bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of falls in patients with epilepsy enrolled in the perampanel phase III randomized double‐blind studies
Authors: Leppik Ilo E. , Yang Haichen , Williams Betsy , Zhou Sharon , Fain Randi , Patten Anna , Bibbiani Francesco , Laurenza Antonio
Published: November 2016

Objective

To analyze occurrence of falls among patients with partial seizures, with/without secondarily generalized seizures (SGS), and primary generalized tonic–clonic seizures (PGTCS) in the perampanel phase III clinical studies.

Methods

Studies 304, 305, and 306 randomized subjects (≥12 years) with drug‐resistant partial seizures (with/without SGS) to perampanel 2, 4, 8, or 12 mg or placebo for double‐blind treatment. The adverse event (AE) of falls was analyzed in the Safety Analysis Set (N = 1480). Study 332 randomized subjects aged ≥12 years with a diagnosis of PGTCS into perampanel 8 mg or placebo groups for double‐blind treatment. In a systematic review of reported falls in the study 332 Safety Analysis Set (N = 163), falls were queried to establish whether each was seizure related; subjects with falls resulting from a seizure were not included in this analysis.

Results

For studies 304/305/306, treatment‐emergent falls occurred in 5.1% perampanel‐treated versus 3.4% placebo‐treated subjects with partial seizures. Exposure‐adjusted rate for falls (falls/subject‐month of exposure) was greater for total perampanel than for placebo (0.0175 vs. 0.0093) and was dose related for those receiving perampanel. In subjects with SGS, incidence of treatment‐emergent falls was 4.3% in perampanel and 4.0% in placebo groups. Exposure‐adjusted rates were 0.0169 and 0.0097 falls per subject‐month of exposure in perampanel and placebo, respectively. For study 332, 2.5% perampanel‐treated and 1.2% placebo‐treated subjects with PGTCS had treatment‐emergent falls that were not part of a seizure. Exposure‐adjusted rates were 0.0169 and 0.0032 falls per subject‐month of exposure in perampanel and placebo, respectively.

Significance

Results of the perampanel studies suggest that patients with epilepsy should be monitored due to the common risk of falls.
Disclose or not? Effect of impression management tactics on hireability of persons with epilepsy
Authors: Sung Connie , Lin Chien‐Chun , Connor Annemarie , Chan Fong
Published: November 2016

Objective

The purpose of this study is to determine the effect of assertive impression management (IM) tactics, such as personal storytelling and self‐promotion, on job interview outcomes of people with epilepsy. Specifically, the effect of IM on interviewers’ subjective impressions and evaluation of hireability of job candidates with epilepsy were examined.

Methods

Ninety‐nine master's level graduate students majoring in business or human resources were randomly assigned to three experimental conditions to view one of three 15‐min video clips of a job applicant interviewing for a technical computer sales position. The three experimental conditions were (1) job applicant who did not disclose any disability, (2) job applicant with epilepsy who did not use IM tactics, and (3) job applicant with epilepsy who used IM tactics. After watching the job interview video portraying the experimental conditions, participants were asked to rate the job applicant in terms of general impression and hireability for the described position.

Results

The use of IM was found to have a significant effect on job interview outcomes (p < 0.01). Post hoc comparisons indicated that the average rating of business/human resources students on both general impression and hireability for the job applicant with epilepsy and IM condition were significantly higher than for the job applicant with epilepsy who did not use IM condition. Furthermore, mediation analysis revealed that general impression is a mediator for the relationship between IM and interview outcomes.

Significance

This study demonstrates that IM has a significant and positive effect on job interview outcomes for persons with epilepsy. IM can be used as a powerful strategy for empowering people with epilepsy to combat disability stigma, and offset negative perceptions of employers about the potential of this population to be productive workers.
Neighboring phosphoSer‐Pro motifs in the undefined domain of IRAK1 impart bivalent advantage for Pin1 binding
Authors: Rogals Monique J. , Greenwood Alexander I. , Kwon Jeahoo , Lu Kun Ping , Nicholson Linda K.
Published: November 2016

The peptidyl prolyl isomerase Pin1 has two domains that are considered to be its binding (WW) and catalytic (PPIase) domains, both of which interact with phosphorylated Ser/Thr‐Pro motifs. This shared specificity might influence substrate selection, as many known Pin1 substrates have multiple sequentially close phosphoSer/Thr‐Pro motifs, including the protein interleukin‐1 receptor‐associated kinase‐1 (IRAK1). The IRAK1 undefined domain (UD) contains two sets of such neighboring motifs (Ser131/Ser144 and Ser163/Ser173), suggesting possible bivalent interactions with Pin1. Using a series of NMR titrations with 15N‐labeled full‐length Pin1 (Pin1‐FL), PPIase, or WW domain and phosphopeptides representing the Ser131/Ser144 and Ser163/Ser173 regions of IRAK1‐UD, bivalent interactions were investigated. Binding studies using singly phosphorylated peptides showed that individual motifs displayed weak affinities (> 100 μm) for Pin1‐FL and each isolated domain. Analysis of dually phosphorylated peptides binding to Pin1‐FL showed that inclusion of bivalent states was necessary to fit the data. The resulting complex model and fitted parameters were applied to predict the impact of bivalent states at low micromolar concentrations, demonstrating significant affinity enhancement for both dually phosphorylated peptides (3.5 and 24 μm for peptides based on the Ser131/Ser144 and Ser163/Ser173 regions, respectively). The complementary technique biolayer interferometry confirmed the predicted affinity enhancement for a representative set of singly and dually phosphorylated Ser131/Ser144 peptides at low micromolar concentrations, validating model predictions. These studies provide novel insights regarding the complexity of interactions between Pin1 and activated IRAK1, and more broadly suggest that phosphorylation of neighboring Ser/Thr‐Pro motifs in proteins might provide competitive advantage at cellular concentrations for engaging with Pin1.
Decreasing, not increasing, leaf area will raise crop yields under global atmospheric change
Authors: Srinivasan Venkatraman , Kumar Praveen , Long Stephen P.
Published: November 2016

Without new innovations, present rates of increase in yields of food crops globally are inadequate to meet the projected rising food demand for 2050 and beyond. A prevailing response of crops to rising [CO2] is an increase in leaf area. This is especially marked in soybean, the world's fourth largest food crop in terms of seed production, and the most important vegetable protein source. Is this increase in leaf area beneficial, with respect to increasing yield, or is it detrimental? It is shown from theory and experiment using open‐air whole‐season elevation of atmospheric [CO2] that it is detrimental not only under future conditions of elevated [CO2] but also under today's [CO2]. A mechanistic biophysical and biochemical model of canopy carbon exchange and microclimate (MLCan) was parameterized for a modernUSMidwest soybean cultivar. Model simulations showed that soybean crops grown under current and elevated (550 [ppm]) [CO2] overinvest in leaves, and this is predicted to decrease productivity and seed yield 8% and 10%, respectively. This prediction was tested in replicated field trials in which a proportion of emerging leaves was removed prior to expansion, so lowering investment in leaves. The experiment was conducted under open‐air conditions for current and future elevated [CO2] within the Soybean Free Air Concentration Enrichment facility (SoyFACE) in central Illinois. This treatment resulted in a statistically significant 8% yield increase. This is the first direct proof that a modern crop cultivar produces more leaf than is optimal for yield under today's and future [CO2] and that reducing leaf area would give higher yields. Breeding or bioengineering for lower leaf area could, therefore, contribute very significantly to meeting future demand for staple food crops given that an 8% yield increase across theUSAalone would amount to 6.5 million metric tons annually.
Experimental whole‐stream warming alters community size structure
Authors: Nelson Daniel , Benstead Jonathan P. , Huryn Alexander D. , Cross Wyatt F. , Hood James M. , Johnson Philip W. , Junker James R. , Gíslason Gísli M. , Ólafsson Jón S.
Published: November 2016

How ecological communities respond to predicted increases in temperature will determine the extent to which Earth's biodiversity and ecosystem functioning can be maintained into a warmer future. Warming is predicted to alter the structure of natural communities, but robust tests of such predictions require appropriate large‐scale manipulations of intact, natural habitat that is open to dispersal processes via exchange with regional species pools. Here, we report results of a two‐year whole‐stream warming experiment that shifted invertebrate assemblage structure via unanticipated mechanisms, while still conforming to community‐level metabolic theory. While warming by 3.8 °C decreased invertebrate abundance in the experimental stream by 60% relative to a reference stream, total invertebrate biomass was unchanged. Associated shifts in invertebrate assemblage structure were driven by the arrival of new taxa and a higher proportion of large, warm‐adapted species (i.e., snails and predatory dipterans) relative to small‐bodied, cold‐adapted taxa (e.g., chironomids and oligochaetes). Experimental warming consequently shifted assemblage size spectra in ways that were unexpected, but consistent with thermal optima of taxa in the regional species pool. Higher temperatures increased community‐level energy demand, which was presumably satisfied by higher primary production after warming. Our experiment demonstrates how warming reassembles communities within the constraints of energy supply via regional exchange of species that differ in thermal physiological traits. Similar responses will likely mediate impacts of anthropogenic warming on biodiversity and ecosystem function across all ecological communities.
Contribution of above‐ and belowground bioenergy crop residues to soil carbon
Authors: Carvalho Joao L. N. , Hudiburg Tara W. , Franco Henrique C. J. , DeLucia Evan H.
Published: November 2016

GHG mitigation by bioenergy crops depends on crop type, management practices, and the input of residue carbon (C) to the soil. Perennial grasses may increase soil C compared to annual crops because of more extensive root systems, but it is less clear how much soil C is derived from above‐ vs. belowground inputs. The objective of this study was to synthesize the existing knowledge regarding soil C inputs from above‐ and belowground crop residues in regions cultivated with sugarcane, corn, and miscanthus, and to predict the impact of residue removal and tillage on soil C stocks. The literature review showed that aboveground inputs to soil C (to 1‐m depth) ranged from 70% to 81% for sugarcane and corn vs. 40% for miscanthus. Modeled aboveground C inputs (to 30 cm depth) ranged from 54% to 82% for sugarcane, but were 67% for miscanthus. Because 50% of observed miscanthus belowground biomass is below 30 cm depth, it may be necessary to increase the depth of modeled soil C dynamics to reconcile modeled belowground C inputs with measured. Modeled removal of aboveground corn residue (25–100%) resulted in C stock reduction in areas of corn–corn–soybean rotation under conventional tillage, while no‐till management lessoned this impact. In sugarcane, soil C stocks were reduced when total aboveground residue was removed at one site, while partial removal of sugarcane residue did not reduce soil C stocks in either area. This study suggests that aboveground crop residues were the main C‐residue source to the soil in the current bioethanol sector (corn and sugarcane) and the indiscriminate removal of crop residues to produce cellulosic biofuels can reduce soil C stocks and reduce the environmental benefits of bioenergy. Moreover, a switch to feedstocks such as miscanthus with more allocation to belowground C could increase soil C stocks at a much faster rate.
Evaluating 318 continental‐scale species distribution models over a 60‐year prediction horizon: what factors influence the reliability of predictions?
Authors: Morán‐Ordóñez Alejandra , Lahoz‐Monfort José J. , Elith Jane , Wintle Brendan A.
Published: November 2016

Aim

Species distribution models (SDMs) are currently the most widely used tools in ecology for evaluating the suitability of environments for biodiversity in the face of future environmental change. In this study we seek to provide an assessment of the predictive performance of SDMs over time. How well do SDMs predict for future time periods and what factors influence predictive performance?

Innovation

We used a historical spatially explicit database of 1.8 million occurrence records for 318 tetrapod species from across continental Australia over the period 1950–2013. We fitted distribution models for each species to data from four multi‐decadal time slices and used these to predict the species distributions up to 60 years after the data collection period for the fitted models. We evaluated predictions against observed data from the relevant time period. Predictions were made assuming either complete knowledge of changes in climatic and environmental conditions or assuming the environment and climate remained unchanged between the fitting and evaluation time periods. We used generalized linear mixed models to model variation in the predictive performance of SDMs over time in relation to a variety of factors, including the length of time between fitting and evaluation, species traits, taxonomic group and attributes of the dataset used to fit models.

Main conclusions

We found that most models provided useful predictions even when the period between model fitting and evaluation was 60 years (area under the receiver operator characteristic curve > 0.7 in 80% of the species evaluated). Variation in predictive performance over time was strongly related to the species range breadth (models for species with broad geographical ranges tended to perform worse than models for locally restricted species) and to the environmental coverage of occupancy data. Conversely, taxonomic group, habitat preferences and body size were not highly influential in describing the variation in predictive performance over time.
The relationship between plant species richness and soil pH vanishes with increasing aridity across Eurasian dry grasslands
Authors: Palpurina Salza , Wagner Viktoria , von Wehrden Henrik , Hájek Michal , Horsák Michal , Brinkert Annika , Hölzel Norbert , Wesche Karsten , Kamp Johannes , Hájková Petra , Danihelka Jiří , Lustyk Pavel , Merunková Kristina , Preislerová Zdenka , Kočí Martin , Kubešová Svatava , Cherosov Mikhail , Ermakov Nikolai , German Dmitry , Gogoleva Paraskovia , Lashchinsky Nikolai , Martynenko Vassiliy , Chytrý Milan
Published: November 2016

Aim

Soil pH is considered an important driver of fine‐scale plant species richness in terrestrial ecosystems. However, it is unclear to what extent this relationship is influenced by precipitation, which often directly affects both soil pH and species richness. We asked: (1) what is the relationship between fine‐scale vascular plant species richness and soil pH in regions with different levels of precipitation and (2) what are the relative effects of soil pH and precipitation on species richness?

Location

Dry grasslands in eight regions of northern Eurasia.

Methods

Species richness and soil pH were measured in 1055 10 m × 10 m plots and precipitation values were derived from global datasets. Relationships between variables were explored using general linear models, mixed‐effect models and partial regressions. Variation partitioning was used to assess the relative effect of each predictor on species richness.

Results

In wetter regions, soil pH range was broader, mean species richness was higher and the richness–pH relationship was unimodal. In drier regions, mean soil pH was higher and its range narrower, species richness was on average lower and less variable, and the richness–pH relationship was negative or absent. The richness–pH relationship persisted after controlling for the effect of precipitation, but precipitation, uniquely or together with soil pH, explained more variation in species richness in most regions than did pH alone.

Main conclusions

The relationship between plant species richness and soil pH in dry grasslands changes from unimodal, through negative, to none with decreasing regional precipitation in Eurasia. However, it seems that the species richness–soil pH relationship in dry grasslands over broad areas is substantially influenced and confounded by precipitation either indirectly, by shortening and shifting the pH gradient, or directly, by decreasing the negative effects of drought stress on richness.
Biogeography of a plant invasion: drivers of latitudinal variation in enemy release
Authors: Allen Warwick J. , Meyerson Laura A. , Cummings David , Anderson John , Bhattarai Ganesh P. , Cronin James T.
Published: November 2016

Aim

The relationship between herbivory and latitude may differ between native and invasive plant taxa, which can generate biogeographical heterogeneity in the strength of enemy release. Our aim was to compare latitudinal gradients in herbivory between native and invasive plants and investigate whether gradients are driven by local adaptation or phenotypic plasticity.

Location

North America.

Methods

Using sympatric native and invasive lineages of the wetland grassPhragmites australisand the specialist gall‐flyLipara rufitarsis, we conducted a field survey to examine whether the relationship between herbivory (the proportion of stems galled) and latitude was parallel between lineages. In a subsequent common garden experiment, we assessed whether latitudinal gradients in herbivory were genetically based or driven by phenotypic plasticity.

Results

In the field,L. rufitarsisherbivory on the nativeP. australislineage increased from 27% of stems galled in southern populations (36.5°) to 37% in northern populations (43.6°), whereas there was no relationship for the invasive lineage. Similar relationships were evident in the common garden experiment, indicating a genetic basis to latitudinal variation in herbivory. Moreover, the invasive lineage suffered five times less herbivory than the native lineage on average, supporting the enemy release hypothesis. However, a genetic basis to this pattern was absent in the common garden experiment, suggesting that local environmental conditions were responsible for the enemy release observed in nature. Specifically, stem height, diameter and density during theL. rufitarsisoviposition period appeared to be important drivers of herbivory.

Main conclusions

Non‐parallel gradients in herbivory may help explain the equivocal results of other studies that examine enemy release and biotic resistance at local scales, and can be an important mechanism promoting biogeographical variation in invasion success. We suggest that these latitudinal patterns in herbivory and other species interactions are likely to be a common phenomenon across a range of invaded systems.
Association between dialysis treatment and cognitive decline: A study from the Project in Sado for Total Health (PROST), Japan
Authors: Watanabe Yumi , Kitamura Kaori , Nakamura Kazutoshi , Sanpei Kazuhiro , Wakasugi Minako , Yokoseki Akio , Kabasawa Keiko , Onodera Osamu , Ikeuchi Takeshi , Kuwano Ryozo , Momotsu Takeshi , Narita Ichiei , Endo Naoto
Published: November 2016

Aim

Evidence for the association between dialysis treatment and cognitive decline is limited. The present study aimed to determine whether dialysis treatment is associated with cognitive decline in adult outpatients of a general hospital in Japan.

Methods

This was a cross‐sectional substudy of the Project in Sado for Total Health (PROST). Total Health PROST targeted adult outpatients of a general hospital in Sado City, Niigata, Japan. Among 753 patients (mean age 68.1 ± 11.6 years) analyzed, 66 received dialysis. Cognitive state was evaluated using the Mini‐Mental State Examination, and those with a Mini‐Mental State Examination score <24 were considered “cognitively declined.” The prevalence of cognitive decline was compared by odds ratios calculated with multiple logistic regression analysis. Variables included in the analyses were dialysis, age, sex and self‐reported histories of hypertension, diabetes, stroke and ischemic heart disease.

Results

Of the 66 dialysis patients, 24 (36.4%) showed cognitive decline, whereas 172 (25.0%) of 687 non‐dialysis patients showed cognitive decline. The age and sex‐adjusted odds ratio for cognitive decline in dialysis patients was 2.57 (95% confidence interval 1.43–4.61), relative to non‐dialysis patients. The odds ratio remained significant (odds ratio 2.69, 95% confidence interval 1.49–4.88) even after adjusting for all covariates.

Conclusion

The prevalence of cognitive decline was high in dialysis patients relative to non‐dialysis patients among outpatients of a general hospital in Japan. Geriatr Gerontol Int 2017; 17: 1584–1587.
Predictors of rehospitalization among older adults: Results of the CRIME Study
Authors: Sganga Federica , Landi Francesco , Volpato Stefano , Cherubini Antonio , Ruggiero Carmelinda , Corsonello Andrea , Fabbietti Paolo , Lattanzio Fabrizia , Gravina Ester Manes , Bernabei Roberto , Onder Graziano
Published: November 2016

Aim

To assess the predictors of readmission among older adults hospitalized in acute care wards.

Methods

A prospective cohort study was carried out among 921 hospitalized older adults participating in the CRiteria to Assess Appropriate Medication Use among Elderly Complex Patients (CRIME) project. The primary outcome of the study was rehospitalization within 1 year after discharge from acute care hospitals. We assessed the participants with a questionnaire including 350 items about demographic, social and clinical characteristics. We analyzed all factors at discharge that could be considered predictors of readmission.

Results

The mean age of the participants was 81.2 years (SD 7.4 years), and 509 were women (55.3%). Overall, 280 of 921 patients (30.4%) were rehospitalized during the 1‐year follow up of the study. Patients with a Mini‐Mental State Examination score equal to or higher than 24 had a higher probability of rehospitalization, as compared with those who performed lower than 24 (OR 1.76, 95% CI 1.04–2.83). In addition, heart failure (OR 1.77, 95% CI 1.14–2.24), the number of falls during 1‐year follow up (OR 1.15, 95% CI 1.05–1.28) and the number of drugs during first hospitalization (OR 1.15, 95% CI 1.01–1.07) were significantly associated with rehospitalization, whereas no significant association was shown for age, sex and walking speed for minimum size (OR 1.15, 95% CI 0.99–2.00).

Conclusions

Predictors of readmission in older people are an intact cognitive status; the presence of a geriatric condition, such as heart failure and falls; and a high number of drugs during first hospitalization. Further studies are required to assess the impact of home care for avoiding readmission in patients with an intact cognitive status, and supporting and treating patients with dementia. Geriatr Gerontol Int 2017; 17: 1588–1592.
Older people's description of factors that facilitate and impede regular dental care – a qualitative interview study
Authors: Derblom C , Hagman‐Gustafsson M‐L , Gabre P
Published: November 2016

Objectives

The aim of this study was to achieve an understanding of older people's view of the benefits of regular dental care and investigate factors that facilitate and impede regular dental care.

Methods

A qualitative research method was used. To gain a deeper understanding of the elderly people's views, individual interviews were conducted. Fifteen respondents, eleven women and four men aged between 65 and 95, participated, all recruited from senior social centres. All interviews were tape‐recorded and transcribed verbatim, and the content analysis method was then used. Meaning units were identified and condensed into codes which were labelled and grouped into categories and subcategories.

Results

Findings were grouped into three categories: experiences of dental care, obstacles and facilitators to dental care and about oral health and responsibility. The elderly had experience of both regular and irregular dental care. Obstacles to visiting dental services included high costs and complicated dental insurance, other practical obstacles, lack of confidence in dentistry and seeing no benefits of dental care at their age. Views of the importance of oral health varied, and some people thought poor teeth were shameful. Some expressed that oral health was your own responsibility, while others thought that oral health was the responsibility of the dental services.

Conclusions

Several factors which hamper regular dental care have been identified, and taken together, these obstacles often became unsurmountable. However, individuals taking their own responsibility for their dental status and dental services making certain adaptations, both encourage people to seek regular dental care.
Public Hospital Spending in England: Evidence from National Health Service Administrative Records
Authors: Kelly Elaine , Stoye George , Vera‐Hernández Marcos
Published: November 2016

Health spending per capita in England has almost doubled since 1997, yet relatively little is known about how that spending is distributed across the population. This paper uses administrative National Health Service (NHS) hospital records to examine key features of public hospital spending in England. We describe how costs vary across the life cycle, and the concentration of spending among people and over time. We find that costs per person start to increase after age 50 and escalate after age 70. Spending is highly concentrated in a small section of the population, but the degree of concentration is lower for older age groups. For those aged 25 and under, a third of all hospital spending is accounted for by 1 per cent of the population under 25 and a fifth of spending is accounted for by 1 per cent of patients under 25. For those aged 65 and over, these figures fall to 22 and 13 per cent, respectively. There is persistence in spending over time, with patients with high spending more likely to have spending in subsequent years and those with zero expenditures more likely to remain out of hospital.
Spending on Health Care in the Netherlands: Not Going So Dutch
Authors: Bakx Pieter , O'Donnell Owen , van Doorslaer Eddy
Published: November 2016

The Netherlands is among the top spenders on health in the OECD. We document the life‐cycle profile, concentration and persistence of this expenditure using claims data covering both curative and long‐term care expenses for the full Dutch population. Spending on health care is strongly concentrated: the 1 per cent of individuals with the highest levels of expenditure account for one‐quarter of the aggregate in any one year. Averaged over three years, the top 1 per cent still account for more than a fifth of the total, indicating a very high degree of persistence in the largest expenses. Spending on long‐term care, which amounts to one‐third of all expenditure on health care, is even more concentrated: the top 1 per cent account for more than half of total spending on this type of care. Average expenditure rises steeply with age and even more so with proximity to death. Spending on individuals in their last year of life absorbs one‐tenth of aggregate health care expenditure. In a given year, spending on health care is highly skewed toward individuals with lower incomes. Average expenditure on the poorest fifth is more than three times that on the richest fifth.
The Concentration of Hospital‐Based Medical Spending: Evidence from Canada
Authors: Côté‐Sergent Aurélie , Échevin Damien , Michaud Pierre‐Carl
Published: November 2016

In this paper, we present evidence on the concentration of hospital‐based medical spending in Canada. We use longitudinal administrative data from the province of Quebec to document how medical spending is concentrated cross‐sectionally, over time and near the end of life when death occurs in hospital. Average expenditures rise rapidly with age, starting around the age of 50, and are concentrated in a small fraction of high‐cost users. For example, the top 1 per cent of men and women in terms of hospital spending account for 52.9 per cent and 49.8 per cent of total spending respectively. Persistence among high users is quite low. Fewer than 19.7 per cent of those in the top quintile of hospital spending stay in the same quintile the following year. Finally, hospital spending among those in their last year of life and who die in hospital can account for 11.3 per cent of total hospital spending in the population.
Retracted: Randomized controlled trial of vitamin D supplementation in children with autism spectrum disorder
Authors: Saad Khaled , Abdel‐Rahman Ahmed A. , Elserogy Yasser M. , Al‐Atram Abdulrahman A. , El‐Houfey Amira A. , Othman Hisham A. -K. , Bjørklund Geir , Jia Feiyong , Urbina Mauricio A. , Abo‐Elela Mohamed Gamil M. , Ahmad Faisal‐Alkhateeb , Abd El‐Baseer Khaled A. , Ahmed Ahmed E. , Abdel‐Salam Ahmad M.
Published: November 2016

Background

Autism spectrum disorder (ASD) is a frequent developmental disorder characterized by pervasive deficits in social interaction, impairment in verbal and nonverbal communication, and stereotyped patterns of interests and activities. It has been previously reported that there is vitamin D deficiency in autistic children; however, there is a lack of randomized controlled trials of vitamin D supplementation in ASD children.

Methods

This study is a double‐blinded, randomized clinical trial (RCT) that was conducted on 109 children with ASD (85 boys and 24 girls; aged 3–10 years). The aim of this study was to assess the effects of vitamin D supplementation on the core symptoms of autism in children. ASD patients were randomized to receive vitamin D3 or placebo for 4 months. The serum levels of 25‐hydroxycholecalciferol (25 (OH)D) were measured at the beginning and at the end of the study. The autism severity and social maturity of the children were assessed by the Childhood Autism Rating Scale (CARS), Aberrant Behavior Checklist (ABC), Social Responsiveness Scale (SRS), and the Autism Treatment Evaluation Checklist (ATEC). Trial registration number: UMIN‐CTR Study Design: trial number: UMIN000020281.

Results

Supplementation of vitamin D was well tolerated by the ASD children. The daily doses used in the therapy group was 300 IU vitamin D3/kg/day, not to exceed 5,000 IU/day. The autism symptoms of the children improved significantly, following 4‐month vitamin D3 supplementation, but not in the placebo group. This study demonstrates the efficacy and tolerability of high doses of vitamin D3 in children with ASD.

Conclusions

This study is the first double‐blinded RCT proving the efficacy of vitamin D3 in ASD patients. Depending on the parameters measured in the study, oral vitamin D supplementation may safely improve signs and symptoms of ASD and could be recommended for children with ASD. At this stage, this study is a single RCT with a small number of patients, and a great deal of additional wide‐scale studies are needed to critically validate the efficacy of vitamin D in ASD.
Reversible splenial lesion syndrome with a hyperosmolar hyperglycemic state and neuroleptic malignant syndrome caused by olanzapine
Authors: Kaino Kenta , Kumagai Ryo , Furukawa Shoko , Isono Momoko , Muramatsu Aiko , Fujii Masanao , Muta Yumiko , Asada Tomoyuki , Fujihara Kazuya , Yagyu Hiroaki
Published: November 2016

A 27‐year‐old woman with panic disorder taking 20 mg olanzapine daily for 4 months was admitted to Mito Kyodo General Hospital, Mito, Ibaraki, Japan, because of disturbed consciousness with fever, hyperglycemia, hyperosmolarity and elevated creatine phosphokinase. She was diagnosed with a hyperosmolar hyperglycemic state and neuroleptic malignant syndrome. Brain magnetic resonance imaging showed transiently restricted diffusion in the splenium of the corpus callosum, with a high signal intensity on diffusion‐weighted imaging. The neurological abnormalities disappeared along with improvement of metabolic derangements, and the follow‐up magnetic resonance imaging carried out on the 26th day of admission showed complete resolution of the lesions in the splenium of the corpus callosum. These clinical and radiological features are highly suggestive of clinically mild encephalitis/encephalopathy with a reversible splenial lesion. The first case of mild encephalitis/encephalopathy with a reversible splenial lesion caused by olanzapine‐induced hyperosmolar hyperglycemic state and neuroleptic malignant syndrome is reported.
Associations between changes in the maternal gut microbiome and differentially methylated regions of diabetes‐associated genes in fetuses: A pilot study from a birth cohort study
Authors: Tachibana Kaori , Sakurai Kenichi , Watanabe Masahiro , Miyaso Hidenobu , Mori Chisato
Published: November 2016

Several intrauterine environmental factors can increase the future risk of type 2 diabetes. The microbiome can influence the balance between health and disease. However, the influence of the maternal gut microbiome on the future risk of diabetes in the fetus is unknown. The present study investigated the associations between maternal gut microbiome and differentially methylated regions of diabetes‐associated genes in umbilical cord samples. The present study included 10 pregnant participants from a birth cohort study. 16S ribosomal ribonucleic acid metagenome analysis of maternal stool samples and deoxyribonucleic acid methylation assays of umbilical cord samples were carried out. The present study found that changes in the UBE2E2 and KCNQ1 methylation rates in umbilical cord samples were associated with the proportion of Firmicutes in the maternal gut, albeit with marginal correlations after adjustment for age and body mass index. These findings suggest a link between the methylation of diabetes‐associated genes in fetuses and maternal microbiota components during pregnancy.
Sea‐level variations have influenced the demographic history of estuarine and freshwater fishes of the coastal plain of Paraná, Brazil
Authors: Tschá M. K. , Baggio R. A. , Marteleto F. M. , Abilhoa V. , Bachmann L. , Boeger W. A.
Published: November 2016

This study surveyed the mitochondrial haplotype diversity of nine freshwater fish species and two estuarine–marine species from the coastal basins and drainages of the highland plateaus of Paraná, Brazil. Portions of the cytochrome b gene or the control region were sequenced. The demographic history of each species was inferred using the Bayesian skyline method, mismatch distribution analysis and statistical neutrality tests. Demographic reconstruction analyses revealed a single pattern of variation in the effective population size (Ne) among species. No dramatic changes in Ne were detected in upland species. By contrast, evidence of population expansion over the past 200 000 years was detected in all coastal plain and estuarine species. These findings correspond to periods of low sea‐level (regressions) followed by a rapid increase in the sea‐level by >100 m. The resulting reconnections and subsequent fragmentation and isolation between the estuarine and freshwater bodies were putatively relevant to the historical demography of the fish species in these areas.
Brain Function Is Linked to LDL Cholesterol in Older Adults with Cardiovascular Risk
Authors: Meusel Liesel‐Ann C. , Anderson Nicole D. , Parrott Matthew D. , Yuen William , Tchistiakova Ekaterina , MacIntosh Bradley J. , Feldman Sid , Greenwood Carol E.
Published: November 2016

Objectives

To determine how cardiovascular risk is associated with working memory task performance and task‐related suppression of default‐mode network (DMN) activity in cognitively intact older adults.

Design

A cross‐sectional functional magnetic resonance imaging study of older adults with cardiovascular risk factors.

Setting

Rotman Research Institute, Baycrest Health Sciences.

Participants

Thirty older adults with cardiovascular risk factors.

Measurements

Participants provided health information and a blood sample, and underwent functional magnetic resonance imaging during a working memory task and during a breath‐hold task to assess cerebrovascular reactivity.

Results

Higher plasma low‐density lipoprotein cholesterol (LDL‐C) was associated with poorer working memory task performance (P = 0.008) and reduced task‐related DMN suppression (P = 0.005). A composite index of cardiovascular risk, the Framingham General Cardiovascular Risk Profile, showed no associations with task performance or task‐related DMN suppression. These findings were independent of white matter burden and cerebrovascular reactivity and thus cannot be accounted for by individual differences in neurovascular health.

Conclusion

These findings suggest a deleterious effect of elevated LDL‐C on working memory task performance and task‐related DMN suppression in older adults with cardiovascular risk. The relations between the Framingham General Cardiovascular Risk Profile, cognitive task performance, and DMN function require further study.
Changes in Care Goals and Treatment Orders Around the Occurrence of Health Problems and Hospital Transfers in Dementia: A Prospective Study
Authors: Hendriks Simone A. , Smalbrugge Martin , Hertogh Cees M. P. M. , van der Steen Jenny T.
Published: November 2016

Objectives

To explore changes in care goals and treatment orders around the occurrence of pneumonia and intake problems, and whether hospitalization is in line with earlier agreed‐upon do‐not‐hospitalize orders.

Design

Data were collected as part of the Dutch End of Life in Dementia study (2007–2011), a longitudinal observational study with up to 3.5 years of follow‐up.

Setting

Long‐term care facilities (N = 28) in the Netherlands.

Participants

Newly admitted nursing home patients (N = 372) in various stages of dementia.

Measurements

Semiannually, physicians completed questionnaires about care goals and treatment orders, and they continuously registered episodes of pneumonia, intake problems and hospitalization. We report on changes in care goals and treatment orders during follow‐up in relation to the developing of pneumonia and intake problems and on hospitalization and reasons for hospitalization.

Results

The proportion of patients with palliative care goals and do‐not‐treat orders rose during follow‐up, especially before death. Treatment orders most frequently referred to resuscitation and hospitalization (do‐not order increased from 73% to 92%, and from 28% to 76%, respectively). The proportions of patients with a palliative care goal and do‐not‐treat orders were similar after developing pneumonia, but increased after intake problems. During follow‐up, 46 patients were hospitalized one or more times. Hospitalization occurred despite a do‐not‐hospitalize order in 21% of decisions. The most frequently reported reason for hospitalization was a fracture, especially in patients with a do‐not‐hospitalize order.

Conclusion

Care plans, including global care goals (predominantly palliative care goals), are made soon after admission, and specific treatment orders are agreed upon in more detail when the condition of the patient worsens. Establishing care plans shortly after nursing home admission may help to prevent burdensome treatment.
Profiles of children with Down syndrome who meet screening criteria for autism spectrum disorder (ASD): a comparison with children diagnosed with ASD attending specialist schools
Authors: Warner G. , Howlin P. , Salomone E. , Moss J. , Charman T.
Published: November 2016

Background

Recent research suggests that around 16% to 18% of children with Down syndrome (DS) also meet diagnostic criteria for autism spectrum disorder (ASD). However, there are indications that profiles of autism symptoms in this group may vary from those typically described in children with ASD.

Method

Rates of autism symptoms and emotional and behavioural problems among children with DS who screened positive for ASD on the Social Communication Questionnaire (SCQ) (n = 183) were compared with a group of children with clinical diagnoses of ASD (n = 189) attending specialist schools in the UK. Groups were matched for age and approximate language level (use of phrase speech).

Results

Profiles of autistic symptoms in the two groups were generally similar, but children with DS meeting ASD cut‐off on the SCQ tended to show fewer problems in reciprocal social interaction than those in the ASD group. They also showed slightly lower rates of emotional and peer‐related problems. The results mostly confirm findings from a previous study in which the original validation sample for the SCQ was used as a comparison group.

Conclusion

Findings suggest that children with DS who meet screening criteria for ASD show similar profiles of communication and repetitive behaviours to those typically described in autism. However, they tend to have relatively milder social difficulties. It is important that clinicians are aware of this difference if children with DS and ASD are to be correctly diagnosed and eligible for specialist intervention and education services.
Introducing Technology for Thriving in Residential Long‐Term Care
Authors: Østensen Elisabeth , Gjevjon Edith Roth , Øderud Tone , Moen Anne
Published: November 2016

Purpose

To present an emerging innovative care model that supports participation and thriving by older adults in residential care, by introduction to new technology and mobilizing volunteer services.

Design

Qualitative, exploratory study, introducing tablet computers to 15 older adults in two municipalities.

Methods

The intervention encompassed weekly workshops over the course of 1 year with volunteer adolescents as personal tutors. Observations of workshops, interviews with nurses, and repeated semistructured interviews with older adult participants eliciting their perspective on use, experiences, perceived usefulness, and overall evaluation of the intervention.

Findings

A model of four components is suggested to support participation and thriving by older adults in residential care: (a) simplified tools: iPad—technology relatively easy to use; (b) person‐centered process: one‐to‐one tutoring following each individual's own pace; (c) young volunteers to teach technology, establishing an intergenerational arena; and (d) being mindful of driving forces that encourage use and learning. We found that all kinds of use and all levels of mastery generated a sense of pride that supported thriving and enjoyment.

Conclusions

These findings support the use of new technology and use of volunteer services for sustaining thriving in older adults. The person‐centered approach stimulates use of the tablet, and participants showed enjoyment, more social participation, and reported subjective experiences of thriving.

Clinical Relevance

Innovative models of care that prevent (or postpone) functional decline and support thriving in older adults are highly sought after in health care. A model that systematically involves volunteer services comes with potentials to alleviate nurses’ workload, and then the intervention is seen as a manageable and low‐cost initiative in residential care.
Design of Complete Dentures by Adopting CAD Developed for Fixed Prostheses
Authors: Li Yanfeng , Han Weili , Cao Jing , Iv Yuan , Zhang Yue , Han Yishi , Shen Yi , Ma Zheng , Liu Huanyue
Published: November 2016

The demand for complete dentures is expected to increase worldwide, but complete dentures are mainly designed and fabricated manually involving a broad series of clinical and laboratory procedures. Therefore, the quality of complete dentures largely depends on the skills of the dentist and technician, leading to difficulty in quality control. Computer‐aided design and manufacturing (CAD/CAM) has been used to design and fabricate various dental restorations including dental inlays, veneers, crowns, partial crowns, and fixed partial dentures (FPDs). It has been envisioned that the application of CAD/CAM technology could reduce intensive clinical/laboratory work for the fabrication of complete dentures; however, CAD/CAM is seldom used to fabricate complete dentures due to the lack of suitable CAD software to design virtual complete dentures although the CAM techniques are in a much advanced stage. Here we report the successful design of virtual complete dentures using CAD software of 3Shape Dental System 2012, which was developed for designing fixed prostheses instead of complete dentures. Our results demonstrated that complete dentures could be successfully designed by the combination of two modeling processes, single coping and full anatomical FPD, available in the 3Shape Dental System 2012.
The influence of sex and gonadectomy on hepatic and brain fatty acid composition, lipogenesis and β‐oxidation
Authors: Starčević K. , Filipović N. , Šperanda M. , Đidara M. , Mašek T.
Published: November 2016

The aim of this study was to investigate the influence of sex and castration of rats on liver and brain fatty acid profile and liver mRNA expression of genes involved in lipogenesis and β‐oxidation. Castration significantly increased body weight and liver index and decreased serum triglyceride content in the female rats. The fatty acid composition of the liver tissue was influenced by sex and castration. Male rats had higher content of C16:0, C18:1n7, C18:2n6 and C22:5n3, while female rats had higher content of C18:0, C20:4n6 and C22:6n3. Castration of male rats decreased differences caused by sex for C18:2n6, C20:4n6 and C22:6n3. Values for C16:1n7 were higher in the castrated male rats in comparison with all other groups. Liver phospholipids showed a distribution of fatty acids similar to the total lipids. Brain total lipids and phospholipids were not influenced by sex or castration. Castration increased ∆6D gene expression in both the sexes, while ∆5D and ∆9D increased in females and males respectively. Gonadectomy increased expression of the FASN gene in the females and decreased CPT1 and ACOX1 gene expression in the liver tissue of male rats. The observed results of lipid peroxidation, measured by TBARS, were the lowest in the intact females in comparison with all other groups. In conclusion, sex strongly influences both SFA and PUFA in liver tissue, and castration decreases these differences only for PUFA. Castration also influences the expression of the genes involved in lipid metabolism differently in male and female rats, with an increase in lipogenic genes in female rats and a decrease in key genes for mitochondrial and peroxisomal β‐oxidation in male rats.