bluuebunny/crossref_metadata_2025 huggingface dataset:
A brief history of bioinformatics
Authors: Gauthier Jeff , Vincent Antony T , Charette Steve J , Derome Nicolas
Published: June 2018

It is easy for today’s students and researchers to believe that modern bioinformatics emerged recently to assist next-generation sequencing data analysis. However, the very beginnings of bioinformatics occurred more than 50 years ago, when desktop computers were still a hypothesis and DNA could not yet be sequenced. The foundations of bioinformatics were laid in the early 1960s with the application of computational methods to protein sequence analysis (notably, de novo sequence assembly, biological sequence databases and substitution models). Later on, DNA analysis also emerged due to parallel advances in (i) molecular biology methods, which allowed easier manipulation of DNA, as well as its sequencing, and (ii) computer science, which saw the rise of increasingly miniaturized and more powerful computers, as well as novel software better suited to handle bioinformatics tasks. In the 1990s through the 2000s, major improvements in sequencing technology, along with reduced costs, gave rise to an exponential increase of data. The arrival of ‘Big Data’ has laid out new challenges in terms of data mining and management, calling for more expertise from computer science into the field. Coupled with an ever-increasing amount of bioinformatics tools, biological Big Data had (and continues to have) profound implications on the predictive power and reproducibility of bioinformatics results. To overcome this issue, universities are now fully integrating this discipline into the curriculum of biology students. Recent subdisciplines such as synthetic biology, systems biology and whole-cell modeling have emerged from the ever-increasing complementarity between computer science and biology.
Sequencing era methods for identifying signatures of selection in the genome
Authors: Horscroft Clare , Ennis Sarah , Pengelly Reuben J , Sluckin Timothy J , Collins Andrew
Published: June 2018

Insights into genetic loci which are under selection and their functional roles contribute to increased understanding of the patterns of phenotypic variation we observe today. The availability of whole-genome sequence data, for humans and other species, provides opportunities to investigate adaptation and evolution at unprecedented resolution. Many analytical methods have been developed to interrogate these large data sets and characterize signatures of selection in the genome. We review here recently developed methods and consider the impact of increased computing power and data availability on the detection of selection signatures. Consideration of demography, recombination and other confounding factors is important, and use of a range of methods in combination is a powerful route to resolving different forms of selection in genome sequence data. Overall, a substantial improvement in methods for application to whole-genome sequencing is evident, although further work is required to develop robust and computationally efficient approaches which may increase reproducibility across studies.
Essential Physiological Differences Characterize Short- and Long-Lived Strains of Drosophila melanogaster
Authors: Gubina Nina , Naudi Alba , Stefanatos Rhoda , Jove Mariona , Scialo Filippo , Fernandez-Ayala Daniel J , Rantapero Tommi , Yurkevych Ihor , Portero-Otin Manuel , Nykter Matti , Lushchak Oleh , Navas Placido , Pamplona Reinald , Sanz Alberto
Published: June 2018

Aging is a multifactorial process which affects all animals. Aging as a result of damage accumulation is the most accepted explanation but the proximal causes remain to be elucidated. There is also evidence indicating that aging has an important genetic component. Animal species age at different rates and specific signaling pathways, such as insulin/insulin-like growth factor, can regulate life span of individuals within a species by reprogramming cells in response to environmental changes. Here, we use an unbiased approach to identify novel factors that regulate life span in Drosophila melanogaster. We compare the transcriptome and metabolome of two wild-type strains used widely in aging research: short-lived Dahomey and long-lived Oregon R flies. We found that Dahomey flies carry several traits associated with short-lived individuals and species such as increased lipoxidative stress, decreased mitochondrial gene expression, and increased Target of Rapamycin signaling. Dahomey flies also have upregulated octopamine signaling known to stimulate foraging behavior. Accordingly, we present evidence that increased foraging behavior, under laboratory conditions where nutrients are in excess increases damage generation and accelerates aging. In summary, we have identified several new pathways, which influence longevity highlighting the contribution and importance of the genetic component of aging.
An experiential learning theory of high level wellness: Australian salutogenic research
Authors: Allen Connie , Boddy Jennifer , Kendall Elizabeth
Published: June 2018

At the broadest level, salutogenesis refers to an emphasis on the origins of health, as opposed to a predilection with the determinants of disease. Kickbusch urges health promotion professionals to adopt a salutogenic orientation; directing research and practice towards the question of ‘what creates health?’ This salutogenic study focused on the most pleasant part of the health continuum by asking: (i) what is high level wellness and (ii) how do people attain and maintain this way of being? Semi-structured interviews were conducted with 25 Australian adults who reported a ‘high’ or ‘very high’ level of wellness, health and happiness. Participants described what high level wellness meant to them, their wellness journeys, and the things that helped and hindered their wellbeing. This information was coded, compared and crafted into a constructivist grounded theory. Our interpretation of the data suggests that high level wellness is the sense of peace (wellbeing) that comes from knowing, liking and being one’s best self. Happy, healthy people seem to attain and maintain this way of being over time, through a series of self-initiated experiential learning cycles. The ‘experiential learning theory of high level wellness’ links and extends literature on salutogenesis, eudaimonic wellbeing, self-actualization and experiential learning; positioning everyday people as the leaders of their own life-long wellness journeys. It also suggests a new dimension for Antonovsky’s salutogenic theory: aspiring, not just adapting. Future research could explore the utility of our approach with a range of populations and professions, progressing towards ‘high level wellness for all’.
A GIS-based framework for addressing conflicting objectives in the context of an ecosystem approach to fisheries management—a case study of the Portuguese sardine fishery
Authors: Szalaj D , Wise L , Rodríguez-Climent S , Angélico M M , Marques V , Chaves C , Silva A , Cabral H
Published: June 2018

An ecosystem approach to fisheries management (EAFM) is as a new paradigm in fisheries management. In this study, a combination of geographic information systems (GISs) and multi-criteria decision-making method (MCDM) is proposed as a framework supporting an ecosystem approach to European sardine (Sardina pilchardus, Clupeidae) fishery management in Portugal. This case study was chosen due to the recent severe decline shown by the species. To develop an EAFM for the sardine fishery, a set of criteria were defined based on literature review and expert knowledge. To address multiple conflicting objectives, namely conservation and fisheries, five scenarios were considered: (i) baseline; (ii) nurseries protection; (iii) spawning areas protection; (iv) fishery profit driven, and (v) safeguarding dependent fishing communities. Combination of GIS and MCDM methods highlighted important areas to implement spatial conservation measures for sardine. The analyses indicate that some areas are suitable for conservation in several scenarios, such as the area near Aveiro and the area near the Tejo estuary. However, conservation measures implemented in the area near Aveiro would imply higher economic trade-offs when compared with the actions applied in the region near the Tejo estuary. Results also suggested some of the conservation objectives, such as the protection of sardine eggs and juveniles, to not be compatible. The proposed framework is an important tool supporting EAFM by addressing conflicting objectives, trade-offs and identifying areas that could be considered as potential fishery closure sites or subjected to further analyses.
Implementation of electronic charting is not associated with significant change in physician productivity in an academic emergency department
Authors: Sarangarm Dusadee , Lamb Gregory , Weiss Steven , Ernst Amy , Hewitt Lorraine
Published: June 2018

Objectives

To compare physician productivity and billing before and after implementation of electronic charting in an academic emergency department (ED).

Materials and methods

This retrospective, blinded, observational study compared the 6 months pre-implementation (January to June 2012) with the 6 months post-implementation 1 year later (January to June 2013). Thirty-one ED physicians were recruited, with each physician acting as his/her own control in a before-after design. Productivity was measured via total number of encounters and “productivity index” defined as worked relative value units divided by the clinical full-time equivalent. Values for charges, encounters, and productivity index were determined during each study period and separately for procedures, observational stays, and critical care.

Results

No differences were found for total productivity index per month (758 [623-876] pre-group vs. 756 [673-886] post-group; P = 0.30). There was, however, a 9% decrease in total encounters per month (138 [101-163] pre-group vs. 125 [99-159] post-group; P = 0.01). Significant decreases were seen across all observation stay categories. Conversely, significant increases were seen across all critical care categories. There was no difference in total charges per month.

Discussion

This is one of few studies to demonstrate minimal disruption in physician productivity after transitioning to electronic documentation. The reasons for these findings are likely multi-factorial.

Conclusion

In this study, implementation of electronic charting was not associated with decreases in productivity or billing for total ED care, but may be associated with increases for critical care and decreases for observational stays.
Participatory Visual Research with Displaced Persons: ‘Listening’ to Post-conflict Experiences through the Visual
Authors: Weber Sanne
Published: June 2018

Research with refugees, internally displaced persons (IDPs) and other marginalized groups entails complexities that make it imperative to think through the ethical and methodological strategies to not only ‘do no harm’, but also allow the research to be valuable for the participants. This article contributes to this methodological debate by demonstrating how participatory visual research offers an innovative tool for democratizing research and avoiding the risk of retraumatization. This type of research moreover enables participants to visually represent and communicate their—gender-specific—truth, thus enabling them to counter official representations of their situation and gendered stereotypes of vulnerable IDP women. Participatory visual research can thus become an instrument to contribute to social change, in line with the goals of feminist research. This article describes its use during a research process with women in two communities of returned IDPs in Colombia’s Caribbean coast.
Low-Dose Prasugrel vs Clopidogrel-Based Tailored Premedication for Endovascular Treatment of Cerebral Aneurysms
Authors: Cho Won-Sang , Lee Joongyub , Ha Eun Jin , Kim Kyung Hyun , Lee Jeongjun , Cho Young Dae , Kim Jeong Eun , Han Moon Hee , Kang Hyun-Seung
Published: June 2018

BACKGROUND

Antiplatelet premedication is widely accepted for interventional treatment of cerebral aneurysms to prevent thromboembolism. However, antiplatelet resistance sometimes limits the effectiveness of premedication.

OBJECTIVE

To compare 2 groups administered low-dose prasugrel (PSG group) or clopidogrel-based tailored antiplatelet (CPG group) in terms of platelet function and procedure-related complications.

METHODS

A total of 411 patients with 505 unruptured aneurysms who underwent endovascular treatment within the past 17 mo were retrospectively enrolled in this study. The PSG (225 patients with 277 aneurysms) and CPG groups (186 patients with 228 aneurysms) were administered the respective medication prior to endovascular treatment. We measure the response to the antiplatelet medication with a laboratory test. Episodes of periprocedural bleeding and thromboembolism were compared between the 2 groups.

RESULTS

There were significant differences between the 2 groups in terms of the mean P2Y12 reaction unit values (125.7 in the PSG group vs 251.0 in the CPG group; P < .001) and percentage inhibition (57.8% vs 18.7%, respectively; P < .001). Drug resistance was 29.6% per patient in the CPG group and 2.7% per patient in the PSG group. The PSG group reported 1 thromboembolism and bleeding each; meanwhile, the CPG group reported 7 thromboembolism and 3 bleeding. Compared to clopidogrel administration, prasugrel administration significantly decreased the risk of thromboembolism (weighted hazard ratio, 0.17; 95% confidence interval, 0.03-0.99). However, the risk of bleeding was not significant.

CONCLUSION

Prasugrel was found to be more effective in reducing periprocedural thromboembolism compared to clopidogrel.
Impact of Direct-Acting Antivirals on the Burden of HCV Infection Among Persons Who Inject Drugs and Men Who Have Sex With Men in the Swiss HIV Cohort Study
Authors: Salazar-Vizcaya Luisa , Wandeler Gilles , Fehr Jan , Braun Dominique , Cavassini Matthias , Stoeckle Marcel , Bernasconi Enos , Hoffmann Matthias , Rougemont Mathieu , Béguelin Charles , Rauch Andri ,   the Swiss HIV Cohort Study, Aubert V , Battegay M , Bernasconi E , Böni J , Braun D L , Bucher H C , Calmy A , Cavassini M , Ciuffi A , Dollenmaier G , Egger M , Elzi L , Fehr J , Fellay J , Furrer H , Fux C A , Günthard H F , Haerry D , Hasse B , Hirsch H H , Hoffmann M , Hösli I , Kahlert C , Kaiser L , Keiser O , Klimkait T , Kouyos R D , Kovari H , Ledergerber B , Martinetti G , Martinez de Tejada B , Marzolini C , Metzner K J , Müller N , Nicca D , Pantaleo G , Paioni P , Rauch A , Rudin C , Scherrer A U , Schmid P , Speck R , Stöckle M , Tarr P , Trkola A , Vernazza P , Wandeler G , Weber R , Yerly S
Published: June 2018

In the Swiss HIV Cohort Study, the number of people who inject drugs with replicating hepatitis C virus (HCV) infection decreased substantially after the introduction of direct-acting antivirals (DAAs). Among men who have sex with men, the increase in DAA uptake and efficacy was counterbalanced by frequent incident HCV infections.
Genome Sequences of Three Races of Peronospora effusa: A Resource for Studying the Evolution of the Spinach Downy Mildew Pathogen
Authors: Feng Chunda , Lamour Kurt H. , Bluhm Burt H. , Sharma Sandeep , Shrestha Sandesh , Dhillon Braham Deep Singh , Correll James C.
Published: June 2018

Downy mildew disease, caused by the obligate oomycete pathogen Peronospora effusa, is the most important economic constraint for spinach production. Three races (races 12, 13, and 14) of P. effusa have been sequenced and assembled. The draft genomes of these three races have been deposited to GenBank and provide useful resources for dissecting the interaction between the host and the pathogen and may provide a framework for determining the mechanism by which new races of the pathogen are rapidly emerging.
Incidence, Population Density, and Spatial Heterogeneity of Plant-Parasitic Nematodes in Corn Fields in Ohio
Authors: Simon Abasola C. M. , Lopez-Nicora Horacio D. , Lindsey Laura E. , Niblack Terry L. , Paul Pierce A.
Published: June 2018

Soil samples were collected from 425 corn fields in 28 Ohio counties between growth stages V3 and V6 during the 2013 and 2014 growing seasons. Ten morphological groups of plant-parasitic nematodes, namely spiral, lesion, lance, dagger, stunt, pin, ring, stubby-root, cyst, and “tylenchids” (several genera morphologically similar to members of the subfamily Tylenchinae [NCBI Taxonomy] including Cephelenchus, Filenchus, Malenchus, and Tylenchus) were identified. Eight species belonging to six of these groups were characterized. Spiral, tylenchids, lesion, pin, lance, stunt, and dagger nematodes were detected in 94, 96, 80, 57, 48, 48, and 37% of the fields, respectively, whereas the stubby-root, cyst, and ring nematodes were present in fewer than 14% of the samples. Averaged across fields, the spiral, tylenchids, and pin nematodes had the highest mean population densities. For all groups, incidence and population density varied among counties, and in some cases, among soil regions and cropping practices. Both population parameters were heterogeneous at multiple spatial scales, with the lowest heterogeneity among soil regions and the highest among fields within county and soil region. Estimated variances at the soil region level were not significantly different from zero for most of the nematodes evaluated. Stunt and lance were two of the most variable groups at all tested spatial scales. In general, the population densities were significantly more heterogeneous at the field level than at the county level. Findings from this study will be useful for developing sampling protocols and establishing on-farm trials to estimate losses and evaluate nematode management strategies.
A novel immunodeficient rat model supports human lung cancer xenografts
Authors: He Di , Zhang Junhui , Wu Wanwan , Yi Ning , He Wen , Lu Ping , Li Bin , Yang Nan , Wang Di , Xue Zhigang , Zhang Peng , Fan Guoping , Zhu Xianmin
Published: June 2018

Patient‐derived xenograft (PDX) animal models allow the exogenous growth of human tumors, offering an irreplaceable preclinical tool for oncology research. Mice are the most commonly used host for human PDX models, however their small body size limits the xenograft growth, sample collection, and drug evaluation. Therefore, we sought to develop a novel rat model that could overcome many of these limitations. We knocked out Rag1, Rag2, and Il2rg in Sprague Dawley (SD) rats by clustered regularly interspaced short palindromic repeats (CRISPR)–CRISPR‐associated protein 9 technology. The development of lymphoid organs is significantly impaired in Rag1−1− Rag2−/− Il2rg−/Υ (designated as SD‐RG) rats. Consequently, SD‐RG rats are severely immunodeficient with an absence of mature T, B, and NK cells in the immune system. After subcutaneous injection of tumor cell lines of different origin, such as NCI‐H460, U‐87MG, and MDA‐MB‐231, the tumors grow significantly faster and larger in SD‐RG rats than in nonobese diabetic–Cg‐Prkdcscid Il2rgtm1Wjl / SzJ mice. Most important of all, we successfully established a PDX model of lung squamous cell carcinoma in which the grafts recapitulate the histopathologic features of the primary tumor for several passages. In conclusion, the severely immunodeficient SD‐RG rats support fast growth of PDX compared with mice, thus holding great potential to serve as a new model for oncology research.—He, D., Zhang, J., Wu, W., Yi, N., He, W., Lu, P., Li, B., Yang, N., Wang, D., Xue, Z., Zhang, P., Fan, G., Zhu, X. A novel immunodeficient rat model supports human lung cancer xenografts. FASEB J. 33, 140–150 (2019). www.fasebj.org
Treatment of Kratom Dependence With Buprenorphine-Naloxone Maintenance
Authors: Buresh Megan
Published: June 2018

Introduction:

Use of the unregulated herbal supplement kratom is on the rise in the United States. We present a case series of 2 patients who developed kratom dependence and withdrawal who were successfully transitioned to buprenorphine-naloxone maintenance.

Case Summary:

Two patients using kratom to self-treat chronic pain after prescription opioids were discontinued presenting to our clinic with evidence of kratom dependence and withdrawal. On examination, both patients showed signs of mild opioid withdrawal. Both patients were successfully transitioned to buprenorphine-naloxone maintenance via home initiation with control of both their opioid withdrawal and chronic pain.

Conclusions:

Kratom use is on the rise and with increasing evidence of developing opioid-type dependence due to chronic kratom use. This case series shows that buprenorphine can be used to treat kratom dependence and underlying chronic pain that drives it use.
Stimulant-induced Psychosis in the Postpartum Period: A Case Report
Authors: Gogne Anupriya , Erisman Shannon
Published: June 2018

Psychotic symptoms may emerge in up to 40% of people who misuse stimulants, with physiological changes in the perinatal period potentially contributing to the development of psychosis. In this report, we discuss the case of a woman presenting with stimulant misuse, psychosis, and obsessive compulsive disorder-like symptoms in the postpartum period. We describe the patient's symptoms at presentation, differential diagnoses, treatment course, and related challenges.
Limitation of in-situ arthroscopic fixation for stable juvenile osteochondritis dissecans in the knee
Authors: Ishikawa Masakazu , Nakamae Atsuo , Nakasa Tomoyuki , Ikuta Yasunari , Hayashi Seiju , Ochi Mitsuo , Deie Masataka , Adachi Nobuo
Published: June 2018

Current treatment algorithms for stable juvenile osteochondritis dissecans (JOCD) of the knee have not been established. For arthroscopically stable lesion, in-situ arthroscopic fixation with bioabsorbable pins was introduced as a more desirable approach because of less surgical morbidity and faster recovery. However, there is a paucity of literature that concludes on its efficacy. The aim of this study is to determine the efficacy and limitation of in-situ arthroscopic fixation on stable JOCD lesion in the knee. Ninety-six patients with 110 affected knees were reviewed. Subsequently, patients who underwent in-situ arthroscopic fixation for arthroscopically stable JOCD lesions were grouped for further analysis. Arthroscopic lesion stability was graded according to the Guhl’s grading system from the surgical description of each lesion. The grade I and II were defined as ‘stable’ lesions. The lesion status was also evaluated with the MRI grading system described by Dipaola in preoperative images retrospectively. The grade I and II lesions were also defined as ‘stable’ and more than III as ‘unstable’. Clinical outcomes were evaluated by the Lysholm score at the final office visit. If the patient had a revision surgery, the case was classified as a complete failure. There were 13 lesions in 13 patients with open physis treated with in-situ arthroscopic fixation using bioabsorbable pins. In this population, radiographical lesion status and the Lysholm score were significantly improved in 10 cases (preoperative: 77.5±11.2, postoperative: 98.9±3.1, P=0.002); however, we found three revision cases (failure rate, 23%). Of these revision cases, all lesions were graded as ‘unstable’ in MRI. In this series, the failure rate was 23% for in-situ arthroscopic fixation for arthroscopically stable JOCD lesion of the knee. Because of the potential risk for underestimation of lesion instability, we strongly suggest that this less invasive approach should be chosen with great care for the lesion that presents arthroscopically stable, but as unstable status on MRI. Level of Evidence: Level IV, case series.
Effectiveness of Kinesio Taping in Patients With Chronic Nonspecific Low Back Pain
Authors: Luz Júnior Maurício Antônio Da , Almeida Matheus Oliveira De , Santos Raiany Silva , Civile Vinicius Tassoni , Costa Leonardo Oliveira Pena
Published: June 2018

Study Design.

Systematic review.

Objective.

To investigate the effects of Kinesio Taping (KT) in patients with nonspecific low back pain.

Summary of Background Data.

KT is widely used in patients with low back pain.

Methods.

We conducted searches on PubMed, EMBASE, PEDro, SciELO, and LILACS up to February 26, 2018. We included only randomized controlled trials (RCTs) in adults with chronic nonspecific low back pain that compared KT to no intervention or placebo as well as RCTs that compared KT combined with exercise against exercise alone. The methodological quality and statistical reporting of the eligible trials were measured by the 11-item PEDro scale. The quality of the evidence was assessed using the GRADE classification. We considered pain intensity and disability as the primary outcomes. Whenever possible, the data were pooled through meta-analysis.

Results.

We identified 11 RCTs for this systematic review (pooled n = 743). Two clinical trials (pooled n = 100) compared KT to no intervention at the short-term follow-up. Four studies compared KT to placebo (pooled n = 287) at short-term follow-up and two trials (pooled n = 100) compared KT to placebo at intermediate-term follow-up. Five trials (pooled n = 296) compared KT combined with exercises or electrotherapy to exercises or spinal manipulation alone. No statistically significant difference was found for most comparisons.

Conclusion.

Very low to moderate quality evidence shows that KT was no better than any other intervention for most the outcomes assessed in patients with chronic nonspecific low back pain. We found no evidence to support the use of KT in clinical practice for patients with chronic nonspecific low back pain.

Level of Evidence: 1
Natural History of Cervical Degenerative Spondylolisthesis
Authors: Park Moon Soo , Moon Seong-Hwan , Oh Jae Keun , Lee Ho Won , Riew K. Daniel
Published: June 2018

Study Design.

Retrospective observational and case-control study.

Objective.

To determine the risk factors for progression of degenerative listhesis by comparing patients with and without progression at greater than 5-year follow-up.

Summary of Background Data.

The previous study with 2- to 7-year follow-up showed that degenerative spondylolisthesis of the cervical spine did not progress. Longer-term follow-up may reveal that these patients actually do progress over time.

Methods.

We identified 218 patients with greater than 5-year follow-up without surgery. They were categorized as either having or not having cervical spondylolisthesis. We defined spondylolisthesis as the presence of greater than 2 mm of translation in standing neutral lateral radiographs of the cervical spine at the initial evaluation. The control group at baseline was those without spondylolisthesis. Progression of translation was defined as greater than 2 mm of additional translation on the final standing neutral radiograph.

Results.

The mean follow-up duration was 6.4 ± 1.0 years (range: 5–9.4 yr). Progression of translation was found in 20 patients (9.2%), including 4 patients in the spondylolisthesis group and 16 patients in the control group. Progression of translation was not related to the presence of spondylolisthesis or the severity of translation at the initial evaluation, but was more common in the elderly and in the patients with anterior translation than those with posterior translation at the initial evaluation. In addition, progression of spondylolisthesis was not correlated with any change of symptoms.

Conclusion.

Progression of cervical spondylolisthesis is not related to the presence of spondylolisthesis at baseline.

Level of Evidence: 4
A Technique for Dynamic Cervical Magnetic Resonance Imaging Applied to Cervical Spondylotic Myelopathy
Authors: Pratali Raphael R. , Smith Justin S. , Ancheschi Bruno C. , Maranho Daniel A. , Savarese Aniello , Nogueira-Barbosa Marcello H. , Herrero Carlos Fernando P.S.
Published: June 2018

Study Design.

Cross-sectional study.

Objective.

To evaluate morphometric variations of the cervical spine in patients with cervical spondylotic myelopathy (CSM) using a standard technique of dynamic magnetic resonance imaging (MRI), to assess the inter- and intraobserver reliability of measurements of morphometric parameters based on this imaging, and to compare the resulting measurements with those previously published.

Summary of Background Data.

Because dynamic factors may contribute to the etiology and severity of CSM, dynamic (flexion-extension) MRI may be useful to better evaluate for spinal stenosis and cord compromise.

Methods.

Dynamic cervical MRI was obtained using a standard protocol with the neck in neutral, flexion, and extension positions. The morphometric parameters considered were anterior length of the spinal cord (ALSC), posterior length of the spinal cord (PLSC), spinal canal diameter, and spinal cord width. Two observers analyzed the parameters independently, and the inter- and intraobserver reliabilities were assessed by the intraclass correlation coefficient (ICC).

Results.

A total of 18 patients were included in the study and all completed the dynamic MRI acquisition protocol. The inter- and intraobserver reliabilities demonstrated “almost perfect agreement” (ICC >0.9, P < 0.001) for ALSC and PLSC in all positions. The spinal canal diameter had inter- and intraobserver reliability classified as “almost perfect agreement” (ICC: 0.83–0.98, P < 0.001 and ICC: 0.90–0.99, P < 0.001, respectively) in all positions. The spinal cord width had inter- and intraobserver reliability classified as “substantial agreement” (ICC: 0.73–0.94, P < 0.001 and ICC: 0.79–0.96, P < 0.001, respectively) in all positions. ALSC and PLSC in neutral, flexion, and extension positions from the present study were significantly greater compared to the measurements previously published (P < 0.001).

Conclusion.

The dynamic MRI protocol presented was safe and may allow a more complete evaluation of variations in the cervical spine in patients with CSM than traditional MRI protocols. The morphometric parameters based on this protocol demonstrated excellent inter- and intraobserver reliabilities.

Level of Evidence: 4
Effects of Childhood Life Events on Adjustment Problems in Adolescence: A Longitudinal Study
Authors: Koechlin Helen , Donado Carolina , Berde Charles B. , Kossowsky Joe
Published: June 2018

Objectives:

Stressful life events (SLEs) have been associated with adjustment problems in adolescence (APA) in cross-sectional studies. Using a longitudinal cohort, we examined the influence of these events and predefined covariates on APA and compared internalizing and externalizing trajectories among children with many versus few SLEs.

Methods:

Data were obtained from the Study of Early Child Care and Youth Development. One thousand three hundred sixty-four children and their families were followed from child's birth until age 15 years. Adjustment problems at age 15 years were defined as high (>60 T-score) internalizing and/or externalizing problems on the Youth Self-Report and Child Behavior Checklist. Stressful life events were evaluated at 54 months, and third and fifth grade. Categories created by mixture model analyses for covariates were used in logistic regressions to predict adjustment problems.

Results:

Mothers reported higher rates of adjustment problems than adolescents (21.1% vs 16.3%; p < 0.0001). Adjustment problems were associated with more SLEs (odds ratio [OR] = 1.7; p = 0.0042), male sex (OR = 1.9; p = 0.001), child's high emotional reactivity (OR = 1.6; p = 0.01), and paternal depression (OR = 2.1; p = 0.0165). Analysis using the mother's report of adjustment problems showed the same predictors, as well as lower maternal education level (OR = 3.5; p = 0.0003), and child's friendship quality (OR = 0.4; p = 0.005). Higher internalizing and externalizing T-scores were apparent in children with more SLEs from 2 years of age onward (ps < 0.0001).

Conclusion:

After adjusting for multiple covariates, SLEs during childhood predicted adjustment problems. Our results suggest that emotional reactivity and paternal depression play a role in the development of APA.
Revisional and Reconstructive Surgery for Failing IPAA is Associated with Good Function and Pouch Salvage in Highly Selected Patients
Authors: Lightner Amy L. , Shogan Benjamin D. , Mathis Kellie L. , Larson David W. , Duchalais Emilie , Pemberton John H. , Dozois Eric J.
Published: June 2018

BACKGROUND:

Revisional and reconstructive surgery for IPAA is rare given the high success of pouch surgery for chronic ulcerative colitis. Limited data exist on both surgical and functional outcomes in patients with chronic ulcerative colitis who undergo IPAA revision or reconstruction.

OBJECTIVE:

This study aimed to determine the surgical and functional outcome in patients with chronic ulcerative colitis who undergo IPAA revision or reconstruction.

DESIGN:

A prospectively collected surgical database was accessed for this study.

SETTING:

This study was conducted at an IBD referral center.

PATIENTS:

Patients with chronic ulcerative colitis who underwent IPAA revision or reconstruction were selected.

MAIN OUTCOME MEASURES:

The primary outcomes measured were 30-day postoperative outcomes and long-term pouch function.

RESULTS:

Eighty-one patients were identified. Original IPAA was performed for chronic ulcerative colitis (n = 71; 88%) and indeterminate colitis (n = 11; 12.%), and the most common configuration was a J-pouch (n = 69; 86%) with handsewn anastomosis (n = 41;68%). No independent predictors of 30-day postoperative complications following reconstructive/revisional surgery were identified. Pelvic abscesses and Crohn’s disease of the pouch were independently associated with ultimate pouch excision. Median follow-up following revision/reconstruction was 40 months (range, 1–292 months) during which 15 patients (23%) had pouch failure. The 5- and 10-year pouch survival rates following revision were 85 ± 5% and 65 ± 9% by Kaplan-Meier estimation; age <30 years was significantly associated with pouch survival. Long-term function (n = 30; 35%) compared with a matched control cohort of primary IPAA was characterized by significantly increased daytime bowel incontinence (p = 0.0119), liquid stool (p = 0.0062), and medication to thicken stools (p = 0.0452).

LIMITATIONS:

This was a single-center series, and response rate for functional data was 35%.

CONCLUSIONS:

In properly selected patients with a failing pouch, originally made for chronic ulcerative colitis or indeterminate colitis, revisional and reconstructive surgery is associated with low complication rates, high pouch salvage, and acceptable long-term pouch function. See Video Abstract at http://links.lww.com/DCR/A640.
The impact of genitourinary syndrome of menopause on well-being, functioning, and quality of life in postmenopausal women
Authors: Moral Eloy , Delgado Juan L. , Carmona Francisco , Caballero Borja , Guillán Cristina , González Paula M. , Suárez-Almarza Javier , Velasco-Ortega Syra , Nieto Magro Concepción
Published: June 2018

Objective:

Symptoms of genitourinary syndrome of menopause (GSM) are bothersome to middle-aged and older women, and affect their quality of life (QoL), sexuality, and daily activities. The objective of the study was to evaluate the impact of vaginal symptoms and GSM on the well-being, functioning, and QoL of postmenopausal women from Spain.

Methods:

This study involved 423 postmenopausal women participating in the GENISSE study (a multicenter, cross-sectional, descriptive, observational study) who presented at least 1 vaginal symptom. All women completed the “day-to-day impact of vaginal aging” (DIVA) questionnaire. Analysis of total scores and subdomains of the questionnaire were performed in women diagnosed with GSM and those without the condition.

Results:

In these women, the highest mean scores on the DIVA questionnaire were found in the sexual functioning domain long version (mean 1.8; SD 1.0), followed by the sexual functioning domain short version (mean 1.7; SD 1.1), self-perception and body image (mean 1.4; SD 1.1), activities of daily living (mean 0.7; SD 0.8), and emotional well-being (mean 0.7; SD 0.8) scales. A total of 299 women (70.7%) had vaginal symptoms with a diagnosis of GSM, whereas 124 (29.3%) had no GSM diagnosis. Scores on the DIVA questionnaire were significantly higher in women with a diagnosis of GSM than in those without this condition.

Conclusions:

Vaginal symptoms impact the well-being, functioning, and QoL of postmenopausal women, especially sexual function, self-perception, and body image. This impact is significantly higher in women with GSM. Identifying and treating patients affected by vaginal symptoms and GSM may be beneficial for improving their QoL.
Zumba Fitness and Women's Cardiovascular Health
Authors: Cugusi Lucia , Manca Andrea , Bergamin Marco , Di Blasio Andrea , Yeo Tee Joo , Crisafulli Antonio , Mercuro Giuseppe
Published: June 2018

Purpose:

Zumba fitness (ZF) is a well-known exercise program involving dance and fitness. Despite its increasing popularity, no analysis has been conducted on studies focusing on the cardiovascular (CV) profile of women who performed this activity. The aim of this systematic review is to provide insights into the impact of ZF on women's CV health.

Methods:

Five clinical databases were searched. To be included, the articles had to include (1) women with or without CV risk factors (CVRF) and (2) CV-related outcomes resulting from a ZF program.

Results:

Ten studies (322 women; 181 healthy, 141 with CVRF) were included. In healthy women, low absolute effect sizes for maximal oxygen uptake (

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2max), anthropometric and body composition profile after 8 and 12 wk of ZF were found compared with nonparticipants. Moderate to large absolute effect sizes were recorded for

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2max and body composition following 40 wk of ZF. Findings proved promising but less consistent for ZF studies involving women with CVRF due to the absence of control groups.

Conclusions:

Data describe ZF as feasible for healthy women and a promising fitness option for those with CVRF. Because of the low quality of the studies on women with CVRF and the overall small sample size along with discrepancies such as the average length of the studies on healthy women, cautious interpretation of the findings is recommended. Further investigations with a standardized design are needed to verify whether ZF may be considered as an alternative fitness option in primary prevention of CV disease in women.
Exertional Oxygen Requirements During Exercise Training in Advanced Interstitial Lung Disease
Authors: Wickerson Lisa , Brooks Dina , Reid W. Darlene , Singer Lianne G. , Granton John , Mathur Sunita
Published: June 2018

Purpose:

Little is known about the oxygen requirements during physical exertion or exercise in individuals with interstitial lung disease (ILD). This study examined exertional oxygen requirements, the relationships between exertional oxygen use, exercise capacity and aerobic training parameters, and predictors of change in exertional oxygen requirements during pulmonary rehabilitation (PR).

Methods:

A retrospective study of lung transplant candidates with advanced ILD who underwent at least 4 wk of outpatient PR between 2004 and 2014 was undertaken. Data were extracted at baseline, 4 wk, and 6 mo. Exertional oxygen was prescribed during PR to support continuous, moderate-intensity aerobic training.

Results:

The study cohort (n = 375) had a median age of 61 y (55-66 y), were 57% male, and most were diagnosed with idiopathic pulmonary fibrosis (n = 214). A variety of oxygen delivery systems were used and exertional oxygen requirements increased after 4 wk (0.5 [0.4-0.6] vs 0.5 [0.4-0.73], P < .001, n = 375) and 6 mo (0.44 [0.36-0.5] vs 0.5 [0.4-0.55], P < .001, n = 196) of PR. A higher exertional oxygen requirement was associated with lower 6-min walk distance and lower aerobic training intensity at all time points. There were no identified predictors of the change in exertional oxygen requirements.

Conclusions:

Individuals with advanced ILD had high exertional oxygen requirements to participate in moderate-intensity aerobic training, which increased over time. Exertional oxygen needs may affect exercise prescription and response during PR in ILD patients.
Pulmonary Rehabilitation Only Versus With Nutritional Supplementation in Patients With Bronchiectasis
Authors: Doña Esperanza , Olveira Casilda , Palenque Francisco Javier , Porras Nuria , Dorado Antonio , Martín-Valero Rocío , Godoy Ana M. , Espildora Francisco , Olveira Gabriel
Published: June 2018

Purpose:

Pulmonary rehabilitation (PR) is recommended for bronchiectasis, but there is little evidence of its efficacy in these patients. The aim of this study was to assess the effect of PR in normally nourished patients with noncystic fibrosis bronchiectasis compared with the effect of PR plus an oral nutritional supplement (PRONS).

Methods:

A single-center randomized controlled trial, parallel treatment design in which participants were randomly assigned to receive PR for 12 wk or PR plus a high-protein nutritional supplement enriched with beta-hydroxy-beta-methylbutyrate. Outcome assessments were performed at baseline, 12 and 24 wk including cardiopulmonary exercise testing, health-related quality of life (HRQOL), bronchorrhea, dyspnea, psychological symptoms, spirometry, and exacerbations.

Results:

Thirty patients were randomized into 2 groups of 15 participants. In both groups, cardiopulmonary exercise testing, HRQOL, dyspnea, and spirometry parameters significantly increased from baseline at 3 and/or 6 mo.

Conclusion:

PR improved exercise capacity, HRQOL, and respiratory parameters. The use of PRONS did not have a significant effect on the results.
Characterizing and Comparing Acute Responses of Blood Pressure, Heart Rate, and Forearm Blood Flow to 2 Handgrip Protocols
Authors: Bentley Danielle C. , Thomas Scott G.
Published: June 2018

Purpose:

Growing evidence supports handgrip exercise training for reducing resting blood pressure (BP), with inconsistent exercise protocols reported throughout the literature. To verify safety of such protocols, real-time cardiovascular responses must be assessed. Consequently, this research sought to evaluate the acute impact of dissimilar handgrip protocols on the cardiovascular responses of BP, heart rate (HR), and forearm blood flow.

Methods:

Using a randomized intraindividual crossover design, 20 post-menopausal women completed 2 distinct handgrip protocols compared with a nonexercise control: 4 × 2-min sustained grips at 30% moderate intensity with 1-min rest between sets (ZONA), and 32 × 5-sec intermittent grips at maximal intensity with 5-sec rest between sets (MINT). Cardiovascular responses were measured throughout exercise and post-exercise recovery.

Results:

Compared to ZONA, the MINT protocol required less time and less exercise effort, yet caused greater average BP perturbations (systolic, MINT: 16.9 ± 12.9 mm Hg, ZONA: 7.9 ± 11.6 mm Hg; diastolic, MINT: 8.7 ± 7.2 mm Hg, ZONA: 4.5 ± 4.9 mm Hg) (P < .05), with peak BP changes far below published safety guidelines. Average HR responses were similarly elevated between protocols (MINT: 5.4 ± 4.9 beats/min, ZONA: 3.4 ± 3.6 beats/min). Post-exercise recovery of BP and HR occurred swiftly following MINT while remaining elevated following ZONA.

Conclusions:

Handgrip exercise protocols with distinct design features (ie, grip intensity, grip strategy, and exercise duration) cause dissimilar acute cardiovascular responses. Careful and controlled attention should be directed toward determining how such acute dissimilarities influence corresponding training outcomes. Given the confirmed safety of acute BP perturbations, future researchers can have confidence in prescribing even the high-intensity MINT protocol for at-home, unsupervised activity.
Advancing theory on the multilevel role of leadership in the implementation of evidence-based health care practices
Authors: Guerrero Erick G. , Frimpong Jemima , Kong Yinfei , Fenwick Karissa , Aarons Gregory A.
Published: June 2018

Background:

Top managers’ transformational leadership is associated with significant influence on subordinates. Yet little is known about the extent to which top managers’ transformational leadership influences middle managers’ implementation leadership and, ultimately, frontline staff delivery of evidence-based health care practices.

Purpose:

To test a multilevel leadership model examining the extent to which top managers’ transformational leadership, as mediated by implementation leadership of middle managers (i.e., those who supervise direct clinical services), affects staff attitudes toward evidence-based practices (EBPs) and their implementation.

Methodology/Approach:

We used data collected in 2013 from 427 employees in 112 addiction health services programs in Los Angeles County, California. We relied on hierarchical linear models with robust standard errors to analyze multilevel data, individuals nested in programs. We conducted two path models to estimate multilevel relationships with two EBPs: contingency management and medication-assisted treatment.

Results:

Findings partially supported our theory-driven multilevel leadership model. Specifically, results demonstrated that middle managers’ implementation leadership mediated the relationship between top managers’ transformational leadership and attitudes toward EBPs. At the same time, they showed the mediated relationship for delivery of contingency management treatment was only marginally significant (standardized indirect effect = .006, bootstrap p = .091). We did not find a mediation effect for medication-assisted treatment.

Discussion:

Findings advance leadership theory in health care, highlighting the importance of middle managers’ implementation leadership in transmitting the influence of top managers’ transformational leadership on staff attitudes toward EBPs. The full path model shows the extent to which transformational leadership may influence staff implementation of innovative practices as mediated through staff attitudes toward EBPs and middle managers’ implementation leadership.

Practice Implications:

Our findings have implications for developing a multilevel leadership approach to implementation in health care. Leadership development should build on different competencies based on managers' level but align managers' priorities on the same implementation goals.
Effects of a Physical Activity and Sedentary Behavior Program on Activity Levels, Stress, Body Size, and Sleep in Sedentary Korean College Students
Authors: Choi Jin Yi , Chang Ae Kyung , Choi Eun-Ju
Published: June 2018

This study examined the effects of a physical activity and sedentary behavior program on physical activity, sedentary behavior, stress, body size, and sleep in 63 Korean college students. This study used a quasiexperimental approach with a nonequivalent control group pretest-posttest design. The results showed that the program increased physical activity and step counts and reduced sedentary behavior, waist circumference, and stress levels.