bluuebunny/crossref_metadata_2025 huggingface dataset:
The complex task of measuring intestinal permeability in basic and clinical science
Authors: Galipeau H. J. , Verdu E. F.
Published: June 2016

Intestinal permeability is a key feature of intestinal barrier function. Altered intestinal permeability is described in many chronic diseases and may be a risk factor for disease development and a target for emerging therapeutics. Thus, reliable and sensitive methods to measure intestinal permeability in both the clinical and preclinical setting are needed. There is currently a large array of tests to choose from, each with advantages and disadvantages. When possible, a combination of methods should be used. The choice of tests should be based on a deep understanding of intestinal barrier physiology and the recognition of their limitations. This mini‐review will highlight the advantages and limitations associated with intestinal permeability tests and will identify current problems in the field and how they can be addressed in the future.
Early Implantation of Primary Prevention Implantable Cardioverter Defibrillators for Patients with Newly Diagnosed Severe Nonischemic Cardiomyopathy
Authors: VOSKOBOINIK ALEKSANDR , BLOOM JASON , TAYLOR ANDREW , MARIANI JUSTIN
Published: June 2016

Background

Primary prevention implantable cardioverter defibrillators (ICDs) reduce mortality in selected patients with severe systolic dysfunction. Current guidelines suggest a 3‐ to 6‐month waiting period before implantation.

Methods

We retrospectively studied 29 consecutive patients with newly diagnosed nonischemic cardiomyopathy (NICM) who underwent primary prevention ICD implantation within 6 months of diagnosis between January 2008 and April 2014. Cardiac MRI (CMR) evaluated left ventricular ejection fraction (LVEF) and regional fibrosis preimplant. The primary end point was “failure to qualify for an ICD at 12 months postimplant,” either due to LVEF ≥ 35% or deterioration necessitating mechanical support or transplantation, without appropriate ICD therapy. Secondary end points were appropriate and inappropriate ICD therapy.

Results

Baseline mean age was 44.2 ± 14.8 years and median LVEF 16.4%. Median time from diagnosis to implant was 32 days. At 12 months, 17 patients (58.6%) no longer qualified for an ICD, mainly due to LVEF improvement. At follow‐up (mean 32.0 ± 20.6 months), three patients received appropriate therapy (one for ventricular fibrillation). All three had CMR late gadolinium enhancement (LGE) and nonsustained ventricular tachycardia (NSVT) preimplant. Cardiac resynchronization at implant predicted LVEF improvement.

Conclusion

Early appropriate therapy, particularly for ventricular fibrillation, is infrequent for patients with very severe NICM who have ICDs implanted within 6 months of diagnosis. The majority of these patients would not qualify for an ICD at 12 months postinsertion. In the absence of a multimodality risk score, early ICD insertion should only be considered in selected cases (presence of LGE and NSVT). Wearable cardioverter defibrillators may have a role as a bridge to ICD decision.
The drought response of potato reference cultivars with contrasting tolerance
Authors: Sprenger Heike , Kurowsky Christina , Horn Renate , Erban Alexander , Seddig Sylvia , Rudack Katharina , Fischer Axel , Walther Dirk , Zuther Ellen , Köhl Karin , Hincha Dirk K. , Kopka Joachim
Published: June 2016

Systems responses to drought stress of four potato reference cultivars with differential drought tolerance (Solanum tuberosumL.) were investigated by metabolome profiling and RNA sequencing. Systems analysis was based on independent field and greenhouse trials. Robust differential drought responses across all cultivars under both conditions comprised changes of proline, raffinose, galactinol, arabitol, arabinonic acid, chlorogenic acid and 102 transcript levels. The encoded genes contained a high proportion of heat shock proteins and proteins with signalling or regulatory functions, for example, a homolog of abscisic acid receptor PYL4. Constitutive differences of the tolerant compared with the sensitive cultivars included arbutin, octopamine, ribitol and 248 transcripts. The gene products of many of these transcripts were pathogen response related, such as receptor kinases, or regulatory proteins, for example, a homolog of theArabidopsisFOUR LIPS MYB‐regulator of stomatal cell proliferation. Functional enrichment analyses imply heat stress as a major acclimation component of potato leaves to long‐term drought stress. Enhanced heat stress during drought can be caused by loss of transpiration cooling. This effect and CO2limitation are the main consequences of drought‐induced or abscisic acid‐induced stomatal closure. Constitutive differences in metabolite and transcript levels between tolerant and sensitive cultivars indicate interactions of drought tolerance and pathogen resistance in potato.
Drought‐induced xylem pit membrane damage in aspen and balsam poplar
Authors: Hillabrand Rachel M. , Hacke Uwe G. , Lieffers Victor J.
Published: June 2016

Drought induces an increase in a tree's vulnerability to a loss of its hydraulic conductivity in many tree species, including two common in western Canada, trembling aspen (Populus tremuloides) and balsam poplar (Populus balsamifera). Termed ‘cavitation fatigue’ or ‘air‐seeding fatigue’, the mechanism of this phenomenon is not well understood, but hypothesized to be a result of damage to xylem pit membranes. To examine the validity of this hypothesis, the effect of drought on the porosity of pit membranes in aspen and balsam poplar was investigated. Controlled drought and bench dehydration treatments were used to induce fatigue and scanning electron microscopy (SEM) was used to image pit membranes for relative porosity evaluations from air‐dried samples after ethanol dehydration. A significant increase in the diameter of the largest pore was found in the drought and dehydration treatments of aspen, while an increase in the percentage of porous pit membranes was found in the dehydration treatments of both species. Additionally, the location of the largest pore per pit membrane was observed to tend toward the periphery of the membrane.
The Women's International League for Peace and Freedom and the Challenges of Intersectionality Praxis
Authors: Woehrle Lynne M. , Coy Patrick G. , Maney Gregory M.
Published: June 2016

Black feminist scholars argued decades ago for working for peace and justice from the intersections of people's multiple identities. A body of scholarship focused on intersectionality subsequently arose since doing so is thought to have broader appeal and be more efficacious. However, the degrees to which social movements actually use intersectional discourses is undetermined. Quantitative and qualitative data analyses from a longitudinal study (1990–2005) of peace movement organizations (PMOs) reveals surprisingly low levels of use. A subset of data from the Women's International League for Peace and Freedom (WILPF), a group thought to be highly likely to use intersectional discourses, was used to further explore the disconnect between public statements and organizational sensibility. Findings show that while WILPF historically did not use intersectionality discourses, usage significantly increased in their recent civil society consultation process regarding women and security issues. The findings suggest that an ideological commitment to inclusion alone was not sufficient to produce intersectional discourses; a combination of an external mediated political opportunity and an internal demographic threat to the movement's longevity were necessary before discursive change occurred.
From Social Movement to Ritualized Conference Spaces: The Evolution of Peace Research Professionalism in Germany
Authors: Denskus Tobias
Published: June 2016

The article employs anthropological ritual theory and the concepts of symbolism and liminality to provide a theoretical framework for analyzing ethnographic insights into the academic peace research community in Germany. Using secondary sources for a broader historical outline, I analyze the evolution of peace research discourses in Germany from the beginnings as a new social movement to a contemporary professionalized policy space in which knowledge discourses are (re)produced. Academic conferences and the routines around presenting theoretical papers have become institutionalized by the ritual dynamics of a small group of organizers and venues, fostering “indoor rituals” that represent transformations of the activities of the “outdoor” peace movement that was active in postwar Germany for many decades.
Beyond Paralysis: The Reframing of Israeli Peace Activism Since the Second Intifada
Authors: Fleischmann Leonie
Published: June 2016

This article looks at the transformation of Israeli peace activism since the Second Intifada. It does this by focusing on the collective action frames of Israeli peace activism, using framing processes from social movement theory to identify and explain shifts in the ideas and beliefs surrounding the Israeli–Palestinian conflict. It argues that, contrary to conventional wisdom, Israeli peace activism did not reach a “dead‐end point” following the Second Intifada but instead took on a new trajectory. While the moderate component of Israeli peace activism may have become paralyzed, unable and unwilling to respond to the prevailing realities, the radical and alternative components continued to act, transforming their ideas and presenting new ways to challenge the conflict. This article suggests that although these groups have not had an impact in the policy arena, their influence comes in the realm of norm entrepreneurship and therefore their efforts should not be overlooked.
Surface Arginine Saturation Effect on Unfolding Reaction of Firefly Luciferase: A Thermodynamic and Kinetic Perspective
Authors: Solgi Zahra , Khalifeh Khosrow , Hosseinkhani Saman , Ranjbar Bijan
Published: June 2016

Replacement of some hydrophobic solvent‐exposed residues in Lampyris turkestanicus luciferase with arginine increases thermostability of this enzyme. Herein, thermodynamic and kinetic of unfolding reactions of wild type (WT), E354R/356R, E354R/356R‐I232R and E354R/356R‐Q35R/L182R/I232R variants, has been investigated. Fluorescence and Far‐UV circular dichroism measurements using urea as a chemical denaturant indicated that the value of for all variants is greater than that of WT enzyme. Analysis of m‐values, as a measure of difference in the solvent accessible surface area between the native and denatured states of protein, revealed that higher stability of mutants is related to their higher degree of compactness in the folded state. Results of unfolding kinetic experiments showed that all variants have three‐exponential behavior in which they unfolded with three rate constants and corresponding amplitudes. Increasing the rate constants of fast unfolding phase in mutants relative to WT protein may be attributed to more compactness and more kinetic sensitivity of their folded state to urea. However, more population of WT protein was unfolded from fast unfolding phase. Results of this investigation highlight kinetic stability of luciferase via a slow rate of unfolding.
The Links Among Contested Knowledge, Beliefs, and Learning in European Climate Governance: From Consensus to Conflict in Reforming Biofuels Policy
Authors: Rietig Katharina
Published: June 2016

The close link between scientific knowledge, learning, and beliefs is particularly relevant in environmental policymaking and the interaction of environmental with economic development‐focused policies. This article contributes to a more refined understanding of the links among scientific knowledge, belief changes, and the move from a collaborative to an adversarial policy subsystem within the Advocacy Coalition Framework. It analyzes the process of drafting and negotiating the biofuels aspects of the European Renewable Energy Directive, which was dominated by political disagreements between two advocacy coalitions. Their initial agreement on increasing the share of renewable energies in transport turned into conflict after new scientific evidence emerged on the negative environmental and climate change impacts of crop‐based biofuels. The environmental coalition changed its empirical policy beliefs to reflect normative policy beliefs on environmental protection. This change in empirical policy beliefs uncovered a pre‐existing conflict with the normative policy beliefs of the economic development‐focused coalition. As a consequence, the collaborative policy subsystem shifted to an adversarial policy subsystem.
Bridging the Gap between Evidence and Policy Makers: A Case Study of the Pew‐MacArthur Results First Initiative
Authors: VanLandingham Gary , Silloway Torey
Published: June 2016

Developing ways to bridge the long‐recognized gap between researchers and policy makers is increasingly important in this age of constrained public resources. As noted by recent scholarship, progress toward evidence‐informed policy making requires both improving the supply of research that is reliable, timely, and relevant to the policy process and promoting demand and support for this information among decision makers. This article presents a case study of the Pew‐MacArthur Results First Initiative, which is working in a growing number of state and local governments to build systems that bring rigorous evidence on “what works” into their budget processes and to support its use in resource allocation decisions. The initiative's experience to date is promising, although creating lasting and dynamic evidence‐based policy‐making systems requires a long‐term commitment by both researchers and policy makers.
Beta‐lactam plus macrolides or beta‐lactam alone for community‐acquired pneumonia: A systematic review and meta‐analysis
Authors: Horita Nobuyuki , Otsuka Tatsuya , Haranaga Shusaku , Namkoong Ho , Miki Makoto , Miyashita Naoyuki , Higa Futoshi , Takahashi Hiroshi , Yoshida Masahiro , Kohno Shigeru , Kaneko Takeshi
Published: June 2016

It is unclear whether in the treatment of community‐acquired pneumonia (CAP) beta‐lactam plus macrolide antibiotics lead to better survival than beta‐lactam alone. We report a systematic review and meta‐analysis. Trials and observational studies published in English were included, if they provided sufficient data on odds ratio for all‐cause mortality for a beta‐lactam plus macrolide regimen compared with beta‐lactam alone. Two investigators independently searched for eligible articles. Of 514 articles screened, 14 were included: two open‐label randomized controlled trials (RCTs) comprising 1975 patients, one non‐RCT interventional study comprising 1011 patients and 11 observational studies comprising 33 332 patients. Random‐model meta‐analysis yielded an odds ratio for all‐cause death for beta‐lactam plus macrolide compared with beta‐lactam alone of 0.80 (95% CI 0.69–0.92, P = 0.002) with substantial heterogeneity (I2 = 59%, P for heterogeneity = 0.002). Severity‐based subgroup analysis and meta‐regression revealed that adding macrolide had a favourable effect on mortality only for severe CAP. Of the two RCTs, one suggested that macrolide plus beta‐lactam lead to better outcome compared with beta‐lactam alone, while the other did not. Subgrouping based on study design, that is, RCT versus non‐RCT, which was almost identical to subgrouping based on severity, revealed substantial inter‐subgroup heterogeneity. Compared with beta‐lactam alone, beta‐lactam plus macrolide may decrease all‐cause death only for severe CAP. However, this conclusion is tentative because this was based mainly on observational studies.
Prediction of Settlement Delay in Critical Illness Insurance Claims by Using the Generalized Beta of the Second Kind Distribution
Authors: Dodd Erengul , Streftaris George
Published: June 2016

We analyse the delay between diagnosis of illness and claim settlement in critical illness insurance by using generalized linear-type models under a generalized beta of the second kind family of distributions. A Bayesian approach is employed which allows us to incorporate parameter and model uncertainty and also to impute missing data in a natural manner. We propose methodology involving a latent likelihood ratio test to compare missing data models and a version of posterior predictive p-values to assess different models. Bayesian variable selection is also performed, supporting a small number of models with small Bayes factors, and therefore we base our predictions on model averaging instead of on a best-fitting model.
Factivity and Complement‐Types
Authors: Schueler David
Published: June 2016

In this paper I argue that the presuppositions associated with factive predicates are triggered not by the predicates themselves, but by their complement clauses. Evidence is brought to bear from different clause types in English, some of which, such as some gerunds and nominalizations, cause the presuppositions to disappear in certain uses of the implicit conditional, or simple subjunctive, construction. I survey the attempt to analyze these facts by assuming that factive predicates trigger presuppositions, that their complement clauses do, and that both do, and find that the thesis that solely the complement clauses are responsible for the presuppositions achieves the maximum explanatory power. This hypothesis has further implications for the nature of presuppositions in general.
Identification of a novel frequent RHCE*ce308T variant allele in Chinese D– individuals, resulting in a C+c– phenotype
Authors: Stegmann Tamara C. , Ji Yanli , Bijman Renate , Wang Zhen , Wen Jizhi , Wei Ling , Veldhuisen Barbera , Haer‐Wigman Lonneke , Lighthart Peter , Lodén‐van Straaten Martin , Luo Guangping , van der Schoot C. Ellen
Published: June 2016

BACKGROUND

The RHCE allele is highly polymorphic; more than 60 variants have been described leading to diminished expression of C, c, E, and e antigens. Not much is known about the prevalence of RHCE variants in the Chinese population. Individuals carrying a variant are at risk to develop alloantibodies in response to mismatched pregnancy or transfusion. In this study, phenotyping and genotyping of the RHCE allele in Chinese donors revealed a new clinically relevant mutation.

STUDY DESIGN AND METHODS

Blood samples from 200 D– and 200 D+ Chinese donors were analyzed by the RH multiplex ligation–dependent probe amplification (MLPA) assay and compared to serologically typed RhCE phenotypes, when available. All exons of the RHCE gene were sequenced in samples with aberrant genotyping results. The phenotype of the new variant RHCE allele was tested by transducing cultured human erythroblasts.

RESULTS

Aberrant copy numbers for Exon 2 of the RHCE gene were discovered by MLPA in six D– donors (6/200), but not in D+ donors (0/200). Sequencing of the RHCE gene in these six donors identified a new variant RHCE*ce308C>T (p.103Pro>Leu) allele with an allele frequency of 0.015 within the D– individuals in this study. This variant was not detected in D+ individuals showing linkage with the D– haplotype. Serologically weak C expression and loss of c expression was demonstrated on donor red blood cells. In vitro transfection studies of the RHCE*ce308T variant in cDe/ce and CDe/CDe erythroblasts confirmed that the variant is associated with anti‐C reactivity while abolishing c expression.

CONCLUSION

Genotyping of individuals carrying this variant by standard RHCE genotyping might falsely predict a C– phenotype or a c+ phenotype. This new variant should be taken into account in RHCE genotyping assays designed for the Chinese population.
Editing of the Bacillus subtilis Genome by the CRISPR-Cas9 System
Authors: Altenbuchner Josef
Published: June 2016

The clustered regularly interspaced short palindromic repeat (CRISPR)-associated (Cas) systems are adaptive immune systems of bacteria. A type II CRISPR-Cas9 system from
Streptococcus pyogenes
has recently been developed into a genome engineering tool for prokaryotes and eukaryotes. Here, we present a single-plasmid system which allows efficient genome editing of
Bacillus subtilis
. The plasmid pJOE8999 is a shuttle vector that has a pUC minimal origin of replication for
Escherichia coli
, the temperature-sensitive replication origin of plasmid pE194
ts
for
B. subtilis
, and a kanamycin resistance gene working in both organisms. For genome editing, it carries the
cas9
gene under the control of the
B. subtilis
mannose-inducible promoter P

manP

and a single guide RNA (sgRNA)-encoding sequence transcribed via a strong promoter. This sgRNA guides the Cas9 nuclease to its target. The 20-nucleotide spacer sequence at the 5′ end of the sgRNA sequence, responsible for target specificity, is located between BsaI sites. Thus, the target specificity is altered by changing the spacer sequences via oligonucleotides fitted between the BsaI sites. Cas9 in complex with the sgRNA induces double-strand breaks (DSBs) at its target site. Repair of the DSBs and the required modification of the genome are achieved by adding homology templates, usually two PCR fragments obtained from both sides of the target sequence. Two adjacent SfiI sites enable the ordered integration of these homology templates into the vector. The function of the CRISPR-Cas9 vector was demonstrated by introducing two large deletions in the
B. subtilis
chromosome and by repair of the
trpC2
mutation of
B. subtilis
168.

IMPORTANCE
In prokaryotes, most methods used for scarless genome engineering are based on selection-counterselection systems. The disadvantages are often the lack of a suitable counterselection marker, the toxicity of the compounds needed for counterselection, and the requirement of certain mutations in the target strain. CRISPR-Cas systems were recently developed as important tools for genome editing. The single-plasmid system constructed for the genome editing of
B. subtilis
overcomes the problems of counterselection methods. It allows deletions and introduction of point mutations. It is easy to handle and very efficient, and it may be adapted for use in other firmicutes.
Whole-Genome Shotgun Sequencing and Annotation of Mycobacterium tuberculosis MTBR1/09 Isolated from a Sputum Sample in Malaysia
Authors: Issa Rahizan , Seradja Valentinus H. , Abdullah Mohd Khairul Hafizi , Abdul Hatijah
Published: June 2016

This is a report of an annotated genome sequence of
Mycobacterium tuberculosis
MTBR1/09. The organism was isolated from a sputum sample from a male patient in Malaysia.
Annotated Whole-Genome Shotgun Sequence of Mycobacterium tuberculosis MTBR2/09 Isolated from a Sputum Sample in Malaysia
Authors: Issa Rahizan , Seradja Valentinus H. , Abdullah Mohd Khairul Hafizi , Abdul Hatijah
Published: June 2016

Mycobacterium tuberculosis
MTBR2/09 was isolated from a sputum sample from a male patient in Malaysia. This is a report of an annotated genome sequence of
M. tuberculosis
MTBR2/09.
Annotated Sequence of Mycobacterium tuberculosis MTBR3/09 Isolated from a Sputum Sample in Malaysia
Authors: Issa Rahizan , Seradja Valentinus H. , Abdullah Mohd Khairul Hafizi , Abdul Hatijah
Published: June 2016

This is a report of the annotated genome sequence of
Mycobacterium tuberculosis
MTBR3/09. The organism was isolated from a sputum sample in Malaysia.
Genome Sequence of
Vaccinia virus
Strain Lister-Butantan, a Lister Vaccine Variant Used during a Smallpox Eradication Campaign in Brazil
Authors: Assis Felipe , Trindade Giliane , Drumond Betânia , Frace Mike , Sammons Scott , Emerson Ginny , Li Yu , Carroll Darin , Batra Dhwani , Abrahão Jonatas , Kroon Erna
Published: June 2016

Here, we report the 187.8-kb genome sequence of
Vaccinia virus
Lister-Butantan, which was used in Brazil during the WHO smallpox eradication campaign. Its genome showed an average similarity of 98.18% with the original Lister isolate, highlighting the low divergence among related
Vaccinia virus
vaccine strains, even after several passages in animals and cell culture.
Complete Genome Sequence of Dyella thiooxydans ATSB10, a Thiosulfate-Oxidizing Bacterium Isolated from Sunflower Fields in South Korea
Authors: Hwangbo Kyeong , Um Yurry , Chung Hee , Yoo Jemin , Kim Ki Yoon , Madhaiyan Munusamy , Sa Tong Min , Lee Yi
Published: June 2016

Dyella thiooxydans
ATSB10 (KACC 12756
T
= LMG 24673
T
) is a thiosulfate-oxidizing bacterium isolated from rhizosphere soils of sunflower plants. In this study, we completely sequenced the genome of
D. thiooxydans
ATSB10 and identified the genes involved in thiosulfate oxidation and the metabolism of aromatic intermediates.
What are the cost savings associated with providing access to specialist care through the Champlain BASE eConsult service? A costing evaluation
Authors: Liddy Clare , Drosinis Paul , Deri Armstrong Catherine , McKellips Fanny , Afkham Amir , Keely Erin
Published: June 2016

Objective

This study estimates the costs and potential savings associated with all eConsult cases completed between 1 April 2014 and 31 March 2015.

Design

Costing evaluation from the societal perspective estimating the costs and potential savings associated with all eConsults completed during the study period.

Setting

Champlain health region in Eastern Ontario, Canada.

Population

Primary care providers and specialists registered to use the eConsult service.

Main outcome measures

Costs included (1) delivery costs; (2) specialist remuneration; (3) costs associated with traditional (face-to-face) referrals initiated as a result of eConsult. Potential savings included (1) costs of traditional referrals avoided; (2) indirect patient savings through avoided travel and lost wages/productivity. Net potential societal cost savings were estimated by subtracting total costs from total potential savings.

Results

A total of 3487 eConsults were completed during the study period. In 40% of eConsults, a face-to-face specialist visit was originally contemplated but avoided as result of eConsult. In 3% of eConsults, a face-to-face specialist visit was not originally contemplated but was prompted as a result of the eConsult. From the societal perspective, total costs were estimated at $207 787 and total potential savings were $246 516. eConsult led to a net societal saving of $38 729 or $11 per eConsult.

Conclusions

Our findings demonstrate potential cost savings from the societal perspective, as patients avoided the travel costs and lost wages/productivity associated with face-to-face specialist visits. Greater savings are expected once we account for other costs such as avoided tests and visits and potential improved health outcomes associated with shorter wait times. Our findings are valuable for healthcare delivery decision-makers as they seek solutions to improve care in a patient-centred and efficient manner.
Patients’ experiences of deep brain stimulation for Parkinson's disease: a qualitative systematic review and synthesis
Authors: Mathers J , Rick C , Jenkinson C , Garside R , Pall H , Mitchell R , Bayliss S , Jones L L
Published: June 2016

Objective

To review and synthesise qualitative research studies that have explored patients’ experience of deep brain stimulation (DBS) in advanced Parkinson's disease (PD).

Design

Systematic review and meta-synthesis of 7 original papers, using metaethnography.

Setting

Studies conducted in Denmark, France and Sweden.

Participants

116 patients who had undergone DBS and 9 spouses of patients.

Results

Prior to surgery, the experience of advancing PD is one of considerable loss and a feeling of loss of control. There are significant hopes for what DBS can bring. Following surgery, a sense of euphoria is described by many, although this does not persist and there is a need for significant transitions following this. We suggest that normality as a concept is core to the experience of DBS and that a sense of control may be a key condition for normality. Experience of DBS for patients and spouses, and of the transitions that they must undertake, is influenced by their hopes of what surgery will enable them to achieve, or regain (ie, a new normality).

Conclusions

There is a need for further qualitative research to understand the nature of these transitions to inform how best patients and their spouses can be supported by healthcare professionals before, during and after DBS. In assessing the outcomes of DBS and other treatments in advanced PD, we should consider how to capture holistic concepts such as normality and control. Studies that examine the outcomes of DBS require longer term follow-up.
Review of how we should define (and measure) adherence in studies examining older adults' participation in exercise classes
Authors: Hawley-Hague H , Horne M , Skelton D A , Todd C
Published: June 2016

Exercise classes provide a range of benefits to older adults, reducing risk of illness, promoting functional ability and improving well-being. However, to be effective and achieve long-term outcomes, exercise needs to be maintained. Adherence is poor and reporting of adherence differs considerably between studies.

Objective

To explore how adherence to exercise classes for older people is defined in the literature and devise a definition for pooling data on adherence in future studies.

Design

Methodological review of the approaches used to measure adherence.

Methods

A review of the literature was carried out using narrative synthesis, based on systematic searches of MEDLINE, EMBASE, CINAHL and PsychINFO. 2 investigators identified eligible studies and extracted data independently.

Results

37 papers including 34 studies were identified. 7 papers (7 studies) defined adherence as completion (retention). 30 papers (27 studies) identified adherence using attendance records. 12 papers (11 studies) based adherence on duration of exercise and 5 papers (4 studies) specified the intensity with which participants should exercise. Several studies used multiple methods.

Conclusions

There was little consensus between studies on how adherence should be defined, and even when studies used the same conceptual measure, they measured the concept using different approaches and/or had different cut-off points. Adherence related to health outcomes requires multiple measurements, for example, attendance, duration and intensity. It is important that future studies consider the outcome of the intervention when considering their definition of adherence, and we recommend a series of definitions for future use.
Characteristics of breakthrough cancer pain and its influence on quality of life in an international cohort of patients with cancer
Authors: Hjermstad Marianne Jensen , Kaasa Stein , Caraceni Augusto , Loge Jon H , Pedersen Tore , Haugen Dagny Faksvåg , Aass Nina
Published: June 2016

Objectives

Breakthrough cancer pain (BTP) represents a treatment challenge. Objectives were to examine the prevalence and characteristics of BTP in an international sample of patients with cancer, and to investigate the relationship between BTP and quality of life (QoL).

Methods

This was an observational cross-sectional multicentre study. Participating patients completed self-report questionnaires on a touch-screen laptop computer, including the Brief Pain Inventory, Alberta Breakthrough Pain Assessment Tool (ABPAT) and European Organisation for Research and Treatment of Cancer 30-item Core Quality of Life Questionnaire (EORTC QLQ-C30). The study was performed in 17 centres in 8 countries and involved 4 languages (Norwegian, Italian, German and English).

Results

Records from a convenience sample of 978 patients with advanced cancer were analysed; mean age was 62.2 years, 48.3% were women and 84.4% had metastatic disease. A total of 296 patients (30%) had no pain, defined as worst pain in the past 24 hours <1 on a 0–10 scale. Of the 682 patients with a pain score ≥1, 393 (58%) reported no BTP on the screening item, while 289 (30%) confirmed flare ups of BTP. Patients with BTP reported significantly higher pain intensity scores (<0.001) than patients without BTP; 57.1% of patients rated BTP at its worst as being severe: ≥7 on a 0–10 scale. Time from onset to peak intensity was <10 min for 42.9%, and average time to pain relief was 27.1 min. BTP was commonly triggered by medication wearing off (28%). Patients with BTP had significantly worse mean outcomes on 10 of 15 functional and symptom scales of the EORTC QLQ-C30 (<0.001). Severe pain intensity in the last week was a powerful predictor of BTP (OR 4.1) and poor QoL (OR 1.9).

Conclusions

BTP is highly prevalent with prolonged episodes despite analgaesics, and has a pervasive impact on QoL. Patients reporting high pain intensity should be carefully evaluated for BTP and efficacy of analgaesic treatment, to provide optimal pain management and improve QoL.

Trial registration number

NCT00972634; Results.
Paternal education and adverse birth outcomes in Canada
Authors: Shapiro Gabriel D , Bushnik Tracey , Sheppard Amanda J , Kramer Michael S , Kaufman Jay S , Yang Seungmi
Published: June 2016

Background

Research on predictors of adverse birth outcomes has focused on maternal characteristics. Much less is known about the role of paternal factors. Paternal education is an important socioeconomic marker that may predict birth outcomes over and above maternal socioeconomic indicators.

Methods

Using data from the 2006 Canadian Birth-Census Cohort, we estimated the associations between paternal education and preterm birth, small-for-gestational-age (SGA) birth, stillbirth and infant mortality in Canada, controlling for maternal characteristics. Binomial regression was used to estimate risk ratios and risk differences for adverse birth outcomes associated with paternal education, after controlling for maternal education, age, marital status, parity, ethnicity and nativity.

Results

A total of 131 285 singleton births were included in the present study. Comparing the lowest to the highest paternal education category, adjusted risk ratios (95% CIs) were 1.22 (1.10 to 1.35) for preterm birth, 1.13 (1.03 to 1.23) for SGA birth, 1.92 (1.28 to 2.86) for stillbirth and 1.67 (1.01 to 2.75) for infant mortality. Consistent patterns of associations were observed for absolute risk differences.

Conclusions

Our study suggests that low paternal education increases the risk of adverse birth outcomes, and especially of fetal and infant mortality, independently from maternal characteristics.
Identification of High Resource Utilizing Patients on Internal Medicine Hospital Services
Authors: Walsh David W , McVey Molly C , Gass Abigal , Zhang Jingwen , Mauldin Patrick D , Rockey Don C
Published: June 2016

In order to provide high quality, cost-efficient care, it is critical to understand drivers of the cost of care. Therefore, we sought to identify clinical variables associated with high utilization (cost) in patients admitted to medical services and to develop a robust model to identify high utilization patients. In this case–control analysis, cases were identified as the 200 most costly patients admitted to internal medicine/internal medicine subspecialty services using our institution's computerized clinical data warehouse over a 7-month time period (November 1, 2012–May 31, 2013). 400 patients admitted in the same time period were randomly selected to serve as controls. The mean cost for the highest utilization patients was $126,343, while that for randomly matched patients was $15,575. In a multivariable regression model, the following variables were associated with high utilization of resources: African American race, age 35–44, admission through the emergency department, primary service of hematology–oncology, a history of heart failure or paralysis, a diagnosis of HIV, cancer, collagen vascular diseases and/or coagulopathy, a reduced albumin, and/or an elevated creatinine. The in hospital mortality rate for high utilization patients was 19%, compared to 8% for controls (p=0.0002). A predictive model using 14 different readily available clinical variables predicted high utilization with an area under the curve of 0.85. The data suggest that high utilization patients share similar demographic and clinical features. We speculate that a predictive model using commonly known patient characteristics should be able to predict high utilization patients.
Republished: Late recurrence of a completely occluded large intracranial aneurysm treated with a Tubridge flow diverter
Authors: Zhang Xiaoxi , Lv Nan , Wang Chi , Cao Wei , Liu Jianmin , Huang Qinghai
Published: June 2016

We report a rare case of recurrence of a large intracavernous aneurysm after angiography proved complete occlusion. The aneurysm was treated by a combination of a Tubridge flow diverter and coils, and balloon angioplasty, after flow diverter devices deployment for parent vessel stenosis. Six month angiographic follow-up demonstrated complete occlusion. Unfortunately, obvious aneurysm recurrence was confirmed on 2 year angiographic follow-up. The probable mechanism of recurrence was analyzed.
Ultra-distal access of the M1 segment with the 5 Fr Navien distal access catheter in acute (anterior circulation) stroke: is it safe and efficient?
Authors: Janssen H , Killer-Oberpfalzer M , Patzig M , Buchholz G , Lutz J
Published: June 2016

Background and aim

The importance of mechanical thrombectomy in acute stroke treatment has grown over recent years. Mechanical thrombectomy comprises many different techniques. Technical improvements in the catheter material have led to the development of large-bore distal access catheters which can enter tortuous intracranial vessels. This has promising applications for endovascular stroke treatment. This study evaluated the safety and success rate of ultra-distal access of the middle cerebral artery (MCA) M1 segment with the 5 Fr Navien 58 distal access catheter in the treatment of acute stroke in combination with stent retrievers.

Methods

We retrospectively analyzed 81 patients with an acute stroke of the anterior circulation in whom ultra-distal access to the M1 segment was carried out using the Navien 58 catheter with an anchoring technique with a stent retriever for mechanical thrombectomy. Technical complications, success rates of catheter placement, success rates of thrombectomy using the modified Thrombolysis In Cerebral Infarction (mTICI) score, and the procedure times were evaluated.

Results

Ultra-distal access with the Navien 58 was successful in 75% (61/81) of cases. Recanalization success with a mTICI score of 2b and better was achieved in 83% overall (67/81), in 90% (55/61) of cases with successful ultra-distal access and in 60% (12/20) of cases without ultra-distal access. No severe adverse effects such as dissections or perforations occurred as a result of the ultra-distal catheter placement in the M1 segment. In 4% (3/81) of the cases a reversible MCA vasospasm occurred.

Conclusions

Ultra-distal placement of the Navien 58 distal access catheter into the M1 segment in acute anterior circulation stroke can be achieved consistently, is safe in practice, and results in good recanalization success rates.
Survey of the use of domperidone and the association with QTc prolongation in general practice
Authors: Ioannou Adam , Jain Alka , Kassianos George , Missouris Constantinos
Published: June 2016

Purpose of the study

Domperidone is associated with QTc prolongation, predisposing to the development of ventricular arrhythmias. In 2014, The Medicines and Healthcare Regulatory Agency (MHRA) recommended restricting its use. We assessed whether these recommendations have been implemented in a general practice.

Study design

We conducted a prospective study using the general practitioner (GP) computer database on patients who had at least one repeat prescription for domperidone in 12 months. Data were presented to the doctors and the survey was repeated 7 months later.

Results

Sixty-four patients (mean age 61.3±16.4 years) were identified who had received at least one repeat prescription of domperidone. Twenty patients were being prescribed over the recommended daily dose. Nineteen patients were coprescribed medications known to prolong the QTc interval and two CYP3A4 inhibitors. The repeat survey performed 7 months later demonstrated a 70% reduction in the number of patients prescribed domperidone to a total of 19 (three patients prescribed above the recommended dose) none of which had a history of cardiac disease or were being coprescribed drugs known to prolong the QTc interval.

Conclusions

Following the publication of the MHRA recommendations and presentation of our initial survey, there has been a significant reduction in the number of patients treated with domperidone and those coprescribed drugs known to prolong the QTc interval. We suggest that regular review of GP practice database should be performed to identify those patients prescribed domperidone and at risk of life-threatening arrhythmias and measures taken to use alternative pharmacological agents.
Nitrogen-doped carbon coated silicon derived from a facile strategy with enhanced performance for lithium storage
Authors: Zeng Lingxing , Liu Renpin , Qiu Heyuan , Chen Xi , Huang Xiaoxia , Xiong Peixun , Qian Qingrong , Chen Qinghua , Wei Mingdeng
Published: June 2016

Silicon-based nanostructures are receiving intense interest in lithium-ion batteries (LIBs) because they have ultrahigh lithium ion storage ability. However, the fast capacity fading induced by the considerably tremendous volume changes of Si anode during the Li-ion intercalation processes as well as the low intrinsic electric conductivity have hindered its deployment. Herein, we initially developed an effective technique to synthesize the core-shell Si/nitrogen-doped carbon (Si/N[Formula: see text]C), composite by combining in situ interfacial polymerization and decorate with melamine, followed by carbonization. When used as anode material for LIBs, the Si/N[Formula: see text]C composite delivered a notable reversible capacity (1084 mAh g[Formula: see text] at 0.2 A g[Formula: see text] for 50 cycles) and high rate capability (495 mAh g[Formula: see text] at 1 A g[Formula: see text]).
A pragmatic approach to abstract the excavation damaged zone around tunnels of a geological radioactive waste repository: application to the HG-A experiment in Mont Terri
Authors: Alcolea Andrés , Kuhlmann Uli , Marschall Paul , Lisjak Andrea , Grasselli Giovanni , Mahabadi Omid , de La Vaissière Rémi , Leung Helen , Shao Hua
Published: June 2016

The excavation damaged zone (EDZ) around the backfilled tunnels of a geological repository represents a possible release path for radionuclides, corrosion and degradation gases that needs to be adequately addressed by safety assessment (SA) modelling tools. The hydromechanical phenomena associated with the creation and temporal evolution of the EDZ are of high complexity, precluding detailed representations of the EDZ in conventional SA. Thus, simplified EDZ models mimicking the safety-relevant features of the EDZ are required. In this context, a heuristic modelling approach has been developed to represent the creation and evolution of the EDZ in an abstracted and simplified manner. The key features addressed are the stochastic character of the excavation-induced fracture network and the self-sealing processes associated with the re-saturation after backfilling of the tunnels. The approach has been applied to a range of generic repository settings to investigate the impact of repository depth and
in situ
conditions on the hydraulic significance of the EDZ after repository closure. The model has been benchmarked with a dataset from a self-sealing experiment at the Mont Terri underground rock laboratory (URL), demonstrating the ability of the approach to mimic the evolution of the hydraulic significance of the EDZ during the re-saturation phase.
Hyperplasia, de novo lymphangiogenesis, and lymphatic regression in mice with tissue-specific, inducible overexpression of murine VEGF-D
Authors: Lammoglia Gabriela M. , Van Zandt Carolynn E. , Galvan Daniel X. , Orozco Jose L. , Dellinger Michael T. , Rutkowski Joseph M.
Published: June 2016

Lymphatic vessels modulate tissue fluid balance and inflammation and provide a conduit for endocrine and lipid transport. The growth of new lymphatic vessels in the adult, lymphangiogenesis, is predominantly mediated through vascular endothelial growth factor receptor-3 (VEGFR-3) signaling. We took advantage of the unique binding of murine VEGF-D specifically to VEGFR-3 and generated mice capable of inducible, tissue-specific expression of murine VEGF-D under a tightly-controlled tetracycline response element (TRE) promoter to stimulate adult tissue lymphangiogenesis. With doxycycline-activated expression, TRE-VEGF-D mouse crossed to mice with tissue-specific promoters for the lung [Clara cell secretory protein-reverse tetracycline transactivator (rtTA)] developed pulmonary lymphangiectasia. In the kidney, (kidney-specific protein-rtTA × TRE-VEGF-D) mice exhibited rapid lymphatic hyperplasia on induction of VEGF-D expression. Crossed with adipocyte-specific adiponectin-rtTA mice [Adipo-VEGF-D (VD)], chronic VEGF-D overexpression was capable of inducing de novo lymphangiogenesis in white adipose tissue and a massive expansion of brown adipose tissue lymphatics. VEGF-D expression in white adipose tissue also increased macrophage infiltration and tissue fibrosis in the tissue. Expression did not, however, measurably affect peripheral fluid transport, the blood vasculature, or basal metabolic parameters. On removal of the doxycycline stimulus, VEGF-D expression returned to normal, and the expanded adipose tissue lymphatics regressed in Adipo-VD mice. The inducible TRE-VEGF-D mouse thus provides a novel murine platform to study the adult mechanisms and therapies of an array of disease- and tissue-specific models of lymphangiogenesis.
Granzyme A impairs host defense duringStreptococcus pneumoniaepneumonia
Authors: van den Boogaard Florry E. , van Gisbergen Klaas P. J. M. , Vernooy Juanita H. , Medema Jan P. , Roelofs Joris J. T. H. , van Zoelen Marieke A. D. , Endeman Henrik , Biesma Douwe H. , Boon Louis , van't Veer Cornelis , de Vos Alex F. , van der Poll Tom
Published: June 2016

Streptococcus pneumoniae is the most common causative pathogen in community-acquired pneumonia (CAP). Granzyme A (GzmA) is a serine protease produced by a variety of cell types involved in the immune response. We sought to determine the role of GzmA on the host response during pneumococcal pneumonia. GzmA was measured in bronchoalveolar lavage fluid (BALF) harvested from CAP patients from the infected and contralateral uninfected side and in lung tissue slides from CAP patients and controls. In CAP patients, GzmA levels were increased in BALF obtained from the infected lung. Human lungs showed constitutive GzmA expression by both parenchymal and nonparenchymal cells. In an experimental setting, pneumonia was induced in wild-type (WT) and GzmA-deficient (GzmA−/−) mice by intranasal inoculation of S. pneumoniae. In separate experiments, WT and GzmA−/−mice were treated with natural killer (NK) cell depleting antibodies. Upon infection with S. pneumoniae, GzmA−/−mice showed a better survival and lower bacterial counts in BALF and distant body sites compared with WT mice. Although NK cells showed strong GzmA expression, NK cell depletion did not influence bacterial loads in either WT or GzmA−/−mice. These results implicate that GzmA plays an unfavorable role in host defense during pneumococcal pneumonia by a mechanism that does not depend on NK cells.