bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of contextual factors in the rehabilitation of adolescent survivors of traumatic brain injury: emerging concepts identified through modified narrative review
Authors: Ciccia Angela Hein , Threats Travis
Published: February 2015

Background

Recently research in traumatic brain injury (TBI) intervention has identified the benefits of contextualized, embedded, functionally based approaches to maximize treatment outcomes. An essential component of contextualized intervention is the direct and purposeful consideration of the broader context, in which the person with TBI functions. However, systematic consideration of contextual factors remains limited both in research and clinical practice.

Aims

The purposes of this modified narrative review were (1) to provide a succinct review of the available literature regarding the contextual factors that are specific to adolescent survivors of TBI, one of highest incidence groups for brain injury; (2) to connect these contextual factors to the direct long‐term management of TBI and to identify their potential impact on outcome; and (3) to highlight areas that are open to research and clinical advances that could enhance positive outcomes for adolescent survivors of TBI. The framework of the World Health Organization's (WHO) International Classification of Functioning, Disability and Health—Children and Youth Version (ICF‐CY; 2007) was used as a foundation for this review.

Methods & Procedures

A systematic literature search was conducted using databases and hand searches. A total of 102 articles were originally identified. Twenty‐five original research articles, eight review papers and four expert opinion papers met inclusion and exclusion criteria and were included in the final review.

Main Contribution

The body of research specifically focused on contextual factors is an emerging area. Early findings indicate that a focus on the direct modification of contextual factors is promising for the facilitation of positive outcomes long into the chronic phase of management for adolescences who have survived a TBI. The contextual factors included in this review were the overall ability of the school to support a student post‐TBI, family psychosocial risk (sibling/sibling relationships/stress/burden/support), coping style (TBI survivor and their caregivers), and socioeconomic status of the family. Given the promise of these findings, research and clinical application efforts should be focused on identifying well‐prescribed rehabilitation paradigms that capitalize on the modification of contextual factors throughout the recovery process.

Conclusions & Implications

The results of this modified narrative review provide an initial summary of the available evidence for addressing contextual factors in the rehabilitation process for adolescents with TBI. This is an area that is wide open for both systematic research and clinical application and holds potential to improve long‐term outcome for survivors of adolescent TBI.
The Consequences of Inequality for Public Policy in Australia
Authors: Triffitt Mark
Published: February 2015

Growing debate on economic inequality in the West has refocused discussion on whether economic elites have too much influence on public policy‐making. The article highlights the extent to which public policy in Australia has been captured by corporate interests and other economic elites in recent years. This raises questions about the quality of public policy now being generated in key areas of reform. It also raises questions about the sustainability of public support for policy constructed by, and on behalf of, narrow corporate interests.
Rising Inequality: A Benign Outgrowth of Markets or a Symptom of Cancerous Political Favours?
Authors: Frijters Paul , Foster Gigi
Published: February 2015

Is the rise in inequality in Australia due to global changes in the distribution of marginal productivity or changes in the allocation of political favours? This article lays out the arguments for both views. Looking at the tax and subsidy changes that favour the rich, and considering that almost all the 200 richest Australians look like the beneficiaries of political favours rather than innovators or superstars, the article concludes that inequality is probably increasing due to changes in the political realm. The discussion outlines a research agenda and possible counter‐moves, such as more direct democracy and having open markets for political favours.
‘Underclassism’ and access to healthcare in urban centres
Authors: Tang Sannie Y. , Browne Annette J. , Mussell Bill , Smye Victoria L. , Rodney Patricia
Published: February 2015

In this article, we draw on findings from an ethnographic study that explored experiences of healthcare access from the perspectives of Indigenous and non‐Indigenous patients seeking services at the non‐urgent division of an urban emergency department (ED) in Canada. Our aim is to critically examine the notion of ‘underclassism’ within the context of healthcare in urban centres. Specifically, we discuss some of the processes by which patients experiencing poverty and racialisation are constructed as ‘underclass’ patients, and how assumptions of those patients as social and economic Other (including being seen as ‘drug users’ and ‘welfare dependents’) subject them to marginalisation, discrimination, and inequitable treatment within the healthcare system. We contend that healthcare is not only a clinical space; it is also a social space in which unequal power relations along the intersecting axes of ‘race’ and class are negotiated. Given the largely invisible roles that healthcare plays in controlling access to resources and power for people who are marginalised, we argue that there is an urgent need to improve healthcare inequities by challenging the taken‐for‐granted assumption that healthcare is equally accessible for all Canadians irrespective of differences in social and economic positioning.
Towards a universal barcode of oomycetes – a comparison of the cox1 and cox2 loci
Authors: Choi Young‐Joon , Beakes Gordon , Glockling Sally , Kruse Julia , Nam Bora , Nigrelli Lisa , Ploch Sebastian , Shin Hyeon‐Dong , Shivas Roger G. , Telle Sabine , Voglmayr Hermann , Thines Marco
Published: February 2015

Oomycetes are a diverse group of eukaryotes in terrestrial, limnic and marine habitats worldwide and include several devastating plant pathogens, for example Phytophthora infestans (potato late blight). The cytochrome c oxidase subunit 2 gene (cox2) has been widely used for identification, taxonomy and phylogeny of various oomycete groups. However, recently the cox1 gene was proposed as a DNA barcode marker instead, together with ITS rDNA. The cox1 locus has been used in some studies of Pythium and Phytophthora, but has rarely been used for other oomycetes, as amplification success of cox1 varies with different lineages and sample ages. To determine which out of cox1 or cox2 is best suited as a universal oomycete barcode, we compared these two genes in terms of (i) PCR efficiency for 31 representative genera, as well as for historic herbarium specimens, and (ii) sequence polymorphism, intra‐ and interspecific divergence. The primer sets for cox2 successfully amplified all oomycete genera tested, while cox1 failed to amplify three genera. In addition, cox2 exhibited higher PCR efficiency for historic herbarium specimens, providing easier access to barcoding‐type material. Sequence data for several historic type specimens exist for cox2, but there are none for cox1. In addition, cox2 yielded higher species identification success, with higher interspecific and lower intraspecific divergences than cox1. Therefore, cox2 is suggested as a partner DNA barcode along with ITS rDNA instead of cox1. The cox2‐1 spacer could be a useful marker below species level. Improved protocols and universal primers are presented for all genes to facilitate future barcoding efforts.
How sex and age affect immune responses, susceptibility to infections, and response to vaccination
Authors: Giefing‐Kröll Carmen , Berger Peter , Lepperdinger Günter , Grubeck‐Loebenstein Beatrix
Published: February 2015

Do men die young and sick, or do women live long and healthy? By trying to explain the sexual dimorphism in life expectancy, both biological and environmental aspects are presently being addressed. Besides age‐related changes, both the immune and the endocrine system exhibit significant sex‐specific differences. This review deals with the aging immune system and its interplay with sex steroid hormones. Together, they impact on the etiopathology of many infectious diseases, which are still the major causes of morbidity and mortality in people at old age. Among men, susceptibilities toward many infectious diseases and the corresponding mortality rates are higher. Responses to various types of vaccination are often higher among women thereby also mounting stronger humoral responses. Women appear immune‐privileged. The major sex steroid hormones exhibit opposing effects on cells of both the adaptive and the innate immune system: estradiol being mainly enhancing, testosterone by and large suppressive. However, levels of sex hormones change with age. At menopause transition, dropping estradiol potentially enhances immunosenescence effects posing postmenopausal women at additional, yet specific risks. Conclusively during aging, interventions, which distinctively consider the changing level of individual hormones, shall provide potent options in maintaining optimal immune functions.
Regulation of the p19Arf/p53 pathway by histone acetylation underlies neural stem cell behavior in senescence‐prone SAMP8 mice
Authors: Soriano‐Cantón Raúl , Perez‐Villalba Ana , Morante‐Redolat José Manuel , Marqués‐Torrejón María Ángeles , Pallás Mercé , Pérez‐Sánchez Francisco , Fariñas Isabel
Published: February 2015

Brain aging is associated with increased neurodegeneration and reduced neurogenesis. B1/neural stem cells (B1‐NSCs) of the mouse subependymal zone (SEZ) support the ongoing production of olfactory bulb interneurons, but their neurogenic potential is progressively reduced as mice age. Although age‐related changes in B1‐NSCs may result from increased expression of tumor suppressor proteins, accumulation of DNA damage, metabolic alterations, and microenvironmental or systemic changes, the ultimate causes remain unclear. Senescence‐accelerated‐prone mice (SAMP8) relative to senescence‐accelerated‐resistant mice (SAMR1) exhibit signs of hastened senescence and can be used as a model for the study of aging. We have found that the B1‐NSC compartment is transiently expanded in young SAMP8 relative to SAMR1 mice, resulting in disturbed cytoarchitecture of the SEZ, B1‐NSC hyperproliferation, and higher yields of primary neurospheres. These unusual features are, however, accompanied by premature loss of B1‐NSCs. Moreover, SAMP8 neurospheres lack self‐renewal and enter p53‐dependent senescence after only two passages. Interestingly, in vitro senescence of SAMP8 cells could be prevented by inhibition of histone acetyltransferases and mimicked in SAMR1 cells by inhibition of histone deacetylases (HDAC). Our data indicate that expression of the tumor suppressor p19, but not of p16, is increased in SAMP8 neurospheres, as well as in SAMR1 neurospheres upon HDAC inhibition, and suggest that the SAMP8 phenotype may, at least in part, be due to changes in chromatin status. Interestingly, acute HDAC inhibition in vivo resulted in changes in the SEZ of SAMR1 mice that resembled those found in young SAMP8 mice.
Kullback–Leibler Distance Methods for Detecting Disease Association with Rare Variants from Sequencing Data
Authors: Turkmen Asuman S. , Yan Zhifei , Hu Yue‐Qing , Lin Shili
Published: February 2015

Because next generation sequencing technology that can rapidly genotype most genetic variations genome, there is considerable interest in investigating the effects of rare variants on complex diseases. In this paper, we propose four Kullback–Leibler distance‐based Tests (KLTs) for detecting genotypic differences between cases and controls. There are several features that set the proposed tests apart from existing ones. First, by explicitly considering and comparing the distributions of genotypes, existence of variants with opposite directional effects does not compromise the power of KLTs. Second, it is not necessary to set a threshold for rare variants as the KL definition makes it reasonable to consider rare and common variants together without worrying about the contribution from one type overshadowing the other. Third, KLTs are robust to null variants thanks to a built‐in noise fighting mechanism. Finally, correlation among variants is taken into account implicitly so the KLTs work well regardless of the underlying LD structure. Through extensive simulations, we demonstrated good performance of KLTs compared to the sum of squared score test (SSU) and optimal sequence kernel association test (SKAT‐O). Moreover, application to the Dallas Heart Study data illustrates the feasibility and performance of KLTs in a realistic setting.
Human herpes virus reactivations and dynamic cytokine profiles in patients with cutaneous adverse drug reactions – a prospective comparative study
Authors: Chen Y.‐C. , Chiang H.‐H. , Cho Y.‐T. , Chang C.‐Y. , Chen K.‐L. , Yang C.‐W. , Lee Y.‐H. , Chu C.‐Y.
Published: February 2015

Background

Sequential human herpes virus (HHV) reactivation is well known in drug reaction with eosinophilia and systemic symptom (DRESS), but such a phenomenon has seldom studied in other types of cutaneous adverse drug reactions (cADRs). Moreover, the association between viral reactivations and cytokine or chemokine changes is largely unknown. We aimed to evaluate the viral reactivation rates of HHV‐6, HHV‐7, Epstein–Barr virus (EBV), and cytomegalovirus (CMV) in different cADRs and their impacts on clinical prognosis. Cytokine and chemokine changes with viral reactivations were also examined.

Methods

A prospective study was conducted to monitor the viral statuses of patients with different cADRs by polymerase chain reaction and serum‐specific antibody titers. Changes in plasma cytokine and chemokine levels were also evaluated by sequential blood samples.

Results

Among the various cADRs, HHV‐6 reactivation was only observed in DRESS, but EBV and CMV could be detected in other cADRs. Many proinflammatory cytokines and chemokines, including interleukin (IL)‐1β, IL‐2, IL‐6, interferon‐γ, tumor necrosis factor‐α, were significantly lower in DRESS patients with HHV‐6 reactivation when compared to those without HHV‐6 reactivation. In addition, these mediators were significantly lower before and during HHV‐6 reactivation, compared to cytokine levels after HHV‐6 reactivation in the same patient.

Conclusion

HHV‐6 reactivation was only observed in DRESS patients, not in any other cADR. In DRESS patients, some proinflammatory cytokines were significantly lower before or during HHV‐6 reactivation.
Effect of topical prostaglandin analogues on corneal hysteresis
Authors: Bolívar Gema , Sánchez‐Barahona Cristina , Teus Miguel , Castejón Miguel A. , Paz‐Moreno‐Arrones Javier , Gutiérrez‐Ortiz Consuelo , Mikropoulos Dimitrios G.
Published: February 2015

Purpose

To evaluate possible changes in corneal hysteresis (CH) after topical treatment with a prostaglandin analogue in medication‐naïve eyes.

Methods

This was a prospective, observational cohort study. Sixty‐eight eyes of 68 patients were prospectively included who were newly diagnosed with primary open‐angle glaucoma or ocular hypertension in our institution. All patients were treatment‐naïve. Patients were evaluated at baseline and after 6 months of treatment with latanoprost in the eye with the lower intraocular pressure (IOP) measured by Goldmann applanation tonometry (GAT). The ocular response analyzer was used to measure CH.

Results

CH increased significantly (p = 0.0001) from 8.96 ± 2.3 mmHg to 9.79 ± 1.97 mmHg, and this increase was correlated significantly (p = 0.0001, r = 0.64, r2 = 0.41) with the basal CH. We identified a weak but significant (r2 = 0.06, p = 0.01) relationship between the basal CH and the drug‐induced reduction of the GAT IOP. Nevertheless, the increase in the drug‐induced CH was not correlated with the decrease in the GAT IOP.

Conclusion

Treatment with latanoprost increases CH. The CH increase was not correlated with the drug‐induced decrease in the GAT IOP, which suggested a direct effect of latanoprost on the viscoelastic corneal properties.
Ultrasound‐guided rectus sheath block for single‐incision laparoscopic cholecystectomy
Authors: Kamei Hideki , Ishibashi Nobuya , Nakayama Gouichi , Hamada Nobuya , Ogata Yutaka , Akagi Yoshito
Published: February 2015

Introduction

Single‐incision laparoscopic cholecystectomy (SILC) is increasingly applied for cholecystectomy and has been reported as safe and feasible, with short‐term operative outcomes equivalent to four‐port cholecystectomy. Although many investigators in randomized studies have noted the cosmetic advantages of SILC, the benefit of decreased pain in SILC remains controversial. Therefore, this study aimed to assess the efficacy of the rectus sheath block in SILC with respect to subjective pain.

Methods

From April 2010 to March 2012, 75 patients with symptomatic gallstone or gallbladder polyps were assigned to one of three groups: (i) four‐port laparoscopic cholecystectomy (n = 29); (ii) SILC (n = 15); and (iii) rectus sheath block in SILC (n = 30). We evaluated the operative details, length of hospital stay, and the need and usage of analgesia. Postoperative pain was recorded at 2, 6, 12, and 24 h after surgery based on a visual analog scale.

Results

There was no difference with regard to age, ASA score, BMI, duration of operation, or length of hospital stay among the three groups. A significantly lower pain score was observed in the rectus sheath block in SILC group than in the SILC group at 2 and 6 h after operation. The pain score and need for analgesia were similar between the SILC group and the four‐port cholecystectomy group.

Conclusion

SILC using an ultrasound‐guided rectus sheath block significantly reduces postoperative pain.
The lived experiences of individuals with Tourette syndrome or tic disorders: A meta‐synthesis of qualitative studies
Authors: Smith Heather , Fox John R.E. , Trayner Penny
Published: February 2015

There is a growing body of qualitative literature describing the lived experiences of people with tic disorders (TDs). The aim of this paper was to conduct a systematic review of this literature, synthesizing the perspectives of individuals on their experiences. Meta‐synthesis methodology was utilized to review and draw together findings from 10 articles, from which key concepts were extracted, and over‐arching themes generated. Six themes were identified to encompass the experience of TDs, including (1) cultural, semantic issues of the condition; (2) negative experiences in organizations and treatment; (3) the value and negative impact on interpersonal relationships; (4) personal identity in the constant presence of TDs; (5) concerns for the future; and (6) strategies to control and manage the observable presence of tics. Adaptive coping strategies were found to encompass continuous social adaptation, strategies to manage tics and social perceptions, self‐acceptance, advocacy, and support from others. The results highlighted the significant role of social and cultural issues related to understanding and stigma, which underpinned many of the lived experiences. Implications for clinical practice in supporting individuals with TDs were also highlighted.
Structure‐Aware Mesh Decimation
Authors: Salinas D. , Lafarge F. , Alliez P.
Published: February 2015

We present a novel approach for the decimation of triangle surface meshes. Our algorithm takes as input a triangle surface mesh and a set of planar proxies detected in a pre‐processing analysis step, and structured via an adjacency graph. It then performs greedy mesh decimation through a series of edge collapse, designed to approximate the local mesh geometry as well as the geometry and structure of proxies. Such structure‐preserving approach is well suited to planar abstraction, i.e. extreme decimation approximating well the planar parts while filtering out the others. Our experiments on a variety of inputs illustrate the potential of our approach in terms of improved accuracy and preservation of structure.
Assessment of the contralateral routing of signal system in unilateral cochlear implantation
Authors: Guevara N. , Grech C. , Gahide I. , Gallego S.
Published: February 2015

Objectives

The purpose of this study was to evaluate the contribution of a contralateral routing of signal (CROS) system in unilateral cochlear implants (CI) users.

Design

Single‐centre prospective interventional study.

Setting

Tertiary referral centre.

Participants

Eight unilateral cochlear implants patients with >30% speech perception in silence and >6 months’ implantation.

Main outcome measures

Free‐field speech perception assessed by ‘vowel–consonant–vowel’ pseudoword test and free‐field spatial localisation by Fournier lists on five loudspeakers (in silence and in noise). Subjective benefit assessed on the abbreviated profile of hearing aid benefit (APHAB) questionnaire. These tests were performed on the 1st and 15th day of the trial (denoted by D1 and D15, respectively).

Results

Contralateral routing of signal‐cochlear implants provided significant improvement in speech perception at D1 and D15 in silence (P, respectively, 0.03 and 0.025) and in noise (P 0.012 and 0.036). No improvement in spatial localisation was demonstrated. The abbreviated profile of hearing aid benefit quality of life questionnaire administered at D15 showed overall benefit and a significant difference in ease of communication with versus without contralateral routing of signal. By 6 months, however, 75% of the patients (6/8) had abandoned the system due to trouble in noise (5/6), trouble with the device's wiring (3/6) and onset of headache (4/6).

Conclusion

Contralateral routing of signal‐cochlear implants is an interesting novel option, restoring a binaural effect and providing improved speech perception and non‐negligible comfort of hearing in certain patients, without the medical and economic costs of bilateral cochlear implants. However, the drawbacks (especially the difficulty of modulating the signal‐to‐noise ratio) do not presently allow it to be an effective alternative to bilateral cochlear implants.
Indikation und praktische Durchführung mikrobiologischer Diagnostik bei Patienten mit chronischen Wunden
Authors: Schwarzkopf Andreas , Dissemond Joachim
Published: February 2015

Eine bakteriologische Diagnostik wird häufig bei Patienten mit chronischen Wunden durchgeführt. Sowohl die Indikationen als auch die praktische Durchführung dieser bakteriologischen Diagnostik sind jedoch zurzeit nicht einheitlich. Da bekannt ist, dass die Resultate durch die Entnahmetechniken und die jeweilige Vorbereitung wesentlich beeinflusst werden können, zeigt sich die Notwendigkeit für einen einheitlichen Standard, der bislang fehlt.

Oberflächlich entnommene bakteriologische Abstriche für Screening‐Untersuchungen bei Patienten mit chronischen Wunden werden in Deutschland oft in der täglichen Routine insbesondere für den Nachweis von multiresistenten Erregern entnommen. Bei diesen Abstrichen sollte zuvor keine Wundsäuberung durchgeführt werden. Die Durchführung entsprechend der Technik des Essener Kreisels stellt für diese Fragestellung eine leicht anzuwendende und rasch durchführbare Option dar. Bei klinischem Verdacht auf Wundinfektion sollte vor Abnahme bakteriologischer Abstriche eine Wundsäuberung mit steriler 0,9%iger NaCl‐Lösung und/oder sterilen Kompressen erfolgen. Eine routinemäßige Entnahme von Biopsien für die Erregerdiagnostik ist für die meisten Patienten mit chronischen Wunden nicht notwendig. Biopsien können jedoch dann sinnvoll sein, wenn der klinische Verdacht auf Wundinfektionen insbesondere bei Patienten mit tieferen Ulzerationen, diabetischem Fußsyndrom, schweren Weichgewebeinfektionen oder Fistelgewebe besteht. Auch wenn spezifische Erreger wie beispielsweise Mykobakterien, Leishmanien, Aktinomyzeten, Nokardien oder Schimmelpilze nachgewiesen werden sollen, ist für die mikrobiologische Diagnostik Biopsiematerial erforderlich.
Online Intermediary as a Channel for Selling Quality‐Differentiated Services
Authors: Akçura M. Tolga , Ozdemir Zafer D. , Rahman Mohammad S.
Published: February 2015

When deciding whether to utilize an online intermediary in addition to their own distribution channels, quality differentiated service providers face the trade‐off between the benefit of extended reach and the threat of increased competition. Using an analytical framework, we analyze when and how service providers may utilize an online intermediary to their advantage in the presence of advance selling (i.e., selling a service at an early date for future consumption). In general, when an online intermediary is used, the competition effect dominates the reach effect and leads to a falling price trend. Interestingly, we find that the negative effect of increased competition on profits, due to intermediary usage, can be reversed by committing to self‐imposed participation limits (i.e., selling only a predetermined amount of services through the online intermediary). This ensures that the service provider is better off selling through both its own site and the online intermediary, rather than selling exclusively using either channel.
Correlation of urine and plasma cytokine levels among reproductive‐aged women
Authors: Nobles Carrie , Bertone‐Johnson Elizabeth R. , Ronnenberg Alayne G. , Faraj Joyce M. , Zagarins Sofija , Takashima‐Uebelhoer Biki B. , Whitcomb Brian W.
Published: February 2015

Background

Inflammation is implicated in many adverse health conditions, and recent interest has focused on the effects of chronic low‐grade inflammation in generally healthy populations. Cytokines measured in plasma or serum are commonly used as biomarkers of systemic levels of inflammation. Measurement of cytokines in urine may offer a simpler and less invasive alternative, although the degree to which levels of cytokines correlate in plasma and urine among healthy individuals is unknown.

Materials and methods

We assessed the correlation of blood and urine levels of 13 cytokines, including interleukin (IL)‐1b, IL‐2, IL‐4, IL‐5, IL‐6, IL‐7, IL‐8, IL‐10, IL‐12(p70) and IL‐13, granulocyte macrophage colony‐stimulating factor, interferon gamma and tumour necrosis factor alpha in 61 healthy women aged 18–30. Cytokine concentrations were considered with and without correction for creatinine.

Results

Plasma and urine levels of the 13 cytokines were not significantly correlated using measured urinary cytokine concentrations and after adjustment for creatinine. Correlation coefficients for log‐transformed cytokine concentrations in paired plasma and urine specimens ranged from −0·28 to 0·087.

Conclusions

These results suggest that urine has limited utility as a proxy for plasma for the measurement of inflammatory factors in a healthy population with low levels of inflammation.
Low bird diversity in the Fynbos plant diversity hotspot: Quaternary legacies in the current distributions of passerine birds
Authors: Péron Guillaume , Altwegg Res
Published: February 2015

The Fynbos Biome or Cape Floristic Region is well‐known for its plant diversity. This diversity does not seem to carry over at higher trophic levels, and in particular in birds. Here, we analyzed the passerine bird assemblages of the Fynbos Biome at the quarter degree resolution with occupancy models and citizen science data. Multivariate analysis of distribution summary metrics revealed a gradient of specialist to generalist species, in which range‐restricted, specialist species responded positively to increases in number of competing species and included ancient lineages. Wide‐ranging, generalist species exhibited stronger affinities for the arid Karoo Biomes than for the other neighboring biome (Albany Thicket) and for the other mesic biomes in South Africa. Both results are explained by the Quaternary legacy hypothesis: the combined effects of habitat filtering, isolation by distance, and limited in situ diversification, acting throughout the Quaternary, and caused by the contrasting winter‐rainfall regime of the region and the low phylogenetic diversity and original adaptations of the plant assemblages.
Evaluating an individualized lifestyle and life skills intervention to prevent antipsychotic‐induced weight gain in first‐episode psychosis
Authors: Curtis Jackie , Watkins Andrew , Rosenbaum Simon , Teasdale Scott , Kalucy Megan , Samaras Katherine , Ward Philip B.
Published: February 2015

Aim

Initiating antipsychotic medication frequently induces rapid, clinically significant weight gain. We aimed to evaluate the effectiveness of a lifestyle and life skills intervention, delivered within 4 weeks of antipsychotic medication initiation, in attenuating weight gain in youth aged 14–25 years with first‐episode psychosis (FEP).

Methods

We undertook a prospective, controlled study in two early psychosis community services. Intervention participants (n = 16) received a 12‐week individualized intervention delivered by specialist clinical staff (nurse, dietician and exercise physiologist) and youth peer wellness coaches, in addition to standard care. A comparison group was recruited from a similar service and received standard care (n = 12).

Results

The intervention group experienced significantly less weight gain at 12 weeks compared to standard care (1.8 kg, 95% CI −0.4 to 2.8 vs. 7.8 kg, 4.8–10.7, P < 0.001). Thirteen per cent (2/16) of the intervention group experienced clinically significant weight gain (greater than 7% of baseline weight), while 75% (9/12) of the standard care group experienced this level of weight gain. Similar positive effects of the intervention were observed for waist circumference.

Conclusions

A lifestyle and life skills intervention delivered as part of standard care attenuated antipsychotic‐induced weight gain in young people with FEP. The intervention was acceptable to the young people referred to the service. Such interventions may prevent the seeding of future disease risk and in the long‐term help reduce the life expectancy gap for people living with serious mental illness.
Modulation in the mirror neuron system when action prediction is not satisfied
Authors: Plata Bello Julio , Modroño Cristián , Marcano Francisco , González‐Mora José Luis
Published: February 2015

The ability to understand competitive games is closely connected to the mirror neuron system (MNS). This network is activated not only when an action is performed, but also when it is observed. Apart from allowing the understanding of actions performed by others, the MNS has been implicated in predicting subsequent actions. However, the results concerning the modulation of this network by the final outcome of these predictions are contradictory. These contradictions may be related to the use of complex experimental conditions. The aim of this research is to identify changes in the activity of the MNS when the predictions are or are not satisfied in a simple intransitive action‐based game. An event‐related functional magnetic resonance imaging study was conducted. It consisted of the observation of videos with two actors playing the well‐known rock–paper–scissors game. The participants were asked to predict the response of the second actor when the first actor performed one of the three possible actions. In some videos (congruents) the prediction was satisfied, but in the rest of the videos (incongruents) the prediction was not satisfied. When the result was shown, higher activity in the MNS was observed in the congruent videos than in the incongruent ones. Therefore, the observation of a simple manual game leads to a significant activation of the MNS, and this activity seems to be modulated by the final outcome of a prediction, and when predictions are satisfied the activity is higher.
Much Ado about Nothing? The Surprising Persistence of Nascent Entrepreneurs through Macroeconomic Crisis
Authors: Davidsson Per , Gordon Scott R.
Published: February 2015

We hypothesize that a major macroeconomic crisis triggers four alternative responses among nascent entrepreneurs: disengagement, delay, compensation, and adaptation. We also suggest that commitment and ambition (or “high potential”) moderate these responses. Our most important finding is the relative absence of behavioral crisis responses. However, crises may make high–tech founders become more likely to disengage, whereas the opposite holds for founders far into the process. Our study sheds light on the mechanisms behind aggregate effects of crises on the number and type of start–ups in an economy, and can guide future research on the effect of crises on nascent entrepreneurship.
rs2294008T, a risk allele for gastric and gallbladder cancers, suppresses the PSCA promoter by recruiting the transcription factor YY1
Authors: Saeki Norihisa , Ono Hiroe , Yanagihara Kazuyoshi , Aoyagi Kazuhiko , Sasaki Hiroki , Sakamoto Hiromi , Yoshida Teruhiko
Published: February 2015

Previous genomewide association studies identified prostate stem cell antigen (PSCA) as a gastric cancer (GC) susceptibility gene and showed an association between GC and the T allele of the single nucleotide polymorphism rs2294008 (C/T) in this gene. The protein product of this gene inhibits cell growth, and the T allele significantly suppresses the transcriptional activity of the −3.2 kb PSCA upstream region. However, the mechanism remains unknown. In this study, we conducted reporter assays using the PSCA upstream region containing the C allele and identified the region from −200 to +38 bp of the transcription initiation site of the gene as a critical region of the −3.2 kb PSCA upstream region. We found that introducing the T allele at rs2294008 generated a consensus binding sequence for the Polycomb group transcription factor Yin Yang 1 (YY1) and that disruption of the consensus sequence restored the transcriptional activity to the −3.2 kb PSCA upstream region. These findings imply that the T allele significantly suppresses PSCA expression in vivo by recruiting YY1 to its promoter, which eventually predisposes gastric epithelial cells to GC development.
Hyperferritinemia and markers of inflammation and oxidative stress in the cord blood of HIV‐exposed, uninfected (HEU) infants
Authors: Selvam A , Buhimschi IA , Makin JD , Pattinson RC , Anderson R , Forsyth BW
Published: February 2015

Objectives

The purpose of this study was to evaluate markers of iron status and inflammation/oxidative stress in maternal and cord blood (CB) of HIV‐infected and HIV‐uninfected women as potential mechanisms for poor outcomes among HIV‐exposed, uninfected (HEU) infants.

Methods

Maternal venous blood and CB specimens were obtained from 87 pregnant women (45 HIV‐infected and 42 HIV‐uninfected) enrolled at Kalafong Hospital, Pretoria, South Africa. Iron status [serum iron, ferritin and transferrin concentrations, transferrin saturation, soluble transferrin receptor (sTfR) concentration and the sTfR/log ferritin (sTfR/F) index], antenatal exposure to inflammation (CB C‐reactive protein and interleukin‐6 concentrations and haptoglobin switch‐on status) and oxidative stress [total radical trapping ability of CB plasma (TRAP) and chronic oxidative stress (soluble receptor of advanced glycation end‐products (sRAGE) concentration] were assessed in laboratory studies.

Results

There were no differences between the HIV‐infected and HIV‐uninfected groups in maternal haematological and iron indices, except that HIV‐infected mothers had decreased white blood cell counts (P = 0.048) and increased serum ferritin concentrations (P = 0.032). Ferritin levels were significantly higher in CB than in maternal blood (P < 0.001) in both groups and further elevated in the CB of HEU infants (P = 0.044). There was also an inverse relationship between CB sTfR/F index and sRAGE (r = −0.43; P = 0.003) in the HIV‐infected but not in the HIV‐uninfected group.

Conclusions

Our study showed for the first time that ferritin was significantly elevated in CB of HEU infants. The inverse relationship between sTfR/F index and sRAGE in CB suggests that chronic oxidative stress or RAGE axis activation in HIV‐infected mothers may play a role in modulating ferritin levels.
Efficacy of glycine powder air polishing in comparison with sodium bicarbonate air polishing and ultrasonic scaling – a double‐blind clinico‐histopathologic study
Authors: Simon CJ , Munivenkatappa Lakshmaiah Venkatesh P , Chickanna R
Published: February 2015

Background

Subgingival biofilm removal using glycine powder air polishing (GPAP) has antecedently been shown to be safe. The hypothesis that GPAP is efficacious during periodontal maintenance therapy and results in less gingival erosion than sodium bicarbonate air polishing (SBAP) or ultrasonic scaling was assessed.

Methods

Initial periodontal therapy was performed in each of the 22 chronic periodontitis patients having residual 5 mm probing depth in each quadrant and were randomly assigned to one of the following interventions: GPAP (test), SBAP (positive control), ultrasonic scaling (positive control) or no treatment. Clinical parameters were assessed, and gingival biopsies were taken immediately after instrumentation and sent for histological quantification.

Results

Significant improvement in plaque and gingival index scores were noted in glycine powder air‐polishing and ultrasonic group. GPAP resulted in minor erosion of the gingival epithelium (score 1 & 2), whereas positive control specimens displayed moderate to severe erosions (score 3 & 4). Difference between GPAP and positive control was significant. (P < 0.05).

Conclusion

GPAP results in clinically significant improvement in plaque and gingival index scores and histologically causes less gingival erosion than SBAP or ultrasonic instrumentation, further supporting the safety of this debridement technique in periodontal maintenance therapy.
Taking the guesswork out of supplying multicompartment compliance aids: do pharmacists require further guidance on medication stability?
Authors: Gilmartin Julia Fiona-Maree , Raimi-Abraham Bahijja Tolulope , Jani Yogini , Smith Felicity , Orlu-Gul Mine
Published: February 2015

Objective

The purpose of this article is to identify information that is currently available to pharmacists concerning the stability of medications repackaged into multicompartment compliance aids (MCAs). This article explores the potential risks associated with repackaging medications into MCAs for pharmacists who supply and patients who use them.

Key findings

There is a paucity of information currently available to pharmacists concerning the stability of medications repackaged into MCAs as it is not routinely provided by pharmaceutical manufacturers. However, some studies have identified the potential for adverse effects on safety, bioavailability and stability that may have a clinical impact. There are also professional and legal implications of removing medications from their original packaging for storage in MCAs.

Conclusion

There is a growing need for further information concerning the stability of medications repackaged into MCAs to guide pharmacists who are supplying these compliance aids to primary and secondary care. Pharmaceutical manufacturers and researchers should be advised to conduct stability testing in MCAs for orally administered medications. This information should be readily available, and pharmacists should be made aware of it via their pharmaceutical bodies. As a result, decisions regarding MCA preparation can be more informed, and pharmacist and patient risks associated with repackaging potentially unstable medications can be minimised.
A concept analysis of patient‐centred nursing in the intensive care unit
Authors: Jakimowicz Samantha , Perry Lin
Published: February 2015

Aim

To report an analysis of the concept of patient‐centred nursing in the context of intensive care.

Background

Clarification of patient‐centred nursing in the intensive care unit is important because consensus definition of this concept is lacking. The severely compromised physiological state of these people and the sequelae of this differentiate patient‐centred nursing in intensive care from that occurring in other hospital settings. While the broad concept has been analysed, it has not been examined in the context of intensive care.

Design

Concept analysis.

Data sources

CINAHL, PsycINFO, Medline and PubMed databases (2000–2014) were searched. Peer‐reviewed papers were identified and reference lists of relevant articles searched.

Methods

Walker and Avant's eight‐stage approach was used.

Results

Patient‐centred nursing in the intensive care unit incorporates antecedents of a physiologically compromised patient requiring biomedical intervention, a professional and competent nurse and organizational support. The concept's defining attributes entail maintenance of patient identity by a compassionate and professional nurse exercising biomedical expertise. Consequences include patient satisfaction, positive patient experience, nurse job satisfaction and better nurse workforce retention.

Conclusion

Patient‐centred nursing in intensive care is differentiated from other healthcare areas by the particular characteristics of critically ill patients, the critical care environment and the challenging bio‐psycho‐social demands made on intensive care nurses. Effective patient‐centred nursing in this environment promotes beneficial outcomes for patients, nurses and healthcare service. Decision‐makers and policymakers should support critical care nurses in this challenging role, to maintain delivery of patient‐centred nursing and grow an effective nursing workforce.
Age, Atrial Fibrillation, and Structural Heart Disease Are the Main Determinants of Left Atrial Fibrosis Detected by Delayed‐Enhanced Magnetic Resonance Imaging in a General Cardiology Population
Authors: COCHET HUBERT , MOURIES AMAURY , NIVET HUBERT , SACHER FREDERIC , DERVAL NICOLAS , DENIS ARNAUD , MERLE MATHILDE , RELAN JATIN , HOCINI MÉLÈZE , HAÏSSAGUERRE MICHEL , LAURENT FRANÇOIS , MONTAUDON MICHEL , JAÏS PIERRE
Published: February 2015

Atrial Fibrosis on MRI in Patients

Introduction

We studied the extent and distribution of left atrial (LA) fibrosis on delayed‐enhanced (DE) MRI in a general cardiology population.

Methods and Results

One hundred ninety consecutive patients referred for cardiac MRI underwent DE imaging using a free breathing method. The population comprised 60 AF patients and 130 patients without AF, including 75 with structural heart disease (SHD). DE was quantified using histogram thresholding, expressed in % of the wall. Regression analysis was performed to identify predictors of DE. Additionally, DE was registered on a template to study its distribution in subpopulations. In the total population, age, AF, and SHD were independently associated with DE. DE was increasingly observed from 11.1 ± 4.7% in patients with no SHD nor AF, 18.8 ± 7.8% in SHD and no AF history, 22.9 ± 7.8% in paroxysmal AF, to 27.8 ± 7.7% in persistent AF. Among non‐AF patients, age and SHD were independently associated with DE. Among AF patients, female gender and AF persistence were independently associated with DE. DE was variably distributed but more frequently detected in the posterior wall.

Conclusion

Age, history of AF, and SHD are the most powerful predictors of atrial fibrosis, as detected by MRI, in a general cardiology population. Atrial fibrosis predominates in the posterior LA wall.
Blood Pressure and Atrial Fibrillation: A Combined AF‐CHF and AFFIRM Analysis
Authors: TREMBLAY‐GRAVEL MAXIME , WHITE MICHEL , ROY DENIS , LEDUC HUGUES , WYSE D. GEORGE , CADRIN‐TOURIGNY JULIA , SHOHOUDI AZADEH , MACLE LAURENT , DUBUC MARC , ANDRADE JASON , RIVARD LENA , GUERRA PETER G. , THIBAULT BERNARD , TALAJIC MARIO , KHAIRY PAUL
Published: February 2015

Blood Pressure and Atrial Fibrillation

Background

Hypertension is an established risk factor for new‐onset atrial fibrillation (AF). However, the relationship between blood pressure and recurrent AF is less well understood.

Methods and Results

A pooled analysis of patient‐level data from AFFIRM and AF‐CHF trials was conducted on all 2,715 patients with paroxysmal or persistent AF, 68 ± 8 years, 66% male, randomized to rhythm control and followed for 40.6 ± 16.5 months. We assessed the impact of a baseline systolic blood pressure (SBP; <120 mmHg [N = 1,008], 120–140 mmHg [N = 930], >140 mmHg [N = 777]) on recurrent AF and proportion of time spent in AF. In patients with LVEF >40% (N = 1,719), SBP was not associated with recurrent AF in multivariate regression analyses (P = 0.752). In contrast, in patients with LVEF ≤40% (N = 996), the AF recurrence rate was higher in those with an SBP >140 mmHg compared to 120–140 mmHg (hazard ratio 1.47; 95% CI [1.12–1.93], P = 0.005). The rate of recurrent AF was similar in patients with SBP <120 mmHg compared to 120–140 mmHg (hazard ratio 1.15; 95% CI [0.92–1.43], P = 0.225). Consistently, the proportion of time spent in AF was not influenced by SBP in patients with LVEF >40% (P = 0.645). However, in patients with LVEF ≤40%, the adjusted mean proportion of time spent in AF was 17.2% if SBP was <120 mmHg, 15.4% for SBP 120–140 mmHg, and 24.0% for SBP >140 mmHg (P = 0.025).

Conclusion

Systolic blood pressure is an important determinant of recurrent AF and overall AF burden in patients with left ventricular dysfunction (LVEF≤40%) but not in those with preserved ventricular function.
Minimally Invasive Single Implant Treatment (M.I.S.I.T.) based on ridge preservation and contour augmentation in patients with a high aesthetic risk profile: one‐year results
Authors: Cosyn Jan , Pollaris Louis , Van der Linden Filip , De Bruyn Hugo
Published: February 2015

Aim

To evaluate the 1‐year outcome of Minimally Invasive Single Implant Treatment (M.I.S.I.T.) based on ridge preservation and contour augmentation in patients with a high aesthetic risk profile.

Materials and Methods

Periodontally healthy non‐smoking patients with a failing tooth in the anterior maxilla (15–25) were selected. All were in need of a single implant and demonstrated high risk for aesthetic complications given mid‐facial recession at the failing tooth and/or a buccal bone dehiscence and/or a thin‐scalloped gingival biotype. Patients without mid‐facial recession (NRG) received flapless tooth extraction and ridge preservation using a collagen‐enriched bovine‐derived xenograft, flapless installation of a bone condensing implant with variable‐thread design (4–6 months later), a provisional screw‐retained crown and connective tissue graft (CTG) inserted in the buccal mucosa (3 months later) and a permanent crown (3 months later). Patients with mid‐facial recession (RG) were treated similarly, yet they received a CTG at the time of ridge preservation. All patients were treated by an experienced periodontist using a microsurgical approach. Primary outcome variables included papillary and mid‐facial recession. Clinical parameters, pink (PES) and white aesthetic score (WES) were considered secondary outcome variables.

Results

Fifty patients (25 females, 25 males; mean age 39, range 19–81; 42 in NRG and 8 in RG) met the selection criteria and consented to the treatment. Forty‐seven could be examined at 12 months and all implants survived. Mean bone loss amounted to 0.48 mm (range 0.00–1.80) at 12 months. Papillary recession was minimal in both groups at 12 months (mean ≤ 0.3 mm), as was mid‐facial recession in the NRG (mean 0.1 mm). Twelve patients in the NRG even demonstrated coronal migration of the mucosal margin following CTG and needed adaptation of the provisional crown to induce soft tissue retraction. Due to CTG at the time of ridge preservation in the RG, mid‐facial soft tissue gain amounted to 0.9 mm at 12 months, hereby eliminating 2/3rd of the initial recession. PES and WES were favourable pointing to 10.9/14 and 8.2/10 respectively.

Conclusion

This short‐term prospective study offers a proof of principle of M.I.S.I.T. in patients with a high aesthetic risk profile.