bluuebunny/crossref_metadata_2025 huggingface dataset:
Validating screening tools for depression in epilepsy
Authors: Fiest Kirsten M. , Patten Scott B. , Wiebe Samuel , Bulloch Andrew G.M. , Maxwell Colleen J. , Jetté Nathalie
Published: August 2014

Objective

Depression is a common comorbidity of epilepsy, and its timely identification in persons with epilepsy is essential. The use of screening tools to detect depression is common in epilepsy, but some scales in current use have not been validated using a gold standard in this population. The present study aims to validate three commonly used depression‐screening scales and assess new cut points for scoring in those with epilepsy.

Methods

Persons with epilepsy (n = 300) from the only epilepsy clinic in a large urban health region completed questionnaires (e.g., sociodemographics, adverse event profile) and three depression‐screening tools (Hospital Anxiety and Depression Scale [HADS]; Patient Health Questionnaire [PHQ]‐9 and PHQ‐2). One hundred eighty‐five patients participated in a gold‐standard structured clinical interview to assess depression. The diagnostic accuracy of the depression scales was assessed comparing a variety of scoring cut points to the gold‐standard diagnosis of depression.

Results

The prevalence of current depression in this population, according to the gold‐standard, was 14.6%. The scale with the highest sensitivity (84.6%) was the HADS with a cut point of 6 and the scale with the highest specificity (96.2%) was the PHQ‐9 algorithm scoring method. Overall, the PHQ‐9 at a cut point of 9 and the HADS at a cut point of 7 resulted in the greatest balance of sensitivity and specificity (area under the curve: 88% and 90%, respectively).

Significance

The PHQ‐9 at a cut point of 9 and the HADS at a cut point of 7 had the best overall balance of sensitivity and specificity. However, for screening purposes the PHQ‐9 algorithm method is ideal (optimizing specificity), whereas for case finding the HADS at a cut point of 6 performed best (optimizing sensitivity). Appropriate scale cut points should be chosen based on the study's goals and available resources. Disease‐specific scale cut points are recommended for future studies assessing depression in persons with epilepsy.
A review of anhidrosis in horses
Authors: MacKay R. J. , Mallicote M. , Hernandez J. A. , Craft W. F. , Conway J. A.
Published: August 2014

Horses with anhidrosis are defined by signs of impaired thermoregulation caused by sweating that is inadequate for the ambient conditions. Anhidrosis has been recognised since the early twentieth century; affected horses have been variably described as nonsweaters, drycoats, blowers or puffers. The condition affects horses of all age groups, breeds, coat colours, genders and activities and is common among horses in hot, humid environments. Despite the enormous financial and emotional costs of anhidrosis, the causes and pathogenesis of the condition are largely unknown and no consistently effective treatment has been found.
Selective herbivory by an invasive cyprinid, the rudd Scardinius erythrophthalmus
Authors: Kapuscinski Kevin L. , Farrell John M. , Stehman Stephen V. , Boyer Gregory L. , Fernando Danilo D. , Teece Mark A. , Tschaplinski Timothy J.
Published: August 2014

Herbivory by non‐native animals is a problem of growing concern globally, especially for ecosystems where there were few native herbivores or where they have been replaced by non‐natives. The rudd (Scardinius erythrophthalmus) is an omnivorous cyprinid (native to Europe) now very widespread due to human introductions, yet it is unknown whether the invasive rudd feeds selectively among aquatic macrophyte species common in North America.

We tested feeding selectivity by rudd using five species of aquatic macrophytes: Ceratophyllum demersum, Elodea canadensis, Najas flexilis, Stuckenia pectinata and Vallisneria americana. Fish were presented with known quantities of each macrophyte species in a randomized complete block design, and we measured the mean per cent mass remaining in each case. We also quantified differences in the chemical attributes of the five macrophyte species and determined whether feeding by rudd was related to dry matter content (DMC), per cent C by dry mass (%C), per cent N by dry mass (%N), and the concentrations of total soluble proteins, two organic acids (aconitic and oxalic acid), total soluble phenolic compounds (<1000 Da), nine soluble phenolic metabolites and total phenolic compounds.

Rudd fed selectively, with consumption declining in the order N. flexilis > E. canadensis > S. pectinata > V. americana > C. demersum. Selection was positively related to %C and atomic C : N, but not DMC, %N or concentration of total soluble proteins, contrary to the expectation that rudd would select the most nutritious plants available. The concentration of aconitic acid was greatest in N. flexilis, a preferred macrophyte, contrary to the expectation that this compound provides resistance to herbivory. The concentration of oxalic acid, which negatively affects palatability, was highest in C. demersum, the least preferred macrophyte.

Selection was also positively related to the concentration of total (and some specific) soluble phenolic compounds. The concentrations of caffeic acid, trans‐caftaric acid and quercetin were positively related to macrophyte preference by rudd, whereas concentrations of cis‐4‐O‐ and trans‐4‐O‐ferulic acid glucoside were negatively related.

Selective feeding by rudd (which can be very numerous in North American fresh waters) could evidently alter macrophyte assemblages and hinder attempts to restore plant communities.
On the difference in the net ecosystem exchange of CO2 between deciduous and evergreen forests in the southeastern United States
Authors: Novick Kimberly A. , Oishi A. Christopher , Ward Eric J. , Siqueira Mario B. S. , Juang Jehn‐Yih , Stoy Paul C.
Published: August 2014

The southeastern United States is experiencing a rapid regional increase in the ratio of pine to deciduous forest ecosystems at the same time it is experiencing changes in climate. This study is focused on exploring how these shifts will affect the carbon sink capacity of southeastern US forests, which we show here are among the strongest carbon sinks in the continental United States. Using eight‐year‐long eddy covariance records collected above a hardwood deciduous forest (HW) and a pine plantation (PP) co‐located in North Carolina, USA, we show that the net ecosystem exchange of CO2 (NEE) was more variable in PP, contributing to variability in the difference in NEE between the two sites (ΔNEE) at a range of timescales, including the interannual timescale. Because the variability in evapotranspiration (ET) was nearly identical across the two sites over a range of timescales, the factors that determined the variability in ΔNEE were dominated by those that tend to decouple NEE from ET. One such factor was water use efficiency, which changed dramatically in response to drought and also tended to increase monotonically in nondrought years (P < 0.001 in PP). Factors that vary over seasonal timescales were strong determinants of the NEE in the HW site; however, seasonality was less important in the PP site, where significant amounts of carbon were assimilated outside of the active season, representing an important advantage of evergreen trees in warm, temperate climates. Additional variability in the fluxes at long‐time scales may be attributable to slowly evolving factors, including canopy structure and increases in dormant season air temperature. Taken together, study results suggest that the carbon sink in the southeastern United States may become more variable in the future, owing to a predicted increase in drought frequency and an increase in the fractional cover of southern pines.
Comprehensive geriatric assessment in elderly patients with dementia
Authors: Namioka Nayuta , Hanyu Haruo , Hatanaka Hirokuni , Fukasawa Raita , Sakurai Hirofumi , Iwamoto Toshihiko
Published: August 2014

Aim

We have recently developed and validated a screening test for comprehensive geriatric assessment (CGA) named “Dr. SUPERMAN”. We compared the results obtained by the CGA of patients with Alzheimer's disease (AD), vascular dementia (VaD) and dementia with Lewy bodies (DLB), and determined the relationship between functional deficits and clinical characteristics in each type of dementia.

Methods

We used Dr. SUPERMAN to examine patients with AD (24 men and 53 women, mean age 83.0 ± 5.1 years), VaD (10 men and 12 women, mean age 80.4 ± 5.0 years) and DLB (28 men and 20 women, mean age 81.2 ± 5.5 years).

Results

Patients with DLB or VaD had functional deficits more frequently than those with AD in many fields. Significant correlations between functional impairments and clinical characteristics, such as age, sex and Mini‐Mental State Examination scores, in the non‐AD group (including DLB and VaD) were found in more extensive fields than those in the AD group.

Conclusions

Patients with dementia, particularly DLB, have several geriatric problems. Correlations between functional deficits and clinical characteristics differ between the AD group and the non‐AD group. Non‐AD patients of older age who are male and have advanced dementia are more likely have several functional deficits. In addition to age and severity of dementia, the type of dementia should be considered in the treatments and interventions of elderly patients with dementia. Geriatr Gerontol Int 2015; 15: 27–33.
Severity of cognitive impairment as a prognostic factor for mortality and functional recovery of geriatric patients with hip fracture
Authors: Tarazona‐Santabalbina Francisco José , Belenguer‐Varea Ángel , Rovira Daudi Eduardo , Salcedo Mahiques Enmanuel , Cuesta Peredó David , Doménech‐Pascual Juan Ramón , Gac Espínola Homero , Avellana Zaragoza Juan Antonio
Published: August 2014

Aim

To identify how the severity of dementia influences functional recovery and mortality in elderly patients hospitalized for hip fracture.

Methods

An observational retrospective study of 1258 patients aged older than 69 years and diagnosed with hip fracture who received care within an orthogeriatrics unit from 2004 to 2008 was carried out. During a 12‐month follow‐up period, functional recovery and mortality outcomes were measured.

Results

Dementia was present in 383 (28.1%) patients: it was mild in 183 (48%), moderate in 102 (26.5%) and severe in 98 (25.5%). Compared with patients with preserved cognitive status, patients with dementia had the following statistically significant differences (means [standard deviation] or percentage): older age (preserved, 82.29 years [6.5 years]; mild, 83.63 years [6.1 years]; moderate, 83.47 years [5.9 years]; severe, 84.46 years [6.1 years]; P < 0.001); lower Barthel Index (89.7 [21.6], 72.7 [24.6], 58.9 [28.6], 38.0 [28.1]; P < 0.001); delirium (11.7%, 25.6%, 37.6%, 44.7%; P < 0.001); less ambulation at 6 months postdischarge (83.9%, 72.8%, 56.9%, 41.7%; P < 0.001); and higher mortality at discharge (4%, 5.7%, 8.2%, 10.6%; P < 0.001) and 12 months after discharge (21.2%, 32.3%, 46.3%, 53.5%; P < 0.001). Patients with severe dementia had lower probability of functional recovery at discharge (OR 0.272, 95% CI 0.140–0.526, P < 0.001) and 6 months after discharge (OR 0.439, 95% CI 0.197–0.979, P = 0.04), as well as a greater probability of dying (HR 1.640, 95% CI 1.020–2.635, P = 0.04).

Conclusions

We observed higher 12‐month mortality and less functional recovery with increasing severity of dementia. Geriatr Gerontol Int 2015; 15: 289–295.
Macronutrients intake and risk of Parkinson's disease: A meta‐analysis
Authors: Wang Aimin , Lin Yan , Wu Yili , Zhang Dongfeng
Published: August 2014

Aims

We carried out a meta‐analysis to summarize the evidence from published studies on macronutrients intake and risk of Parkinson's disease (PD).

Methods

Pertinent studies were identified by a search of PubMed and Embase. Study‐specific effect was combined with the random‐effect model. The dose–response relationship was assessed by the restricted cubic spline.

Results

For highest versus lowest level of intake, the relative risk (RR) of PD was 1.13 (95% CI 0.88–1.44) for protein (7 articles including 1570 PD cases among 357 827 subjects), RR 1.24 (95% CI 1.05–1.48) for carbohydrate (8 articles including 1482 PD cases among 232 869 subjects), RR 0.88 (95% CI 0.74–1.06) for fat (12 articles including 2936 PD cases among 374 124 subjects), RR 0.97 (95% CI 0.75–1.26) for cholesterol (6 articles including 1713 PD cases among 170 058 subjects) and 1.39 (95% CI 1.01–1.92) for energy (8 articles including 1553 PD cases among 170 317 subjects), respectively. Among prospective studies adjusting for smoking and coffee/caffeine, no associations were found between PD risk and intake of protein (RR 1.02, 95% CI 0.80–1.30), carbohydrate (RR 1.11, 95% CI 0.86–1.43), fat (RR 0.90, 95% CI 0.70–1.16), cholesterol (RR 0.89, 95% CI 0.74–1.09) and energy (RR 0.97, 95% CI 0.93–1.02); however, polyunsaturated fatty acid (RR 0.78, 95% CI 0.64–0.96) was inversely associated with PD risk. Limited data showed a linear dose–response relationship between the aforementioned macronutrients and PD risk.

Conclusions

Dietary intake of protein, carbohydrate, cholesterol and energy might be not independently associated with PD risk. Higher intake of polyunsaturated fatty acid might be inversely associated with PD risk. Confounding by smoking and coffee/caffeine should be considered regarding the association between fat intake and PD risk in further studies. Geriatr Gerontol Int 2015; 15: 606–616.
Older adults with chronic musculoskeletal pain are at increased risk of recurrent falls and the brief pain inventory could help identify those most at risk
Authors: Stubbs Brendon , Eggermont Laura , Patchay Sandhi , Schofield Pat
Published: August 2014

Aim

Chronic musculoskeletal pain (CMP) and falls are common among community‐dwelling older adults. The study aims were: (i) to investigate the relationship between CMP and any falls (≥1), single falls and recurrent falls (≥2) in community‐dwelling older adults; and (ii) to determine the discriminative validity of the Brief Pain Inventory (BPI) to differentiate between non‐fallers and (a) any and (b) recurrent fallers.

Methods

A cross‐sectional study involving 295 community‐dwelling participants (mean age 77.5 ± 8.1 years, 66.4% female) was carried out. CMP was assessed and classified as none (comparison group), single and multisite (≥2). The BPI severity and interference subscales were used, and falls were recorded over 12 months. Data were analyzed with logistic regression and receiver operating characteristic curves (ROC).

Results

Over half of the participants (154/295, 52.2%) had CMP (41.6% single and 58.4% multisite pain). Participants with CMP were at increased risk of recurrent falls (OR 2.25, 95% CI 1.03–4.88), and this risk was highest in those with multisite CMP (OR 3.43, CI 1.34–8.65). The BPI severity subscale showed good discriminative ability to differentiate between recurrent and non‐fallers with an area under the curve (AUC) of 0.731 (95% CI 0.635–0.826); a mean score of 5.1 had a sensitivity of 93.3% and specificity of 56.7%. The AUC for the BPI interference subscale was 0.724 (95% CI 0.630–0.818), and a cut‐off score of 4.6 had a sensitivity of 84.4% and specificity of 57.8%

Conclusion

Older adults with multisite CMP are at greatest risk of recurrent falls. In clinical settings, the BPI could prove useful to discriminate between recurrent and non‐fallers. Geriatr Gerontol Int 2015; 15: 881–888.
Risk factors for severe or fatal drug‐induced liver injury from amoxicillin–clavulanic acid
Authors: Yazici Cemal , Mutlu Ece , Bonkovsky Herbert L. , Russo Mark W.
Published: August 2014

Aim

To identify risk factors for severe liver injury or mortality from drug‐induced liver injury (DILI) from amoxicillin–clavulanic acid. To determine if co‐administration of potentially hepatotoxic drugs was associated with an increased risk of DILI from amoxicillin–clavulanic acid.

Methods

We conducted a systematic review of the published work and data extraction of articles on DILI injury from amoxicillin–clavulanic acid. Potentially hepatotoxic drugs were defined as medications with DILI listed in the package insert or reported in the published work. Individual patient data were entered into an SPSS (version 17.0; Chicago, IL, USA) database and were analyzed using the χ2‐test or Fisher's exact test; Student's t‐test; and non‐parametric tests such as Mann–Whitney U‐test as appropriate.

Results

We identified 3932 articles of which 41 publications with 255 reported cases met inclusion criteria. Mortality from DILI from amoxicillin–clavulanic acid was increased among patients receiving concomitant potentially hepatotoxic drugs compared with patients not on concomitant potential hepatotoxic drugs (21.4% [3/14] vs 2.3% [2/89], P = 0.017]. The most common classes of concomitant drugs were: antimicrobials, analgesics and hormonal therapy. Female patients were more likely to receive a concomitant potentially hepatotoxic medication (25% vs 9.1% for men, P = 0.05).

Conclusion

Patients who developed severe or fatal DILI from amoxicillin–clavulanic acid were more likely to be on concomitant hepatotoxic medications. Female patients were more likely to receive concomitant hepatotoxic drugs. Further studies are needed to investigate drug interaction between amoxicillin–clavulanic acid and concomitant potentially hepatotoxic drugs.
Inhibition of the CXCL12/CXCR4 chemokine axis with AMD3100, a CXCR4 small molecule inhibitor, worsens murine hepatic injury
Authors: Saiman Yedidya , Jiao JingJing , Fiel M. Isabel , Friedman Scott L. , Aloman Costica , Bansal Meena B.
Published: August 2014

Aim

Activation of hepatic stellate cells and development of chronic inflammation are two key features in the progression of hepatic fibrosis. We have shown that in vitro activated stellate cells increase their expression of CXCL12 as well as the receptor CXCR4 and that receptor engagement promotes a profibrogenic phenotype. Furthermore, injury promotes increased hepatic expression of CXCL12 and a massive infiltration of CXCR4‐expressing leukocytes, granulocytes and myeloid cells. The primary site of inflammatory cell accumulation is around the CXCL12‐rich portal tracts and within fibrotic septae, indicating a role for CXCR4 during injury. In order to characterize the relevance of the CXCR4/CXCL12 chemokine axis during hepatic injury we inhibited the axis using AMD3100, a CXCR4 small molecule inhibitor, in models of chronic and acute liver injury.

Methods

Mice were subjected to acute and chronic CCl4 liver injury with and without AMD3100 administration. The degree of liver injury, fibrosis and the composition of the intrahepatic inflammatory response were characterized.

Results

Treatment of mice with AMD3100 in the chronic CCl4 model of liver injury led to an increase in hepatic inflammation and fibrosis with a specific increase in intrahepatic neutrophils. Furthermore, in an acute model of CCl4‐induced liver injury, AMD3100 led to an increase in the number of intrahepatic neutrophils and a trend towards worse necrosis.

Conclusion

Together, this data suggests that inhibition of the CXCR4/CXCL12 chemokine axis is injurious through modulation of the hepatic inflammatory response and that this axis may serve a protective role in liver injury.
Online health information seeking: how people with multiple sclerosis find, assess and integrate treatment information to manage their health
Authors: Synnot Anneliese J. , Hill Sophie J. , Garner Kerryn A. , Summers Michael P. , Filippini Graziella , Osborne Richard H. , Shapland Sue D.P. , Colombo Cinzia , Mosconi Paola
Published: August 2014

Background and objective

The Internet is increasingly prominent as a source of health information for people with multiple sclerosis (MS). But there has been little exploration of the needs, experiences and preferences of people with MS for integrating treatment information into decision making, in the context of searching on the Internet. This was the aim of our study.

Design

Sixty participants (51 people with MS; nine family members) took part in a focus group or online forum. They were asked to describe how they find and assess reliable treatment information (particularly online) and how this changes over time. Thematic analysis was underpinned by a coding frame.

Results

Participants described that there was both too much information online and too little that applied to them. They spoke of wariness and scepticism but also empowerment. The availability of up‐to‐date and unbiased treatment information, including practical and lifestyle‐related information, was important to many. Many participants were keen to engage in a ‘research partnership’ with health professionals and developed a range of strategies to enhance the trustworthiness of online information. We use the term ‘self‐regulation’ to capture the variations in information seeking behaviour that participants described over time, as they responded to their changing information needs, their emotional state and growing expertise about MS.

Conclusions

People with MS have developed a number of strategies to both find and integrate treatment information from a range of sources. Their reflections informed the development of an evidence‐based consumer web site based on summaries of MS Cochrane reviews.
Interacting influences of climate factors and land cover types on the distribution of caddisflies (Trichoptera) in streams of a central European low mountain range
Authors: Kusch Jürgen
Published: August 2014

Effects of various climatic factors, altitude and land cover types on the distribution of eight caddisfly species were modelled from occurrence data by the use of the maximum entropy method. The predicted habitat use and the most contributing environmental factors differed considerably among species. Those differences of responses may be a basis for changes of assemblage structures with climate changes.

Precipitation in late spring to early summer, minimum temperatures in the second half of the year, and temperature seasonality, or other bioclimatic factors that give information about the temporal stability of temperatures (‘diurnal range’, ‘isothermality’), were key climate factors influencing the distribution of most of the studied species. Therefore, climate change may affect Trichoptera assemblages not only by the height of mean temperatures but also by temperature variability.

Land cover types contributed to the development of distribution models for several caddisfly species. Forests promoted most of the species, whereas cultivated and managed areas were less preferred. Few species concentrated on individual land cover types, e.g.Wormalida occipitalison coniferous forest. Therefore, different adaptations of caddisfly species to land cover types, in addition to climatic factors, seam to occur, and are discussed to facilitate niche partitioning.

Environmental variables that were observed to affect the distribution of caddisflies, i.e. temperature, precipitation, and vegetation, may interact with each other. Climate changes may influence caddisflies not only via temperature changes, but by related changes of precipitation regimes, and by a long‐term change of vegetation types, e.g. tree species predominant in forests.
Integrative species delimitation and conservation of tarantulas (Araneae, Mygalomorphae, Theraphosidae) from a North American biodiversity hotspot
Authors: Hendrixson Brent E. , Guice Alexis V. , Bond Jason E.
Published: August 2014

The Madrean Sky Islands of northern Mexico and the south‐western United States are located in the Madrean pine–oak woodlands ‘biodiversity hotspot’. This area is renowned for its exceptional flora and fauna, but comparatively little is known about arthropod diversity in this region. We obtained specimens of the tarantula genus Aphonopelma from five different mountain ranges (Huachucas, Pajaritos, Peloncillos, Santa Catalinas, and Santa Ritas) to assess patterns of diversity within the group.

Species delimitation in tarantulas is difficult because they possess few informative morphological features. We implemented a rigorous methodological framework for delimiting species that incorporated multiple lines of evidence (molecules, distributional information, morphology, and breeding period) in an explicitly hypothesis‐driven manner.

Our integrative taxonomic approach delimited three species (all undescribed): one endemic to the Peloncillos, one endemic to the Santa Catalinas, and one that is more widely distributed in the Huachucas, Santa Ritas, and Pajaritos. These patterns of diversity and endemicity are comparable to other arachnids in the region and suggest that species‐level diversity of stenotypic/dispersal‐limited arthropods throughout the Madrean Sky Island Region may be underestimated.

Ecological data are not widely available for Madrean Sky Island tarantulas and it is difficult to evaluate their conservation status. Several intrinsic (patterns of endemicity, limited vagility, and life history) and extrinsic (habitat degradation, commercial exploitation, and climate change) factors, however, suggest that these spiders may be of conservation concern. The approach taken in this study highlights the importance of considering multiple lines of evidence when species delimitation has direct implications on conservation.
The Association between Client‐specific Investment Opportunities and Audit Fees of Industry Specialists and Non‐Specialists
Authors: Cahan Steven F. , Godfrey Jayne M. , Hamilton Jane , Jeter Debra C.
Published: August 2014

Audit clients' investment opportunity sets (IOS) include firm‐specific opportunities that are unique to the client, as well as opportunities generalizable to the client's industry and opportunities even more generically available to all firms. Prior research does not examine the variation in audit fees related to firm‐specific IOS nor how firm‐specific IOS affects the premiums charged by industry specialist auditors. We find that firm‐specific IOS plays a distinct role in the pricing of audit services, leading to higher fees as the auditor demands compensation for increased audit risk. Further, we find that the ability of an industry specialist auditor to charge fee premiums is reduced in the case of clients that are highly differentiated based on firm‐specific IOS, as the knowledge gleaned in auditing other clients within the industry is often not applicable to clients in more unique IOS environments. We contribute to the literature by showing that industry specialist premiums are not constant for firms in the same industry; rather, they reflect a trade‐off between firm‐ and industry‐specific knowledge.
Impact of appearance on degree of liking and eating quality expectations of selected apple cultivars
Authors: van der Merwe Anreza , Muller Magdalena , van der Rijst Marieta , Labuschagné Iwan F. , Næs Tormod , Steyn Willem J.
Published: August 2014

This study investigated the effect of taste expectations based on cultivar recognition on the preference for apple‐eating quality. Consumer preference for eating quality was assessed using three levels of product information, viz. (i) no visual information, (ii) a photograph depicting the typical appearance of the specific cultivar and (iii) an incorrect photograph, misleadingly depicting a different cultivar. Consumers scored the eating quality of ‘Pink Lady™’ served with the correct photograph significantly higher compared with presentation without pictorial information, suggesting a positive image for this trademark cultivar. Conversely, consumers had lower eating quality expectations for ‘Starking’ and ‘Golden Delicious’ indicated by lower scores when supplied with matching photos. Cultivar developers and researchers should be mindful of the confounding effect of fruit appearance on the hedonic assessment of eating quality. The order of presentation (matching or wrong photograph first) affected the preference scores and should be considered in future studies.
Physical activity and sedentary behaviour: applying lessons to chronic obstructive pulmonary disease
Authors: Hill K. , Gardiner P. A. , Cavalheri V. , Jenkins S. C. , Healy G. N.
Published: August 2014

In health and disease, the benefits of regular participation in moderate to vigorous intensity physical activity are well documented. However, individuals with chronic conditions, such as those with chronic obstructive pulmonary disease (COPD), typically do very little activity at a moderate or vigorous intensity. Much of their day is instead spent in sedentary behaviour, such as sitting or reclining, which requires very little energy expenditure. This high level of time spent in sedentary behaviour can have serious health consequences, including increased risk of diabetes, cardiovascular disease and premature mortality. There is emerging evidence to suggest that participation in light intensity physical activities (e.g. standing or slow walking) may have benefits for cardio‐metabolic health. Given the low aerobic capacity of individuals with moderate to severe COPD, increasing light intensity activity (through reducing sedentary time) may be a feasible additional strategy to improve health in this population, alongside traditional recommendations to increase the time spent in moderate to vigorous intensity physical activity. This review provides an overview of physical activity and sedentary behaviour, with a particular emphasis on these behaviours for people with COPD. It provides suggestions for the measurement of these behaviours within the clinical setting, as well as for interventions that may be effective at increasing physical activity and reducing sedentary behaviour in this population.
Motivations of nurses who migrate to Canada as domestic workers
Authors: Salami B. , Nelson S. , Hawthorne L. , Muntaner C. , McGillis Hall L.
Published: August 2014

Background

While some trained nurses migrate to destination countries to work as domestic workers, little is known about their migration motivations.

Aim

This study explores the motivations of Philippine educated nurses who migrated to Canada through the Live‐in Caregiver Program from 2001 to 2011 (a Canadian domestic worker programme).

Methods

A single case study qualitative methodology and the transnational feminist concept of global care chains were utilized for this study. Interviews of 15 Philippine educated nurses who migrated to Canada as domestic workers were conducted in the province of Ontario, Canada, between February to October 2012. All participants had a baccalaureate degree from the Philippines. Interviews were tape recorded, transcribed verbatim and analysed using critical discourse analysis, aided by NVIVO 10 data analysis software.

Results

Findings reveal a multi‐step immigration process in which nurses migrate from the Philippines to the Middle East (especially Saudi Arabia) and finally to Canada. While emigration from the Philippines is mainly economically driven, migration from the Middle East to Canada is primarily motivated by the desire for Canadian citizenship for the family. Also, perceived social status and lifestyle in Canada as compared to the Middle East motivates this group of women to migrate to Canada.

Limitation

The major limitation of this study is the lack of input from nursing policy makers.

Conclusion

Gender‐based familial ideologies and perspective on social status influence the migration decision of this group of nurses.

Implications for Nursing and Health Policy

Implications for nursing and health policy makers include the provision of clear pre‐migration information (including on the nursing registration process) to internationally educated nurses, advocacy for stronger immigration policies to ensure the integration of internationally educated nurses and a consideration of gender in all health human resource policies.
From cell membrane to the nucleus: an emerging role of E‐cadherin in gene transcriptional regulation
Authors: Du Wenjun , Liu Xi , Fan Guiling , Zhao Xingsheng , Sun Yanying , Wang Tianzhen , Zhao Ran , Wang Guangyu , Zhao Ci , Zhu Yuanyuan , Ye Fei , Jin Xiaoming , Zhang Fengmin , Zhong Zhaohua , Li Xiaobo
Published: August 2014

E‐cadherin is a well‐known mediator of cell–cell adherens junctions. However, many other functions of E‐cadherin have been reported. Collectively, the available data suggest that E‐cadherin may also act as a gene transcriptional regulator. Here, evidence supporting this claim is reviewed, and possible mechanisms of action are discussed. E‐cadherin has been shown to modulate the activity of several notable cell signalling pathways, and given that most of these pathways in turn regulate gene expression, we proposed that E‐cadherin may regulate gene transcription by affecting these pathways. Additionally, E‐cadherin has been shown to accumulate in the nucleus where documentation of an E‐cadherin fragment bound to DNA suggests that E‐cadherin may directly regulate gene transcription. In summary, from the cell membrane to the nucleus, a role for E‐cadherin in gene transcription may be emerging. Studies specifically focused on this potential role would allow for a more thorough understanding of this transmembrane glycoprotein in mediating intra‐ and intercellular activities.
Notch3 is necessary for neuronal differentiation and maturation in the adult spinal cord
Authors: Rusanescu Gabriel , Mao Jianren
Published: August 2014

Notch receptors are key regulators of nervous system development and promoters of neural stem cells renewal and proliferation. Defects in the expression of Notch genes result in severe, often lethal developmental abnormalities. Notch3 is generally thought to have a similar proliferative, anti‐differentiation and gliogenic role to Notch1. However, in some cases, Notch3 has an opposite, pro‐differentiation effect. Here, we show that Notch3 segregates from Notch1 and is transiently expressed in adult rat and mouse spinal cord neuron precursors and immature neurons. This suggests that during the differentiation of adult neural progenitor cells, Notch signalling may follow a modified version of the classical lateral inhibition model, involving the segregation of individual Notch receptors. Notch3 knockout mice, otherwise neurologically normal, are characterized by a reduced number of mature inhibitory interneurons and an increased number of highly excitable immature neurons in spinal cord laminae I–II. As a result, these mice have permanently lower nociceptive thresholds, similar to chronic pain. These results suggest that defective neuronal differentiation, for example as a result of reduced Notch3 expression or activation, may underlie human cases of intractable chronic pain, such as fibromyalgia and neuropathic pain.
First evidence of TRPV5 and TRPV6 channels in human parathyroid glands: possible involvement in neoplastic transformation
Authors: Giusti Laura , Cetani Filomena , Da Valle Ylenia , Pardi Elena , Ciregia Federica , Donadio Elena , Gargini Claudia , Piano Ilaria , Borsari Simona , Jaber Ali , Caputo Antonella , Basolo Fulvio , Giannaccini Gino , Marcocci Claudio , Lucacchini Antonio
Published: August 2014

The parathyroid glands play an overall regulatory role in the systemic calcium (Ca2+) homeostasis. The purpose of the present study was to demonstrate the presence of the Ca2+ channels transient receptor potential vanilloid (TRPV) 5 and TRPV6 in human parathyroid glands. Semi‐quantitative and quantitative PCR was carried out to evaluate the presence of TRPV5 and TRPV6 mRNAs in sporadic parathyroid adenomas and normal parathyroid glands. Western blot and immunocytochemical assays were used to assess protein expression, cellular localization and time expression in primary cultures from human parathyroid adenoma. TRPV5 and TRPV6 transcripts were then identified both in normal and pathological tissues. Predominant immunoreactive bands were detected at 75–80 kD for both vanilloid channels. These channels co‐localized with the calcium‐sensing receptor (CASR) on the membrane surface, but immunoreactivity was also detected in the cytosol and around the nuclei. Our data showed that western blotting recorded an increase of protein expression of both channels in adenoma samples compared with normal glands suggesting a potential relation with the cell calcium signalling pathway and the pathological processes of these glands.
Heterodimerization of apelin receptor and neurotensin receptor 1 induces phosphorylation of ERK1/2 and cell proliferation via Gαq‐mediated mechanism
Authors: Bai Bo , Cai Xin , Jiang Yunlu , Karteris Emmanouil , Chen Jing
Published: August 2014

Dimerization of G protein‐coupled receptors (GPCRs) is crucial for receptor function including agonist affinity, efficacy, trafficking and specificity of signal transduction, including G protein coupling. Emerging data suggest that the cardiovascular system is the main target of apelin, which exerts an overall neuroprotective role, and is a positive regulator of angiotensin‐converting enzyme 2 (ACE2) in heart failure. Moreover, ACE2 cleaves off C‐terminal residues of vasoactive peptides including apelin‐13, and neurotensin that activate the apelin receptor (APJ) and neurotensin receptor 1 (NTSR1) respectively, that belong to the A class of GPCRs. Therefore, based on the similar mode of modification by ACE2 at peptide level, the homology at amino acid level and the capability of forming dimers with other GPCRs, we have been suggested that APJ and NTSR1 can form a functional heterodimer. Using co‐immunoprecipitation, BRET and FRET, we provided conclusive evidence of heterodimerization between APJ and NTSR1 in a constitutive and induced form. Upon agonist stimulation, hetrodimerization enhanced ERK1/2 activation and increased proliferation via activation of Gq α‐subunits. These novel data provide evidence for a physiological role of APJ/NTSR1 heterodimers in terms of ERK1/2 activation and increased intracellular calcium and induced cell proliferation and provide potential new pharmaceutical targets for cardiovascular disease.
Improving the Bandwidth Selection in Kernel Equating
Authors: Andersson Björn , von Davier Alina A.
Published: August 2014

We investigate the current bandwidth selection methods in kernel equating and propose a method based on Silverman's rule of thumb for selecting the bandwidth parameters. In kernel equating, the bandwidth parameters have previously been obtained by minimizing a penalty function. This minimization process has been criticized by practitioners for being too complex and that it does not offer sufficient smoothing in certain cases. In addition, the bandwidth parameters have been treated as constants in the derivation of the standard error of equating even when they were selected by considering the observed data. Here, the bandwidth selection is simplified, and modified standard errors of equating (SEEs) that reflect the bandwidth selection method are derived. The method is illustrated with real data examples and simulated data.
Impact of serum levels of interleukin‐6 and adiponectin on all‐cause, liver‐related, and liver‐unrelated mortality in chronic hepatitis C patients
Authors: Nakagawa Hayato , Fujiwara Naoto , Tateishi Ryosuke , Arano Toru , Nakagomi Ryo , Kondo Mayuko , Minami Tatsuya , Sato Masaya , Uchino Koji , Enooku Kenichiro , Asaoka Yoshinari , Kondo Yuji , Shiina Shuichiro , Yoshida Haruhiko , Koike Kazuhiko
Published: August 2014

Background and Aim

Various inflammatory cytokines and adipokines have been implicated in hepatitis C virus (HCV)‐mediated liver disease, and interleukin‐6 (IL‐6) and adiponectin may play key roles. In addition, these factors may be associated with chronic hepatitis C (CHC)‐induced extrahepatic manifestations. However, little data are available on the role of these factors on future outcomes of CHC patients. This study aims to evaluate the impact of serum levels of IL‐6 and adiponectin on all‐cause mortality, liver‐related mortality, and liver‐unrelated mortality.

Methods

A long‐term follow‐up study was conducted, consisting of 325 CHC patients, for which we previously reported positive associations between these factors (Serum levels of IL‐6 and adiponectin) and hepatocellular carcinoma (HCC) development.

Results

During the follow‐up period (mean, 13.0 year), there were 92 events consisting of 91 deaths (liver related, 72; liver unrelated, 19) and 1 liver transplantation due to liver failure. High IL‐6 and adiponectin levels, defined as being higher than each median value at baseline, were associated with significantly higher incidences of not only HCC development but also all‐cause mortality. Interestingly, high IL‐6 was strongly associated with only liver‐related mortality, whereas high‐serum adiponectin was associated with not only liver‐related, but also liver‐unrelated mortality. Multivariate analysis identified high IL‐6 as an independent risk factor for liver‐related mortality and high adiponectin as an independent risk factor for liver‐unrelated mortality.

Conclusion

High serum levels of IL‐6 and adiponectin were associated with higher all‐cause and liver‐related mortality in CHC patients. In addition, high adiponectin was associated with liver‐unrelated mortality. The measurement of these factors may provide information useful for predicting future outcomes in CHC patients.
Fecal microbiota transplantation through mid‐gut for refractory Crohn's disease: Safety, feasibility, and efficacy trial results
Authors: Cui Bota , Feng Qiang , Wang Honggang , Wang Min , Peng Zhaoyuan , Li Pan , Huang Guangming , Liu Zheng , Wu Ping , Fan Zhining , Ji Guozhong , Wang Xin , Wu Kaichun , Fan Daiming , Zhang Faming
Published: August 2014

Abstact

Background and Aim

The gut microbiota plays a pivotal role in the intestinal diseases. Fecal microbiota transplantation (FMT) might be a rescue therapy for refractory inflammatory bowel disease. This study aimed to evaluate the safety, feasibility, and efficacy of FMT through mid‐gut for refractory Crohn's disease (CD).

Methods

We established standardized laboratory protocol and clinical work flow for FMT. Only refractory CD patients with Harvey–Bradshaw Index (HBI) score ≥ 7 were enrolled for this study. All included patients were treated with single FMT through mid‐gut and assessed during follow‐up.

Results

Metagenomics analysis showed a high concordance between feces sample and purified fecal microbiota from same donors. Standardized fecal microbiota preparation and clinical flow significantly simplified the practical aspects of FMT. Totally, 30 patients were qualified for the present analysis. The rate of clinical improvement and remission based on clinical activity at the first month was 86.7% (26/30) and 76.7% (23/30), respectively, which was higher than other assessment points within 15‐month follow‐up. Patients' body weight increased after FMT, and the lipid profile improved as well. FMT also showed a fast and continuous significant effect in relieving the sustaining abdominal pain associated with sustaining CD.

Conclusion

This is a pilot study with the largest sample of patients with refractory CD who underwent single FMT. The results demonstrated that FMT through mid‐gut might be a safe, feasible, and efficient rescue therapy for refractory CD.
Investigating the use of the neutropenic diet: a survey of UK dietitians
Authors: Carr S. E. , Halliday V.
Published: August 2014

Background

Patients with chemotherapy‐induced neutropenia are at increased risk of infection. Historically, dietary restrictions commonly referred to as ‘clean’, ‘low bacteria’, ‘low‐microbial’ or ‘neutropenic’ diets have been prescribed to reduce the risk of foodborne infection. Although research does not support their effectiveness, they continue to be used in clinical practice. The present study aimed to investigate the use of dietary restrictions in patients with cancer in the UK by surveying registered dietitians (RDs).

Methods

An online questionnaire was distributed to 573 RDs via local and specialist interest groups of the British Dietetic Association.

Results

One hundred and ten questionnaires were returned. Of these, 67.8% of RDs prescribed dietary restrictions to patients, with ‘neutropenic diet’ being the most commonly used term. Specialist oncology or haematology RDs were more likely to use the diet than nonspecialist RDs (P < 0.005). The variety of foods restricted varied greatly and was often contradicting. Unpasteurised dairy products and raw or lightly cooked meat or fish were most commonly restricted. Less than half (43.6%) of RDs had a policy in place for the use of neutropenic diets, with specialist oncology and haematology RDs more likely to report this (P < 0.005).

Conclusions

Neutropenic dietary advice provided by dietitians in the UK varies greatly. Further high‐quality research is required to create an evidence base from which national clinical guidelines can be formed.
Effects of a single course versus repeated courses of antenatal corticosteroids on fetal growth, placental morphometry and the differential regulation of vascular endothelial growth factor
Authors: Elfayomy Amr K. , Almasry Shaima M.
Published: August 2014

Aim

To investigate the impact of antenatal exposure to a single course or repeated courses of dexamethasone (DEX) on neonatal anthropometrics, placental morphometry and potential effect on maternal plasma levels and placental expression of vascular endothelial growth factor (VEGF).

Methods

Pregnant women between 27 and 32 weeks of gestation who delivered between 28 and 40 weeks and received a single course (n = 38) or repeated courses (n = 33) of DEX were compared to gestational age‐matched controls (n = 30). Maternal blood samples were obtained, and placental biopsy was taken. Area percent of VEGF immunostaining and villous capillarization index were evaluated using image analysis.

Results

Infants exposed to repeated courses of DEX were significantly associated with decreased birthweight, body length, head circumference and placental weight compared with controls (P = 0.011, P < 0.001, P = 0.004, P < 0.001, respectively) and with the group that received a single course of DEX (P = 0.021, P = 0.020, P = 0.049, P = 0.010, respectively). There was a significant decrease in maternal VEGF plasma levels and percentage of VEGF immunostained area after repeated courses of DEX compared with controls (P < 0.001 and P = 0.001, respectively) or a single course (P = 0.028 and P = 0.002, respectively). Notably, repeated courses of DEX impaired normal increase in villous capillarization index compared with controls or a single course (P = 0.001 and P = 0.041, respectively).

Conclusion

Repeated antenatal courses of DEX compromised fetal and placental growth compared with a single course of DEX, and these effects were potentially mediated by altered maternal plasma levels and placental expression of VEGF with consequent decrease in placental vascularization. Because of continuing uncertainties, several key messages for clinicians are provided.
Large rectovaginal fistula due to a cube pessary despite routine follow‐up; but what is ‘routine'?
Authors: Torbey Matthew J.
Published: August 2014

Vaginal pessaries are generally considered a safe and effective form of management for pelvic organ prolapse. Serious complications such as rectovaginal fistula can develop with or without regular follow‐up. This case report describes the rapid development over a 10‐week period of a large rectovaginal fistula in a 75‐year‐old woman, despite routine follow‐up and replacement of her cube pessary. Currently, there is a lack of evidence‐based guidelines for pessary care and, in particular, the frequency of pessary replacement. Intervals for pessary replacements vary greatly and are often based on the manufacturer's recommendations. This case highlights the rapidity at which serious complications can develop and also represents the first reported case of a cube pessary‐induced rectovaginal fistula.