bluuebunny/crossref_metadata_2025 huggingface dataset:
Paternalism and Ethnicity in Giving
Authors: Jones Kristy
Published: April 2017

This paper investigates paternalism and ethnicity in giving. In this experiment donors choose to donate to one of three recipient types, varying by ethnicity. In one treatment, donors can impose a costly restriction on their donation. I find a higher proportion of donors choose to donate to a commonly negatively stereotyped recipient (Indigenous Australians) when they are able to act paternalistically. Even when paternalism is costly, almost 60 per cent chose to restrict their donation. Paternalism is also found to be related to recipient type. The results indicate that to increase donations, charities may need to reduce donors’ perceptions of misuse.
Assessing Impact Direction in 3‐point Bending of Human Femora: Incomplete Butterfly Fractures and Fracture Surfaces,,
Authors: Isa Mariyam I. , Fenton Todd W. , Deland Trevor , Haut Roger C.
Published: April 2017

Current literature associates bending failure with butterfly fracture, in which fracture initiates transversely at the tensile surface of a bent bone and branches as it propagates toward the impact surface. The orientation of the resulting wedge fragment is often considered diagnostic of impact direction. However, experimental studies indicate bending does not always produce complete butterfly fractures or produces wedge fragments variably in tension or compression, precluding their use in interpreting directionality. This study reports results of experimental 3‐point bending tests on thirteen unembalmed human femora. Complete fracture patterns varied following bending failure, but incomplete fractures and fracture surface characteristics were observed in all impacted specimens. A flat, billowy fracture surface was observed in tension, while jagged, angular peaks were observed in compression. Impact direction was accurately reconstructed using incomplete tension wedge butterfly fractures and tension and compression fracture surface criteria in all thirteen specimens.
Paediatric acute care: Highlights from the Paediatric Acute Care–Advanced Paediatric Life Support Conference, Adelaide, 2016
Authors: Teo Stephen SS , Schutz Jacquie , Stanford Jane , Rao Arjun
Published: April 2017

The Paediatric Acute Care Conference (PACC) is an annual conference organised by Advanced Paediatric Life Support Australia to advance paediatric acute care topics for clinicians in pre‐hospital medicine, EDs, acute paediatrics, intensive care and anaesthesia. The PACC 2016 was held at Glenelg, Adelaide, Australia. We provide a summary of some of the presentations.
Plasma concentrations of lipids during pregnancy and the risk of gestational diabetes mellitus: A longitudinal study
Authors: Bao Wei , Dar Sharon , Zhu Yeyi , Wu Jing , Rawal Shristi , Li Shanshan , Weir Natalie L. , Tsai Michael Y. , Zhang Cuilin
Published: April 2017

Background

Abnormal lipid profiles have been associated with gestational diabetes mellitus (GDM), but studies with longitudinal measures of lipids throughout pregnancy are sparse. The aim of the present study was to characterize longitudinal changes in lipid profiles throughout pregnancy and prospectively examine the associations of plasma lipid concentrations with risk of GDM.

Methods

This study was a nested case‐control study including 107 GDM cases and 214 matched non‐GDM controls from participants in the National Institute of Child Health and Human Development (NICHD) Fetal Growth Studies – Singleton cohort. Blood samples were collected longitudinally at Gestational Weeks (GW) 10–14, 15–26 (fasting sample), 23–31, and 33–39. Plasma concentrations of triglycerides, total cholesterol, and high‐density lipoprotein cholesterol (HDL‐C) were measured by enzymatic assays. Low‐density lipoprotein cholesterol (LDL‐C) was calculated using Friedewald's formula.

Results

Plasma triglycerides, total cholesterol, and LDL‐C increased as pregnancy progressed. At GW 10–14, the adjusted odds ratios (aORs) of GDM comparing the highest versus lowest quartile were 3.15 (95% confidence interval [CI] 1.38–7.15; P
trend = 0.002) for triglycerides and 0.44 (95% CI 0.18–1.09; P
trend = 0.045) for HDL‐C. At GW 15–26, the aORs were 6.57 (95% CI 2.25–19.17; P
trend = 0.001) for triglycerides and 0.23 (95% CI 0.08–0.63; P
trend = 0.005) for HDL‐C. No significant associations were observed for total cholesterol and LDL‐C concentrations with risk of GDM.

Conclusions

Higher plasma triglyceride and lower HDL‐C concentrations in early and mid‐pregnancy were significantly associated with a greater risk of GDM. Total cholesterol and LDL‐C concentrations during pregnancy were not significantly associated with GDM risk.
The Relationship between Intergenerational Educational Mobility and Public Spending: Evidence from Canada
Authors: Latif Ehsan
Published: April 2017

Using data from the General Social Survey‐2011 (Family), this study examines intergenerational educational mobility in Canada, with a particular focus on the role of public educational spending. This study finds that children's education is significantly correlated with father's education. However, the strength of the correlation declines with an increase in provincial educational spending. In other words, public educational spending positively affects intergenerational educational mobility. To check the robustness of these results, the study compares son's and daughter's education with father's education. Furthermore, this study also compares children's education with both father's and mother's education. In all cases, the results show that the intergenerational educational elasticity declines with an increase in provincial educational spending. This result has important policy implications, particularly at a time when Canada is concerned about growing income inequality.
Analyzing epidermal growth factor receptor mutation status changes in advanced non‐small‐cell lung cancer at different sampling time‐points of blood within one day
Authors: Wang Jin , Bai Hua , Hong Chaoyu , Wang Jie , Mei Tong‐hua
Published: April 2017

Background

We investigated whether different sampling time‐points within one day would influence epidermal growth factor receptor mutation (EGFRm) status in plasma and evaluated the clinical outcomes according to the quantity analysis of EGFRm in circulating tumor DNA (ctDNA) in non‐small‐cell lung cancer (NSCLC).

Methods

EGFR‐tyrosine kinase inhibitor naïve advanced NSCLC patients who carried EGFRm in both tissues and ctDNA were enrolled in this study. Plasma samples were collected at three time‐points within one day (at 8 am, 11 am and 2 pm) for EGFRm analysis by droplet digital PCR.

Results

Twenty‐two advanced NSCLC patients were enrolled in the study. In a total of 66 blood specimens, the median EGFRm frequency was 7.13% (range 0–35.09%), and among them six specimens had less than 1.0% EGFRm frequency. Moreover, one time‐point blood specimen did not display any EGFRm, even by droplet digital PCR. The frequency of EGFRm changed dynamically across different time‐points within one day, but the differences were not significant (P = 0.557). We observed that patients with a relatively high frequency of EGFRm (>6.76%) had a better response to gefitinib (P = 0.024).

Conclusion

The release of ctDNA maybe a temporal heterogenous process. The different sampling time‐points within one day did not seem to influence EGFRm status in ctDNA. The relative EGFRm frequency in ctDNA could predict a benefit of EGFR‐tyrosine kinase inhibitor treatment for advanced NSCLC patients.
Endoplasmic reticulum proteostasis impairment in aging
Authors: Martínez Gabriela , Duran‐Aniotz Claudia , Cabral‐Miranda Felipe , Vivar Juan P. , Hetz Claudio
Published: April 2017

Perturbed neuronal proteostasis is a salient feature shared by both aging and protein misfolding disorders. The proteostasis network controls the health of the proteome by integrating pathways involved in protein synthesis, folding, trafficking, secretion, and their degradation. A reduction in the buffering capacity of the proteostasis network during aging may increase the risk to undergo neurodegeneration by enhancing the accumulation of misfolded proteins. As almost one‐third of the proteome is synthetized at the endoplasmic reticulum (ER), maintenance of its proper function is fundamental to sustain neuronal function. In fact, ER stress is a common feature of most neurodegenerative diseases. The unfolded protein response (UPR) operates as central player to maintain ER homeostasis or the induction of cell death of chronically damaged cells. Here, we discuss recent evidence placing ER stress as a driver of brain aging, and the emerging impact of neuronal UPR in controlling global proteostasis at the whole organismal level. Finally, we discuss possible therapeutic interventions to improve proteostasis and prevent pathological brain aging.
A state‐price volatility index for the U.S. government bond market
Authors: Pan Zheyao
Published: April 2017

Using the Arrow–Debreu state‐contingent pricing methodology, this paper derives a U.S. government bond market volatility index (GBVX). I show that GBVX is an unbiased predictor for the next 30 day realised volatility of the Treasury note futures return. GBVX also subsumes the information of GARCH, EWMA and historical volatility measures. Furthermore, GBVX serves as an effective predictor for the future realised volatilities of a wide class of fixed income portfolios. The results suggest GBVX as a powerful instrument for volatility forecasting in the fixed income markets.
Selective imaging modalities after first pyelonephritis failed to identify significant urological anomalies, despite normal antenatal ultrasounds
Authors: Mola Gylli , Wenger Therese Ramstad , Salomonsson Petra , Knudsen Inge Jenny Dahl , Madsen Jan Lysgaard , Møller Søren , Olsen Beth Härstedt , Vinicoff Pablo Gustavo , Thorup Jorgen , Cortes Dina
Published: April 2017

Aim

We investigated the consequences of applying different imaging guidelines for urological anomalies after first pyelonephritis in children with normal routine antenatal ultrasounds.

Methods

The cohort comprised 472 children treated for their first culture‐positive pyelonephritis and investigated with ultrasound and renal scintigraphy. We excluded patients with known urological anomalies and patients born before routine antenatal ultrasound. We followed the cohort for a median of 5.7 years (3.1–10.1 years) by reviewing their medical reports.

Results

Urological anomalies were diagnosed in 95 patients. Dilated vesicoureteral reflux (VUR) was the predominant finding (n = 29), including nine who initially had surgery. Using imaging guidelines from the American Academy of Pediatrics would have missed 11 urological patients, including two with initial surgery, and avoided 339 scintigraphies. Using the European Association of Paediatric Urology guidance would have missed three urological patients, one with initial surgery, and avoided 46 scintigraphies. Investigating patients under two years with ultrasound and scintigraphy, and just ultrasound in children over two years, would have identified all patients initially treated with surgery and avoided 65 scintigraphies.

Conclusion

Dilated VUR was the dominant anomaly in a cohort with first time pyelonephritis and normal antenatal ultrasound. The optimal imaging strategy after pyelonephritis must be identified.
Systematic review with meta‐analysis: the efficacy and safety of tenofovir to prevent mother‐to‐child transmission of hepatitis B virus
Authors: Hyun M. H. , Lee Y.‐S. , Kim J. H. , Je J. H. , Yoo Y. J. , Yeon J. E. , Byun K. S.
Published: April 2017

Background

Preventing mother to child transmission of chronic hepatitis B infection in the setting of a high maternal viral load is challenging. The idea has emerged from antepartum tenofovir treatment with combination immunoprophylaxis.

Aims

To demonstrate the efficacy and safety of tenofovir to prevent mother to child transmission of hepatitis B virus.

Methods

PubMed, EMBASE, and Cochrane databases were searched through August 16, 2016. Comparative trials of second or third trimester tenofovir administration vs. controls for patients with chronic hepatitis B infection and non‐comparative case series assessing mother to child transmission rates and evaluating maternal and foetal safety outcomes were included.

Results

Ten studies (one randomised controlled trial, four non‐randomised controlled trials and five case series) that enrolled 733 women were included. The pooled results from comparative trials (599 pregnancies) showed that tenofovir significantly reduced the risk of infant hepatitis B surface antigen seropositivity by 77% (odds ratio=0.23, 95% confidence intervals=0.10‐0.52, P=.0004) without heterogeneity (I2=0%). In the case series analysis (134 pregnancies), only two cases (1.5%) of mother to child transmission with extremely high maternal viral load and non‐compliance to treatment were identified. Maternal and foetal safety parameters including congenital malformation and foetal death were re‐assuring.

Conclusions

For pregnant women with high hepatitis B virus DNA levels, tenofovir administration in the second or third trimester can prevent mother to child transmission when combined with hepatitis B immunoglobulin and the hepatitis B vaccine. Tenofovir is safe and tolerable for both the mother and foetus.
Bilateral inguinal hernia after axillary‐femoral artery bypass effectively treated with laparoscopic repair: A case report
Authors: Susumu Seiya , Nagakawa Kantoku , Kawakami Shunsuke , Okada Kazuya , Kishikawa Hiroki
Published: April 2017

We report herein our experience with bilateral inguinal hernia surgery for a patient who had previously undergone a Y‐shaped vascular graft for an abdominal aortic aneurysm and then right axillary‐bilateral femoral artery bypass surgery. Preoperative physical examination and imaging revealed a subcutaneous vascular graft passing from the right axilla through the right flank region and branching at the lower abdomen to reach the femoral areas on both sides. As repair surgery by inguinal incision was considered difficult, we performed laparoscopic surgery. Bilateral direct hernia was observed on intraperitoneal observation. Essentially no intraperitoneal organ adhesion to the abdominal wall was present, and the previous surgery was also confirmed not to have reached the inguinal preperitoneal space. Transabdominal preperitoneal repair was therefore performed, yielding favorable results.
Inferring Network Structure in Non-normal and Mixed Discrete-continuous Genomic Data
Authors: Bhadra Anindya , Rao Arvind , Baladandayuthapani Veerabhadran
Published: April 2017

Inferring dependence structure through undirected graphs is crucial for uncovering the major modes of multivariate interaction among high-dimensional genomic markers that are potentially associated with cancer. Traditionally, conditional independence has been studied using sparse Gaussian graphical models for continuous data and sparse Ising models for discrete data. However, there are two clear situations when these approaches are inadequate. The first occurs when the data are continuous but display non-normal marginal behavior such as heavy tails or skewness, rendering an assumption of normality inappropriate. The second occurs when a part of the data is ordinal or discrete (e.g., presence or absence of a mutation) and the other part is continuous (e.g., expression levels of genes or proteins). In this case, the existing Bayesian approaches typically employ a latent variable framework for the discrete part that precludes inferring conditional independence among the data that are actually observed. The current article overcomes these two challenges in a unified framework using Gaussian scale mixtures. Our framework is able to handle continuous data that are not normal and data that are of mixed continuous and discrete nature, while still being able to infer a sparse conditional sign independence structure among the observed data. Extensive performance comparison in simulations with alternative techniques and an analysis of a real cancer genomics data set demonstrate the effectiveness of the proposed approach.
Influence of inflammation and nitric oxide upon platelet aggregation following deposition of diesel exhaust particles in the airways
Authors: Smyth E , Solomon A , Birrell M A , Smallwood M J , Winyard P G , Tetley T D , Emerson M
Published: April 2017

Background and Purpose

Exposure to nanoparticulate pollution has been implicated in platelet‐driven thrombotic events such as myocardial infarction. Inflammation and impairment of NO bioavailability have been proposed as potential causative mechanisms. It is unclear, however, whether airways exposure to combustion‐derived nanoparticles such as diesel exhaust particles (DEP) or carbon black (CB) can augment platelet aggregation in vivo and the underlying mechanisms remain undefined. We aimed to investigate the effects of acute lung exposure to DEP and CB on platelet activation and the associated role of inflammation and endothelial‐derived NO.

Experimental Approach

DEP and CB were intratracheally instilled into wild‐type (WT) and eNOS−/− mice and platelet aggregation was assessed in vivo using an established model of radio‐labelled platelet thromboembolism. The underlying mechanisms were investigated by measuring inflammatory markers, NO metabolites and light transmission aggregometry.

Key Results

Platelet aggregation in vivo was significantly enhanced in WT and eNOS−/− mice following acute airways exposure to DEP but not CB. CB exposure, but not DEP, was associated with significant increases in pulmonary neutrophils and IL‐6 levels in the bronchoalveolar lavage fluid and plasma of WT mice. Neither DEP nor CB affected plasma nitrate/nitrite concentration and DEP‐induced human platelet aggregation was inhibited by an NO donor.

Conclusions and Implications

Pulmonary exposure to DEP and subsequent platelet activation may contribute to the reports of increased cardiovascular risk, associated with exposure to airborne pollution, independent of its effects on inflammation or NO bioavailability.
Training Basic Visual Attention Leads to Changes in Responsiveness to Social‐Communicative Cues in 9‐Month‐Olds
Authors: Forssman Linda , Wass Sam V.
Published: April 2017

This study investigated transfer effects of gaze‐interactive attention training to more complex social and cognitive skills in infancy. Seventy 9‐month‐olds were assigned to a training group (n = 35) or an active control group (n = 35). Before, after, and at 6‐week follow‐up both groups completed an assessment battery assessing transfer to nontrained aspects of attention control, including table top tasks assessing social attention in seminaturalistic contexts. Transfer effects were found on nontrained screen‐based tasks but importantly also on a structured observation task assessing the infants’ likelihood to respond to an adult's social‐communication cues. The results causally link basic attention skills and more complex social‐communicative skills and provide a principle for studying causal mechanisms of early development.
Brain responses to mechanical rectal stimulation in patients with faecal incontinence: an fMRI study
Authors: Mirbagheri N. , Hatton S. , Ng K.‐S. , Lagopoulos J. , Gladman M. A.
Published: April 2017

Aim

Continence is dependent on anorectal–brain interactions. Consequently, aberrations of the brain–gut axis may be important in the pathophysiology of faecal incontinence (FI) in certain patients. The aim of this study was to assess the feasibility of recording brain responses to rectal mechanical stimulation in patients with FI using functional magnetic resonance imaging (fMRI).

Method

A prospective, cohort pilot study was performed to assess brain responses during rectal stimulation in 14 patients [four men, mean (SD) age 62 (15) years]. Blood oxygen level dependent (BOLD) signals were measured by fMRI during rest and mechanical distension, involving random repetitions of isobaric phasic rectal distensions at fixed (15 and 45 mmHg) and variable (10% above sensory perception threshold) pressures.

Results

Increases in BOLD signals in response to high pressure rectal distension (45 mmHg) and maximum toleration were observed in the cingulate gyrus, thalamus, insular cortex, inferior frontal gyrus, cerebellum, caudate nucleus, supramarginal gyrus, putamen and amygdala. Additionally, activation of the supplementary motor cortex and caudate nucleus with inconsistent activity in the frontal lobe was observed.

Conclusions

This study has demonstrated the feasibility of recording brain responses to rectal mechanical stimulation using fMRI in patients with FI, revealing activity in widespread areas of the brain involved in visceral sensory processing. The observed activity in the supplementary motor cortex and caudate nucleus, with relative paucity of activity in the frontal lobes, warrants investigation in future studies to determine whether aberrations in cerebral processing of rectal stimuli play a role in the pathogenesis of FI.
Trait syndromes among North American trees are evolutionarily conserved and show adaptive value over broad geographic scales
Authors: Rueda Marta , Godoy Oscar , Hawkins Bradford A.
Published: April 2017

Adaptive syndromes and their evolutionary constraints represent a powerful construct for understanding plant distributions. However, it is unclear how the species requirements to face multiple stressors promotes syndrome formation and to which abiotic stressors these syndromes show adaptive value over broad geographic scales. We combined local occurrence data from the U.S. Forest Inventory and Analysis (FIA) of 219 angiosperm and 85 gymnosperm species living across the conterminous US with phylogenies and trait data to identify tree syndromes, their evolutionary conservatism, and their adaptive value over broad scales. Factor analyses and evolutionary model selection revealed that trees possess functional trait syndromes that are strongly conserved. Major syndromes at the species level differed between angiosperms and gymnosperms. While the two main syndromes in angiosperms were related to cold and drought‐waterlogging tolerance, in gymnosperms a trade‐off between shade and drought tolerance was the main syndrome followed by a growth‐fire resistance syndrome. Additional RLQ and fourth‐corner approaches revealed that trait syndromes at the community level were broadly similar to those observed at the species level for angiosperms, although this was less clear for gymnosperms. This suggests that syndrome evolution has played an important role on angiosperm distributions, whereas additional ecological factors explain gymnosperm distributions. Importantly, syndromes show adaptive value, as they were geographically associated with several environmental variables showing structure from continental to local scales, being temperature the main abiotic stressor. Our results indicate that across the conterminous US tree species possess clear syndromes that are subjected to strong evolutionary constraints driving tree species and forest community distribution.
The rise and demise ofgedikmarkets in Istanbul, 1750–1860
Authors: Ağir Seven
Published: April 2017

Using new evidence uncovered from Istanbul court records, this paper shows that Ottoman markets were capable of spontaneous financial innovation before the introduction of modern financial instruments. At the same time, however, it demonstrates that the impact and sustainability of these innovations depended on the underlying political equilibrium.Gediks—entitlements to usufruct rights over the factors of production used in urban commercial and industrial activity—gradually transformed into liquid assets during the late eighteenth century. This transformation was enabled by the coercive power of Janissary‐infiltrated guilds in response to the financial needs of small‐ and medium‐scale actors operating within the confines of the domestic economy. The entry barriers, which enabledgedikmarkets to exist in the first place, also limited their use for growth‐promoting purposes and thus set them apart from similar financial instruments that emerged in the West.Gedikmarkets disappeared as the Janissary–guild coalition declined and better financial instruments emerged during the mid‐nineteenth century.
Urbanisation and the loss of phylogenetic diversity in birds
Authors: Sol Daniel , Bartomeus Ignasi , González‐Lagos César , Pavoine Sandrine
Published: April 2017

Despite the recognised conservation value of phylogenetic diversity, little is known about how it is affected by the urbanisation process. Combining a complete avian phylogeny with surveys along urbanisation gradients from five continents, we show that highly urbanised environments supported on average 450 million fewer years of evolutionary history than the surrounding natural environments. This loss was primarily caused by species loss and could have been higher had not been partially compensated by the addition of urban exploiters and some exotic species. Highly urbanised environments also supported fewer evolutionary distinctive species, implying a disproportionate loss of evolutionary history. Compared with highly urbanised environments, changes in phylogenetic richness and evolutionary distinctiveness were less substantial in moderately urbanised environments. Protecting pristine environments is therefore essential for maintaining phylogenetic diversity, but moderate levels of urbanisation still preserve much of the original diversity.
The power of evolutionary rescue is constrained by genetic load
Authors: Stewart Gavin S. , Morris Madeline R. , Genis Allison B. , Szűcs Marianna , Melbourne Brett A. , Tavener Simon J. , Hufbauer Ruth A.
Published: April 2017

The risk of extinction faced by small isolated populations in changing environments can be reduced by rapid adaptation and subsequent growth to larger, less vulnerable sizes. Whether this process, called evolutionary rescue, is able to reduce extinction risk and sustain population growth over multiple generations is largely unknown. To understand the consequences of adaptive evolution as well as maladaptive processes in small isolated populations, we subjected experimental Tribolium castaneum populations founded with 10 or 40 individuals to novel environments, one more favorable, and one resource poor, and either allowed evolution, or constrained it by replacing individuals one‐for‐one each generation with those from a large population maintained in the natal environment. Replacement individuals spent one generation in the target novel environment before use to standardize effects due to the parental environment. After eight generations we mixed a subset of surviving populations to facilitate admixture, allowing us to estimate drift load by comparing performance of mixed to unmixed groups. Evolving populations had reduced extinction rates, and increased population sizes in the first four to five generations compared to populations where evolution was constrained. Performance of evolving populations subsequently declined. Admixture restored their performance, indicating high drift load that may have overwhelmed the beneficial effects of adaptation in evolving populations. Our results indicate that evolution may quickly reduce extinction risk and increase population sizes, but suggest that relying solely on adaptation from standing genetic variation may not provide long‐term benefits to small isolated populations of diploid sexual species, and that active management facilitating gene flow may be necessary for longer term persistence.
The association between oral examination findings and computed tomographic appearance of the equine temporomandibular joint
Authors: Carmalt J. L. , Simhofer H. , Bienert‐Zeit A. , Rawlinson J. E. , Waldner C. L.
Published: April 2017

Background

The temporomandibular joint (TMJ) forms the junction between the maxilla and mandible. Movement of the jaw and resulting masticatory forces have been extensively studied in the horse; however, less is known about the inter‐relationship between this joint and oral and dental pathology.

Objectives

To determine the association between specific oral and dental pathologies and anatomical variations of the TMJ imaged with computed tomography (CT) in horses with asymptomatic TMJs.

Study design

Retrospective cross‐sectional study.

Methods

Horses (n = 201) from three practices with a complete oral examination and skull or upper cervical CT study were reviewed. Age, breed, sex, clinical presentation, oral examination findings, slice width and practice were recorded. Alterations in contour and density of the mandibular condyle, mandibular fossa and intra‐articular disc were also documented. Logistic regression, corrected for clustering by practice, was used to determine whether CT anatomical variations were significantly associated with the oral examination findings.

Results

Horses categorised as having abnormal TMJs were older than those with normal TMJ. Horses with periodontal disease were less likely to have abnormal TMJ findings compared with horses with no oral pathology. In contrast, horses with infundibular disease were more likely to have TMJ abnormalities.

Main limitations

Due to the cross‐sectional nature of the study, it was difficult to establish whether oral pathology preceded TMJ abnormalities.

Conclusions

Despite examining over 200 horses of varying ages, the biological significance of the observed associations between oral, or dental disease and anatomically appreciable temporomandibular joint disorders remains uncertain.
Impact of living arrangements on clinical outcomes among older patients with dementia or cognitive impairment admitted to the geriatric evaluation and management unit in Taiwan
Authors: Hung Cheng‐Hao , Tang Ting‐Ching , Wang Chih‐Jen , Liu Li‐Kuo , Peng Li‐Ning , Chen Liang‐Kung
Published: April 2017

Aim

To evaluate the impact of living arrangements on mortality and functional decline among older patients with dementia or cognitive impairment after discharge from a geriatric evaluation and management unit (GEMU) in Taiwan.

Methods

The present retrospective cohort study used data from the Veteran Affairs Comprehensive Geriatric Assessment from January 2015 to May 2016 for analysis. Data of patients aged 65 years and older with dementia or cognitive impairment at admission to the GEMU of Taipei Veterans General Hospital during the study period were retried for study. The Veteran Affairs Comprehensive Geriatric Assessment included demographic characteristics, Clinical Frailty Scale, Braden Scale, St. Thomas's Risk Assessment Tool in Falling Elderly Inpatients Scale, Cumulative Illness Rating Scale for Geriatrics, Barthel Index, Instrumental Activities of Daily Living, Mini‐Mental State Examination, Geriatric Depression Scale‐5 and Mini‐Nutritional Assessment – Short Form, as well as common geriatric syndromes. All patients were categorized into the home care group and institutional care group based on their living arrangement before GEMU admissions. Six‐month mortality and decline in Barthel Index were defined as adverse clinical outcomes.

Results

Overall, data of 395 patients were used for analysis. The baseline comparisons showed that the institutional care group was more likely to be unmarried, have lower education, lower risk of falls and less polypharmacy, but more likely to experience functional decline at follow up than the home care group. Multivariate logistic regression showed that male (OR 3.59, 95% CI 1.04–12.38, P = 0.043) and higher Cumulative Illness Rating Scale for Geriatrics score (OR 4.08, 95% CI 1.49–11.19, P = 0.006) were associated with mortality, whereas the institutional care group (OR 0.30, 95% 0.09–0.99, P = 0.048) and lower Braden Scale (OR 0.80, 95% CI 0.67–0.94, P = 0.008) were protective against mortality. However, the institutional care group was independently associated with functional decline during the follow‐up period (OR 2.19, 95% CI 1.12–4.29, P = 0.022).

Conclusions

Institutional care was associated with lower 6‐month mortality risk for patients with dementia or cognitive impairment after discharge from the GEMU, but this group was more likely to experience functional decline. Further prospective study is required to clarify the clinical impact of living arrangements on long‐term outcomes when people with dementia or cognitive impairment are admitted to acute hospitals. Geriatr Gerontol Int 2017: 17 (Suppl. 1): 44–49.
Predictive factors for dementia and cognitive impairment among residents living in the veterans’ retirement communities in Taiwan: Implications for cognitive health promotion activities
Authors: Chen Liang‐Yu , Wu Yi‐Hui , Huang Chung‐Yu , Liu Li‐Kuo , Hwang An‐Chun , Peng Li‐Ning , Lin Ming‐Hsieh , Chen Liang‐Kung
Published: April 2017

Aim

To identify potentially modifiable risk factors for cognitive decline among veterans’ home residents in Taiwan

Methods

The present retrospective cohort study was part of the Veteran Affairs‐Comprehensive Geriatric Assessment study that retrieved data of the comprehensive geriatric assessment for 946 residents living at four veterans’ homes in Taiwan. The study participants were interviewed every 3–6 months from January 2012 and December 2014. Demographic characteristics,multimorbidity by Charlson's Comorbidities Index, physical function by the Barthel Index, cognition by the Mini‐Mental State Examination (MMSE), depression by the five‐item Geriatric Depression Scale and nutritional status by the Mini‐Nutrition Assessment‐Short Form were collected for analysis. A generalized estimating equation model was used after it was adjusted for age, educational level, five‐item Geriatric Depression Scale, and problem of communication difficulty to identify potential modifiable risk factors for cognitive decline.

Results

The mean age of the participants was 85.7 ± 5.2 years, with a mean follow‐up period of 41 ± 21.6 weeks. The prevalence of cognitive impairment (defined by MMSE <24) was 65.6%, whereas 34% of the study participants were positive for depressive symptoms. Approximately one‐fifth of the study participants were using psychotropic agents, which was higher among participants with cognitive impairment (23.6% vs 15.6%, P < 0.05) than those without. In the generalized estimating equation model, physical function, nutritional status, depressive symptoms, ex‐drinker, multimorbidity and stool incontinence were positively correlated with MMSE score; whereas advanced age, low educational level (<6 years), presence of communication difficulty and use of psychotropic agents were inversely associated with the MMSE score.

Conclusions

Physical function and nutritional status were positively associated with the MMSE score, and use of psychotropic agents was negatively correlated with cognitive function. Further intervention study is required to improve the cognitive health of older adults living in the veterans’ retirement communities. Geriatr Gerontol Int 2017: 17 (Suppl. 1): 7–13.
Protective factors against cognitive decline among community‐dwelling middle‐aged and older people in Taiwan: A 6‐year national population‐based study
Authors: Lee Wei‐Ju , Liang Chih‐Kuang , Peng Li‐Ning , Chiou Shu‐Ti , Chen Liang‐Kung
Published: April 2017

Aim

Dementia and cognitive impairment are important public health challenges to a rapidly aging country. The present study aimed to explore the protective factors against cognitive decline among community‐dwelling middle‐aged and older people from health, social, and lifestyle perspectives.

Methods

Data of the Social Environment and Biomarkers of Aging Study, a population‐based cohort study in Taiwan, were retrieved for the study. Overall, 676 participants with intact baseline cognitive function (measured by the Short Portable Mental Status Questionnaire) were enrolled and followed for six years. Any increasing score of the Short Portable Mental Status Questionnaire in the observational period was referred to as cognitive function decline. Associated factors for cognitive decline were identified by the logistic regression model.

Results

Among all participants, 205 (30%) experienced cognitive decline during the study period. Crude logistic regression showed that women (odds ratio [OR] 1.9, 95% confidence interval [CI] 1.3–2.6), low educational level (OR 2.0, 95% CI 1.4–3.0) and low mastery (OR 1.4, 95% CI 1.0–1.9) were associated with cognitive decline, but no daily consumption of vegetables and fruits had only a marginal association (OR 1.3, 95% CI 0.9–1.8). In the fully adjusted logistic regression analysis, old age, women, low educational level and low sense of mastery were independent predictors for cognitive decline. Participants with two modifiable factors (mastery, and daily consumptions of vegetables and fruits) had a lower risk of cognitive decline (OR 0.5, 95% CI 0.3–0.9), compared with those without any protective factor.

Conclusions

Participants with a better educational level, better personal mastery, and more consumption of fruits and vegetables were less likely to experience cognitive decline. An intervention study combining these features should be carried out to promote better cognitive health in communities. Geriatr Gerontol Int 2017: 17 (Suppl. 1): 20–27.
Effects of a simple home‐based exercise program on fall prevention in older adults: A 12‐month primary care setting, randomized controlled trial
Authors: Boongird Chitima , Keesukphan Prasit , Phiphadthakusolkul Soontraporn , Rattanasiri Sasivimol , Thakkinstian Ammarin
Published: April 2017

Aim

To investigate the effects of a simple home‐based exercise program on falls, physical functioning, fear of falling and quality of life in a primary care setting.

Methods

Participants (n = 439), aged ≥65 years with mild‐to‐moderate balance dysfunction were randomly assigned to an exercise (n = 219) or control (n = 220) group. The program consisted of five combined exercises, which progressed in difficulty, and a walking plan. Controls received fall prevention education. Physical functioning and other outcomes were measured at 3‐ and 6‐month follow‐up visits. Falls were monitored with fall diaries and phone interviews at 3, 6, 9, and 12 months respectively.

Results

The 12 months of the home‐based exercise program showed the incidence of falls was 0.30 falls per person year in the exercise group, compared with 0.40 in the control group. The estimated incidence rate ratio was 0.75 (95% CI 0.55–1.04), which was not statistically significant. The fear of falling (measured by the Thai fall efficacy scale) was significantly lower in the exercise than control group (24.7 vs 27.0, P = 0.003). Also, the trend of program adherence increased in the exercise group. (29.6% to 56.8%).

Conclusions

This simple home‐based exercise program showed a reduction in fear of falling and a positive trend towards exercise adherence. Further studies should focus on factors associated with exercise adherence, the benefits of increased home visits and should follow participants longer in order to evaluate the effects of the program. Geriatr Gerontol Int 2017; 17: 2157–2163.
Clinical practice guidelines on iron therapy: A critical evaluation
Authors: Del Vecchio Lucia , Locatelli Francesco
Published: April 2017

Anemia is common among patients with chronic kidney disease (CKD) and it is managed primarily with erythropoiesis‐stimulating agents (ESA) and iron therapy. Following concerns around ESA therapy and economic constraints, IV iron is more and more administered worldwide.

Several guidelines or position papers, which give indications on iron therapy in CKD patients, have been issued in Nephrology. Unfortunately, the field is characterized by a lack of evidence. As a result, the recommendations/suggestions are not uniform.

There is general consensus to prescribe iron therapy to patients who are clearly iron deficient. In addition, iron therapy may increase Hb values, delay the start of ESA therapy in ESA‐naïve patients and reduce ESA dose in ESA‐treated patients. However, there is debate on the safety and efficacy of IV iron therapy when given in the presence of already high serum ferritin levels. In addition, not all the guidelines/position papers differentiate between non‐dialysis/dialysis patients and between the presence/absence of ESA therapy. Many international Bodies or Societies suggest caution when administering IV iron during infections. A trial of oral iron should be considered as a first step, especially in the ND‐CKD population. Finally, recommendations on the prevention of anaphylactic reactions following IV iron therapy are given by several bodies. There is consensus that IV iron is to be administered in the presence of resuscitative facilities (including medications) and personnel trained for emergencies.
Designating conservation priorities for Southeast European hoverflies (Diptera: Syrphidae) based on species distribution models and species vulnerability
Authors: Miličić Marija , Vujić Ante , Jurca Tamara , Cardoso Pedro
Published: April 2017

Information on the distribution and vulnerability of invertebrates is often scarce and, as a consequence, this group of organisms is usually neglected in conservation studies. Yet it is possible to reasonably infer ranges and vulnerabilities of species and establish spatial conservation priorities, even with incomplete information. We investigated conservation priorities of hoverflies in Southeast Europe based on species distribution models (SDM) and vulnerability indices.

Species distribution models were used to compensate for the lack of knowledge on species ranges. Measures related to geographical rarity, endemism and habitat specialisation were used to assess species vulnerability. Potential distribution and three alternative vulnerability indices were used to calculate two spatial conservation indices: potential Biodiversity Conservation Concern index (pBCC) and potential Biodiversity Conservation Weight (pBCW).

pBCC highlighted areas with a large proportion of highly vulnerable species, even where species richness was low, such as the Danube delta and mid‐Aegean islands. It also identified potentially important areas yet‐to‐be surveyed (e.g. Carpathian mountains), which might deserve future conservation measures. pBCW emphasised areas hosting high richness of both vulnerable and resilient species, such as the eastern Aegean Islands and the eastern part of Crete.

We demonstrate that: (i) it is possible to establish conservation priorities at large scales if SDM and simple vulnerability measures are combined; (ii) complementary approaches are necessary to emphasise the importance of areas with different characteristics; and (iii) several understudied areas should be targets of future sampling schemes to confirm their importance for the conservation of hoverfly diversity in Southeast Europe.
The use of topical minoxidil to accelerate nail growth: a pilot study
Authors: Aiempanakit Kumpol , Geater Alan , Limtong Preeyachat , Nicoletti Kathleen
Published: April 2017

Linear nail growth rate is affected by various conditions, one of which is the level of blood flow. Our supposition was that topical minoxidil, which has vasodilatory properties, can increase the rate of nail growth. The aim of this study was to determine the impact of topical minoxidil on nail growth. A 5% topical minoxidil solution was applied twice daily to the fingernails of 32 participants. Two groups of 16 participants were randomly chosen. In one group, the applications were made to the right index and left ring fingernails, and, in the other, the left index and right ring fingernails. During each visit (weekly during the first month and every 2 weeks during the second month), the nail length of six fingernails (index, middle, and ring of both hands) was measured using a digital caliper. Beginning in the first week, the mean nail length of the treated nails was greater than that of nails in the untreated group with statistical significance. There were no systemic or cutaneous side effects. During the first month, the mean growth of the treated nails was 4.27 mm/month compared with 3.91 mm/month in the untreated nails (P = 0.003). These findings suggest that a 5% concentration of topical minoxidil can stimulate nail growth with increased growth beginning in the first week of application. The results may have important implications for the treatment of nail disorders; however, a comparable study involving participants with nail disorders is highly recommended.
Early clinical presentations and progression of calciphylaxis
Authors: Ghosh Toshi , Winchester Daniel S. , Davis Mark D.P. , el‐Azhary Rokea , Comfere Nneka I.
Published: April 2017

Background

Untreated calciphylaxis is a fatal disease of intra‐ and extravascular calcification, most commonly presenting in end‐stage renal disease (ESRD) patients. While early identification is critical for timely treatment, early‐stage clinical and histopathological descriptions have not, to our knowledge, been elucidated. As early clinical recognition is essential to prompt definitive histopathological diagnosis, this study describes a range of clinical and histopathological manifestations of early‐stage calciphylaxis.

Methods

Five patients with clinical photographs of lesions of early‐phase calciphylaxis were chosen from a recent database of 101 patients. Their clinical histories were reviewed and correlated with their respective clinical and histopathological images of early‐stage disease and progression of the disease.

Results

Two of the five patients were identified early to have calciphylaxis and were promptly initiated on aggressive, multimodal therapy, resulting in complete resolution and remission of calciphylaxis. The other three patients were also recognized in early stages, one without renal disease, although the disease had progressed to more advanced stages associated with greater morbidity and mortality.

Conclusions

These cases demonstrate that calciphylaxis may be clinically misdiagnosed due to ill‐defined presentations, particularly in the early stages without the characteristic features of livedo racemosa and ulceration. However, recognition in the early stages is critical to implement timely treatment. As such, definitively diagnostic skin biopsy should be considered early in suspected cases to confirm the diagnosis of calciphylaxis and ensure prompt management of this lethal disease.
Burning mouth syndrome: results of screening tests for vitamin and mineral deficiencies, thyroid hormone, and glucose levels—experience at Mayo Clinic over a decade
Authors: Morr Verenzuela Claudia S. , Davis Mark D. P. , Bruce Alison J. , Torgerson Rochelle R.
Published: April 2017

Background

Burning mouth syndrome (BMS) is a disorder characterized by chronic mouth pain in the absence of objective clinical abnormalities. Vitamin or mineral deficiencies may have a role in BMS, but data regarding the prevalence and relevance of hematinic deficiencies are conflicting. We aimed to determine the frequency of specific laboratory abnormalities in patients with BMS.

Methods

We retrospectively reviewed the results of screening blood tests in patients with BMS at our institution between January 2003 and December 2013.

Results

Among 659 patients with BMS, the most common decreased values or deficiencies were vitamin D3 (15%), vitamin B2 (15%), vitamin B6 (5.7%), zinc (5.7%), vitamin B1 (5.3%), thyrotropin (TSH) (3.2%), vitamin B12 (0.8%), and folic acid (0.7%). Laboratory values for fasting blood glucose and TSH were increased in 23.7% and 5.2%, respectively.

Conclusions

In patients with symptoms of BMS, our results suggest it is reasonable to screen for fasting blood glucose, vitamin D (D2 and D3), vitamin B6, zinc, vitamin B1, and TSH. Deficiencies of vitamin B12 and folic acid were rare (<1% abnormal).