bluuebunny/crossref_metadata_2025 huggingface dataset:
Examining chronic care patient preferences for involvement in health‐care decision making: the case of Parkinson's disease patients in a patient‐centred clinic
Authors: Zizzo Natalie , Bell Emily , Lafontaine Anne‐Louise , Racine Eric
Published: September 2016

Background

Patient‐centred care is a recommended model of care for Parkinson's disease (PD). It aims to provide care that is respectful and responsive to patient preferences, values and perspectives. Provision of patient‐centred care should entail considering how patients want to be involved in their care.

Objective

To understand the participation preferences of patients withPDfrom a patient‐centred care clinic in health‐care decision‐making processes.

Design, setting and participants:

Mixed‐methods study with early‐stage Parkinson's disease patients from a patient‐centred care clinic. Study involved a modified Autonomy Preference Index survey (N=65) and qualitative, semi‐structured in‐depth interviews, analysed using thematic qualitative content analysis (N=20, purposefully selected from survey participants). Interviews examined (i) the patient preferences for involvement in health‐care decision making; (ii) patient perspectives on the patient–physician relationship; and (iii) patient preferences for communication of information relevant to decision making.

Results

Preferences for participation in decision making varied between individuals and also within individuals depending on decision type, relational and contextual factors. Patients had high preferences for communication of information, but with acknowledged limits. The importance of communication in the patient–physician relationship was emphasized.

Discussion

Patient preferences for involvement in decision making are dynamic and support shared decision making. Relational autonomy corresponds to how patients envision their participation in decision making. Clinicians may need to assess patient preferences on an on‐going basis.

Conclusion

Our results highlight the complexities of decision‐making processes. Improved understanding of individual preferences could enhance respect for persons and make for patient‐centred care that is truly respectful of individual patients’ wants, needs and values.
Prevalence of and factors associated with depression among people living with HIV in France
Authors: Feuillet P , Lert F , Tron L , Aubriere C , Spire B , Dray‐Spira R ,   the Agence Nationale de Recherche sur le Sida et les Hépatites Virales (ANRS)‐VIH: Enquête sur les personnes atteintes (Vespa2) Study Group
Published: September 2016

Objectives

Depression is common among people living with HIV (PLWHIV) and is associated with poorer therapeutic outcomes and risky behaviours. We sought to estimate the prevalence of major depressive episode (MDE) across PLWHIV groups, to compare this with its prevalence in the general population and to assess factors associated with it.

Methods

We used data from the Agence Nationale de Recherche sur le Sida et les Hépatites Virales (ANRS)‐Vespa2 study, a national study on a representative sample of PLWHIV conducted in France in 2011. The short form of the depression module of the World Health Organization's Composite International Diagnostic Instrument (CIDI‐SF) was used to characterize the occurrence of an MDE during the previous year. MDE prevalence was assessed among the various groups of PLWHIV and compared with that in the general population, accounting for the sociodemographic characteristics of the two populations, using multivariate Poisson regression models. The same method was used to assess associated factors.

Results

MDE prevalence was 28.1% among PLWHIV, ranging from 10.9 to 55.7% across groups. Compared with the general population by sex, regardless of sexual orientation and origin, MDE prevalence was 5.1‐fold higher in HIV‐infected men who have sex with men [95% confidence interval (CI) 3.9–6.6], 3.1‐fold higher in non‐sub‐Saharan African (SSA) heterosexual men (95% CI 2.2–4.4), 1.6‐fold higher in SSA migrant men (95% CI 0.9–2.6), 2.6‐fold higher in non‐SSA heterosexual women (95% CI 2.1–3.3), and 1.9‐fold higher in SSA migrant women (95% CI 1.5–2.5). In the HIV‐infected population, MDE was positively related to unemployment, material deprivation, disclosure, experience of discrimination, and untreated hepatitis C, and negatively related to age.

Conclusions

The prevalence of depression varied across the different groups of PLWHIV, with levels much higher than in the general population. Moreover, there was a strong association with socioeconomic status and HIV experience.
Real‐world cardiovascular assessment of mirabegron treatment in patients with overactive bladder and concomitant cardiovascular disease: Results of a Japanese post‐marketing study
Authors: Katoh Takao , Kuwamoto Kana , Kato Daisuke , Kuroishi Kentarou
Published: September 2016

Objectives

To assess the effect of 25 or 50 mg mirabegron on cardiovascular end‐points and adverse drug reactions in real‐world Japanese patients with overactive bladder and cardiovascular disease.

Methods

Participants had overactive bladder, a history of/coexisting cardiovascular disease and a 12‐lead electrocardiogram carried out ≤7 days before initiating 4 weeks of mirabegron treatment. Patients with “serious cardiovascular disease” (class III or IV on the New York Heart Association functional classification and further confirmed by expert analysis) were excluded. Patient demographics, physical characteristics and cardiovascular history were recorded. After 4 weeks, patients underwent another electrocardiogram. Incidence of cardiovascular adverse drug reactions and change from baseline in electrocardiogram parameters (RR, PR, QRS intervals, Fridericia's corrected QT and heart rate) were assessed.

Results

Of 316 patients registered, 236 met criteria and had baseline/post‐dose electrocardiograms: 61.9% male; 60.2% aged ≥75 years; 93.6% with coexisting cardiovascular disease, notably, arrhythmia (67.8%) and angina pectoris (19.1%). Starting mirabegron daily doses were 25 mg (19.9%) or 50 mg (80.1%). The incidence of cardiovascular adverse drug reactions was 5.51%. After 4 weeks, the mean heart rate increased by 1.24 b.p.m. (statistically significant, but clinically acceptable as per previous trials). No significant changes were observed in PR, QRS or Fridericia's corrected QT. No significant correlations in the total population or age‐/sex‐segregated subgroups were observed between baseline Fridericia's corrected QT and change at 4 weeks. No correlation for heart rate versus change from baseline heart rate with treatment was observed.

Conclusions

Mirabegron was well tolerated in real‐world Japanese patients with overactive bladder and coexisting cardiovascular disease. No unexpected cardiovascular safety concerns were observed.
Regional Mobility Spaces? Visa Waiver Policies and Regional Integration
Authors: Gülzau Fabian , Mau Steffen , Zaun Natascha
Published: September 2016

Visa policies today are a central instrument for filtering wanted and unwanted types of travellers, leading to a hierarchy of mobility rights. While there is evidence of a “global mobility divide”, we still know little about the role of regional integration when it comes to the distribution of mobility rights and the (re)structuring of mobility spaces. Against this background, the article examines the structure of visa relations in different bodies of regional integration (EU,MERCOSUR,ASEAN,ECOWAS,EAC,NAFTA,SADCandSICA). The article compares visa policies in the member states of these institutions in 1969 and 2010 from a social network perspective. While one would generally expect each institution's member states to become more similar with regard to both internal and external mobility regulations, we find that not all regional clusters align their visa policies. Potential explanations for this state of affairs are investigated.
The nonfeeding auricularia of Holothuria mexicana (Echinodermata, Holothuroidea)
Authors: Emlet Richard B.
Published: September 2016

Among echinoderms, nonfeeding larvae usually are simplified in body shape, have uniform ciliation, and have lost the larval gut. A few species have nonfeeding larvae that express some remnant features of feeding larvae like ciliated bands and larval skeleton or larval arms, but typically their larval mouth never opens and their gut does not function. Still other species have retained the feeding larval form, a functional gut, and can feed, but they do not require food to metamorphose. The present note describes the development of a tropical holothurian, Holothuria mexicana, which hatches as a gastrula that is already generating coelomic structures. A translucent auricularia forms with a mouth that opens but becomes reduced soon thereafter. In form and ciliation this auricularia resembles a feeding larva, but it does not respond to food. A doliolaria forms on day 4 and the pentactula on day 6 post‐fertilization. Further study of this larva and that of its closely related congener, Holothuria floridana, is warranted.
Observations of false mating behavior in entocytherid ostracods from the northwestern United States
Authors: Weaver Patricia G. , Williams Bronwyn W.
Published: September 2016

Five male entocytherid ostracods of four different species recovered from signal crayfish Pacifastacus leniusculus were observed exhibiting false mating behaviors with either another adult male, an A1 sub‐adult male, or an A3 juvenile of indeterminate species and sex. In all five instances, the ostracod being mated was not sclerotized, indicating recent molt. In one case, a male of Uncinocythere thektura was observed in false copulation with an A1 male of a different species, U. occidentalis, suggesting that taxonomic designations of females in mixed populations of Uncinocythere can be problematic. Possible reasons for false mating behavior include stress of being confined post‐collection, lack of available females, or possibly males mistaking non‐sclerotized partners for A1 females.
Automated intravitreal injection system for the efficient treatment of AMD
Authors: Ullrich F.
Published: September 2016

Intravitreal therapy is the most common treatment for many ophthalmic diseases, such as age‐related macular degeneration or diabetic retinopathy. To render this procedure time and cost efficient, as well as to increase patient safety, an automated assistive device for intravitreal injections has been designed and is introduced in this talk. The system allows for precise and safe injections through the pars plana but is still controlled and monitored by the treating physician.
Molecular genetic basis of Usher syndrome in the Czech population
Authors: Liskova P. , Kousal B. , Bujakowska K. , Dudakova L.
Published: September 2016

A systematic literature search of the PubMed database (1 March 2016) using keywords ‘Usher syndrome’ AND ‘mutation’ AND ‘Czech Republic’ (or Belarus, Bulgaria, Estonia, Hungary, Latvia, Lithuania, Moldova, Poland, Slovakia, Romania, Russia, Ukraine) yielded 3 results. After inspection of retrieved abstracts we concluded that none of the published patients had an established molecular genetic cause of Usher syndrome. This is in striking contrast to numerous reports from Western European populations. In this presentation we will discuss our recently established program at a tertiary referral centre in Prague to genotype patients with Usher syndrome. So far 17 probands and 27 unaffected first degree relatives have been examined and donated DNA samples. The search into the molecular genetic causes is ongoing, however it is already apparent that there is an overrepresentation of the c.11864G>A; p.(Trp3955*) mutation in USH2A which was found on at least one allele in 9 probands (53%). The impact of our findings on clinical care and their potential to provide translational outcomes will be discussed. The spectrum of mutations identified in Czech Usher syndrome patients may also be relevant for neighbouring countries.
Searching for the molecular causes of syndromic inherited retinal degenerations
Authors: Bujakowska K.
Published: September 2016

Syndromic inherited retinal degenerations (IRDs) include a large group of diseases, called ciliopathies, which affect primary sensory cilia. These rare genetic disorders may affect one or multiple organs including the retina, central nervous system, olfactory epithelium, cardiovascular system, liver, kidneys, skeletal system, gonads and adipose tissue. Mutations in a single gene may lead to an isolated or syndromic phenotype and mutations in at least fourteen genes have been shown to lead to an isolated or a syndromic form of IRD. In certain cases this broad phenotypic spectrum can be explained by the primary disease‐causing mutations in the ciliopathy gene; however in other instances, the relationship between the primary mutation and the phenotype is not clear and epistatic effects of other alleles have been suggested. The presentation will discuss the genetics behind the broad phenotypic spectrum of ciliopathies and will show strategies for functionally classifying mutations, using the Intraflagellar Transport 172 (IFT172) gene as an example.
Topical N‐acetylcystein on patients with refractory filamentary keratitis
Authors: Koh J.W. , Yang Y.R.
Published: September 2016

Purpose

To investigate the effect of topical N‐acetylcystein (NAC) on patients with refractory filamentary keratitis.

Methods

29 eyes from 20 patients diagnosed with filamentary keratitis were reviewed retrospectively. The cause, treatment methodology, relief of symptoms, number of filaments, change in fluorescein stains score, degree of healing and relapse of the disease were reviewed.

Results

19 eyes of 14 patients completely healed in average 10.78 ± 8.68 days using drops of topical antibiotics, artificial tears, steroid, serum, cyclosporine, therapeutic lense and punctal plug. After complete remission, one patient with GVHD and two patients with keratoconjunctivitis sicca (KCC) experienced relapse. 10 eyes of 6 patients refractory to the therapy for more than 1 month were additionally prescribed with 10% topical N‐acetylcystein (NAC). In average of 60.33 ± 21.11 days, 7 eyes were completely healed and 2 eyes were partially healed. One eye were ceased of 10% topical N‐acetylcystein (NAC) due to severe eye irritation.

Conclusions

Topical N‐acetylcysteine treatment might have some side effect as irritation in the eye, but it could be considered as an effective treatment of refractory filamentary keratitis.
The effect of silica nanoparticles on human corneal epithelial cells
Authors: Park J. , Yim B. , Park C.Y. , Chang M.W.
Published: September 2016

Purpose

Silica nanoparticles (SiNPs) are manipulated as potential drug delivery method. Some previous studies focused on the cellular toxicities depending on size and dose. In this study, we analyzed the effect of SiNPs on human corneal epithelial cells (HCECs).

Methods

Cell culture‐HCECs were purchased from American Type Culture Collection

Treatment of SiNPs‐50 nm, 100 nm and 150 nm of SiNPs are provided from Chung‐Ang Univ.

Cell Viability Assay‐performed using CCK‐8 reagent

Lactate Dehydrogenase (LDH) assay‐was measured by LDH cytotoxicity detection kit

Measurement of reactive oxygen species (ROS)‐detected using OxiSelect In Vitro ROS/RNS Assay Kit

Total Glutathione (GSH) assay‐was measured by OxiSelect™ Total Glutathione Assay Kit

Terminal Deoxynucleotidyl Transferase (TUNEL) assay‐performed with APO‐BrdU TUNEL assay kit

Western Blot‐rabbit anti‐LC3B (1:1,000), rabbit anti‐Beclin1 (1:1,000), rabbit anti‐pmTOR (1:1,000), rabbit anti‐mTOR (1:1,000), and β‐actin (1:10,000).

Results

Intracellular and extracellular ROS elevated dose‐dependently in all size of SiNPs and, especially, intracellular ROS by 50 and 100 nm‐SiNPs showed most dramatic increase. Total GSH was also diminished dose dependently in all size of SiNPs. In addition, cellular autophagy was slightly increased as revealed by western blot for LC3A/B. Despite these changes, the cellular cytotoxicity and membrane damage were not observed. Apoptosis of HCEC were not affected by 24 h‐treatment of SiNPs as shown by flow cytometry, HCEC proliferation was slightly increased by SiNPs. Further analysis about the upper part of signaling cascade, the mTOR pathway was significantly activated in 150 nm‐SiNPs treated cells unlike other 50 and 100 nm size of SiNPs.

Conclusions

Our data suggested SiNPs affected cellular ROS and autophagy in HCEC, however, this cellular stress did not influence the viability.
Robot assisted retinal vein cannulation in an in vivo porcine retinal vein occlusion model
Authors: Willekens K. , Gijbels A. , Schoevaerdts L. , Esteveny L. , Janssens T. , Jonckx B. , Feyen J.H.M. , Meers C. , Reynaerts D. , Vander Poorten E. , Stalmans P.
Published: September 2016

Purpose

To evaluate the feasibility of robot assisted retinal vein cannulation for retinal vein occlusion.

Methods

Prospective experimental study performed in in vivo porcine eyes. A standard three port pars plana vitrectomy was followed by laser induced branch retinal vein occlusion. Consequently, a retinal vein cannulation with the help of a surgical robot and a micro‐needle was performed. Complete success was defined as a stable intravenous position of the needle tip confirmed by blood washout for at least 3 min. Secondary outcomes were the occurrence of intraoperative complications and technical failures.

Results

Cannulation was successful in 15 out of 18 eyes with a complete success rate (duration of infusion of more than 3 min) of 73.3% after exclusion of 2 eyes from analysis due to failure in establishing a blood clot. There were no technical failures regarding the robotic device. The intravessel injections of ocriplasmin in 2 out of 2 eyes led to a clot dissolution. In a subset of 5 eyes, a second cannulation attempt at the border of the optic disc resulted in a stable intravessel position and infusion during 361.8 (±138.5) seconds.

Conclusions

Robot assisted retinal vein cannulation with prolonged infusion time is technically feasible. Human experiments are required to analyze the clinical benefit of this new therapy.
Hypoxia and inflammation in human retinal cells
Authors: Arjamaa O. , Aaltonen V. , Piippo N. , Csont T. , Petrovski G. , Kaarniranta K. , Kauppinen A.
Published: September 2016

Purpose

Retina is extremely sensitive to low oxygen tension as its metabolic rate is the highest one among tissues. In diabetic macular edema, there always occur both hypoxia and inflammation. It is not, however, clear if VEGF release in hypoxia takes place without inflammation in retinal cells. We set out to study the issue using both human ARPE cells and human primary RPE cell culture.

Methods

Human ARPE‐19 cells were routinely cultured in humified CO2 atmosphere as reported previously. The cells were exposed for 24 h to hypoxia and a part of a cell culture was followed up to 48 h. Inflammatory responses were induced with a pre‐treatment by bacterial lipopolysaccharide (LPS). In parallel, human primary RPE cells were used to verify results. IL‐6, IL‐8, IL‐1β, IL‐18 and VEGF were measured with specific ELISA kits. Statistical analyses were performed with the GraphPadPrism software.

Results

Significantly increased IL‐6 and IL‐8 levels were found after hypoxia exposure in ARPE cells and the trend was seen in the primary RPE cell culture as well; LPS‐treatment did not change the expression profile of these interleukins. Hypoxia and LPS pre‐treatment did not affect the release of IL‐1β and IL‐18. The hypoxia exposure increased significantly the release of VEGF as anticipated but the LPS pre‐treatment had no effects on the release.

Conclusions

Hypoxia induced inflammation both in human ARPE cells and in human primary RPE cell culture as shown with IL‐6 and IL‐8. LPS pretreatment increased this response. Hypoxia stimulated directly the VEGF secretion independent of the inflammatory pathway.
Optical coherence tomography in patients with amyotrophic lateral sclerosis
Authors: Rojas Lozano M.P. , Salobrar‐García E. , Salazar J.J. , Ramírez A. , Urcelay Segura J.L. , Muñoz Blanco J.L. , Ramírez J.M.
Published: September 2016

Purpose

To correlate OCT parameters Macular Thickness (MT), Ganglion Cell Layer (GCL) and Retinal Nerve‐Fiber Layer (RNFL), in mild Amyotrophic Lateral Sclerosis (ALS) in comparison with age‐matched controls.

Methods

In a prospective study, 9 ALS patients in the first year of diagnosis were compared with 11 age‐matched healthy controls. All patients underwent a complete neurological and ophthalmological examination and spectral domain OCT Cirrus HD, using Optic Disc Macular Cube 200 × 200 and 512 × 128 Cube scanning protocols.

Results

The OCT measurement showed a statistically significant increase of MT in the superior, nasal, and inferior perifoveal areas (p < 0.05, in all cases). A non‐significant decrease of GCL was observed (p > 0.05). RNFL registered a non‐significant increase in the temporal quadrant, corresponding to papillo‐macular bundle, and a decrease in the remaining quadrants, while the nasal quadrant proved statistically significant (p < 0.05). ALS patients underwent a significant decrease (18%) in sectors 2 and 6 compared to controls (p < 0.05).

Conclusions

MT increases in ALS patients, probably due to a process of reactive gliosis. Furthermore, the nasal papilla thins in ALS patients, presumably because of a loss of ganglion cells. This is the first report available which classifies ALS patients by the time course of the disease and describes these changes in the macula, in correlation with early changes in retina previously shown in pathological studies.
Choroid thickened after non‐penetrating deep sclerectomy
Authors: Rebolleda G. , De Juan V. , Moreno‐Montañés J. , Muñoz‐Negrete F.J.
Published: September 2016

Purpose

To evaluate changes in peripapillary and macular choroidal thickness (CT) as well in optic nerve head (ONH) including prelaminar tissue, lamina cribrosa and optic disc cupping following deep sclerectomy (DS) and to analyze the relationship between these parameters and intraocular pressure (IOP) change.

Methods

Prospective observational study involving glaucomatous eyes undergoing DS. ONH was evaluated by Spectralis optical coherence tomography (OCT) and enhanced depth imaging (EDI) technology. CT was automatically measured with swept‐source – OCT Triton at the macula (fovea, inner and outer ring) and at four peripapillary locations. All OCTs were performed before surgery and at 1 week postoperatively and changes in choroid and ONH postoperatively were calculated. Linear regression models were used to determine predictors of choroidal changes including age, IOP change, and axial length (AL).

Results

Thirty‐two eyes of 32 patients undergoing DS were included (mean age: 71.9 ± 9.4). There was a significant reversal of ONH cupping after DS (p = 0.001). The mean choroidal thicknesses significantly increased compared to preoperatively (p = 0.002 for average peripapilar, p = 0.000 for four locations around the optic disc and p = 0.000 for all nine macular sectors). Mean pCT thickening was inversely correlated with the mean IOP change (rho −0.754, p = 0.000). Mean cupping reversal significantly correlated with both mean prelaminar tissue thickening and pCT thickening (rho: −0.832, p = 0.000 and rho: −0.582, p = 0.012 respectively).

Conclusions

Besides the well‐known ONH morphological changes following IOP reduction after DS, peripapillary and macular choroid significantly thickened early after DS. Larger studies with longer follow‐up are necessary to establish if these changes remain stable over time.
Consensus on guidelines for idebenone administration in Leber's hereditary optic neuropathy (LHON)
Authors: Carelli V. ,   on behalf of the Consensus Study Group
Published: September 2016

Purpose

To reach a consensus on guidelines for diagnostic and clinical management including idebenone administration in Leber's hereditary optic neuropathy (LHON). Idebenone has recently received provisional approval by the European Agency of Medicine (EMA) with the indication of LHON.

Methods

A consensus international meeting was held in Milan, Italy, on 17th March 2016, with the participation of a study group of 15 invited experts in the field of mitochondrial optic neuropathies, with particular interest and expertise in LHON. The group discussed and voted 19 statements, mostly oriented at defining disease stages, clinical and diagnostic criteria, and precise guidelines for idebenone administration with four choices 1) Disagree 2) Partially disagree 3) Partially agree 4) Agree.

Results

The key result was the agreement on treating with idebenone 900 mg/day all patients with subacute/dynamic stage of disease (<6 months from onset and 6–12 months from onset), starting as soon as possible. However, there was not sufficient evidence for recommending treatment in chronic patient between 1 and 5 years, and no evidence at all to recommend treatment in chronic patients with more than 5 years of disease duration. Furthermore, in subacute/dynamic patients the treatment should be continued for at least 1 year in order to assess response, and if the outcome is favorable and clinically relevant, the treatment should be continued after plateau for 1 more year. Last, treatment was unanimously not recommended for asymptomatic relatives of LHON patients, whereas lifestyle counseling was suggested.

Conclusions

The consensus, after extensive debate, defined a series of recommendations without being unanimous in most cases, in consideration of evidence‐based idebenone administration in LHON.
Congenital malignant ciliary body medullepithelioma in two newborns
Authors: Hadjistilianou T. , Mittica P. , Bagaglia S. , Fruschelli M. , Menicacci C. , Fusco F. , Defrancesco S. , Borri M. , Galluzzi P.
Published: September 2016

Purpose

Intraocular medulloepithelioma is an extremely rare unilateral intraocular tumor arising from the nonpigmented ciliary epithelium. Medulloepitheliomas may be classified as benign and malignant and as teratoid and nonteratoid tumors.

Ciliary body medulloepithelioma is usually manifesting in early childhood, rarely at birth.

Differential diagnosis includes in particular unilateral retinoblastoma. Intraocular medulloepithelioma may also occur as masquerade‐syndrome simulating uveitis.

Methods

We report two new cases of intraocular malignant ciliary body medulloepithelioma in newborns presenting as leucokoria and buphthalmos at birth..

Results

Both infants were enucleated and diagnosis was confirmed by histopathology.

Conclusions

Medulloepithelioma is a rare childhood tumor and should be considered in the differential diagnosis of an intraocular mass in a child.

Imaging plays a limited role in differentiating the mass from other solid and cystic ciliary body masses but it is valuable in determining tumor extension and recurrences.

Advanced medulloepithelioma at birth with buphthalmos can simulate retinoblastoma and easily be misdiagnosed.
Novel harmful recessive haplotypes for reproductive traits in pigs
Authors: Häggman J. , Uimari P.
Published: September 2016

Harmful recessive haplotypes for reproductive and fertility traits have previously been detected in cattle, but so far, no studies have been published for pigs. The aim of this study was to locate chromosomal regions with putative lethal haplotypes and estimate the effects of the identified haplotypes on reproductive traits in the Finnish Yorkshire pig breed. We used marker genotypes of 871 Finnish Yorkshire AI boars, genotyped with Illumina's PorcineSNP60 BeadChip. The analysed traits were number of stillborn piglets in first (NSB1) and later (NSB2) parities, total number of piglets born in first and later parities and piglet mortality between birth and weaning in first and later parities. A haplotype was claimed as a putative lethal if it was common in the population, but no homozygous animals were found. We detected altogether 26 putative lethal haplotypes, but only one haplotype on chromosome 8 (position 107.0–113.3 Mb) was significantly associated with traits NSB1 and NSB2. Three possible candidate genes were found in this chromosomal region: MAD2LI, FGF2 and ANXA5. Further analysis is needed to confirm the role of these genes on pig reproductive performance.
Disappearance of Idiopathic Outflow Tract Premature Ventricular Contractions After Catheter Ablation of Overt Accessory Pathways
Authors: SZILI TOROK TAMAS , DE VRIES LENNART J. , ÖZCAN EMIN E. , HASDEMIR CAN , KIS ZSUZSANNA , KARDOS ATTILA , GÉCZY TAMAS , KOVACS ISTVAN , BENEDEK IMRE , OOSTERWERFF ERIK , HENDRIKS ASTRID A. , KHAN MUCHTIAR , YAP SING‐CHIEN
Published: September 2016

Outflow Tract PVC Termination After AP Ablation

Background

Multiple mechanisms have been proposed for idiopathic premature ventricular contractions (PVCs) originating from the outflow tracts (OTs). Recent observations such as the coexistence of these arrhythmias with atrioventricular nodal reentrant tachycardias and the association between discrete prepotentials and successful ablation sites of ventricular arrhythmias (VAs) from the OTs suggest a common link.

Objective

In this case series we draw attention to a unique association between accessory pathways (APs) and idiopathic PVCs from the OTs, disappearing after AP ablation.

Methods

We identified 6 cases in collaboration with several international electrophysiology centers, which presented with pre‐excitation in association with OT, and in 1 case inflow tract (IT), PVCs on 12‐lead surface ECG.

Results

Six cases displayed pre‐excitation and PVCs, in 5 cases originating from the right ventricular outflow tract (RVOT) and in 1 case from the right ventricular inflow tract (RVIT). In all patients, PVCs were monomorphic and had fixed coupling intervals, in 3 cases presenting in bigeminy. Catheter ablation of the AP led to the simultaneous disappearance of PVCs in 5 of 6 cases. The sites of ablation were remote from the OTs in all these cases. In most cases, the occurrence of OT PVCs was closely associated with the presence of pre‐excitation.

Conclusion

The coexistence of pre‐excitation and PVCs from the OTs and the fact that in 5 of 6 cases PVCs disappeared after AP ablation suggests a common mechanism for arrhythmia genesis.
Alternol, a natural compound, exerts an anti‐tumour effect on osteosarcoma by modulating of STAT3 and ROS/MAPK signalling pathways
Authors: Zuo Dongqing , Zhou Zifei , Wang Hongsheng , Zhang Tao , Zang Jie , Yin Fei , Sun Wei , Chen Jiepeng , Duan Lili , Xu Jing , Wang Zhuoying , Wang Chongren , Lin Binhui , Fu Zeze , Liao Yuxin , Li Suoyuan , Sun Mengxiong , Hua Yingqi , Zheng Longpo , Cai Zhengdong
Published: September 2016

Osteosarcoma (OS) is the most frequent primary malignant bone tumour. Alternol, a novel compound purified from microbial fermentation products exerts anti‐tumour effects across several cancer types. The effect of alternol on human OS remains to be elucidated. We first evaluated the anti‐tumour effect of alternol in several human OS cell lines in vitro and investigated its underlying mechanism. Alternol inhibited OS cell proliferation, migration and induced caspase‐dependent apoptosis, G2/M cell cycle arrest in a dose and time‐dependent manner. Moreover, alternol treatment inhibited signal transducer and activator of transcription‐3 (STAT3) phosphorylation in 143B and MG63 human OS cells, as evaluated using a STAT3‐dependent dual luciferase reporter system. Exposure to alternol resulted in excessive reactive oxygen species (ROS) generation and Jun amino‐terminal kinases (JNK), extracellular signal‐regulated kinases (ERK1/2) and p38 activation. Furthermore, alternol‐induced cell death was significantly restored in the presence of the ROS scavenger, N‐acetyl‐l‐cysteine (NAC) or a caspase inhibitor Z‐VAD‐FMK. NAC also prevented G2/M phase arrest and phosphorylation of mitogen‐activated protein kinases (MAPK), but did not reverse STAT3 inactivation. Finally, alternol suppressed tumour growth in vivo in the nude mouse OS tibia orthotopic model. Immunohistochemistry revealed that alternol treatment resulted in down‐regulation of phosph‐STAT3 Tyr705 and up‐regulation of cleaved caspase‐3 and phosph‐SAPK (Stress‐activated protein kinases)/JNK expression. Taken together, our results reveal that alternol suppresses cell proliferation, migration and induces apoptosis, cell cycle arrest by modulating of ROS‐dependent MAPK and STAT3 signalling pathways in human OS cells. Therefore, alternol is a promising candidate for developing anti‐tumour drugs target OS.
Effect of Intensive Chemotherapy on Physical, Cognitive, and Emotional Health of Older Adults with Acute Myeloid Leukemia
Authors: Klepin Heidi D. , Tooze Janet A. , Pardee Timothy S. , Ellis Leslie R. , Berenzon Dmitriy , Mihalko Shannon L. , Danhauer Suzanne C. , Rao Arati V. , Wildes Tanya M. , Williamson Jeff D. , Powell Bayard L. , Kritchevsky Stephen B.
Published: September 2016

Objectives

To measure short‐term changes in physical and cognitive function and emotional well‐being of older adults receiving intensive chemotherapy for acute myeloid leukemia (AML).

Design

Prospective observational study.

Setting

Single academic institution.

Participants

Individuals aged 60 and older with newly diagnosed AML who received induction chemotherapy (N = 49, mean age 70 ± 6.2, 56% male).

Measurements

Geriatric assessment (GA) was performed during inpatient examination for AML and within 8 weeks after hospital discharge after induction chemotherapy. Measures were the Pepper Assessment Tool for Disability (activity of daily living, instrumental activity of daily living (IADL), mobility questions), Short Physical Performance Battery (SPPB), grip strength, Modified Mini‐Mental State examination, Center for Epidemiologic Studies Depression Scale, and the Distress Thermometer. Changes in GA measures were assessed using paired t‐tests. Analysis of variance models were used to evaluate relationships between GA variables and change in function over time.

Results

After chemotherapy, IADL dependence worsened (mean 1.4 baseline vs 2.1 follow‐up, P < .001), as did mean SPPB scores (7.5 vs 5.9, P = .02 for total). Grip strength also declined (38.9 ± 7.7 vs 34.2 ± 10.3 kg, P < .001 for men; 24.5 ± 4.8 vs 21.8 ± 4.7 kg, P = .007 for women). No significant changes in cognitive function (mean 84.7 vs 85.1, P = .72) or depressive symptoms (14.0 vs. 11.3, P = .11) were detected, but symptoms of distress declined (5.0 vs 3.2, P < .001). Participants with depressive symptoms at baseline and follow‐up had greater declines in SPPB scores those without at both time points.

Conclusions

Short‐term survivors of intensive chemotherapy for AML had clinically meaningful declines in physical function. These data support the importance of interventions to maintain physical function during and after chemotherapy. Depressive symptoms before and during chemotherapy may be linked to potentially modifiable physical function declines.
Differences Between Men and Women Aged 65 and Older in the Relationship Between Self‐Reported Sleep and Cognitive Impairment: A Nationwide Survey in Taiwan
Authors: Chiu Hsiao‐Yean , Lai Fu‐Chih , Chen Pin‐Yuan , Tsai Pei‐Shan
Published: September 2016

Objectives

To examine the prevalence of self‐reported sleep disturbances and cognitive impairment in men and women aged 65 and older and to determine sex‐specific effects on the relationship between self‐reported sleep and cognitive impairment.

Design

A secondary data analysis from the 2009 Taiwan National Health Interview Survey.

Participants

Individuals aged 65 and older (N = 2,413, n = 1,094 men, n = 1,319 women).

Measurements

Subjective sleep characteristics including sleep duration, difficulty initiating sleep, difficulty maintaining sleep, early‐morning awakening, daytime sleepiness, difficulty breathing during sleep, habitual snoring, and daytime napping were measured using survey questions. The Mini‐Mental State Examination was used to identify cognitive impairment.

Results

The prevalence of cognitive impairment was 16.3% for men and 27.1% for women. Men and women with cognitive impairment had higher prevalence of self‐reported sleep disturbances than those without. There was a significant effect of the interaction between sex and difficulty breathing during sleep on cognitive impairment (adjusted odds ratio (aOR) = 0.39, 95% confidence interval (CI) = 0.20–0.77). In men, difficulty breathing during sleep (aOR = 2.31, 95% CI = 1.39–3.84), habitual snoring (aOR = 2.30, 95% CI = 1.49–3.54), and prolonged sleep duration (> 8.5 hours) (aOR = 1.95, 95% CI = 1.11–3.43) correlated significantly with cognitive impairment. In women, only prolonged sleep duration (>8.5 hours) was associated with higher likelihood of cognitive impairment (aOR = 2.32, 95% CI = 1.33–4.03).

Conclusion

This nationwide survey confirmed sex differences in the association between various self‐reported sleep disturbances and cognitive impairment in people aged 65 and older.
Self‐Reported Sleep Problems Prospectively Increase Risk of Disability: Findings from the Survey of Midlife Development in the United States
Authors: Friedman Elliot M.
Published: September 2016

Objectives

To determine whether subjective poor sleep prospectively increases functional limitations and incident disability in a national sample of adults living in the United States.

Design

Prospective cohort.

Setting

Longitudinal Survey of Midlife Development in the United States (MIDUS).

Participants

Young, middle‐aged, and older men and women (aged 24–75) surveyed in 1995/96 (MIDUS 1) and followed up in 2004–06 (MIDUS 2). Complete data were available for 3,620 respondents.

Measurements

Data were from telephone interviews and self‐administered questionnaires. Participant reported chronic sleep problems within the prior month; functional limitations were assessed using the Functional Status Questionnaire. Demographic (age, sex, race), socioeconomic (educational attainment), health (chronic conditions, depression), and health behavior (obesity, smoking) covariates were assessed to reduce potential confounding.

Results

Approximately 11% of the sample reported chronic sleep problems at both MIDUS waves. Average number of activity of daily living (ADL) and instrumental activity of daily living (IADL) limitations increased significantly between MIDUS 1 (ADL limitations: 0.06; IADL limitations: 0.95) and MIDUS 2 (ADL limitations: 0.15; IADL limitations: 1.6; P < .001). Adjusted regression models estimating change in ADL scores showed that chronic sleep problems at MIDUS 1 predicted significantly greater increases in ADL (incident rate ratio (IRR) = 1.55, P < .001) and IADL (IRR = 1.28, P < .001) limitations. In those with no functional limitations at baseline, logistic regression models showed that chronic sleep problems significantly increased the odds of incident ADL (odds ratio (OR) = 2.33, 95% confidence interval (CI) = 1.68–3.24, P < .001) and IADL (OR = 1.70, 95% CI = 1.21–2.42, P = .002) disability.

Conclusion

Reports of chronic sleep problems predicted greater risk of onset of and increases in functional limitations 9 to 10 years later. Poor sleep may be a robust and independent risk factor for disability in adults of all ages.
Pharmacological evidence of specific acetylcholine transport in rat cerebral cortex and other brain regions
Authors: Muramatsu Ikunobu , Yoshiki Hatsumi , Uwada Junsuke , Masuoka Takayoshi , Sada Kiyonao , Taniguchi Takanobu , Nishio Matomo
Published: September 2016

Functional acetylcholine receptors (AChRs) were recently demonstrated to exist not only in the plasma membrane but also intracellularly in brain tissues. In order to activate intracellular AChRs, endogenous hydrophilic ACh must cross the plasma membrane. Here, we examined the pharmacological characteristics of this process, including whether it is mediated by active ACh uptake. When ACh esterase (AChE) was suppressed by diisopropylfluorophosphate, [3H]ACh was effectively taken up into segments of rat cerebral cortex and other brain regions, in contrast to peripheral tissues such as liver and kidney. The uptake of [3H]ACh in rat cerebral cortex was temperature‐dependent, and the uptake capacity was comparable to that of [3H]choline. However, [3H]ACh uptake was inhibited by lower concentrations of ACh, carbachol, tetraethylammonium (TEA), compared with uptake of [3H]choline. Uptake of [3H]ACh was also inhibited by several organic cations, including choline, hemicholinium‐3 (HC‐3), quinidine, decynium 22, clonidine, diphenhydramine, but was little affected by some amino acids and biogenic amines, corticosterone, spermine, atropine, and tetrodotoxin. Unlike diisopropylfluorophosphate, several ACh esterase inhibitors, including drugs for Alzheimer's disease, such as donepezil, galantamine, and rivastigmine, also suppressed the uptake of [3H]ACh, but not [3H]choline. These results indicate that in the brain, ACh is specifically taken up through a unique transport system with different pharmacological properties from known organic cation transporters (OCTs), and suggest that this mechanism may be involved in intracellular cholinergic transmission in the brain.

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Vulnerability in patients and nurses and the mutual vulnerability in the patient–nurse relationship
Authors: Angel Sanne , Vatne Solfrid
Published: September 2016

Aims and objectives

To examine the mutual vulnerability of patients and nurses, anticipating that an enhanced understanding of the phenomenon may help reduce vulnerability.

Background

Patient vulnerability is a key issue in nursing, aimed at protecting the patient from harm. In the literature, vulnerability is described both from a risk perspective and a subjective perspective. This implies that the objective dimension of patient vulnerability does not necessarily reflect the patient's own perception of being vulnerable. However, external judgment may influence internal perception. Adding to this complexity, attention has also been drawn to the vulnerability of the nurse.

Design

A definition deduced from central literature on vulnerability captures the complexity of objective versus subjective vulnerability. Based on the perspective of vulnerability in general, vulnerability in healthcare services shows how dependency may increase patient vulnerability. Further, despite education, training and supportive settings, patients may increase nurse vulnerability. The core of this mutuality is explored in the light of Martin Heidegger's philosophy of being.

Conclusion

The patient's need for help from the nurse opens the patient to engage in supportive and/or harmful encounters. Thus, dependency adds to the vulnerability related to health issues. The nurse's vulnerability lies in her engagement in caring for the patient. If failing to provide proper care, the nurse's existence as ‘a good nurse’ is threatened. This is exacerbated if the patient turns against the nurse. Therefore, the core of vulnerability seems to lie in the fact that the patient and the nurse are both striving to be the persons they want to be, and the persons they have not yet become.

Relevance to clinical practice

Recognition of the mutual vulnerability in the patient–nurse relationship calls for collective acknowledgement of the demanding nature of caring relationships, for support and for a strengthening of professional skills.
Factors related to taste sensitivity in elderly: cross‐sectional findings fromSONICstudy
Authors: Uota M. , Ogawa T. , Ikebe K. , Arai Y. , Kamide K. , Gondo Y. , Masui Y. , Ishizaki T. , Inomata C. , Takeshita H. , Mihara Y. , Maeda Y.
Published: September 2016

The sense of taste is important, as it allows for assessment of nutritional value, as well as safety and quality of foods, with several factors suggested to be associated with taste sensitivity. However, comprehensive variables regarding taste and related factors have not been utilised in previous studies for assessments of sensitivity. In the present study, we performed cross‐sectional analyses of taste sensitivity and related factors in geriatric individuals who participated in theSONICStudy. We analysed 2 groups divided by age, 69–71 years (young–old,n= 687) and 79–81 years (old–old,n= 621), and performed a general health assessment, an oral examination and determination of taste sensitivity. Contributing variables were selected by univariate analysis and then subjected to multivariate logistic regression analysis. In both groups, females showed significantly better sensitivity for bitter and sour tastes. Additionally, higher cognitive scores for subjects with a fine taste for salty were commonly seen in both groups, while smoking, drinking, hypertension, number of teeth, stimulated salivary flow salt intake and years of education were also shown to be associated with taste sensitivity. We found gender and cognitive status to be major factors affecting taste sensitivity in geriatric individuals.
Hyaluronan metabolism in overloaded temporomandibular joint
Authors: Shinohara T. , Izawa T. , Mino‐Oka A. , Mori H. , Iwasa A. , Inubushi T. , Yamaguchi Y. , Tanaka E.
Published: September 2016

This study aimed to examine hyaluronan (HA) metabolism in relation to the onset and progression of temporomandibular joint osteoarthritis (TMJ‐OA) induced by mechanical overloading. Two‐month‐old and 6‐month‐old C57BL/6N mice were divided into experimental and untreated control groups (n = 5/group). A sliding plate was attached to the maxillary incisors of the experimental mice for 10 days to overload the condylar cartilage in TMJ. In experimental group, profound cartilage degradation was detected in haematoxylin–eosin, Safranin‐O‐Fast Green‐stained sections. It was also shown that the cartilage degradation was greater in older mice in both the control and the experimental groups. The number of HABP‐positive cells was decreased by mechanical overloading and with age. The reduction of HA expression was correlated with the progression of cartilage degradation induced by mechanical overloading. The absolute quantification of the mRNA expression related to HA synthesis and HA degradation was also performed in each group. The mRNA expression levels of HA synthase (HAS) 2 and 3 were lower in the experimental group compared with the control group in the younger mice. In contrast, the mRNA expression levels of the HA degradation gene, HYAL2 and KIAA1199, were higher in the experimental group compared with the control group in the older mice. Thus, mechanical overload differently affected the balance of HA degradation and HA synthesis in the older and younger mice, respectively. In conclusion, mechanical overloading affects HA metabolism and it might initiate or amplify the condylar cartilage degradation.