bluuebunny/crossref_metadata_2025 huggingface dataset:
Maternal perception of weight status in first‐born Australian toddlers aged 12–16 months – the NOURISH and SAIDI cohorts
Authors: Byrne R. , Magarey A. , Daniels L.
Published: March 2016

Background

The preference amongst parents for heavier infants is in contrast to obesity prevention efforts worldwide. Parents are poor at identifying overweight in older children, but few studies have investigated maternal perception of weight status amongst toddlers and none in the Australian setting.

Methods

Mothers (n = 290) completed a self‐administered questionnaire at child age 12–16 months, defining their child's weight status as underweight, normal weight, somewhat overweight or very overweight. Weight‐for‐length z‐score was derived from measured weight and length, and children categorized as underweight, normal weight, at risk overweight or obese (WHO standards). Objective classification was compared with maternal perception of weight status. Mean weight‐for‐length z‐score was compared across categories of maternal perception using one‐way ANOVA. Multinomial logistic regression was used to determine child or maternal characteristics associated with inaccurate weight perception.

Results

Most children (83%) were perceived as normal weight. Twenty nine were described as underweight, although none were. Sixty‐six children were at risk of overweight, but 57 of these perceived as normal weight. Of the 14 children who were overweight, only 4 were identified as somewhat overweight by their mother. Compared with mothers who could accurately classify their normal weight child, mothers who were older had higher odds of perceiving their normal weight child as underweight, while mothers with higher body mass index had slightly higher odds of describing their overweight/at risk child as normal weight.

Conclusion

The leaner but healthy weight toddler was perceived as underweight, while only the heaviest children were recognized as overweight. Mothers unable to accurately identify children at risk are unlikely to act to prevent further excess weight gain. Practitioners can lead a shift in attitudes towards weight in infants and young children, promoting routine growth monitoring and adequate but not rapid weight gain.
Are patients with hormonally functional phaeochromocytoma and paraganglioma initially receiving a proper adrenoceptor blockade? A retrospective cohort study
Authors: Luiz Henrique Vara , Tanchee Mary Jane , Pavlatou Maria G. , Yu Run , Nambuba Joan , Wolf Katherine , Prodanov Tamara , Wesley Robert , Adams Karen , Fojo Tito , Pacak Karel
Published: March 2016

Objective

Pharmacological treatment is mandatory in patients with hormonally functional phaeochromocytoma and paraganglioma (PHAEO/PGL). We evaluated if patients initially diagnosed with hormonally functional PHAEO/PGL by various medical subspecialties received proper adrenoceptor blockade, and analysed factors predicting the prescription of adequate treatment.

Methods

In a retrospective cohort study, we reviewed data from patients initially diagnosed with hormonally functional PHAEO/PGL outside the National Institutes of Health and Cedars‐Sinai Medical Center, who were referred to these institutions between January 2001 and April 2015. Logistic regression was used to assess factors associated with proper adrenoceptor blockade.

Results

A total of 381 patients were included. Adequate pharmacological treatment was prescribed to 69·3%, of which 93·1% received α‐adrenoceptor blockers. Regarding patients who were inappropriately treated, 53% did not receive any medication. Independent predictors of the prescription of a proper blockade were the diagnosis by endocrinologists [odds ratio (OR) 4·14; 95% confidence interval (CI), 2·51–6·85; P < 0·001], the presence of high blood pressure (OR 5·94; 95% CI, 3·11–11·33; P < 0·001) and the evidence of metastasis (OR 5·96; 95% CI, 1·93–18·46; P = 0·002).

Conclusions

Although most patients received adequate pharmacological treatment, almost one‐third were either not treated or received inappropriate medications. The diagnosis by endocrinologists, the presence of high blood pressure and the evidence of metastatic disease were identified as independent predictors of a proper blockade. These results highlight the need to educate physicians about the importance of starting adequate adrenoceptor blockade in all patients with hormonally functional PHAEO/PGL.
Auditory Verbal Experience and Agency in Waking, Sleep Onset, REM, and Non‐REM Sleep
Authors: Speth Jana , Harley Trevor A. , Speth Clemens
Published: March 2016

We present one of the first quantitative studies on auditory verbal experiences (“hearing voices”) and auditory verbal agency (inner speech, and specifically “talking to (imaginary) voices or characters”) in healthy participants across states of consciousness. Tools of quantitative linguistic analysis were used to measure participants’ implicit knowledge of auditory verbal experiences (VE) and auditory verbal agencies (VA), displayed in mentation reports from four different states. Analysis was conducted on a total of 569 mentation reports from rapid eye movement (REM) sleep, non‐REM sleep, sleep onset, and waking. Physiology was controlled with the nightcap sleep–wake mentation monitoring system. Sleep‐onset hallucinations, traditionally at the focus of scientific attention on auditory verbal hallucinations, showed the lowest degree of VE and VA, whereas REM sleep showed the highest degrees. Degrees of different linguistic‐pragmatic aspects of VE and VA likewise depend on the physiological states. The quantity and pragmatics of VE and VA are a function of the physiologically distinct state of consciousness in which they are conceived.
Exchange Rate Pass‐through to China's Export Price: A Product‐level Investigation
Authors: Han Jian , Shen Yanzhi
Published: March 2016

Exchange rate movement usually results in changes in the production costs of exporting firms, and, therefore, the prices and the quantity of traded products. The present paper constructs a theoretical model to demonstrate that export products with higher productivity, or with larger market share, or of higher quality will experience a less complete pass‐through. Using the six‐digit harmonized system export data from the CEPII database over the period of 2000 to 2013, the present paper examines how product heterogeneity affects the exchange rate pass‐through of Chinese exports. The empirical results show that the most competitive Chinese export products, or those least affected by exchange rate risks, are those of higher quality, with higher technological complexity and at the high end of the international value chain. Therefore, Chinese exporting firms should pay more attention to improving export quality and upgrading technology to better cope with exchange rate risks and to enjoy more bargaining power in the international market.
Increased iron levels and lipid peroxidation in a Mediterranean population of Spain
Authors: Aranda Nuria , Fernandez‐Cao Jose Candido , Tous Monica , Arija Victoria
Published: March 2016

Background

Many chronic diseases are adversely affected by elevated iron levels. It has been speculated that this relationship is mediated by increased oxidative stress, due to the ability of iron to generate reactive oxygen species. The aim of this study was to assess the relationship between elevated iron levels and lipid peroxidation in Caucasian adults residing in the north‐eastern Mediterranean region of Spain.

Materials and methods

This cross‐sectional case–control study included 300 subjects: 150 adults displaying elevated iron levels (cases) selected from a representative sample of our general population and 150 age‐ and sex‐matched adults exhibiting normal iron levels (controls). Dietary assessment (3‐day food records), iron biomarkers (serum iron, ferritin and transferrin saturation) and lipid profile were determined. Elevated iron levels were defined by high serum ferritin (SF>110 μg/L in women and>200 μg/L in men) and/or transferrin saturation (TS)>45%. Oxidized low‐density lipoprotein (oxLDL) plasma levels were measured, and oxLDL/LDL‐cholesterol ratio was calculated to estimate lipid peroxidation. Multiple linear regression (MLR) models were applied.

Results

Individuals with elevated serum iron levels showed increased oxLDL/LDL ratio, but not oxLDL levels, compared to control subjects (20·92 ± 4·89 U/mmol vs. 19·72 ± 3·573 U/mmol, P = 0·028). These results were further confirmed by the regression models adjusted for demographic characteristics, diet, lipid profile and inflammation. Importantly, higher serum levels of triglycerides, LDL‐cholesterol and lower intake of Vitamin E increased lipid peroxidation.

Conclusions

In our general population, we have observed that higher circulating levels of iron, measured by serum ferritin and/or TS, increased lipid peroxidation (measured by oxLDL/LDL ratio).
Work–Family Conflict and Health Among Working Parents: Potential Linkages for Family Science and Social Neuroscience
Authors: Grzywacz Joseph G. , Smith Amy M.
Published: March 2016

In this paired article the authors review research on paid work, parenting, and health in order to isolate fundamental questions and issues that remain unaddressed. Next, consistent with the theme of this special issue, the authors introduce social neuroscience and highlight how this emerging multidisciplinary science offers substantial promise for advancing key unresolved issues in the paid work, parenting, and health literature. The article concludes with suggestions for promising areas of research wherein family scientists and social neuroscientists could build collaborative research to address gaps in the work–family literature.
Addressing Early Adversity Through Mental Health Consultation in Early Childhood Settings
Authors: Perry Deborah F. , Conners‐Burrow Nicola
Published: March 2016

The science of early childhood adversity has advanced in recent years, documenting long‐term consequences of exposure to traumatic events and toxic stress for health and development. Sequelae of toxic stress exposure can be mitigated by the buffering effect of a caregiver who can help young children manage their reactivity to these early stressors. Interventions are needed to build the capacity for caregivers (including the early childhood workforce) to build resilience in young children exposed to early adversity. This article shares best practices from the field of early childhood mental health consultation (ECMHC) as a strategy to help reduce the impact of stressors on young children. ECMHC embedded with child care, focused on children in foster care, and lessons learned from early work on ECMHC in home visiting are highlighted as examples of interventions to build the buffering capacities of important adults in children's lives. Policy recommendations are offered for integrating mental health services into early childhood settings to build resilience in high‐risk children and families.
Descriptive Analysis of Intervention for Parents of Young Children Having Sleep Problems
Authors: Skúladóttir Arna
Published: March 2016

The aim of this qualitative study was to describe an intervention for parents at a nurse‐led clinic for children age 6–24 months with sleeping problems. Data were gathered from 10 families. Intervention sessions were recorded. The nurse also wrote field notes and kept a reflection diary about the interventions. The data were coded in a search for categories of meaning and then grouped and raised to a higher level of abstraction to describe the intervention. Three themes were constructed. Theme 1: Sharing Stories, includes establishing a working relationship and learning about the family. Theme 2: Empowering, includes education and motivation. Theme 3: Guidance, includes environmental and behavioral intervention and review plans. Empowering was the strongest theme. Behavioral intervention had less emphasis than expected. Environmental intervention was surprisingly relevant. These results can be used to design a protocol for an experimental study and teaching materials for professionals who work with infant sleep problems.
Family Caregiving Amidst Age‐Associated Cognitive Changes: Implications for Practice and Future Generations
Authors: Bailey Whitney A. , Gordon Sarah R.
Published: March 2016

As the number of older adults has increased, so has the prevalence of age‐associated needs, including cognitive changes. Correspondingly, more than 43 million people provide care for an older family member whose needs range from basic household maintenance to 24‐hour care. Those who serve aging families exclusively or work with multigenerational families face the challenges of inaccurate and/or incomplete information, confusing and unreachable services, and uncertainty about managing stress and ways to foster resilience within multigenerational family systems. Thus, the purpose of this article is to highlight the prevalence of age‐associated cognitive changes and how they relate to the short‐ and long‐term family resilience processes. More specifically, this article is directed to orient practitioners to the critical roles caregivers play, and individual, relational, and sociological dynamics of cognition, care, and resilience are discussed. The authors provide an overview of assumptions and outcomes related to caregiving, as well as considerations for care recipients, including personhood and empowerment. Finally, because practitioners become a key ingredient in navigating the normative and nonnormative processes of aging, the authors provide a checklist of relational processes to focus on when working with aging families, along with specific recommendations for practice for family life educators and marriage and family therapists.
KIBRA promotes prostate cancer cell proliferation and motility
Authors: Stauffer Seth , Chen Xingcheng , Zhang Lin , Chen Yuanhong , Dong Jixin
Published: March 2016

KIBRA is a regulator of the Hippo‐yes‐associated protein (YAP) pathway, which plays a critical role in tumorigenesis. In the present study, we show that KIBRA is a positive regulator in prostate cancer cell proliferation and motility. We found that KIBRA is transcriptionally upregulated in androgen‐insensitive LNCaPC4‐2 and LNCaP‐C81 cells compared to parental androgen‐sensitive LNCaP cells. Ectopic expression of KIBRA enhances cell proliferation, migration and invasion in both immortalized and cancerous prostate epithelial cells. Accordingly, knockdown of KIBRA reduces migration, invasion and anchorage‐independent growth in LNCaP‐C4‐2/C81 cells. Moreover, KIBRA expression is induced by androgen signaling and KIBRA is partially required for androgen receptor signaling activation in prostate cancer cells. In line with these findings, we further show that KIBRA is overexpressed in human prostate tumors. Our studies uncover unexpected results and identify KIBRA as a tumor promoter in prostate cancer.
Contrasting changes in the abundance and diversity of North American bird assemblages from 1971 to 2010
Authors: Schipper Aafke M. , Belmaker Jonathan , de Miranda Murilo Dantas , Navarro Laetitia M. , Böhning‐Gaese Katrin , Costello Mark J. , Dornelas Maria , Foppen Ruud , Hortal Joaquín , Huijbregts Mark A. J. , Martín‐López Berta , Pettorelli Nathalie , Queiroz Cibele , Rossberg Axel G. , Santini Luca , Schiffers Katja , Steinmann Zoran J. N. , Visconti Piero , Rondinini Carlo , Pereira Henrique M.
Published: March 2016

Although it is generally recognized that global biodiversity is declining, few studies have examined long‐term changes in multiple biodiversity dimensions simultaneously. In this study, we quantified and compared temporal changes in the abundance, taxonomic diversity, functional diversity, and phylogenetic diversity of bird assemblages, using roadside monitoring data of the North American Breeding Bird Survey from 1971 to 2010. We calculated 12 abundance and diversity metrics based on 5‐year average abundances of 519 species for each of 768 monitoring routes. We did this for all bird species together as well as for four subgroups based on breeding habitat affinity (grassland, woodland, wetland, and shrubland breeders). The majority of the biodiversity metrics increased or remained constant over the study period, whereas the overall abundance of birds showed a pronounced decrease, primarily driven by declines of the most abundant species. These results highlight how stable or even increasing metrics of taxonomic, functional, or phylogenetic diversity may occur in parallel with substantial losses of individuals. We further found that patterns of change differed among the species subgroups, with both abundance and diversity increasing for woodland birds and decreasing for grassland breeders. The contrasting changes between abundance and diversity and among the breeding habitat groups underscore the relevance of a multifaceted approach to measuring biodiversity change. Our findings further stress the importance of monitoring the overall abundance of individuals in addition to metrics of taxonomic, functional, or phylogenetic diversity, thus confirming the importance of population abundance as an essential biodiversity variable.
Gloria Anzaldúa's Affective Logic ofVolverse Una
Authors: Paccacerqua Cynthia M.
Published: March 2016

Although Gloria Anzaldúa's critical categories have steadily entered discussions in the field of philosophy, a lingering skepticism remains about her works’ ability to transcend the particularity of her lived experience. In an effort to respond to this attitude, I make Anzaldúa's corpus the center of philosophical analysis and posit that immanent to this work is a logic that lends it the unity of a critical philosophy that accounts for its concrete, multilayered character and shifting, creative force. I call this an “affective logic ofvolverse una.” Starting with the understanding of a situated modality of all subjectivity, Anzaldúa's work exhibits a logic of three moments distinguished by states of awareness. Each state of awareness is characterized by the generative degree of the subject's responses to its conditions: critical, individuating, and expansive. Led by her late concepts of conocimiento and nepantlera, I return to her earlier works and trace Anzaldúa's innovative exploration of undoing the oppressive condition of marginal subjectivities from “La Prieta” throughBorderlands/La Fronterato her final published essay “now let us shift.” I find a liberatory schema ofvolverse una/becoming whole that is grounded in an active receptivity of sensibility and facilitated by affective technologies for transformation.
A new family of insect muscarinic acetylcholine receptors
Authors: Xia R.‐Y. , Li M.‐Q. , Wu Y.‐S. , Qi Y.‐X. , Ye G.‐Y. , Huang J.
Published: March 2016

Most currently used insecticides are neurotoxic chemicals that target a limited number of sites and insect cholinergic neurotransmission is the major target. A potential target for insecticide development is the muscarinic acetylcholine receptor (mAChR), which is a metabotropic G‐protein‐coupled receptor. Insects have A‐ and B‐type mAChRs and the five mammalian mAChRs are close to the A‐type. We isolated a cDNA (CG12796) from the fruit fly, Drosophila melanogaster. After heterologous expression in Chinese hamster ovary K1 cells, CG12796 could be activated by acetylcholine [EC50 (half maximal effective concentration), 73 nM] and the mAChR agonist oxotremorine M (EC50, 48.2 nM) to increase intracellular Ca2+ levels. Thus, the new mAChR is coupled to Gq/11 but not Gs and Gi/o. The classical mAChR antagonists atropine and scopolamine N‐butylbromide at 100 μM completely blocked the acetylcholine‐induced responses. The orthologues of CG12796 can also be found in the genomes of other insects, but not in the genomes of the honeybee or parasitoid wasps. Knockdown of CG12796 in the central nervous system had no effect on male courtship behaviours. We suggest that CG12796 represents the first recognized member of a novel mAChR class.
The use of composite indicators to evaluate the performance of Brazilian hydropower plants
Authors: Calabria Felipe A. , Camanho Ana S. , Zanella Andreia
Published: March 2016

This paper investigates the performance of the largest Brazilian hydropower plants. This study covers 78% of the total installed capacity from hydros in the country, and considers indicators reflecting operational and maintenance costs as well as quality of service. The assessment was conducted using a new approach for the construction of composite indicators, based on a directional distance function model. First, we assessed the hydropower plants allowing for complete flexibility in the definition of weights, enabling the identification of underperforming plants, and quantification of their potential for improvement. Next, we assessed the plants considering different perspectives regarding the importance attributed to each indicator. This allowed reflecting different points of view, focusing primarily on operation and maintenance costs or quality issues. The results identify the hydropower plants that can be considered benchmarks in different scenarios, and allow testing the robustness of plants' classification as benchmarks in the unrestricted model.
Domain Structure Evolutions During the Poling Process for [011]‐Oriented PMN–xPT Crystals Across the MPB Region
Authors: Xu Chao , Li Qiang , Yan Qingfeng , Luo Nengneng , Zhang Yiling , Chu Xiangcheng
Published: March 2016

The poling effect on the [011]‐oriented (1−x)Pb(Mg1/3Nb2/3)O3‐xPbTiO3 (PMN–xPT) single crystals across the morphotropic phase boundary (MPB) was studied. The dielectric and piezoelectric properties were investigated as a function of the poling field. Domain structure evolutions during the poling process were recorded. In the unpoled PMN–xPT phase diagram, an apparent rhombohedral (R)‐tetragonal (T) phase boundary exists. With room‐temperature poling, the structure transformation sequence strongly depends on the composition. The crystal experiences a direct transition to the 2R/2T domain state in the rhombohedral or tetragonal phase field beyond the MPB region, whereas within the MPB zone it is hard to achieve the 2R/2T engineered configuration although the initial state is either rhombohedral or tetragonal as well. The piezoelectric responses of the MPB·PMN–xPTs are extraordinary weak (d33 ~ 250 pC/N), in contrast to the [011]‐oriented multidomain PMN–xPTs with ultrahigh‐piezoelectric coefficient (d33 > 1000 pC/N). We demonstrate that a slight composition variation near the MPB will significantly influence the domain evolution route and piezoelectricity for the [011]‐oriented PMN–xPT crystals. We also confirm the feasibility to realize the 2R/2T engineered domain configuration for the [011]‐oriented MPB crystals, which will extend the desired portion of the Bridgeman‐grown boules with optimal piezoelectric properties.
Utility of hypertriglyceridemic waist phenotype for predicting incident type 2 diabetes: The Isfahan Diabetes Prevention Study
Authors: Janghorbani Mohsen , Amini Masoud
Published: March 2016

Aim/Introduction

We evaluated the association between hypertriglyceridemic waist (HTW) phenotype and the risks of type 2 diabetes in an Iranian high‐risk population.

Materials and Methods

We analyzed 7‐year follow‐up data (n = 1,865) in non‐diabetic first‐degree relatives of consecutive patients with type 2 diabetes aged 30–70 years. The primary outcome was the diagnosis of type 2 diabetes based on repeated oral glucose tolerance tests. We used multiple logistic regressions to estimate the odds ratio (OR) for incident type 2 diabetes across four groups according to baseline fasting serum triglycerides (TG) level and waist circumference (WC): normal WC and normal TG, normal WC and high TG, enlarged WC and normal TG, and HTW (enlarged WC high TG).

Results

The HTW phenotype at baseline was associated with the incidence of type 2 diabetes. Those with HTW were 2.4‐fold (OR 2.36, 95% confidence interval 1.61–3.44), those with normal WC high TG were 1.9‐fold (OR 1.87, 95% confidence interval 1.29–2.70) and those with enlarged WC but normal TG were 2.8‐fold (OR 2.84, 95% confidence interval 1.96–4.13) more likely to develop type 2 diabetes than those with normal WC and normal TG.

Conclusions

These data provide further evidence that the HTW phenotype is a robust predictor of type 2 diabetes in high‐risk individuals in Iran, and the predictive power is not higher than that of simple enlarged WC and normal TG, emphasizing the importance of enlarged WC to the development of type 2 diabetes.
Trade‐offs between salinity preference and antipredator behaviour in the euryhaline sailfin molly Poecilia latipinna
Authors: Tietze S. M. , Gerald G. W.
Published: March 2016

Salinity preference and responses to predatory chemical cues were examined both separately and simultaneously in freshwater (FW) and saltwater (SW)‐acclimated sailfin mollies Poecilia latipinna, a euryhaline species. It was hypothesized that P. latipinna would prefer FW over SW, move away from chemical cues from a crayfish predator, and favour predator avoidance over osmoregulation when presented with both demands. Both FW and SW‐acclimated P. latipinna preferred FW and actively avoided predator cues. When presented with FW plus predator cues v. SW with no cues, P. latipinna were more often found in FW plus predator cues. These results raise questions pertaining to the potential osmoregulatory stress of salinity transitions in euryhaline fishes relative to the potential fitness benefits and whether euryhalinity is utilized for predator avoidance. This study sheds light on the potential benefits and consequences of being salt tolerant or intolerant and complicates the understanding of the selection pressures that have favoured the different osmoregulatory mechanisms among fishes.
Optimization of Protein Removal from Soybean Whey Wastewater Using Chitosan Ultrafiltration
Authors: Cheng Jianjun , Xie Siyu , Wang Shuai , Xue Yanfang , Jiang Lianzhou , Liu Li
Published: March 2016

Proteins were removed from soybean whey wastewater using the chitosan flocculation technique, and this method was compared with lime flocculation, and transglutaminase polymerization. Compared with other flocculation methods, chitosan flocculation exhibited higher saccharide levels (p < 0.05), lower protein movement (p < 0.05) through the membrane and lower ultrafiltration membrane pollution levels and could be[0] useful for the development of industrial flocculation processes. The chitosan flocculation procedure was optimized by an L18(37) orthogonal array experimental design (OAD) with four factors at three levels. Optimum variables were a chitosan dosage of 0.8 g/L and a standing pH, time and temperature of 5.5, 60 min and 30C, respectively. Under these conditions, the experimental rate of protein removal was 61.21%, which was consistent with the predicted value (58.85%). These results showed that chitosan flocculation alleviated membrane fouling to a large extent.

Practical Applications

This study demonstrated the differences in the protein removal properties due to the different processes, i.e., lime flocculation, transglutaminase polymerization and chitosan flocculation technique, in the purification soybean whey wastewater. The information on chitosan combined with ultrafiltration would help in understanding their influences on soybean whey wastewater. Chitosan‐ultrafiltration process will facilitate the subsequent recovery of soybean polysaccharides and can be used as an environmentally friendly means for soy whey wastewater purification.
Nanoemulsions‐Based Delivery Systems for Encapsulation of Quercetin: Preparation, Characterization, and Cytotoxicity Studies
Authors: Ni Shilei , Hu Caibiao , Sun Rui , Zhao Guodong , Xia Qiang
Published: March 2016

In this study, quercetin loaded nanoemulsions (QT‐NE) were prepared using high pressure homogenization (HPH) method.The optimum QT‐NE exhibited an average droplet size of 152 ± 6 nm, zeta potential of −50 ± 2 mV and entrapment efficiency of 93.50 ± 0.35%. The selected QT‐NE had good physical and chemical stability. DPPH free radical scavenging assay showed comparable antioxidant activity of QT‐NE to free quercetin. The release behavior of quercetin in simulated gastrointestinal conditions was investigated and kinetically modeled. The in vitro digestion model demonstrated that the bioaccessibility of quercetin in simulated small intestinal conditions was improved by nanoencapsulation. MTT cell viability assay showed that QT‐NE did not have significant toxicity on HeLa cell line. In general, nanoemulsions‐based delivery systems can be developed to encapsulate quercetin for improved stability and bioavailability.

Practical Applications

Quercetin is widely found in the plant kingdom, and has been proved to exert numerous benefits in body. However, the applications of QT in functional fields are greatly limited due to its low solubility and chemical unstability. This study aimed at incorporating QT into lipid‐based delivery systems produced by high pressure homogenization (HPH) method for improved bioavailability and evaluating its potential application in functional food industries.
Long‐term outcome of 154 patients receiving balloon‐occluded retrograde transvenous obliteration for gastric fundal varices
Authors: Imai Yukinori , Nakazawa Manabu , Ando Satsuki , Sugawara Kayoko , Mochida Satoshi
Published: March 2016

Background and Aim

This study aims to clarify the long‐term outcome of therapeutic strategies including balloon‐occluded retrograde transvenous obliteration (B‐RTO) for patients with gastric fundal varices.

Methods

The subjects were 154 patients with gastric fundal varices fulfilling the criteria for receiving B‐RTO. In patients showing variceal bleeding, endoscopic therapies and/or balloon tamponade was performed to achieve hemostasis. B‐RTO was accomplished with injection of 5% ethanolamine oleate through a standard balloon catheter except for patients with atypical varices, in whom a microballoon catheter was used to occlude drainage vessels other than a gastrorenal shunt. In patients complicated with esophageal varices at baseline, endoscopic therapies were performed following B‐RTO.

Results

Balloon‐occluded retrograde transvenous obliteration was performed successfully in 147 patients (95%), including 15 patients using a microballoon catheter. Complete variceal obliteration was achieved in all patients. Additional endoscopic therapies for esophageal varices were performed in 31 patients. Gastric varices did not recur in any of these patients. The cumulative survival rates at 1, 3, and 5 years after B‐RTO were 91%, 76%, and 72%, respectively. Child‐Pugh scores and hepatocellular carcinoma complication were identified as prognostic factors associated with survival rates. The cumulative exacerbation rates of esophageal varices at 1, 3, and 5 years were 13%, 20%, and 27%, respectively, and rupture developed in six patients, which were successfully treated with endoscopic therapies.

Conclusions

Therapeutic strategies including B‐RTO with a microballoon catheter were useful to achieve a favorable outcome in patients with gastric fundal varices especially in those manifesting Child‐Pugh class‐A liver damage and/or those without hepatocellular carcinoma complication.
Diabetes Mellitus as a Risk Factor for Development of Depressive Symptoms in a Population‐Based Cohort of Older Mexican Americans
Authors: Garcia Maria E. , Lee Anne , Neuhaus John , Gonzalez Hector , To Tu My , Haan Mary N.
Published: March 2016

Objectives

To determine whether diabetes mellitus increases depressive symptoms in older Latinos in a population‐based cohort.

Design

Prospective cohort study.

Participants

Individuals from the Sacramento Latino Study on Aging aged 60 and older in 1998–99 and followed annually until 2008 (N = 1,586).

Measurements

Diabetes mellitus was defined according to self‐report, fasting blood glucose of 126 mg/dL or greater, glycosylated hemoglobin of 6.5% or greater, or diabetic medication use. Depressive symptoms were defined as Center for Epidemiologic Studies Depression Scale (CES‐D) score of 16 or greater or use of antidepressant medication. Multistate Markov modeling was used to assess the effects of time‐dependent diabetes mellitus on transitions between three states over time: low CES‐D score (normal), high CES‐D score or treated (depressed), and death. Bivariate analyses identified covariates significantly associated with any transition, including sex and baseline measures of age, education, body mass index, hypertension, and stroke.

Results

In a fully adjusted model, participants with diabetes mellitus had a 35% higher rate of developing depressive symptoms or starting treatment with an antidepressant (hazard ratio (HR) = 1.35, 95% confidence interval (CI) = 1.13–1.62). Time‐dependent diabetes mellitus was associated with a lower rate of regression from depressed to normal (HR = 0.72, 95% CI = 0.59–0.88) and a 2.3 greater rate pf progression from depressed to death (HR = 2.31, 95% CI = 1.57–3.40).

Conclusion

Diabetes mellitus increased the risk of developing depressive symptoms in older Mexican Americans. Older Latinos with diabetes mellitus should be screened for depressive symptoms and prioritized for close follow‐up, potentially through greater reliance on team‐based models of care.
Anticholinergic Drug Burden in Persons with Dementia Taking a Cholinesterase Inhibitor: The Effect of Multiple Physicians
Authors: Reppas‐Rindlisbacher Christina E. , Fischer Hadas D. , Fung Kinwah , Gill Sudeep S. , Seitz Dallas , Tannenbaum Cara , Austin Peter C. , Rochon Paula A.
Published: March 2016

Objectives

To explore the association between the number of physicians providing care and anticholinergic drug burden in older persons newly initiated on cholinesterase inhibitor therapy for the management of dementia.

Design

Population‐based cross‐sectional study.

Setting

Community and long‐term care, Ontario, Canada.

Participants

Community‐dwelling (n = 79,067, mean age 81.0, 60.8% female) and long‐term care residing (n = 12,113, mean age 84.3, 67.2% female) older adults (≥66) newly dispensed cholinesterase inhibitor drug therapy.

Measurements

Anticholinergic drug burden in the prior year measured using the Anticholinergic Risk Scale.

Results

Community‐dwelling participants had seen an average of eight different physicians in the prior year. The odds of high anticholinergic drug burden (Anticholinergic Risk Scale score ≥ 2) were 24% higher for every five additional physicians providing care to individuals in the prior year (adjusted odds ratio = 1.24, 95% confidence interval = 1.21–1.26). Female sex, low‐income status, previous hospitalization, and higher comorbidity score were also associated with high anticholinergic drug burden. Long‐term care facility residents had seen an average of 10 different physicians in the prior year. After a sensitivity analysis, the association between high anticholinergic burden and number of physicians was no longer statistically significant in the long‐term care group.

Conclusion

In older adults newly started on cholinesterase inhibitor drug therapy, greater number of physicians providing care was associated with higher anticholinergic drug burden scores. Given the potential risks of anticholinergic drug use, improved communication among physicians and an anticholinergic medication review before prescribing a new drug are important strategies to improve prescribing quality.
Factors Associated With Full Implementation of Scope of Practice
Authors: Ganz Freda DeKeyser , Toren Orly , Fadlon Yafit
Published: March 2016

Purpose

To describe whether nurses fully implement their scope of practice; nurses’ perceptions of future practice implementation; and the association between scope of practice implementation with professional autonomy and self‐efficacy.

Design

A descriptive correlational study was conducted using a convenience sample of 145 registered nurses with post‐basic certification from two Israeli university hospitals, from May 2012 to September 2013.

Methods

Five questionnaires were distributed: (a) Demographic and Work Characteristics, (b) Implementation of Scope of Practice, (c) Attitudes Towards Future Practice, (d) Practice Behavior Scale, and (e) Practice Self‐Efficacy. Descriptive statistics for all demographic and questionnaire data were analyzed. Two regression models were developed, where current and future implementations were the criterion variables and demographic and work characteristics, professional autonomy, and self‐efficacy were the predictors.

Findings

High levels of professional autonomy, self‐efficacy, and attitudes towards future practice were found in contrast to low or moderate levels of current implementation of the full extent of scope of practice. Primary reasons associated with low implementation were lack of relevance to practice and permission to perform the practice. Significant associations were found between professional autonomy, self‐efficacy, and attitudes towards future practice, but not with current implementation.

Conclusions

Nurses wanted to practice to the full extent of their scope of practice and felt able to do so but were hindered by administrative and not personal barriers.

Clinical Relevance

Even though staff nurses with post‐basic certification had high levels of professional autonomy and self‐efficacy, many were not implementing the full extent of their scope of practice. Similar to findings from around the world, external factors, such as administrative and policy barriers, were found to thwart the full implementation of nurses' full scope of practice. Therefore, practicing nurses should be aware of these barriers and work towards reducing them.
Sugar‐Cane and Oil Palm Expansion in Guatemala and its Consequences for the Regional Economy
Authors: Dürr Jochen
Published: March 2016

Corporate‐owned sugar‐cane and oil palm plantations in Guatemala are expanding at the expense of smallholder agriculture. Land control grabs are not only having consequences for local communities and ecosystems, but also for regional economies. The present study compares the value chains of smallholder products with those of sugar and palm oil. Primary data were collected from agricultural producers and their backward and forward sectors in the agricultural regions where the plantations are most prominent. The results show that on a regional level, sugar and palm oil generate fewer jobs in comparison to the products of small‐scale agriculture, which have important forward linkages to small and medium trading and processing sectors. In addition, the wealth created by small‐scale farming remains within the regions, whereas profits from the sugar and palm oil industries are being transferred out of them. Therefore, to achieve inclusive regional development, smallholder agriculture should be strengthened rather than promoting monoculture expansion.
Registry‐based outcome assessment in haemophilia: a scoping study to explore the available evidence
Authors: Osooli M. , Berntorp E.
Published: March 2016

Haemophilia is a congenital disorder with bleeding episodes as its primary symptom. These episodes can result in negative outcomes including joint damage, loss of active days due to hospitalization and reduced quality of life. Effective treatment, however, can improve the outcome. Registries have been used as a valuable source of information regarding the monitoring of treatment and outcome. The two main aims of this exploratory study were to establish which haemophilia registries publish peer‐reviewed outcome assessment research and then to extract, classify and report the treatment outcomes and their extent of use in the retrieved registries. Using relevant keywords, we searched PubMed and Web of Science databases for publications during the period 1990–2015. Retrieved references were screened in a stepwise process. Eligible papers were original full articles on haemophilia outcomes that used data from a computerized patient database. Descriptive results were summarized. Of 2352 references reviewed, 25 full texts were eligible for inclusion in the study. These papers were published by 11 registries ranging from local to international in coverage. It is still relatively rare for registries to produce peer‐reviewed publications about outcomes, and most that currently do produce such papers are located in Europe and North America. More information is available on traditional outcomes such as comorbidities and arthropathy than on health‐related quality of life or the social and developmental impact of haemophilia on patients. Inhibitors, HIV and viral hepatitis are amongst the most commonly reported comorbidities. Research has focused more on factor consumption and less on hospitalization or time lost at school or work due to haemophilia. Haemophilia registries, especially those at the national level, are valuable resources for the delivery of effective health care to patients. Validated outcome measurement instruments are essential for the production of reliable and accurate evidence. Finally, such evidence should be communicated to physicians, patients, the public and health policymakers.
Effect of Disinfection on the Bond Strength between Denture Teeth and Microwave‐Cured Acrylic Resin Denture Base
Authors: Matos Adaias O. , Costa Josiane O. , Beline Thamara , Ogawa Erika S. , Assunção Wirley G. , Mesquita Marcelo F. , Consani Rafael X. , Barão Valentim A.
Published: March 2016

Purpose

Denture tooth debonding is a common complication for denture wearers; however, the effect of complete denture disinfection on bonding between denture teeth and acrylic resin remains unclear. The aim of this study was to evaluate the effect of disinfection methods on the bond strength between denture teeth and microwave‐cured acrylic resin denture base.

Materials and Methods

Three commercial brands of denture teeth (Trilux, Biolux, Vipi Dent Plus) and one microwave‐cured acrylic resin denture base were tested. Each brand of denture teeth was divided into seven groups (n = 6; estimated by partial Eta squared). The specimenss of groups H and Cl were immersed in 1% sodium hypochlorite and 4% chlorhexidine digluconate for 7 days, respectively. In group Br, the specimens were subjected to toothbrush simulation under 200 g of force for 20,000 cycles. In groups Br‐H and Br‐Cl, the specimens were brushed and further disinfected with 1% sodium hypochlorite and 4% chlorhexidine digluconate, respectively. In control groups 1 (Co1) and 2 (Co2), the specimens were stored in distilled water for 50 ± 2 hours and 7 days, respectively. Shear bond strength testing was performed at the resin/tooth interface in a universal testing machine at a 1 mm/min crosshead speed. The failure pattern was quantified and classified into adhesive, cohesive, or mixed. Data were analyzed using two‐way ANOVA and Tukey HSD test (α = 0.05).

Results

Disinfection with 1% sodium hypochlorite (p = 0.031), brushing (p < 0.0001), and association of brushing with either 1% sodium hypochlorite (p < 0.0001) or 4% chlorhexidine digluconate (p = 0.01) reduced the bond strength between denture teeth and microwave‐cured acrylic resin denture base. All commercial brands of denture teeth presented a similar bond strength (p > 0.05). The failure pattern was predominantly adhesive independent of the disinfection method and denture tooth brand.

Conclusions

Disinfection with sodium hypochlorite, brushing, and the association of mechanical and chemical methods reduced the bond strength between denture tooth and microwave‐cured acrylic resin denture base.
Beyond the skeleton: the role of vitamin D in companion animal health
Authors: Mellanby R. J.
Published: March 2016

While the role of vitamin D in the maintenance of skeletal health has been well‐established for many years, the discovery that many non‐skeletal tissues express the vitamin D receptor stimulated renewed interest in vitamin D and its wider physiological roles. Subsequently, a vast literature has emerged over the past three decades which has linked vitamin D deficiency to the development of many human diseases including cancer, autoimmune, infectious and cardiovascular disorders. In contrast, the role vitamin D plays in the physiology of non‐skeletal tissues in cats and dogs has received little attention. The situation is now starting to change with the publication of several studies that have indicated that vitamin D metabolism is deranged in numerous companion animal disorders. This article reviews the biology of vitamin D in companion animals and highlights some of the recent studies which have advanced understanding of vitamin D homeostasis in cats and dogs. Finally, the essay discusses how a “One Health” approach could further the understanding of vitamin D metabolism in mammals. Investigating vitamin D homoeostasis in companion animals offers many advantages compared to human studies in which vitamin D status is influenced by many more variables.
High circulating oestrone and low testosterone correlate with adverse clinical outcomes in men with advanced liver disease
Authors: Sinclair Marie , Gow Paul J. , Angus Peter W. , Hoermann Rudolf , Handelsman David J. , Wittert Gary , Martin Sean , Grossmann Mathis
Published: March 2016

Background & Aims

Circulating testosterone is usually reduced in men with cirrhosis, but there has not been a comprehensive analysis of androgen status or circulating oestrogens. Little is known about associations between circulating sex steroids with aspects of health in this population.

Methods

We report data from men with cirrhosis and low serum testosterone (<12 nmol/L or calculated free testosterone <230 pmol/L). Comprehensive circulating sex steroid profiles were measured by liquid chromatography‐mass spectrometry and compared with age‐matched controls. Relationships between sex hormone levels, severity of liver disease, biochemistry and clinical outcomes were assessed.

Results

Serum oestrone and oestradiol were significantly elevated in men with cirrhosis compared with controls (median, 869.1 pmol/L vs. 133.8 pmol/L and 166.7 pmol/L vs. 84.6 pmol/L respectively). Serum oestrone correlated with MELD score (correlation +0.306, P < 0.001) and inversely correlated with serum sodium (correlation −0.208, P = 0.004) and haemoglobin (correlation −0.177, P = 0.012). No such correlations were observed for oestradiol. Serum testosterone levels inversely correlated with MELD score (correlation −0.294, P < 0.001) and positively with handgrip strength (correlation +0.242, P < 0.001), physical activity (correlation +0.276, P = 0.012), haemoglobin (correlation +0.282, P < 0.001) and serum sodium (+0.344, P < 0.001). Dihydrotestosterone inversely correlated with MELD score (correlation −0.225, P = 0.002) and shared similar significant relationships to testosterone.

Conclusion

Low serum androgens and elevated serum oestrone (but not oestradiol) are associated with higher MELD and individual adverse health outcomes in cirrhotic cohort of men selected for low testosterone. Serum oestrone may be a novel marker of ill health in this population. Whether low androgens are markers or mediators of ill health requires further investigation.
The role of autonomic dysfunction in cirrhotic patients before and after liver transplantation. Review of the literature
Authors: Di Stefano Cristina , Milazzo Valeria , Milan Alberto , Veglio Franco , Maule Simona
Published: March 2016

In patients affected by hepatic cirrhosis, autonomic dysfunction is a common finding; usually it is asymptomatic but it may correlate with increased mortality and morbidity before, during and after liver transplant, due to hemodynamic instability in the course of stressful events like sepsis, gastrointestinal bleeding and reperfusion after transplantation surgery. Hyperdynamic circulation and hepatic dysfunction seem to play a role in the pathogenesis of autonomic dysfunction, even if pathophysiological mechanisms are not completely known. We present a revision of previous literature about prevalence, pathophysiological mechanisms, clinical features, and mortality and morbidity of autonomic dysfunction secondary to hepatic cirrhosis.