bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes of perceived control after kidney transplantation: a prospective study
Authors: Schulz Torben , Niesing Jan , Homan van der Heide Jaap J. , Westerhuis Ralf , Ploeg Rutger J. , Ranchor Adelita V.
Published: January 2017

Aims

The aim of this study was to determine if kidney transplantation is associated with increases of perceived control and how changes of perceived control affect the course of psychological distress until 1 year after transplantation.

Background

Low levels of perceived control are associated with reduced well‐being among dialysis patients.

Design

Prospective longitudinal cohort study.

Methods

Perceived control (Mastery Scale) and psychological distress (GHQ‐12) were prospectively assessed before (T0; n = 470) and three (T1; n = 197), six (T2; n = 210) and twelve (T3; n = 183) months after transplantation. Differences between T1 and T0 perceived control were used to stratify the sample into three groups (control gain, stable control and control loss). Socio‐demographic and clinical variables, including complications, were examined as potential correlates and the course of psychological was distress compared across groups. Data were collected between July 2008 ‐ July 2013.

Results

Perceived control showed a small increase overall, with 35·1%, 50·0% and 14·9% reporting gain, stable level and loss respectively. Patients with secondary schooling were overrepresented in the control loss group. The course of psychological distress varied across perceived control change groups, with patients in the control gain group experiencing a significant reduction in psychological distress.

Conclusion

A considerable number of patients report increased levels of perceived control after transplantation that are associated with a subsequent decrease in psychological distress. Results emphasize the importance of perceived control and could inform interventions to facilitate well‐being after kidney transplantation.
Fidelity scorecard: evaluation of a caregiver‐delivered symptom management intervention
Authors: Frambes Dawn , Lehto Rebecca , Sikorskii Alla , Tesnjak Irena , Given Barbara , Wyatt Gwen
Published: January 2017

Aim

To evaluate and quantify the intervention fidelity of a symptom management protocol through implementation of a scorecard, using an exemplar study of caregiver‐delivered reflexology for people with breast cancer.

Background

Studies on caregiver‐delivered symptom management interventions seldom include adequate information on protocol fidelity, contributing to potentially suboptimal provision of the therapeutic intervention, hindering reproducibility and generalizability of the results.

Design

Fidelity assessment of a 4‐week intervention protocol in a randomized controlled trial (RCT) with data collection between 2012 ‐ 2016.

Methods

The National Institutes of Health Behaviour Change Consortium (NIH‐BCC) conceptual model for intervention fidelity guided the study. The five NIH‐BCC fidelity elements are: (1) dose; (2) provider training; (3) intervention delivery; (4) intervention receipt; and (5) enactment. To illustrate the elements, an intervention protocol was deconstructed and each element quantified using a newly developed fidelity scorecard.

Results

Mean scores and frequency distributions were derived for the scorecard elements. For dose, the mean number of sessions was 4·4, 96% used the correct intervention duration and 29% had 4 weeks with at least one session. Provider training was achieved at 80% of the maximum score, intervention delivery was 96%, intervention receipt was 99% and enactment indicated moderate adoption at 3·8 sessions per patient. The sample mean score was 15·4 out of 16, indicating the high overall fidelity.

Conclusion

Research findings that include description of how fidelity is both addressed and evaluated are necessary for clinical translation. Clinicians can confidently recommend symptom management strategies to patients and caregivers when fidelity standards are explicitly reported and measured.
The experiences of high intensity therapists delivering cognitive behavioural therapy to people with intellectual disabilities
Authors: Marwood Hayley , Chinn Deborah , Gannon Kenneth , Scior Katrina
Published: January 2017

Background

People with intellectual disabilities (ID) should be able to access the Improving Access to Psychological Therapies (IAPT) programme, currently a main provider of mainstream mental health services in England. IAPT offer cognitive behavioural therapy (CBT) to individuals experiencing mental health problems, although its effectiveness for people with ID, when delivered within IAPT, is unclear.

Method

Ten high‐intensity therapists took part in semi‐structured interviews, analysed using thematic analysis, regarding their experiences of delivering CBT to people with ID in IAPT.

Results

The rigidity of the IAPT model appears to offer a poor fit with the needs of people with ID. Therapists appeared uncertain about how to modify CBT and highlighted training and service development needs.

Conclusions

Findings suggest barriers to accessing IAPT largely remain unaddressed where people with ID are concerned. Services may need to reconsider what constitutes appropriate reasonable adjustments to ensure equitable access.
Impression Management and Non‐GAAP Disclosure in Earnings Announcements
Authors: Guillamon‐Saorin Encarna , Isidro Helena , Marques Ana
Published: January 2017

We study the market's reaction to the disclosure of non‐GAAP earnings measures that are combined with high impression management. We construct an impression management score that captures several communication techniques that managers often use to positively bias investors’ perceptions of firm performance. We hand‐collect and code both quantitative and qualitative information from earnings announcement press releases of large European firms. Our results indicate that non‐GAAP measures are informative to capital markets. However, non‐GAAP adjustments are more persistent when accompanied by higher levels of impression management. This evidence is consistent with managers attempting to distort users’ perceptions when non‐GAAP adjustments are of lower quality. Market reaction tests suggest that investors are able to see through managers’ intentions and discount non‐GAAP information that is accompanied by high impression management. Moreover, investors in more sophisticated markets penalize non‐GAAP measures communicated with high impression management. Our results are robust to a battery of sensitivity tests, including the use of a machine‐coded tone measure.
Sink or swim? Potential for high faunal turnover in Australian rivers under climate change
Authors: James Cassandra S. , Reside April E. , VanDerWal Jeremy , Pearson Richard G. , Burrows Damien , Capon Samantha J. , Harwood Thomas D. , Hodgson Lauren , Waltham Nathan J.
Published: January 2017

Aim

Climate change threatens biodiversity in all ecosystems, and major shifts in species distributions are expected. Freshwater ecosystems are considered particularly vulnerable due to the ectothermic physiology of most freshwater species and their limited habitat extent and capacity to track climate trends. In this study, we examined what broad patterns in freshwater riverine species turnover might be expected under climate change across continental Australia and what are the implications of these patterns for aquatic species and the low aquatic biodiversity of some bioregions?

Location

Continental Australia.

Methods

We built statistical relationships between bioclimatic environments and the occurrence of species of four freshwater taxa (freshwater fish, crayfish, turtles and frogs) and examined trends in projected species turnover for a ‘business as usual’ climate scenario. We used Maxent to model species distributions and present the median projection across 18 global climate models. A recently derived national stream network was used to generate estimates of mean annual river flow and to produce realistic species distributions and migration options by restricting dispersal and migration opportunities usually available to riverine fauna.

Results

High species turnover was driven overwhelmingly by potential local extinctions particularly for stream frogs and crayfish where their current biodiversity is largely confined to higher elevation headwater streams. We predicted high turnover for inland regions of Australia, which are arid and generally support fewer freshwater species.

Main conclusions

Our analysis indicates that under the most severe emissions pathway, projected climate change is likely to cause substantial changes to the composition of faunal assemblages in Australian rivers well before the end of this century. While freshwater systems globally are subject to immediate and pressing threats from anthropogenic land and water use, management interventions addressing these pressures need to be considered within the context of climate change.
Exposure to 15% oxygen in vivo up‐regulates cardioprotective SUR2A without affecting ERK1/2 and AKT: a crucial role for AMPK
Authors: Mohammed Abdul Khaja Shameem , Jovanović Sofija , Jovanović Aleksandar
Published: January 2017

SUR2A is an ‘atypical’ ABC protein that forms sarcolemmal ATP‐sensitive K+ (KATP) channels by binding to inward rectifier Kir6.2. Manipulation with SUR2A levels has been suggested to be a promising therapeutic strategy against ischaemic heart diseases and other diseases where increased heart resistance to stress is beneficial. Some years ago, it has been reported that high‐altitude residents have lower mortality rates for ischaemic heart disease. The purpose of this study was to determine whether SUR2A is regulated by mild‐to‐severe hypoxic conditions (15% oxygen; oxygen tension equivalent to 3000 m above sea level) and elucidate the underlying mechanism. Mice were exposed to either to 21% (control) or 15% concentration of oxygen for 24 hrs. Twenty‐four hours long exposure to 15% oxygen decreased partial pressure of O2 (PO2), but did not affect blood CO2 (PCO2), haematocrit nor levels of ATP, lactate and NAD+/NADH in the heart. Cardiac SUR2A levels were significantly increased while Kir6.2 levels were not affected. Hypoxia did not induce phosphorylation of extracellular signal‐regulated kinases (ERK1/2) or protein kinase B (Akt), but triggered phosphorylation of AMP activated protein kinase (AMPK). AICAR, an activator of AMPK, increased the level of SUR2A in H9c2 cells. We conclude that oxygen increases SUR2A level by activating AMPK. This is the first account of AMPK‐mediated regulation of SUR2A.
Association between particulate matter 2.5 and diabetes mellitus: A meta‐analysis of cohort studies
Authors: He Dian , Wu Shaowen , Zhao Haiping , Qiu Hongyan , Fu Yang , Li Xingming , He Yan
Published: January 2017

Aims/Introduction

The present meta‐analysis was carried out to assess the association between exposure to the level of atmospheric particulate matter 2.5 (PM2.5; fine particulate matter with aerodynamic diameter less than 2.5 μm) and type 2 diabetes mellitus or gestational diabetes mellitus (GDM).

Materials and Methods

We searched the Medline, EMBASE, Cochrane and Web of Science databases to obtain articles according to the responding literature search strategies. Among a total of 279 identified articles, 55 were reviewed in depth, of which 10 articles (11 cohort studies) satisfied the inclusion criteria. Only cohort studies that disclosed the association between PM2.5 and type 2 diabetes mellitus or GDM were included in this article. A fixed‐effects model was selected if P > 0.1 and I2 < 50%; otherwise, a random‐effects model would be used to calculate the total effect value. Subgroup analysis was further carried out according to the types of diabetes mellitus (type 2 diabetes mellitus and GDM). The relative risk was used to estimate the association between PM2.5 and diabetes mellitus.

Results

The positive associations between PM2.5 and the incidence of type 2 diabetes mellitus were found in the long‐term exposure period (relative risk 1.25, 95% confidence interval 1.10–1.43), which showed that with every 10‐μg/m3 increase in PM2.5, the risk of type 2 diabetes mellitus would increase by 25% in the long‐term exposure. Although the significant associations were not identified between maternal exposure to PM2.5 and GDM in the first trimester, the second trimester and the entire pregnancy periods, we could conclude that maternal exposure to PM2.5 in the entire pregnancy period would be more likely to lead to developing GDM (relative risk 1.162, 95% confidence interval 0.806–1.675) than the other two periods.

Conclusions

Long‐term exposure to PM2.5 would be more likely to lead to developing type 2 diabetes mellitus, but more studies would be required to confirm the association between PM2.5 and GDM. It might be a wise to take effective measures to reduce PM2.5 exposure in vulnerable populations, especially for pregnant women.
Association of type 2 diabetes and an inflammatory marker with incident bone fracture among a Japanese cohort
Authors: Mitama Yasuyuki , Fujiwara Saeko , Yoneda Masayasu , Kira Sakurako , Kohno Nobuoki
Published: January 2017

Aims/Introduction

There are various causes of incident bone fracture. Not only aging, low bone mineral density and history of previous fracture, but also diabetes mellitus and inflammation are regarded as risk factors for fracture. The purpose of the present study was to verify the association of glycemic control or one inflammatory marker with incident fracture in a large‐scale Japanese cohort.

Materials and Methods

The present study was carried out at the Hiroshima Atomic Bomb Casualty Council and included 6,556 participants (2,785 men and 3,771 women, aged 55–87 years) who underwent annual health examinations and were followed for 7.4 years. Information about incident fractures was collected at interviews. Participants were classified into three groups: normal, borderline and diabetes mellitus according to glycohemoglobin levels (treated diabetes patients were included in the diabetes mellitus group). Furthermore, participants were classified into four additional groups by glycemic control (diabetes mellitus or non‐diabetes mellitus) and C‐reactive protein (CRP) levels (low or high). Hazard ratios (HRs) of diabetes mellitus, CRP and their combined risk of incident fracture were evaluated.

Results

After adjusting for age, bone mineral density and previous fracture, CRP was associated with increased fracture risk (in men HR 1.04, 95% confidence interval [CI]: 1.003–1.06; in women HR 1.07, 95% CI: 1.03–1.13), and diabetes mellitus predicted fracture risk in men (HR 1.31, 95% CI: 1.02–1.51). Fracture risk was significantly higher among the diabetes mellitus with high CRP group compared with the non‐diabetes mellitus with low CRP group (in men HR 1.47, 95% CI: 1.02–1.98; in women HR 1.41, 95% CI: 1.04–1.92).

Conclusions

Among a Japanese cohort, CRP measurements were helpful to detect high fracture risk in patients with type 2 diabetes mellitus.
Optimizing nano TiO2 assisted decoloration process for industrial date syrup utilizing response surface methodology
Authors: Nasabi Mahshad , Labbafi Mohsen , Khanmohammadi Mohammadreza
Published: January 2017

Titanium dioxide nanoparticle has been proposed to be capable of presenting new consequences in field of date syrup decoloration besides common industrial discoloring techniques like using carbon active. This nano structure was used as a photocatalyst in the presence of ultraviolet radiation to investigate the decrement in high color and turbidity of date syrup. Photocatalytic decoloration process was optimized using response surface methodology statistical design. The effect of TiO2 catalyst portion, date syrup concentration, dose of UV radiation (UV power multiple time of processing) on the qualitative characterization of the date syrup including color and reduced sugars content (glucose and fructose) was investigated. The optimum condition obtained by experimental design method was date syrup concentration 19.06°Brix, TiO2 content 3.81 g/l and dose 5,082.21 kJ. In this condition, 53% color, 5% glucose, and 3% fructose reduction was obtained.

Practical applications

Industrial date syrup is a common source of sugar which its consumption has been limited due to the presence of some coloring and turbidity agents. Thus Investigating new decoloration methods like nanotechnology which may reduce the colorants, as well as leaving less environmental pollution, seems necessary. The study offers using photocatalyst nanoparticle as a decolorant and obtaining the best decoloration condition by response surface methodology to get the least color and sugar loss in industrial date syrup.
Strain‐level characterization of cold‐stressed Listeria monocytogenes using maldi‐tof mass fingerprinting
Authors: Zhao Han , Jia Juntao , Chen Ying , Tang Jing , Jiang Yinghui , Wang Jing , Li Zhengyi , Zhao Liqing
Published: January 2017

Listeria monocytogenes, a common food borne bacterial pathogen, could survive in stress conditions applied in food production such as cold environments. Twenty‐eight strains of L. monocytogenes under cold stress were subjected to MALDI‐TOF MS analysis and compared with control strains under normal growth conditions. The resulting protein mass finger printings were visualized by phyloproteomic cluster and self‐organized map (SOM). It was observed that after cold‐stressed treatment, all strains exhibited change of mass finger printings. In most strains, the variations of the fingerprinting profiles were significant. The diversity in protein fingerprinting of L. monocytogenes after cold stress was also improved. The strain‐level differentiation of the stressed L. monocytogenes would not only improve the understanding of bacterial responses to cold stress but also facilitate classification and detection of stressed bacteria in food industry.

Practical applications

Listeria monocytogenes that causes lethal listeriosis could survive in cold‐stressed treatment and pose high risk to food safety. However, the entire picture of the physiology of stress response adaptation of this strain is still unknown. The protein fingerprinting analysis of the cold‐stressed L. monocytogenes provided an entire picture of phenotypic stress response adaptation at strain level and helped to understand bacterial resistance to cold stress. Additionally, the study on the peptide fingerprints changes, covering 28 strains of L. monocytogenes from different sources would be particularly valuable for the strain‐level differentiation and detection of stressed bacteria in food industry.
Serum viral load at the virological relapse predicts subsequent clinical flares in chronic hepatitis B patients off entecavir therapy
Authors: Hsu Yao‐Chun , Mo Lein‐Ray , Chang Chi‐Yang , Wu Ming‐Shiang , Yang Tzeng‐Huey , Kao Jia‐Horng , Chen Chieh‐Chang , Tseng Cheng‐Hao , Tai Chi‐Ming , Lin Chih‐Wen , Wu Chun‐Ying , Lin Jaw‐Town
Published: January 2017

Background and Aim

Therapeutic duration of nucleos(t)ide analogues for chronic hepatitis B (CHB) is not indefinite in many parts of the world. Viral reactivation is common off therapy, but the risk of subsequent clinical outcome remains unclear and unpredictable. We aimed to quantify the incidence of and explore the predictors for clinical flare following virological relapse in CHB patients who discontinue entecavir therapy.

Methods

This multicenter cohort study prospectively monitored 133 CHB patients who were HBeAg‐negative and viral DNA‐undetectable when discontinuing entecavir after at least 3 years on therapy. Following virological relapse (viral DNA >2,000 IU/mL) that occurred in 92 patients, the incidences of subsequent clinical flare and persistent (unremittent for 3 months) or severe hepatitis (with jaundice or coagulopathy) were determined, and risk factors were explored. Patients did not resume antiviral therapy until occurrence of persistent or severe hepatitis.

Results

The cumulative incidence of clinical hepatitis 2 years after virological relapse was 61.0% (95% confidence interval [CI], 49.9–72.3%) and that of persistent or severe hepatitis was 53.0% (95% CI, 40.9–66.2%). Serum viral load at the virological relapse was associated with both clinical hepatitis (adjusted hazard ratio [HR], 1.31 per log IU/mL; 95% CI, 1.07–1.60) and persistent or severe hepatitis (adjusted HR, 1.63 per log IU/mL; 95% CI, 1.27–2.10), after adjustment for serum aminotransferase and alfa‐fetoprotein levels in the multivariate analysis. Viral DNA >100 000 IU/mL predicted a nearly inevitable occurrence of clinical flare (P < 0.0001).

Conclusions

A high viral load at the virological relapse predicts subsequent clinical hepatitis in CHB patients who discontinue entecavir.
Serotonin 5‐HT7 receptor increases the density of dendritic spines and facilitates synaptogenesis in forebrain neurons
Authors: Speranza Luisa , Labus Josephine , Volpicelli Floriana , Guseva Daria , Lacivita Enza , Leopoldo Marcello , Bellenchi Gian Carlo , di Porzio Umberto , Bijata Monika , Perrone‐Capano Carla , Ponimaskin Evgeni
Published: January 2017

Precise control of dendritic spine density and synapse formation is critical for normal and pathological brain functions. Therefore, signaling pathways influencing dendrite outgrowth and remodeling remain a subject of extensive investigations. Here, we report that prolonged activation of the serotonin 5‐HT7 receptor (5‐HT7R) with selective agonist LP‐211 promotes formation of dendritic spines and facilitates synaptogenesis in postnatal cortical and striatal neurons. Critical role of 5‐HT7R in neuronal morphogenesis was confirmed by analysis of neurons isolated from 5‐HT7R‐deficient mice and by pharmacological inactivation of the receptor. Acute activation of 5‐HT7R results in pronounced neurite elongation in postnatal striatal and cortical neurons, thus extending previous data on the morphogenic role of 5‐HT7R in embryonic and hippocampal neurons. We also observed decreased number of spines in neurons with either genetically (i.e. 5‐HT7R‐knock‐out) or pharmacologically (i.e. antagonist treatment) blocked 5‐HT7R, suggesting that constitutive 5‐HT7R activity is critically involved in the spinogenesis. Moreover, cyclin‐dependent kinase 5 and small GTPase Cdc42 were identified as important downstream effectors mediating morphogenic effects of 5‐HT7R in neurons. Altogether, our data suggest that the 5‐HT7R‐mediated structural reorganization during the postnatal development might have a crucial role for the development and plasticity of forebrain areas such as cortex and striatum, and thereby can be implicated in regulation of the higher cognitive functions.

image

Read the Editorial Highlight for this article on page 644.
Prothymosin alpha‐deficiency enhances anxiety‐like behaviors and impairs learning/memory functions and neurogenesis
Authors: Ueda Hiroshi , Sasaki Keita , Halder Sebok Kumar , Deguchi Yuichi , Takao Keizo , Miyakawa Tsuyoshi , Tajima Atsushi
Published: January 2017

Prothymosin alpha (ProTα) is expressed in various mammalian organs including the neuronal nuclei in the brain, and is involved in multiple functions, such as chromatin remodeling, transcriptional regulation, cell proliferation, and survival. ProTα has beneficial actions against ischemia‐induced necrosis and apoptosis in the brain and retina. However, characterizing the physiological roles of endogenous ProTα in the brain without stress remains elusive. Here, we generated ProTα‐deficiency mice to explore whether endogenous ProTα is involved in normal brain functions. We successfully generated heterozygous ProTα knockout (ProTα+/−) mice, while all homozygous ProTα knockout (ProTα−/−) offspring died at early embryonic stage, suggesting that ProTα has crucial roles in embryonic development. In the evaluation of different behavioral tests, ProTα+/− mice exhibited hypolocomotor activity in the open‐field test and enhanced anxiety‐like behaviors in the light/dark transition test and the novelty induced hypophagia test. ProTα+/− mice also showed impaired learning and memory in the step‐through passive avoidance test and the KUROBOX test. Depression‐like behaviors in ProTα+/− mice in the forced swim and tail suspension tests were comparable with that of wild‐type mice. Furthermore, adult hippocampal neurogenesis was significantly decreased in ProTα+/− mice. ProTα+/− mice showed an impaired long‐term potentiation induction in the evaluation of electrophysiological recordings from acute hippocampal slices. Microarray analysis revealed that the candidate genes related to anxiety, learning/memory‐functions, and neurogenesis were down‐regulated in ProTα+/− mice. Thus, this study suggests that ProTα has crucial physiological roles in the robustness of brain.

image
Comparison between types of dressing following catheter insertion and early exit‐site infection in peritoneal dialysis
Authors: Figueiredo Ana Elizabeth , de Mattos Carolina , Saraiva Cristine , Olandoski Marcia , Barretti Pasqual , Pecoits Filho Roberto , de Moraes Thyago Proença ,   all BRAZPD II Investigators
Published: January 2017

Aims and objectives

To investigate whether the type of dressing used (occlusive vs. semi‐occlusive) impacts on exit‐site infection.

Background

The exit‐site infections are a major predisposing factor for peritoneal dialysis‐related peritonitis, the main cause of technique failure and an important cause of mortality. The care taken in exit‐site dressing is considered an important procedure for the prevention of trauma and contamination of this area. Nevertheless, to our knowledge, no study has yet analysed the impact of different dressing types on early exit‐site infection (up to two months after catheter insertion).

Design

A prospective observational study involving the BRAZPD II (Brazilian Peritoneal Dialysis Multicenter Study) cohort.

Methods

All incident patients with data available for dressing type applied following peritoneal dialysis catheter insertion were included in the study. A multilevel logistic regression model was used to compare the log‐odds of exit‐site infections between groups.

Results

A total of 2460 incident patients were included. Occlusive and semi‐occlusive dressings were applied in 82·6% (n = 2031) and 17·4% (n = 427) of patients, respectively. Exit‐site infection incidence was not affected by the type of dressing used, with a logit for occlusive dressing of 2·15 (95% CI 0·81–5·70). The combined outcome of exit‐site infection and tunnel infection also showed no significance between the groups (logit 1·46, 95% CI 0·72–2·97).

Conclusion

Our results indicate that the type of exit‐site dressing used during the healing phase following peritoneal dialysis catheter insertion has no impact on early exit‐site infection rates.

Relevance to clinical practice

Provides evidence to support the similarity between occlusive and semi‐occlusive dressing regarding infection rates in exit site of peritoneal dialysis catheter, therefore allowing the choice to be made accordingly to routine or availability.
Health care as perceived by persons with inflammatory bowel disease – a focus group study
Authors: Lesnovska Katarina Pihl , Hollman Frisman Gunilla , Hjortswang Henrik , Hjelm Katarina , Börjeson Sussanne
Published: January 2017

Aims and objectives

The aim of this study was to explore the perceptions of health care among persons living with inflammatory bowel disease.

Background

The quality of care plays an important role in the life of persons with a chronic disease. To define what persons with inflammatory bowel disease perceive as high‐quality care, greater focus must be placed on the individual's own perspective of living with the condition.

Design

A qualitative exploratory study was conducted based on focus groups.

Methods

Five focus groups were conducted with adult persons living with inflammatory bowel disease, 14 men and 12 women aged 19–76 years. The interviews were performed between January–June 2014.

Results

The perceptions of health care from the perspective of persons living with inflammatory bowel disease were summarised in two categories: ‘professional attitudes of healthcare staff’ and ‘structure of the healthcare organisation’. Persons with inflammatory bowel disease want to be encountered with respect, experience trust and obtain information at the right time. They also expect shared decision‐making, communication and to encounter competent healthcare professionals. Furthermore, the expectations on and perceptions of the structure of the healthcare organisation comprise access to care, accommodation, continuity of care, as well as the pros and cons of specialised care.

Conclusion

The findings show the importance of establishing a respectful and trusting relationship, facilitating healthcare staff and persons with inflammatory bowel disease to work as a team in fulfilling individual care needs – but there is room for improvement in terms of quality of care.

Relevance to clinical practice

A person‐centred approach, which places the individual and her/his family at the centre, considering them experts on their own health and enabling them to collaborate with healthcare staff, seems important to reach a high‐quality healthcare organisation for patients with Inflammatory bowel disease.
Customized Cheek Plumper with Friction Lock Attachment for a Completely Edentulous Patient to Enhance Esthetics: A Clinical Report
Authors: Bhushan Prem , Aras Meena A. , Coutinho Ivy , Rajagopal Praveen , Mysore Ashwin R. , Kumar Swati
Published: January 2017

Prosthetic rehabilitation of a completely edentulous patient should never be restricted to the replacement of missing teeth. The ultimate aim of complete denture treatment should be restoration of the full range of oral functions and esthetics. Slumped cheeks are always a concern for esthetically demanding complete denture patients. This article describes a simple, scientific, cost‐effective technique to improve facial esthetics in a completely edentulous patient with the help of a cheek plumper. The technique used here implements the concept of neutral zone to precisely determine the amount of space available for the cheek plumper. The simple friction lock attachments that retained the cheek plumpers on the prosthesis were also fabricated after determining the space available in the appropriate areas. Thus an effort was made to keep the cheek plumpers unobtrusive yet effective to ensure complete integration of the prosthesis into the stomatognathic system.
The sensory impact of salt replacers and flavor enhancer in reduced sodium processed meats is matrix dependent
Authors: Gaudette Nicole J. , Pietrasik Zeb
Published: January 2017

Sodium reduction remains an important and ongoing initiative for the meat industry, especially for processed meats. Sodium reduction strategies, including the use of commercial salt replacers and flavor enhancers, are currently available to the food industry, however; their application toward processed meats, and subsequent impact on the sensory profile, has yet to be fully understood. In comparison to control and low salt formulations, two salt replacers (OF45, OF60) and one flavor enhancer (savory powder [SP]) were evaluated for their ability to effectively reduce sodium, while maintaining the sensory properties of restructured hams and smoked turkey sausages. Taste, odor, in‐mouth aroma, and textural properties were evaluated by trained sensory panelists using a hybrid method combining Quantitative Descriptive Analysis® and Texture Profile Analysis®. Formulations with salt replacers were perceived as less salty and more bitter compared to control, especially for OF45, where an off aroma‐induced enhancement of bitterness is postulated. SP elicited lower levels of flavor in restructured ham but may have a flavor enhancing effect in smoked turkey sausages. Processed meat systems with additional flavors may be more optimal for use of salt replacers due to a potential masking effect of bitterness.

Practical applications

Sodium chloride is required for the functionality, shelf stability, and eating quality of processed meats. While sodium chloride plays an important role in processed meat, reduction strategies remain relevant for the industry as they continue to meet the consumer demand for low sodium foods. Current approaches for sodium reduction in processed meats include the use of salt replacers and/or flavor enhancers. This study shows that these ingredients can impact textural sensory attributes in some processed meat products. This work also demonstrates that salt replacers can potentially substitute sodium chloride in processed meats that have complex flavor profiles (e.g., addition of spices, smoke), while meats with simple flavor profiles may require further flavor optimization; however, further flavor optimization through the application of flavor modifying ingredients may be required to suppress undesirable levels of bitterness or other off flavors elicited by these ingredients. Flavor enhancers can provide additional complexity to the sensory profile, but this may be more apparent in complex flavored meat matrices.
Comparative efficacy of topical application of tacrolimus and clotrimazole in the treatment of pityriasis versicolor: A single blind, randomised clinical trial
Authors: Sepaskhah Mozhdeh , Sadat Maryam Sadat , Pakshir Keyvan , Bagheri Zahra
Published: January 2017

Background

Pityriasis versicolor (PV) is a common superficial fungal disease. Possibility of emergence of resistant strains to azoles, and difficulty in differentiation of hypopigmented PV and early vitiligo, encouraged us to evaluate the efficacy of topical tacrolimus (a calcineurin inhibitor agent with proven in vitro anti‐Malassezia effect) for PV treatment generally and its effect on PV‐induced hypopigmentation specifically.

Objectives

To evaluate the efficacy of topical tacrolimus on pityriasis versicolor. Patients/Methods: Fifty PV patients were randomly allocated into two equal groups applying either topical clotrimazol or tacrolimus twice daily for 3 weeks. They were evaluated at the beginning of study, in the third and fifth weeks clinically and mycologically (direct smear).

Results

Although both treatments resulted in global, clinical, and mycological cure of PV, there was no significant difference regarding the mentioned aspects of cure between tacrolimus and clotrimazole treated patients. (P‐value: .63, .45, and .26, respectively) Tacrolimus had no significant effect on hypopigmentation in the fifth week follow‐up. (P‐value: .62).

Conclusions

In spite of the lack of efficacy of tacrolimus on PV‐induced hypopigmentation, the therapeutic effect on PV introduces tacrolimus as a therapeutic option for PV, especially when early vitiligo is among the differential diagnoses without concerning the aggravating effect of topical corticosteroids on PV.
Cycas dharmrajii sp. nov. (Cyadaceae) from Andaman and Nicobar Islands, India
Authors: Singh Lal Ji
Published: January 2017

Cycas dharmrajii L.J.Singh (Cycadaceae), a new species from the Andaman Islands, India is described and illustrated, and its conservation status is assessed. An abnormal branching habit of the giant trunk, its swollen base, often branched, polymorphic aerial roots, medium‐sized leaves, megasporophylls with well‐defined 10–28 paired lateral hook‐like structures and 1–3 pairs of ovules, 2‐schizo‐lysigenous mucilage canals in leaflet, and characteristic pitting on the periclinal walls of the epidermal cells of the leaflets distinguishes it from all previously known species. A key to the species of Cycas from the Andaman and Nicobar Islands is also provided.
Data science, learning, and applications to biomedical and health sciences
Authors: Adam Nabil R. , Wieder Robert , Ghosh Debopriya
Published: January 2017

The last decade has seen an unprecedented increase in the volume and variety of electronic data related to research and development, health records, and patient self‐tracking, collectively referred to as Big Data. Properly harnessed, Big Data can provide insights and drive discovery that will accelerate biomedical advances, improve patient outcomes, and reduce costs. However, the considerable potential of Big Data remains unrealized owing to obstacles including a limited ability to standardize and consolidate data and challenges in sharing data, among a variety of sources, providers, and facilities. Here, we discuss some of these challenges and potential solutions, as well as initiatives that are already underway to take advantage of Big Data.
Nevoid Basal Cell Carcinoma Syndrome and Hairy Skin Patches
Authors: Notay Manisha , Kamangar Faranak , Awasthi Smita , Fazel Nasim
Published: January 2017

We report a case of an increasing number of discrete patches of darkly pigmented terminal hair in a patient with nevoid basal cell carcinoma syndrome. This case adds to a small case series of three patients which have previously reported this observation. We report this case to highlight hairy patches as an important clinical feature associated with nevoid basal cell carcinoma syndrome.
Analysis of gene expression in granulosa cells post‐maturation to evaluate oocyte culture systems in the domestic cat
Authors: Zahmel J , Mundt H , Jewgenow K , Braun BC
Published: January 2017

Contents

Maturation of oocytes is a prerequisite for successful embryo development. The fertilization competence of in vivo derived oocytes is significantly higher than that of oocytes matured in vitro. Commonly evaluated morphological criteria for oocyte maturation do not reflect the complexity and quality of maturation processes. Oocytes and granulosa cells are communicating closely in a bidirectional way during follicular growth and maturation. Assessing the mRNA expression of specific genes in granulosa cells could be a non‐invasive way to evaluate the conditions of in vitro oocyte maturation. The objective of this study was to elucidate the influence of two different FSH additives on the in vitro maturation rate and gene expression of cumulus–oocytes complexes in domestic cat. Feline oocytes were matured in a medium, supplemented with LH and 0.02 IU/ml porcine FSH versus 0.02 IU or 1.06 IU/ml human FSH. Granulosa cells were separated from oocytes directly after 24 hr of maturation or after additional 12 hr of in vitro fertilization. Gene expression levels were analysed by quantitative PCR for aromatase, antimullerian hormone, follicle stimulating hormone receptor (FSHR), luteinizing hormone/choriogonadotropin receptor (LHCGR) and prostaglandin E synthase. Neither oocyte maturation rate nor gene expression levels differed after 24 or 36 hr in all three groups. However, variations were discovered in correlations of expression levels, for instance for FSHR and LHCG, indicating differences in the fine‐tuning of in vitro maturation processes under varying FSH supplementations. We suppose that correlation between gene expressions of selected genes suggests a superior maturation quality of feline oocytes.
Rare variant of MAP2K7 is associated with increased risk of COPD in southern and eastern Chinese
Authors: Qiu Fuman , Li Yinyan , Lu Xiaoxiao , Xie Chenli , Nong Qingqing , Wu Di , Chen Jiansong , Yang Lei , Zhou Yifeng , Lu Jiachun
Published: January 2017

ABSTRACT

Background and objective

A wide range of common loci have been extensively screened and evaluated for their associations with various complex diseases; however, the relevance of rare variants causing missense substitutions in the protein‐coding genes in human diseases is still poorly understood.

Methods

In this study, we conducted a two‐stage retrospective study of a total of 1791 patients with COPD and 1940 controls in southern and eastern Chinese to test relevancies of five rare variants (i.e. p.Glu116Lys, p.Asn118Ser, p.Arg138Cys, p.Ala195Thr and p.Leu259Phe) of human mitogen‐activated protein kinase kinase 7 (MAP2K7) to COPD susceptibility. The effects of these loci on lung function were further estimated.

Results

The p.Glu116Lys rare variant had significant associations with COPD risk. Compared to individuals with Glu/Glu wild‐genotype, those with 116Lys rare variants (Lys/Glu+Lys/Lys) had an increased risk of COPD (OR = 3.83, 95% CI: 2.64–5.56; P = 1.45 × 10−12). Meanwhile, the carriers with 116Lys rare variants (Lys/Glu+Lys/Lys) had lower pre‐forced expiratory volume in 1 s (pre‐FEV1
: 1.74 ± 0.70 vs 2.00 ± 0.68; P = 3.97 × 10−5) and lower pre‐FEV1
to pre‐forced vital capacity ratio (pre‐FEV1
/FVC: 0.68 ± 0.14 vs 0.75 ± 0.12; P = 2.40 × 10−10) than those with Glu/Glu genotype. However, for other rare variants, no significant association with either COPD risk or lung function was observed.

Conclusion

Our data strongly suggest that the p.Glu116Lys rare variant in MAP2K7 predisposes its carriers to develop COPD, which would provide a useful genetic biomarker for COPD susceptibility in Chinese.
Modeling Rabbit Responses to Single and Multiple Aerosol Exposures of Bacillus anthracis Spores
Authors: Coleman Margaret E. , Marks Harry M. , Bartrand Timothy A. , Donahue Darrell W. , Hines Stephanie A. , Comer Jason E. , Taft Sarah C.
Published: January 2017

Survival models are developed to predict response and time‐to‐response for mortality in rabbits following exposures to single or multiple aerosol doses of Bacillus anthracis spores. Hazard function models were developed for a multiple‐dose data set to predict the probability of death through specifying functions of dose response and the time between exposure and the time‐to‐death (TTD). Among the models developed, the best‐fitting survival model (baseline model) is an exponential dose–response model with a Weibull TTD distribution. Alternative models assessed use different underlying dose–response functions and use the assumption that, in a multiple‐dose scenario, earlier doses affect the hazard functions of each subsequent dose. In addition, published mechanistic models are analyzed and compared with models developed in this article. None of the alternative models that were assessed provided a statistically significant improvement in fit over the baseline model. The general approach utilizes simple empirical data analysis to develop parsimonious models with limited reliance on mechanistic assumptions. The baseline model predicts TTDs consistent with reported results from three independent high‐dose rabbit data sets. More accurate survival models depend upon future development of dose–response data sets specifically designed to assess potential multiple‐dose effects on response and time‐to‐response. The process used in this article to develop the best‐fitting survival model for exposure of rabbits to multiple aerosol doses of B. anthracis spores should have broad applicability to other host–pathogen systems and dosing schedules because the empirical modeling approach is based upon pathogen‐specific empirically‐derived parameters.
Is Private Saving in Latin America and the Caribbean Different?
Authors: Grigoli Francesco , Herman Alexander , Schmidt‐Hebbel Klaus
Published: January 2017

Private saving and economic growth are intimately linked, and low saving rates in Latin America and the Caribbean (LAC) have often been held responsible for disappointing growth in the region. Thus, identifying factors that spur saving is critical. This paper surveys previous empirical studies onLAC, highlighting contradictions, omissions and in some cases inconclusiveness of findings. Relying on a large dataset and a nested econometric framework, it analyzes private saving patterns and explores the role of its determinants inLAC, acrossLACsub‐regions and compared with other regions. While the results highlight great heterogeneity in private saving rates withinLACand compared with the rest of the world, saving determinants are broadly the same notwithstanding some differences in sensitivity and contributions' sizes, and include its lag, income, demographics and public saving.
‘Soft’ forms of direct democracy: Explaining the occurrence of referendum motions and advisory referendums in Finnish local government
Authors: Jäske Maija
Published: January 2017

This study investigates ‘soft’ forms of direct democracy and identifies factors that explain their occurrence. Soft direct democracy refers to non‐binding referendum motions and advisory referendums, which the literature on direct democracy has largely ignored. Strategic motives have dominated previous explanations of the occurrence of initiatives and referendums, but are less useful in exploring non‐binding procedures of direct democracy. The article distinguishes four types of factors – socio‐structural, party system, political support and learning – and tests hypotheses on their effects with sub‐national data from Finland. The data enable us to compare two different types of instruments – non‐binding referendum motions and advisory referendums – while controlling for many unobserved factors. The findings show that erosion of political support, participatory traditions and policy diffusion explain the occurrence of bottom‐up referendum motions, while the last two together with small population and party system factors predict the occurrence of advisory government‐initiated referendums.
Caesarean scar ectopic pregnancy: diagnostic challenges and management options
Authors: Jayaram Pradeep M , Okunoye Gbemisola O , Konje Justin
Published: January 2017

Key content

Incidence of caesarean scar pregnancy (CSP) is increasing because of a rising number of caesarean sections. Prompt diagnosis of the condition is required to reduce associated morbidity.

A high index of suspicion is required for women with a suggestive history of CSP. Ultrasound scan is the diagnostic tool of choice.

Management options include medical, surgical and interventional radiology. Appropriate patient selection is important for optimal results.

Major haemorrhage and hysterectomy are the main risks associated with CSP. Therefore, adequate counselling and availability of surgical expertise and blood transfusion should be part of a comprehensive management strategy.

Learning objectives

Understand the clinical and ultrasound features of CSP and distinguish these from features of other low implantation pregnancies.

Learn about available treatment options and the factors influencing treatment choices.

Be aware of the ethical issues associated with the diagnosis of live CSP.

Ethical issues

Do women planning subsequent pregnancy after a resolved CSP require surgery to close the uterine defect in the scar to prevent recurrent scar ectopic pregnancy?

Should the risk of CSP in a future pregnancy be routinely discussed prior to primary caesarean section?
Metabolic robustness in young roots underpins a predictive model of maize hybrid performance in the field
Authors: de Abreu e Lima Francisco , Westhues Matthias , Cuadros‐Inostroza Álvaro , Willmitzer Lothar , Melchinger Albrecht E. , Nikoloski Zoran
Published: January 2017

Heterosis has been extensively exploited for yield gain in maize (Zea mays L.). Here we conducted a comparative metabolomics‐based analysis of young roots from in vitro germinating seedlings and from leaves of field‐grown plants in a panel of inbred lines from the Dent and Flint heterotic patterns as well as selected F1 hybrids. We found that metabolite levels in hybrids were more robust than in inbred lines. Using state‐of‐the‐art modeling techniques, the most robust metabolites from roots and leaves explained up to 37 and 44% of the variance in the biomass from plants grown in two distinct field trials. In addition, a correlation‐based analysis highlighted the trade‐off between defense‐related metabolites and hybrid performance. Therefore, our findings demonstrated the potential of metabolic profiles from young maize roots grown under tightly controlled conditions to predict hybrid performance in multiple field trials, thus bridging the greenhouse–field gap.