bluuebunny/crossref_metadata_2025 huggingface dataset:
Right ventricular dyssynchrony and functional capacity before and after percutaneous balloon mitral valvuloplasty in patients with mitral stenosis: Determinants and clinical impact
Authors: Mahfouz Ragab A. , Gouda Mohamed , Galal Islam , Amin Mohamed I.
Published: December 2018

Objective

We aimed to investigate the utility of right ventricular (RV) dyssynchrony to assess functional capacity utilizing 6‐minute walking test distance (6MWTD) and to measure brain natriuretic peptide levels (BNP) in patients with mitral stenosis (MS) and to study its value to predict adverse outcome following percutaneous balloon mitral valvuloplasty (PBMV).

Methods

A total of 108 patients with moderate to severe MS (26.5 ± 7.5 years) were included in this study. All were candidates for PBMV. RV strain curves were obtained using two‐dimensional speckle‐tracking echocardiography, and standard deviation (SD) of 4 segments without RV apex (‐SD4) was also assessed. 6MWT and BNP were before and after 12 months following PBMV.

Results

RV‐SD4 was significantly prolonged in patients with MS compared with controls (P < 0.001). Patients with 6MWTD ≤300 m had a significantly increased RV‐SD4 (P < 0.001) and had higher BNP values (P < 0.03) compared with those with 6MWTD >300 m. RV‐SD4 showed a strong correlation with 6MWT and BNP level. RV‐SD4 was the strongest independent predictor of adverse outcome following PBMV (P < 0.0001). Receiver operating characteristic analysis showed that RV‐SD4 ≥24 ms was the cutoff value which predicts the adverse outcome following PBMV. A considerable improvement of mean 6MWT with significant reduction of BNP levels after 12 months of follow‐up (P < 0.001) in subjects with RV dyssynchrony <24 ms.

Conclusion

Right ventricular dyssynchrony is a useful predictor of functional status, as assessed with 6MWTD and BNP level in patients with MS. Furthermore, it might be considered as an independent predictor of adverse outcome following PMBV.
Cardiovascular manifestations of Erdheim–Chester disease
Authors: Ghotra Amaninderapal S. , Thompson Kara , Lopez‐Mattei Juan , Bawa Danish , Hernandez Ricardo , Banchs Jose , Palaskas Nicolas , Iliescu Cezar , Kim Peter , Yusuf Syed Wamique , Hassan Saamir A.
Published: December 2018

Introduction

Erdheim–Chester disease is a rare, multisystem hematologic disease. Cardiovascular involvement is seen in patients with Erdheim–Chester disease and can lead to increased morbidity and mortality. In this series, we report various cardiovascular manifestations of patients with Erdheim–Chester disease.

Methods

This study includes patients with Erdheim–Chester disease who were referred to our institution from 12/3/2009 through 12/13/2017. All patients had biopsy‐proven Erdheim–Chester disease. Clinical data, multimodality imaging, and cardiac tests were reviewed.

Results

Cardiovascular findings in 24 patients with Erdheim–Chester disease were included in the study. We reviewed available transthoracic echocardiograms, whole body PET/CT scans, and CMR studies. Most patients were male and mean age at the time of diagnosis was 58 years. Pericardial involvement (13%), myocardial infiltration (25%), endocardial involvement (4%), valvular disease (17%), aortic/vascular disease (17%), conduction system infiltration (8%), and coronary artery disease (25%) were present. At a median follow‐up of 5.5 years, mortality was 17%.

Conclusions

Erdheim–Chester disease can involve various cardiovascular structures and is frequently diagnosed on an imaging modality. Some patients had asymptomatic involvement, but others presented with ischemic heart disease, heart failure, valvular disease, and conduction system abnormalities. Early recognition of cardiovascular involvement of Erdheim–Chester disease is needed because of high morbidity and mortality.
Pseudodidymella fagi in Slovakia: First detection, morphology and culture characteristics
Authors: Czachura Paweł , Owczarek‐Kościelniak Magdalena , Piątek Marcin
Published: December 2018

Pseudodidymella fagi, described from infected leaves of Fagus crenata in Japan, has recently been spreading in Europe, where it causes leaf blotch of European beech Fagus sylvatica. In the years 2008–2016, an outbreak of P. fagi was observed on European beech in Switzerland, Germany and Austria, and it is reported here for the first time from Slovakia where it was detected in 2017. The identification of the pathogen is supported by the morphological analyses of material observed in vivo and in vitro and molecular analyses based on ITS sequences. Detailed morphological characterization of cultures based on European material, on F. sylvatica, is provided here for the first time.
Neurofeedback: Principles, appraisal, and outstanding issues
Authors: Papo David
Published: December 2018

Neurofeedback is a form of brain training in which subjects are fed back information about some measure of their brain activity which they are instructed to modify in a way thought to be functionally advantageous. Over the last 20 years, neurofeedback has been used to treat various neurological and psychiatric conditions, and to improve cognitive function in various contexts. However, in spite of a growing popularity, neurofeedback protocols typically make (often covert) assumptions on what aspects of brain activity to target, where in the brain to act and how, which have far‐reaching implications for the assessment of its potential and efficacy. Here we critically examine some conceptual and methodological issues associated with the way neurofeedback's general objectives and neural targets are defined. The neural mechanisms through which neurofeedback may act at various spatial and temporal scales, and the way its efficacy is appraised are reviewed, and the extent to which neurofeedback may be used to control functional brain activity discussed. Finally, it is proposed that gauging neurofeedback's potential, as well as assessing and improving its efficacy will require better understanding of various fundamental aspects of brain dynamics and a more precise definition of functional brain activity and brain‐behaviour relationships.
Into the weeds: Matching importation history to genetic consequences and pathways in two widely used biological control agents
Authors: Hopper Julie V. , McCue Kent F. , Pratt Paul D. , Duchesne Pierre , Grosholz Edwin D. , Hufbauer Ruth A.
Published: December 2018

The intentional introduction of exotic species through classical biological control programs provides unique opportunities to examine the consequences of population movement and ecological processes for the genetic diversity and population structure of introduced species. The weevils Neochetina bruchi and N. eichhorniae (Coleoptera: Curculionidae) have been introduced globally to control the invasive floating aquatic weed, Eichhornia crassipes, with variable outcomes. Here, we use the importation history and data from polymorphic microsatellite markers to examine the effects of introduction processes on population genetic diversity and structure. We report the first confirmation of hybridization between these species, which could have important consequences for the biological control program. For both species, there were more rare alleles in weevils from the native range than in weevils from the introduced range. N. eichhorniae also had higher allelic richness in the native range than in the introduced range. Neither the number of individuals initially introduced nor the number of introduction steps appeared to consistently affect genetic diversity. We found evidence of genetic drift, inbreeding, and admixture in several populations as well as significant population structure. Analyses estimated two populations and 11 sub‐clusters for N. bruchi and four populations and 23 sub‐clusters for N. eichhorniae, indicating divergence of populations during and after introduction. Genetic differentiation and allocation of introduced populations to source populations generally supported the documented importation history and clarified pathways in cases where multiple introductions occurred. In populations with multiple introductions, genetic admixture may have buffered against the negative effects of serial bottlenecks on genetic diversity. The genetic data combined with the introduction history from this biological control study system provide insight on the accuracy of predicting introduction pathways from genetic data and the consequences of these pathways for the genetic variation and structure of introduced species.
Oxygen triggers signal transduction in the DevS (DosS) sensor of Mycobacterium tuberculosis by modulating the quaternary structure
Authors: Lobão Josiane Bezerra da Silva , Gondim Ana C. S. , Guimarães Wellinson G. , Gilles‐Gonzalez Marie‐Alda , Lopes Luiz Gonzaga de França , Sousa Eduardo H. S.
Published: December 2018

A major challenge to the control and eventual eradication of Mycobacterium tuberculosis infection is this pathogen's prolonged dormancy. The heme‐based oxygen sensor protein DevS (DosS) plays a key role in this phenomenon, because it is a major activator of the transcription factor DevR. When DevS is active, its histidine protein kinase region is ON and it phosphorylates and activates DevR, which can induce the transcription of the dormancy regulon genes. Here, we have investigated the mechanism by which the ligation of molecular oxygen to a heme‐binding domain in DevS switches OFF its histidine protein kinase region. To shed light on the oligomerization states of this protein and possible protein‐surfaces of interaction, we used analytical gel filtration, together with dynamic light scattering, fluorescence spectroscopy and chemical crosslinking. We found that DevS exists as three major species: an octamer, a tetramer and a dimer. These three states were observed for the concentration range between 0.5 and 20 μm DevS, but not below 0.1 μm. Levels of DevS in M. tuberculosis are expected to range from 5 to 26 μm. When this histidine protein kinase was OFF, the DevS was mainly tetrameric and dimeric; by contrast, when the kinase was ON, the protein was predominantly octameric. The changes in quaternary structure were rapid upon binding to the physiological signal. This finding represents a novel strategy for switching the activity of a two‐component heme‐based sensor. An enhanced understanding of this process might potentially lead to the design of novel regulatory agents that target the multimer interfaces for treatment of latent tuberculosis.
A novel fixture for mixed mode I/II/III fracture testing of brittle materials
Authors: Zeinedini Afshin
Published: December 2018

A novel test‐loading device was suggested in order to study the fracture behavior of brittle materials under mixed mode I/II/III loading conditions. A version of the compact tension shear specimen was used as the test configuration. Using a three‐dimensional finite element analysis, the influence of mode mixity on the stress intensity factors, the T‐stress, and 3‐D plastic zone around the crack tip was investigated. In addition, an experimental study was performed on an epoxy polymer using the proposed setup. Finally, the fracture toughness of pure epoxy was measured under several loading conditions. The numerical and experimental results manifested that the proposed setup is able to determine a full range of mixed mode I/II/III fracture properties. At the end, the fracture envelope obtained using the practical study was compared with various three‐dimensional fracture criteria. A negligible discrepancy was concluded between the practical data and the theoretical data estimated by the maximum mean principle stress criterion.
Subjective chewing ability and health‐related quality of life among the elderly
Authors: Cho Min‐Jeong , Kim Eun‐Kyong
Published: December 2018

Objective

Chewing ability may reflect the overall oral health, which affects the general health of the elderly. Therefore, we assessed the association between subjective chewing ability and health‐related quality of life (HRQOL) among the elderly.

Methods

We analysed the data of 3034 elderly people aged ≥65 years from the Korean National Health and Nutrition Examination Survey that was conducted by the Korean government from 2013 to 2015 (KNHANES‐VI). Subjective chewing ability was evaluated using a questionnaire, and HRQOL was assessed using EuroQol 5‐dimension (EQ‐5D) instrument by trained examiners. Covariates, such as socio‐demographic, oral health‐related and general health‐related variables, were investigated.

Results

Logistic regression analysis showed that chewing ability was significantly associated with HRQOL in both crude and adjusted model for covariates such as age, gender, economic activity, residence, education, smoking, alcohol, hypertension, diabetes, remaining teeth, denture, CPI, tooth brushing and oral hygiene (crude OR, 2.67; 95% CI, 2.23‐3.20) (adjusted OR, 2.36; 95% CI, 1.95‐2.86). Chewing ability was also significantly associated with most dimensions of EQ‐5D, such as motor ability, self‐care, daily activities, pain and discomfort, and anxiety and depression (P < 0.05).

Conclusion

Chewing ability was significantly associated with HRQOL, suggesting that elderly people with low chewing ability are more likely to have poor health‐related quality of life.
Influence of physiological and chemical factors on the absorption of bioactive peptides
Authors: Karaś Monika
Published: December 2018

Food‐derived bioactive peptides can be released during digestion and have a potentially beneficial effect on human health. It is known that the penetration of peptides across the small intestine can take place in several ways. The research related to the bioavailability of peptides develops dynamically, but still raises many doubts. Since there are many barriers to absorption of peptides, there is still a need to carry out in vitro and in vivo investigations on the bioavailability of these compounds. Moreover, there are few in vivo studies regarding the absorption and activity of peptides in organs, hence the lack of unequivocal and reliable information about this process. Therefore, this review discusses the current research on in vitro and in vivo absorption of these compounds and factors that play a key role in this process and provides better understanding of the in vitro and in vivo bioavailability and bioaccessibility of peptides.
Carbon dioxide‐ and temperature‐mediated changes in plant defensive compounds alter food utilization of herbivores
Authors: Teawkul Papitchaya , Hwang Shaw‐Yhi
Published: December 2018

Although the impact of elevated carbon dioxide and rising temperature on plants and animals has been extensively documented recently, only limited understanding exists regarding their combined effects. The objective of this research was to address the consequences of using combinations of elevated CO2 and elevated temperature on a plant's defensive chemistry, and subsequent utilization of the plant as insect food. Our results indicated that elevated CO2 and increased temperature, for the most part, act independently on the production of defensive compounds in broccoli leaves (Brassica oleracea L. var. italica). CO2 concentrations had significant effects on the foliar water content, total phenolic compounds, polyphenol oxidase and trypsin inhibitor concentrations. The herbivore Spodoptera litura (Fabricius; Lepidoptera: Noctuidae) responded to changes in the plant secondary chemistry, with larvae consuming more plant materials that had been exposed to elevated CO2. The food utilization efficiencies of second‐instar larvae were more sensitive to CO2‐treated foliage than those of the third‐ and fourth‐instar larvae. Temperature did exert a significant effect on food utilization (ECD) by the larvae. Our study will provide important information in future predictions on plant–insect interactions as a result of climate change. The study also demonstrated that since various larval stages might respond differently to climate change, this possibility needs to be considered in future forecasting and monitoring.
Modeling of coconut milk residue incorporated rice‐corn extrudates properties using multiple linear regression and artificial neural network
Authors: Pandiselvam R. , Manikantan M. R. , Sunoj S. , Sreejith S. , Beegum Shameena
Published: December 2018

The effect of extrusion screw speed (200, 250, and 300 rpm), barrel temperature (100, 120, and 140 °C), and formulation (Coconut milk residue [CMR] 10–20%, corn flour 20–30% and rice flour 60%) on product characteristics like expansion ratio, bulk density, water solubility and water absorption index, compression force, and cutting strength were investigated using multiple linear regression (MLR) and artificial neural network (ANN). The coefficient of determination (R2) of MLR ranged between 0.34 and 0.84, and the sum of squared error (SSE) ranged between 0.0009 and 292.51. Whereas, the R2 of ANN ranged between 0.41 and 0.94, and SSE ranged between 0.0001 and 214.81. This indicates its superior performance over MLR in the present study. The extrusion condition of 15% CMR, 25% corn flour, and 60% rice flour, at 220 rpm screw speed, and 140 °C barrel temperature were determined as optimum conditions for development of coconut milk residue incorporated rice‐corn based extrudates with a desirability value of 0.95 using MLR with optimum responses of expansion ratio 3.19, bulk density 0.08 g/cm3, water absorption index 5.69 ml/g, compression force 20.80 N, and cutting strength 10.81 N.

Practical applications

Coconut milk residue, which is rich in dietary fiber and polyphenols, is the main underutilized co‐product of virgin coconut oil, coconut milk powder, coconut milk yogurt, and flavored coconut milk processing industries. It can be incorporated into the rice‐corn mixture to produce a healthy snack food by extrusion. Hence, this study was focused on optimizing the extrusion conditions and flour ratio using multiple linear regression and artificial neural network to obtain a desirable extruded product. The promising results suggest that CMR can be incorporated with rice and corn to produce extrudates with improved nutrition.
Seed germination and dormancy: The classic story, new puzzles, and evolution
Authors: Nonogaki Hiroyuki
Published: December 2018

This review highlights recent progresses in seed germination and dormancy research. Research on the weakening of the endosperm during germination, which is almost a classic theme in seed biology, was resumed by α‐xylosidase studies. Strong genetic evidence was presented to suggest that the quality control of xyloglucan biosynthesis in the endosperm (and the embryo) plays a critical role in germination. Further analyses on the endosperm and the adjacent layers have suggested that the cutin coat in the endosperm‐testa interphase negatively affects germination while the endosperm‐embryo interphase produces a sheath that facilitates germination. These progresses significantly advanced our understanding of seed germination mechanisms. A breakthrough in dormancy research, on the other hand, revealed the unique abscisic acid signaling pathway that is regulated by DELAY OF GERMINATION1 (DOG1). The detailed analysis of DOG1 expression uncovered the intriguing story of reciprocal regulation of the sense‐antisense pair, which generated new questions. Recent studies also suggested that the DOG1 function is not limited to dormancy but extended through general seed maturation, which provokes questions about the evolution of DOG1 family proteins. Seed biology is becoming more exciting with the classic stories being revitalized and new puzzles emerging from the frontier.
Asthma prevalence and control levels among Special Olympics athletes, and asthma‐related knowledge of their coaches
Authors: O'Neill C. , Russell M. , Balogh R. , Lloyd M. , Dogra S.
Published: December 2018

Background

The prevalence of asthma among athletes with intellectual disabilities, and the asthma knowledge levels of their coaches, is unknown.

Methods

Special Olympics Canada athletes completed a demographic questionnaire (n = 208). Athletes who identified as having ever or current asthma completed the Asthma Control Questionnaire and the Mini Asthma Quality of Life Questionnaire and were measured for height, weight and lung function (n = 73). National level coaches (n = 27) completed a questionnaire pertaining to asthma knowledge.

Results

The prevalence of ever and current asthma were 35.5% (n = 73) and 21.1% (n = 44), respectively. Athletes with asthma reported that they had inadequately controlled asthma, but good quality of life. Coaches correctly answered 43% true/false questions on the survey, indicating suboptimal asthma knowledge.

Conclusions

Athletes with intellectual disabilities appear to have a greater prevalence of asthma than the general population; however, coaches of these athletes appear to have limited knowledge pertaining to asthma and exercise‐induced asthma.
Promotion of Long‐Acting Reversible Contraception Among Adolescents and Young Adults
Authors: Santibenchakul Somsook , Tschann Mary , Carlson Alyssa Dee P. , L. Hurwitz Eric , Salcedo Jennifer
Published: December 2018

Introduction

Intrauterine devices and contraceptive implants are recommended as first‐line contraceptives by health care professional societies. However, uptake among US women lags substantially behind other developed countries. Little information is available on the extent to which clinicians document discussion about long‐acting reversible contraception (LARC) in this patient population. We sought to determine the frequency with which clinicians document LARC discussion with eligible women aged 14 to 25 years in a training clinic and evaluate factors associated with LARC discussion and uptake.

Methods

We conducted a retrospective chart review of all visits of nonpregnant women aged 14 to 25 years seen at an obstetrics and gynecology resident physician clinic during a calendar year. A logistic regression model was used to assess demographic factors associated with LARC education and uptake.

Results

Among 450 visits by eligible patients, LARC discussion was documented during 47.8% (215/450) of visits. Among visits with documentation of LARC counseling, 45.6% (98/215) had documentation of a LARC placement plan. Among patients who decided to initiate LARC, 40.8% (40/98) had a device placed at the same visit. LARC placement was documented during 8.9% (40/450) of visits. Clinicians documented LARC counseling for women aged 14 to 19 years more frequently than for women aged 20 to 25 years. Compared with women who did not use any method of contraception, clinicians documented LARC counseling less frequently for women who used short‐term hormonal contraception.

Discussion

Clinicians in a training clinic did not document LARC counseling for more than half of eligible patients. Every clinical visit is an opportunity to assess risk of unintended pregnancy and ensure that contraceptive needs are addressed.
Rostral ventromedial medulla‐mediated descending facilitation following P2X7 receptor activation is involved in the development of chronic post‐operative pain
Authors: Wang Wei , Zhong Xiongxiong , Li Yongyong , Guo Ruixian , Du Sujuan , Wen Lili , Ying Yanlu , Yang Tao , Wei Xu‐Hong
Published: December 2018

Chronic postsurgical pain (CPSP) remains a medical problem. Whether the descending modulation of nociceptive transmission from the rostral ventromedial medulla (RVM) plays a role in CPSP induced by skin/muscle incision and retraction (SMIR) in the thigh is still unknown. In this study, we found that SMIR surgery, which induced either bilateral or unilateral mechanical allodynia, activated microglia, and up‐regulated interleukin‐1β (IL‐1β), an important cytokine, and 8‐hydroxyguanine, an oxidative stress marker in the RVM. In addition, the release of 5‐hydroxytryptamine (5‐HT) was increased in the ipsilateral and contralateral RVM in rats with either bilateral or unilateral pain following SMIR. The 5‐HT level increase, 5‐HT3 receptor (5‐HT3R) up‐regulation, and microglia activation were found bilaterally in SMIR rats with bilateral pain, but only ipsilaterally in SMIR rats with unilateral pain. The intrathecal injection of the 5‐HT3R antagonist Y25130 prevented the development of CPSP and the activation of spinal microglia induced by SMIR. Furthermore, P2X7 receptor (P2X7R) was up‐regulated in microglia in the RVM. The microinjection of the P2X7R antagonist brilliant blue G (BBG, a non‐competitive P2X7R antagonist) into the RVM prevented the development of mechanical allodynia, inhibited the activation of microglia, and decreased the expression of IL‐1β and 8‐hydroxyguanine in the RVM following SMIR. Importantly, BBG injected into the RVM also decreased the activation of microglia and the level of 5‐HT in the lumbar 3 (L3) spinal cord. The microinjection of the P2X7R agonist BzATP, the NADPH oxidase activator phorbol‐12‐myristate‐13‐acetate, or IL‐1β into the RVM induced bilateral mechanical allodynia, microglia activation, and 5‐HT release in the L3 spinal dorsal horn. Taken together, P2X7R activation in microglia in the RVM following SMIR might be responsible for the development of CPSP via activating descending serotonergic pathway.

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International chronic inflammatory demyelinating polyneuropathy outcome study (ICOS): Protocol of a prospective observational cohort study on clinical and biological predictors of disease course and outcome
Authors: Bunschoten Carina , Eftimov Filip , van der Pol W.‐Ludo , Jacobs Bart C. ,   for the ICOS Consortium
Published: December 2018

Chronic inflammatory demyelinating polyneuropathy (CIDP) is a heterogeneous immune‐mediated disorder with extensive variation in clinical presentation, electrophysiological phenotype, treatment response and long‐term outcome. This heterogeneity may reflect the existence of distinct subtypes of CIDP with a different pathogenesis that require personalized treatment. The International CIDP Outcome Study (ICOS) is a prospective, observational, multicenter cohort study that aims to describe this variation and to define clinical and biological determinants and predictors of these subtypes, disease activity, treatment response and outcome. All patients fulfilling the European Federation of Neurological Societies/Peripheral Nerve Society 2010 diagnostic criteria for CIDP can participate, independent of age, duration and severity of the disease or treatment. We collect data on the clinical presentation, diagnostics, validated clinical outcome measures, (response to) treatment, and we collect biomaterials (DNA, cerebrospinal fluid and serial serum samples). We aim to include at least 1000 CIDP patients with a follow‐up of at least 2 years. ICOS started in November 2015 in three academic medical centers in The Netherlands and by October 2018 169 patients are included: 69 new and 100 prevalent cases. ICOS is based on the format of the International Guillain‐Barré syndrome (GBS) Outcome Study (IGOS). Dutch centers are invited to participate in ICOS that will continue as an independent national registry. International centers will be able to collect data and biomaterials according to the ICOS protocol by using the optional ICOS module within the INCbase infrastructure. ICOS will help to standardize the collection of data and biosamples for future research in CIDP.
Acute flaccid paralysis: Do not forget beriberi neuropathy
Authors: Saini Monica , Lin Wee , Kang Corrine , Umapathi Thirugnanam
Published: December 2018

We aimed to elucidate characteristics of beriberi neuropathy (BB) in a general hospital (GH) setting. Nerve conduction studies (NCS), cross‐referenced with clinical records of patients admitted to a GH (May 2011‐July 2017), were reviewed for diagnosis of BB. Thirteen patients (age range 23‐64 years; five women) were diagnosed with BB. Eleven were incarcerated (2‐24 months) at time of index event. Eleven reported prior, severe anorexia (2‐6 months); five reported significant weight loss, three had recurrent vomiting, and three reported alcohol misuse. Commonest presentation was weakness (12/13); nine had symptom evolution over ≥3 weeks. At nadir, 11/13 could not walk independently. Other features included numbness/paraesthesiae (10/13), dysautonomia (6/13), vocal cord dysfunction/dysphagia (4/13), nystagmus (3/13). Pain was not prominent. Cerebrospinal fluid, tested in five patients, was acellular; one showed mildly increased protein. NCS showed predominantly sensorimotor, axonal polyneuropathy, rarely asymmetric. Only one patient had sural‐sparing pattern. All received high dose thiamine. Two of the thirteen received intravenous immunoglobulin for suspicion of Guillain‐Barré syndrome (GBS). Eleven improved to independent ambulation. One patient died from pulmonary embolism; one was lost to follow‐up. Two of the thirteen had residual neurocognitive effects; both misused alcohol. Besides GBS, BB is an important cause of acute to subacute flaccid paralysis, especially in incarcerated patients and those with significant dietary deprivation. Features favoring BB over GBS are ≥3 weeks of symptoms, nystagmus, confusion, vocal cord dysfunction, volume overload, normal spinal fluid, elevated lactate, and absence of sural‐sparing pattern in NCS.
Using Healthcare Services: Perspectives of Community‐Dwelling Aging Adults With Intellectual Disabilities and Family Members
Authors: Baumbusch Jennifer , Moody Elaine , Hole Rachelle , Jokinen Nancy , Stainton Tim
Published: December 2018

The aging of adults with Intellectual Disability (ID) in the community resulting from deinstitutionalization signals a need for change in healthcare policy and services. This population is growing older at rates similar to the rest of the population, and individuals with ID often have multiple chronic illnesses and may experience young‐onset dementia, increasing their need to use healthcare services. However, it is widely recognized that currently healthcare services are ill‐prepared to meet the unique needs of this population as they age in their communities. The purpose of this study was to explore this issue from the perspectives of aging individuals with ID and family members (FMs). This study employed qualitative description as the method of inquiry and took place in British Columbia, Canada. Adults with ID age 40 years and older (N = 21) and FMs (N = 26) participated. Data were collected through focus groups and semistructured interviews. Thematic data analysis was conducted to generate the main study findings. Two overarching themes were identified. First, “the organization and culture of healthcare services in the community.” This theme included issues such as age restrictions on health services, navigating health services, the culture of appointment‐making, and implications of living in rural settings, all of which influenced how individuals used healthcare services. Second, “interactions with healthcare providers” illustrated ways in which providers contribute to healthcare experiences. Many factors, both organizational and interpersonal, shape the experiences of aging individuals with ID using healthcare services in their communities. There continues to be a policy and service gap that can create unnecessary and avoidable difficulties in using healthcare services. Policies, service delivery, and education of healthcare providers need to be revisited in light of the unique needs of this population aging in the community in order to ensure healthcare is accessible.
Contrasting heterozygosity‐fitness correlations across life in a long‐lived seabird
Authors: Bichet Coraline , Vedder Oscar , Sauer‐Gürth Hedwig , Becker Peter H. , Wink Michael , Bouwhuis Sandra
Published: December 2018

Selection is a central force underlying evolutionary change and can vary in strength and direction, for example across time and space. The fitness consequences of individual genetic diversity have often been investigated by testing for multilocus heterozygosity‐fitness correlations (HFCs), but few studies have been able to assess HFCs across life stages and in both sexes. Here, we test for HFCs using a 26‐year longitudinal individual‐based data set from a large population of a long‐lived seabird (the common tern, Sterna hirundo), where 7,974 chicks and breeders of known age were genotyped at 15 microsatellite loci and sampled for life‐history traits over the complete life cycle. Heterozygosity was not correlated with fledging or post‐fledging prospecting probabilities, but was positively correlated with recruitment probability. For breeders, annual survival was not correlated with heterozygosity, but annual fledgling production was negatively correlated with heterozygosity in males and highest in intermediately heterozygous females. The contrasting HFCs among life stages and sexes indicate differential selective processes and emphasize the importance of assessing fitness consequences of traits over complete life histories.
Variation in milk, serum, and blubber fatty acids in young, free‐ranging Steller sea lions
Authors: Keogh Mandy J. , Taras Brian D. , Eischens Carrie , Kennish John M. , Fadely Brian S. , Rea Lorrie D.
Published: December 2018

We determined the fatty acid signatures in milk, serum, and blubber samples collected from young free‐ranging Steller sea lions (Eumetopias jubatus) and investigated the partitioning of fatty acids among these matrices. We assessed the relationship of fatty acids in each matrix with region, age, season, sex, and body condition to gain information needed to determine the most appropriate type of samples to collect and analyze to address future research questions. The variability of fatty acid composition was almost entirely explained by sample type, highlighting the importance of selecting a matrix consistent with the study objectives. Regional differences in fatty acid composition were found in all sample types and these differences varied among matrices. The proportion of fatty acids in milk and serum were influenced by season of capture whereas blubber samples were more affected by age of the pup. The influence of season on the fatty acid signatures in milk and serum highlights the use of these samples over blubber in studies investigating seasonal changes in diet. Further, our findings suggest that the use of milk samples collected from the stomachs of pups may be a viable alternative to directly collecting milk from adult females.
Ixodid ticks on wild donkeys in a Mediterranean nature reserve (Asinara National Park): diversity and risk factors
Authors: Zanzani S. A. , Pintore E. , Olivieri E. , Columbano N. , Scanu A. , Melosu V. , Sanna Passino E. , Careddu G. , Gazzonis A. L. , Manfredi M. T. , Garippa G.
Published: December 2018

The Sardinian coloured donkey Equus asinus (Perissodactyla: Equidae) and its albino colour morph represent the wildlife species most typical of the island of Asinara. This Mediterranean island represents a favourable context for ticks and tick‐borne diseases; however, knowledge of the tick fauna on Asinara is scarce. A total of 106 Sardinian donkeys were inspected for tick infestation from June to November 2015. All ticks found were collected, classified by stage and sex, and identified to species level. The level of infestation of each donkey was determined; both the overall tick infestation and infestations of each detected species were classified on a scale of 1–3 to give an infestation score (IS). Overall, 256 hard ticks were collected from 60 of 106 donkeys (56.6%). Rhipicephalus bursa, Haemaphysalis punctata and Hyalomma marginatum (all: Ixodida: Ixodidae) infested 26.4%, 28.3% and 6.6% of donkeys, respectively. Different variables affected the IS. With reference to overall tick infestation, a higher IS was observed in donkeys grazing on grassland and Mediterranean shrubland and in albino donkeys compared with coloured donkeys. The collected ticks included species involved in the transmission of pathogens to humans, which highlights the risks for public health in a tourist destination such as Asinara National Park.
Associations between serum mineral metabolism parameters and mortality in patients on peritoneal dialysis
Authors: Wu Meiju , Wu Haishan , Huang Xuan , Ye Hongjian , Huang Fengxian , Yu Xueqing , Yang Xiao
Published: December 2018

Aim

Disturbances in mineral metabolism markers are common in patients with chronic kidney disease but there is no consensus on the association between these markers and clinical outcomes. This study investigated associations between mineral metabolism parameters and mortality in Chinese peritoneal dialysis (PD) patients.

Methods

This was a single‐centre retrospective cohort study. Incident PD patients between 1 January 2006 and 31 December 2013 with baseline phosphate, albumin‐corrected calcium, and calcium‐phosphate product data were enrolled. Associations between these parameters and all‐cause and cardiovascular mortality were assessed using multivariable‐adjusted Cox models.

Results

Of 1662 patients (mean age: 47.4 ± 15.3 years), 59.3% were male and 23.8% had diabetes. Over a median 38.1 month (interquartile range: 21.3–59.7 months) follow‐up period, 382 (23.0%) patients died. After adjusting for confounders, the higher serum phosphate level (>1.78 mmol/L) and calcium‐phosphate product level (≥4.4 mmol2/L2) were significantly associated with an increased risk for all‐cause mortality (hazards ratio (HR) = 1.818, 95% CI = 1.379–2.396 and HR = 1.735, 95% CI = 1.261–2.386) and cardiovascular mortality (HR = 2.069, 95% CI = 1.428–2.998 and HR = 2.175, 95% CI = 1.450–3.262), respectively. While each 1 mmol/L higher baseline albumin‐corrected calcium level was associated with an 14.3% (95% CI = 0.749–0.981) lower risk for all‐cause mortality after adjusting for potential confounders.

Conclusion

Abnormalities in mineral metabolism markers, particularly higher serum phosphate and calcium‐phosphate product levels, at the commencement of PD were independently associated with increased all‐cause and cardiovascular mortality in this cohort of PD patients.
Evolutionary tinkering allows buzz pollinated plants to escape from an adaptive dead‐end
Authors: Vallejo‐Marín Mario
Published: December 2018

This article is a Commentary on Dellinger et al., 221: 1136–1149.
RNA interference suppression of AGAMOUS and SEEDSTICK alters floral organ identity and impairs floral organ determinacy, ovule differentiation, and seed‐hair development in Populus
Authors: Lu Haiwei , Klocko Amy L. , Brunner Amy M. , Ma Cathleen , Magnuson Anna C. , Howe Glenn T. , An Xinmin , Strauss Steven H.
Published: December 2018

The role of the floral homeotic gene AGAMOUS (AG) and its close homologues in development of anemophilous, unisexual catkins has not previously been studied.

We transformed two RNA interference (RNAi) constructs, PTG and its matrix‐attachment‐region flanked version MPG, into the early‐flowering female poplar clone 6K10 (Populus alba) to suppress the expression of its two duplicate AG orthologues.

By early 2018, six out of 22 flowering PTG events and 11 out of 12 flowering MPG events showed modified floral phenotypes in a field trial in Oregon, USA. Flowers in catkins from modified events had ‘carpel‐inside‐carpel’ phenotypes. Complete disruption of seed production was observed in seven events, and sterile anther‐like organs in 10 events. Events with strong co‐suppression of both the two AG and two SEEDSTICK (STK) paralogues lacked both seeds and associated seed hairs. Alterations in all of the modified floral phenotypes were stable over 4 yr of study. Trees from floral‐modified events did not differ significantly (P < 0.05) from nonmodified transgenic or nontransgenic controls in biomass growth or leaf morphology.

AG and STK genes show strong conservation of gene function during poplar catkin development and are promising targets for genetic containment of exotic or genetically engineered trees.
Excess micronutrient intake: defining toxic effects and upper limits in vulnerable populations
Authors: Pike Vanessa , Zlotkin Stanley
Published: December 2018

Excessive micronutrient intake causes a variety of adverse health effects, depending on dose and duration. The risk of excess intake carries significant implications for micronutrient delivery interventions, particularly when such programs are overlapping. To minimize risk and provide public health guidance, several countries and the Food and Agriculture Organization of the United Nations/World Health Organization have set upper intake levels (ULs) for various life‐stage populations using the risk assessment framework. However, there is a lack of international consensus on the actual ULs due to variability in application of this framework and a scarcity of evidence from which to draw upon, especially for children. Often ULs for children are established through a downward weight‐based extrapolation from adult ULs, which is not always appropriate. The published ULs of nine organizations are compared, recent population nutrient intake evidence is presented, and the toxic effects of key minerals and vitamins are reviewed. Finally, the evidence for toxicity and setting of ULs for each nutrient is discussed including a comment on our degree of confidence in the strength of existing individual ULs. Challenges with risk assessment and opportunities for strengthening the definition of ULs are discussed.
Health‐related quality of life, clinical outcomes, and subjective experiences of parent donors of pediatric liver transplant recipients
Authors: Yuen Wing Yan , Tan Ashley , Karthik Sivaramakrishnan Venkatesh , Quak Seng Hock , Kow Alfred Wei‐Chieh , Aw Marion M.
Published: December 2018

Purpose

The understanding of the HRQOL issues for parent donors of children who underwent LDLT is lacking. We evaluated the HRQOL of donor and non‐donor parents, described their subjective experiences and identified factors associated with lower HRQOL post‐donation.

Methods

This is a cross‐sectional study of parent donors whose children underwent LDLT, using SF‐36v2 Health Survey to measure HRQOL, and a self‐developed questionnaire to evaluate their subjective experiences.

Results

Of 32 pairs of donor and non‐donor parents, 27 donor and 19 non‐donor parents responded. The data of respondents were analyzed. Both donor and non‐donor parents’ SF‐36v2 norm‐based scores were average or above average as compared to the Singapore population. Donors who made lifestyle changes post‐donation (adopting a healthy balanced diet, regular physical activity, quitting smoking, and moderate alcohol intake) were associated with lower GH (P = 0.009) and PF (P = 0.002) scores. Donors who took more than 3 months for full recovery had lower RP (P = 0.022) and BP scores (P = 0.038). On multivariate analysis, recipient complication of Clavien grade 3 or 4 was associated with increased RP score by 8.71 points (95% CI: 1.74‐15.68), after adjusting for time taken for full recovery. Majority (88.8%) had self‐reported recovery time under 6 months and returned to work within 3 months (74.0%).

Conclusions

Donors with factors potentially associated with lower HRQOL may need more support to ensure better HRQOL outcomes post‐donation.
When Is Science Used in Science Policy? Examining the Importance of Scientific and Technical Information in National Research Council Reports
Authors: Bozeman Barry , Youtie Jan , Fukumoto Eriko , Parker Marla
Published: December 2018

A frequent lament among researchers is that public policy makers should pay more attention to scientific and technical information (STI). If there is any single area where one might expect STI to be used in public policy making and agenda setting it is in science and technology policy. Many of the policy makers in science and technology policy are themselves scientists or researchers and presumably would prove especially receptive to STI. However, STI is only one of many types of information used in policy making and policy actors often differ in the extent to which they view STI as credible, particularly compared to other types of potentially policy‐relevant information. Research on credibility (the believability of information, information types, and media) has shown variance and policy makers’ “credibility maps.” Thus, some policy makers have preference for formal information generally and STI specifically, but others privilege raw data, personal experience, authority, history and anecdote, analogical reasoning, or conformance to ideology, to name just a few of the information choices. Here, we build on the current researchers’ previous bibliometrics‐based work and use data from 41 semi‐structured elite interviews with National Research Council (NRC) executives and staff and NRC committee members concerning the use of STI in reports issued by the NRC. Findings show that the use of STI in NRC reports varies according to the nature of the inquiry and the sponsor. Information used in the reports is based on not only the assessed credibility of information but also its perceived direct relevance and the availability of STI as compared to other types of information. In general, the amount of STI in the NRC reports tends to have modest effects on the likelihood that reports will be used in policy making or by the mass media. More important factors include the timing of the report with respect to political agendas, the party requesting the report, and the enacted roles of NRC staff members and committee chairs.
“Homeless in life” – loneliness experienced as existential suffering by older adults living at home: a caring science perspective
Authors: Hemberg Jessica , Nyqvist Fredrica , Näsman Marina
Published: December 2018

Background

Due to physical impairments and functional limitations, older adults receiving home care can be considered especially vulnerable to loneliness. To understand how society can provide support that enhances vulnerable individuals’ quality of life, it is important to explore loneliness and its underlying causes in older adults.

Aims

To contribute to a deeper understanding of caring science theory, the aim of this study was to use a caring science perspective to explore and understand experiences of suffering from loneliness in older adults receiving home care. The research questions are as follows: What phenomena are associated with the experience of suffering from loneliness in older adults receiving home care? How can this experience be understood?

Methodology

A hermeneutical approach was used. The material was collected through interviews with 17 older adults about their quality of life, including their experiences of loneliness. The texts were interpreted through latent content analysis.

Findings

The findings resulted in one main category and three subcategories. The main category was as follows: Being homeless in life–loneliness expressed and primarily stemming from existential suffering. The subcategories were as follows: Loss of communion with one's partner or other loved ones, Loss of meaningful social activities due to isolation and Loss of health due to frailty and vulnerability. All categories were described and implications for practice discussed.

Conclusion

This study contributes to an understanding of experiences of suffering from loneliness in older adults receiving home care, with relevance for the healthcare context as well as for what a community or society should focus on when addressing these important issues.