MRI) data from 45 subjects with isolated mild fetal ventriculomegaly (IMVM). The calcarine sulcus development was divided into three categories based on the depth; Grade 1 (undeveloped), Grade 2 (underdeveloped), and Grade 3 (fully developed), and its correlation with fetal ventriculomegaly was analyzed based on Spearman's partial rank correlation test. Based on this analysis, the width of left and right lateral ventricles showed significant downward trend with the calcarine sulcus maturation [undeveloped (Left 13.88 ± 2.70 mm, Right 14.27 ± 3.13 mm) → underdeveloped (Left 12.95 ± 1.93 mm, Right 11.93 ± 2.24 mm) → fully developed (Left 11.06 ± 2.10 mm, Right 10.42 ± 2.10 mm)] (FLeft = 5.12,P = 0.01;FRight = 10.72,P = 1.73 × 10−4). In addition, significant correlations were also observed between the width of the lateral ventricles and the maturity of the calcarine sulcus (Spearman's rank correlation coefficient; −0.47 for the left lateral ventricles and −0.56 for the right, bothP < 0.001). Overall, our data indicated a negative correlation between the fetal morphological development of calcarine sulcus and the width of lateral ventricles in subjects having isolated fetal ventriculomegaly.
An interdisciplinary review of current and future approaches to improving human–predator relations
Authors: Pooley S. , Barua M. , Beinart W. , Dickman A. , Holmes G. , Lorimer J. , Loveridge A.J. , Macdonald D.W. , Marvin G. , Redpath S. , Sillero‐Zubiri C. , Zimmermann A. , Milner‐Gulland E.J.
Published: October 2016

In a world of shrinking habitats and increasing competition for natural resources, potentially dangerous predators bring the challenges of coexisting with wildlife sharply into focus. Through interdisciplinary collaboration among authors trained in the humanities, social sciences, and natural sciences, we reviewed current approaches to mitigating adverse human–predator encounters and devised a vision for future approaches to understanding and mitigating such encounters. Limitations to current approaches to mitigation include too much focus on negative impacts; oversimplified equating of levels of damage with levels of conflict; and unsuccessful technical fixes resulting from failure to engage locals, address hidden costs, or understand cultural (nonscientific) explanations of the causality of attacks. An emerging interdisciplinary literature suggests that to better frame and successfully mitigate negative human–predator relations conservation professionals need to consider dispensing with conflict as the dominant framework for thinking about human–predator encounters; work out what conflicts are really about (they may be human–human conflicts); unravel the historical contexts of particular conflicts; and explore different cultural ways of thinking about animals. The idea of cosmopolitan natures may help conservation professionals think more clearly about human–predator relations in both local and global context. These new perspectives for future research practice include a recommendation for focused interdisciplinary research and the use of new approaches, including human‐animal geography, multispecies ethnography, and approaches from the environmental humanities notably environmental history. Managers should think carefully about how they engage with local cultural beliefs about wildlife, work with all parties to agree on what constitutes good evidence, develop processes and methods to mitigate conflicts, and decide how to monitor and evaluate these. Demand for immediate solutions that benefit both conservation and development favors dispute resolution and technical fixes, which obscures important underlying drivers of conflicts. If these drivers are not considered, well‐intentioned efforts focused on human–wildlife conflicts will fail.
Systemic inflammation as a function of the individual and combined associations of sedentary behaviour, physical activity and cardiorespiratory fitness
Authors: Edwards Meghan K. , Loprinzi Paul D.
Published: October 2016

Background

Previous research demonstrates individual associations of sedentary behaviour, moderate‐to‐vigorous physical activity (MVPA) and cardiorespiratory fitness on systemic inflammation, often assessed via C‐reactive protein (CRP) levels. Their potential additive association on CRP, however, has not been fully evaluated, which was the purpose of this study.

Methods

Data from the 2003–2004 National Health and Nutrition Examination Survey were used (N = 627 adults 20–49 years). Sedentary behaviour and MVPA were objectively assessed (accelerometry) with cardiorespiratory fitness determined from a submaximal treadmill‐based test. Participants were classified as above or below the median values for each of these three parameters, with a PACS (Physical Activity Cardiorespiratory Sedentary) score ranging from 0 to 3, indicating the participant number of these three positive characteristics. A blood sample was obtained from each participant to assess CRP via latex‐enhanced nephelometry.

Results

Above median sedentary behaviour (OR = 1·04; 95% CI: 0·65–1·66) was not associated with elevated (>0·3 mg dl−1) CRP, but above median MVPA (OR = 0·62; 95% CI: 0·40–0·97) and above median VO2max (OR = 0·61; 95% CI: 0·40–0·93) were associated with a reduced odds of having an elevated CRP. With regard to the additive model, and after adjustment, the odds ratios (95% CI) for the PACS score of 1 (versus 0), 2 (versus 0) and 3 (versus 0), respectively, were 0·59 (0·34–1·05; P = 0·07), 0·60 (0·31–1·15; P = 0·11) and 0·34 (0·12–0·97; P = 0·04).

Conclusion

Cardiorespiratory fitness and MVPA, but not sedentary behaviour, were independently associated with reduced odds of elevated CRP. Adults with all three characteristics, however, had the lowest odds of elevated CRP.
Acute cardiorespiratory responses in participants with heart disease during cycling at different immersion levels
Authors: Dionne Andrée , Pérusse Louis , Comtois Alain‐Steve , Leone Mario
Published: October 2016

Physical activity is often avoided or practised at a low‐intensity level because of the limited ability of patients with heart disease (HD) to provide sustained effort. Immersible training has been suggested as a possible alternative as hydrostatic pressure can modify some hemodynamic parameters in healthy patients and potentially increase the exercise capacity in patients with HD. The purpose of this study was to examine the acute cardiorespiratory adaptations at different levels of immersion using an immersible ergometer (IE) in patients with HD. Twenty‐one patients and 13 healthy controls (HC) participated in this study. Several cardiorespiratory parameters were assessed at two levels of immersion (hips and xiphoid) for five different pedalling rates (40, 50, 60, 70 and peak rpm). At submaximal intensity, HD and HC participants did not differ significantly for most variables. However, for nearly and/or maximal workload, HD participants showed significantly lower values for VO2 and higher values for VE/VO2 and VE/VCO2 for both immersion levels. The increase in immersion level from hips to xiphoid resulted in a significant decrease in VO2 in both HC and HD groups at the same exercise intensity. In addition, the increase in the effects of size values based on the exercise workload indicates that group differences are accentuated with the highest pedalling rates. Our data suggest that participants with HD may benefit from the hydrostatic effect during IE cycling by allowing them to alleviate their submaximal efforts and increasing their maximal cardiorespiratory capacity during hip immersion.
Effects of enhanced external counterpulsation on skeletal muscle gene expression in patients with severe heart failure
Authors: Melin Michael , Montelius Andreas , Rydén Lars , Gonon Adrian , Hagerman Inger , Rullman Eric
Published: October 2016

Enhanced external counterpulsation (EECP) is a non‐invasive treatment in which leg cuff compressions increase diastolic aortic pressure and coronary perfusion. EECP is offered to patients with refractory angina pectoris and increases physical capacity. Benefits in heart failure patients have been noted, but EECP is still considered to be experimental and its effects must be confirmed. The mechanism of action is still unclear. The aim of this study was to evaluate the effect of EECP on skeletal muscle gene expression and physical performance in patients with severe heart failure. Patients (n = 9) in NYHA III‐IV despite pharmacological therapy were subjected to 35 h of EECP during 7 weeks. Before and after, lateral vastus muscle biopsies were obtained, and functional capacity was evaluated with a 6‐min walk test. Skeletal muscle gene expression was evaluated using Affymetrix Hugene 1.0 arrays. Maximum walking distance increased by 15%, which is in parity to that achieved after aerobic exercise training in similar patients. Skeletal muscle gene expression analysis using Ingenuity Pathway Analysis showed an increased expression of two networks of genes with FGF‐2 and IGF‐1 as central regulators. The increase in gene expression was quantitatively small and no overlap with gene expression profiles after exercise training could be detected despite adequate statistical power. EECP treatment leads to a robust improvement in walking distance in patients with severe heart failure and does induce a skeletal muscle transcriptional response, but this response is small and with no significant overlap with the transcriptional signature seen after exercise training.
Complementary echo and CCTA findings with superior sinus venosus atrial septal defect
Authors: Turner Jason , Turner Michael C. , Kerut Edmund K.
Published: October 2016

A young female developed progressive dyspnea on minimal exertion. Echocardiography demonstrated a large right heart with severe pulmonary hypertension. Cardiac computed tomographic angiography then demonstrated a superior sinus venosus atrial septal defect with an anomalous right upper pulmonary venous drainage. Echo and CCTA were complementary in making a proper diagnosis.
Insights from echocardiography, magnetic resonance imaging, and microcomputed tomography relative to the mid‐myocardial left ventricular echogenic zone
Authors: Agger Peter , Stephenson Robert S. , Dobrzynski Halina , Atkinson Andrew , Iaizzo Paul A. , Anderson Robert H. , Jarvis Jonathan C. , Allan Sarah L. , Partridge John B. , Zhao Jichao , Zhang Henggui , MacIver David H.
Published: October 2016

Background

The anatomical substrate for the mid‐mural ventricular hyperechogenic zone remains uncertain, but it may represent no more than ultrasound reflected from cardiomyocytes orientated orthogonally to the ultrasonic beam. We sought to ascertain the relationship between the echogenic zone and the orientation of the cardiomyocytes.

Methods

We used 3D echocardiography, diffusion tensor imaging, and microcomputed tomography to analyze the location and orientation of cardiomyocytes within the echogenic zone.

Results

We demonstrated that visualization of the echogenic zone is dependent on the position of the transducer and is most clearly seen from the apical window. Diffusion tensor imaging and microcomputed tomography show that the echogenic zone seen from the apical window corresponds to the position of the circumferentially orientated cardiomyocytes. An oblique band seen in the parasternal view relates to cardiomyocytes orientated orthogonally to the ultrasonic beam.

Conclusions

The mid‐mural ventricular hyperechogenic zone represents reflected ultrasound from cardiomyocytes aligned orthogonal to the ultrasonic beam. The echogenic zone does not represent a space, a connective tissue sheet, a boundary between ascending and descending limbs of a hypothetical helical ventricular myocardial band, nor an abrupt change in cardiomyocyte orientation.
Asynchronous demographic responses to Pleistocene climate change in Eastern Nearctic vertebrates
Authors: Burbrink Frank T. , Chan Yvonne L. , Myers Edward A. , Ruane Sara , Smith Brian Tilston , Hickerson Michael J.
Published: October 2016

Pleistocene climatic cycles altered species distributions in the Eastern Nearctic of North America, yet the degree of congruent demographic response to the Pleistocene among codistributed taxa remains unknown. We use a hierarchical approximate Bayesian computational approach to test if population sizes across lineages of snakes, lizards, turtles, mammals, birds, salamanders and frogs in this region expanded synchronously to Late Pleistocene climate changes. Expansion occurred in 75% of 74 lineages, and of these, population size trajectories across the community were partially synchronous, with coexpansion found in at least 50% of lineages in each taxonomic group. For those taxa expanding outside of these synchronous pulses, factors related to when they entered the community, ecological thresholds or biotic interactions likely condition their timing of response to Pleistocene climate change. Unified timing of population size change across communities in response to Pleistocene climate cycles is likely rare in North America.
Traumatization, Marital Adjustment, and Parenting among Veterans and Their Spouses: A Longitudinal Study of Reciprocal Relations
Authors: Levin Yafit , Bachem Rahel , Solomon Zahava
Published: October 2016

Despite considerable research on secondary traumatization, the ramifications of veterans’ and their wives’ posttraumatic stress symptoms (PTSS) for the family system remain largely uninvestigated. Beginning to fill this gap, the current study aims to investigate the reciprocal relations between both spouses’ PTSS and marital adjustment, and the implications these bear for their parental functioning. Two hundred and twenty‐five Israeli veterans (mean age = 58.62, SD = 7.6) from the 1973 Yom Kippur War and their wives (mean age = 58.28, SD = 5.79) were examined at two points in time: 30 (T1) and 35–37 years after the war (T2). Analysis included longitudinal actor–partner interdependence modeling and sequential mediation analyses. The results show that higher PTSS among the wives at T1 predicted higher PTSS among husbands at T2, and vice versa, and predicted their husbands’ marital adjustment at T2. Moreover, wives’ PTSS at T1 had a significant effect on parental overinvolvement of both parents at T2, but neither their PTSS nor their husbands’ PTSS had an impact on positive parenting. In the intrapersonal domain, better marital adjustment at T1 predicted positive parenting among both spouses in subsequent measurement. Interpersonally, wives’ lower marital adjustment at T1 predicted husbands’ higher parental functioning, but not vice versa. Furthermore, marital adjustment mediated the association between PTSS and positive parenting for both spouses. The results emphasize the detrimental ramifications of war trauma on the interpersonal domains in veterans’ families. Hence, both marital and parental consequences of trauma should be considered in clinical family interventions.
The Dialysis Outcomes and Practice Patterns Study (DOPPS) in Turkey
Authors: Ecder Tevfik , Utas Cengiz , Ates Kenan , Bieber Brian , Robinson Bruce M. , Pisoni Ronald L. , Süleymanlar Gültekin
Published: October 2016

Introduction: Turkey has one of the largest treated end‐stage renal disease (ESRD) patient populations in Europe (N = 66,711). In 2013, the international Dialysis Outcomes and Practice Patterns Study (DOPPS), a prospective study of hemodialysis (HD) practices and outcomes, initiated data collection in Turkey. Here we provide comparisons of HD patients in DOPPS‐Turkey with other international regions and with patients in the Registry of Turkish Nephrology, Dialysis and Transplantation.

Methods: DOPPS‐Turkey study sites were randomly selected from all Turkish HD units treating ≥25 in‐center chronic HD patients. Detailed patient‐ and facility‐level data were collected for 20–30 randomly selected prevalent HD patients per facility.

Findings: Demographic and comorbidity profiles for DOPPS‐Turkey patients were similar to HD patients overall in the 2013 Turkish Registry Report. In Turkey: diabetes was the most common ESRD cause (37%); arteriovenous fistula use was 83%; mean single pool Kt/V was 1.61. Compared with other international regions, Turkey had the highest mean hemoglobin (11.5 g/dL), ferritin (771 ng/mL), and interdialytic weight gain (3.28%), while Turkey had the lowest mean systolic blood pressure (127 mmHg) and erythropoiesis stimulating agent prescription (57%). Turkish patients also reported the highest depression scores.

Discussion: In this first DOPPS‐Turkey report, the DOPPS sample agrees well with national Turkish Registry data. Treatment and laboratory data, and patient‐reported outcomes, demonstrate similarities and previously unrecognized contrasts to DOPPS findings in Europe, Japan, and North America. Long‐term follow‐up of these patients will describe how these differences relate to clinical outcomes within Turkey.
Home hemodialysis associated infection—The “Achilles' Heel” of intensive hemodialysis
Authors: Poon Clara K. , Chan Christopher T.
Published: October 2016

Home hemodialysis (HHD) is emerging as an important alternate renal replacement therapy. Although there are multiple clinical advantages with HHD, concerns surrounding increased risks of infection in this group of patients remain a major barrier to its implementation. In contrast to conventional hemodialysis, infection related complication represents the major morbidity in this mode of renal replacement therapy. Vascular access related infection is an important cause of infection in this population. Use of central vein catheters and buttonhole cannulation in HHD are important modifiable risk factors for HHD associated infection. Several preventive measures are suggested in the literature, which will require further prospective validation.
Habitat selection by breeding WhinchatsSaxicola rubetraat territory and landscape scales
Authors: Border Jennifer A. , Henderson Ian G. , Redhead John W. , Hartley Ian R.
Published: October 2016

We determined breeding season habitat preferences for a declining migrant grassland bird, the WhinchatSaxicola rubetra,using intensive, territory‐scale habitat and invertebrate data, and independently gathered landscape‐scale field survey and remotely sensed habitat data to determine whether the same habitat relationships were evident at both spatial scales. At the territory scale, low‐elevation and a heterogeneous vegetation structure with a high density of perches and tussocks were the dominant features of occupied habitats. The landscape‐scale model successfully predicted areas where breeding Whinchats were more likely to occur, and similar and consistent relationships with habitat features occurred at both spatial scales. However, plant species richness and topographic slope elicited different responses at different spatial scales, with steeper slopes and high plant species richness favoured at the landscape scale, whereas at the territory scale, low plant species richness was preferred and slope did not determine settlement. These differences reflect differences in the way the data were measured and extrapolated. This study identifies important attributes of lowland grassland habitats and landscapes for a stable population of breeding Whinchats, and the analysis shows the good predictive ability of remotely sensed data to model this species' distribution at larger spatial extents. Our findings provide methods for assessing habitat availability for this declining species and for managing habitats and landscapes to provide these essential elements.
Enzymatic preparation of immunomodulatory hydrolysates from defatted wheat germ (Triticum Vulgare) globulin
Authors: Wu Wenjia , Zhang Mengmeng , Sun Chongzhen , Brennan Margaret , Li Huixian , Wang Guang , Lai Furao , Wu Hui
Published: October 2016

Defatted wheat germ globulin (DWGG) was hydrolysed using the enzymes alcalase, neutrase, papain, pepsin or trypsin to improve the immunomodulatory effects of the protein. The degree of hydrolysis (DH), molecular weight distribution, hydrophobicity, secondary structures and immunomodulatory activities were determined. The DH of hydrolysate using alcalase or neutrase was higher (P < 0.05) than that of hydrolysate prepared by other proteases. Alcalase hydrolysate (AH) had the strongest (P < 0.05) immunomodulatory activity with respect to lymphocyte proliferation, phagocytosis of neutral red and secretion of pro‐inflammatory cytokines. The molecular weight of AH ranged between 300 and 1450 Da and was composed of α‐helix and β‐turns. AH also showed the highest hydrophobic value (P < 0.05). The DH and hydrophobicity appear to be related to immunomodulatory activities. The hydrolysate prepared by the alcalase treatment on DWGG may be used as an immune supplement by the food industry.
Innate immune mediators in cancer: between defense and resistance
Authors: Berraondo Pedro , Minute Luna , Ajona Daniel , Corrales Leticia , Melero Ignacio , Pio Ruben
Published: October 2016

Chronic inflammation in the tumor microenvironment and evasion of the antitumor effector immune response are two of the emerging hallmarks required for oncogenesis and cancer progression. The innate immune system not only plays a critical role in perpetuating these tumor‐promoting hallmarks but also in developing antitumor adaptive immune responses. Thus, understanding the dual role of the innate system in cancer immunology is required for the design of combined immunotherapy strategies able to tackle established tumors. Here, we review recent advances in the understanding of the role of cell populations and soluble components of the innate immune system in cancer, with a focus on complement, the adapter molecule Stimulator of Interferon Genes, natural killer cells, myeloid cells, and B cells.
Properdin: a tightly regulated critical inflammatory modulator
Authors: Blatt Adam Z. , Pathan Sabina , Ferreira Viviana P.
Published: October 2016

The complement alternative pathway is a powerful arm of the innate immune system that enhances diverse inflammatory responses in the human host. Key to the effects of the alternative pathway is properdin, a serum glycoprotein that can both initiate and positively regulate alternative pathway activity. Properdin is produced by many different leukocyte subsets and circulates as cyclic oligomers of monomeric subunits. While the formation of non‐physiological aggregates in purified properdin preparations and the presence of potential properdin inhibitors in serum have complicated studies of its function, properdin has, regardless, emerged as a key player in various inflammatory disease models. Here, we review basic properdin biology, emphasizing the major hurdles that have complicated the interpretation of results from properdin‐centered studies. In addition, we elaborate on an emerging role for properdin in thromboinflammation and discuss the potential utility of properdin inhibitors as long‐term therapeutic options to treat diseases marked by increased formation of platelet/granulocyte aggregates. Finally, we describe the interplay between properdin and the alternative pathway negative regulator, Factor H, and how aiming to understand these interactions can provide scientists with the most effective ways to manipulate alternative pathway activation in complex systems.
More than complementing Tolls: complement–Toll‐like receptor synergy and crosstalk in innate immunity and inflammation
Authors: Hajishengallis George , Lambris John D.
Published: October 2016

Complement and Toll‐like receptors (TLRs) play key roles in the host immune response and are swiftly activated by infection or other types of immunological stress. This review focuses on the capacity of complement and TLRs to engage in signaling crosstalk, ostensibly to coordinate immune and inflammatory responses through synergistic or antagonistic (regulatory) interactions. However, overactivation or dysregulation of either system may lead—often synergistically—to exaggerated inflammation and host tissue injury. Intriguingly, moreover, certain pathogens can manipulate complement–TLR crosstalk pathways in ways that undermine host immunity and favor their persistence. In the setting of polymicrobial inflammatory disease, subversion of complement–TLR crosstalk by keystone pathogens can promote dysbiosis. Knowledge of the molecular mechanisms underlying complement–TLR crosstalk pathways can, therefore, be used productively for tailored therapeutic approaches, such as, to enhance host immunity, mitigate destructive inflammation, or counteract microbial subversion of the host response.