bluuebunny/crossref_metadata_2025 huggingface dataset:
Fruit carotenoid‐deficient mutants in tomato reveal a function of the plastidial isopentenyl diphosphate isomerase (IDI1) in carotenoid biosynthesis
Authors: Pankratov Ilya , McQuinn Ryan , Schwartz Jochanan , Bar Einat , Fei Zhangjun , Lewinsohn Efraim , Zamir Dani , Giovannoni James J. , Hirschberg Joseph
Published: June 2016

Isoprenoids consist of a large class of compounds that are present in all living organisms. They are derived from the 5C building blocks isopentenyl diphosphate (IDP) and its isomer dimethylallyl diphosphate (DMADP). In plants, IDP is synthesized in the cytoplasm from mevalonic acid via the MVA pathway, and in plastids from 2‐C‐methyl‐d‐erythritol‐4‐phosphate through the MEP pathway. The enzyme IDP isomerase (IDI) catalyzes the interconversion between IDP and DMADP. Most plants contain two IDI enzymes, the functions of which are characteristically compartmentalized in the cells. Carotenoids are isoprenoids that play essential roles in photosynthesis and provide colors to flowers and fruits. They are synthesized in the plastids via the MEP pathway. Fruits of Solanum lycopersicum (tomato) accumulate high levels of the red carotene lycopene. We have identified mutations in tomato that reduce overall carotenoid accumulation in fruits. Four alleles of a locus named FRUIT CAROTENOID DEFICIENT 1 (fcd1) were characterized. Map‐based cloning of fcd1 indicated that this gene encodes the plastidial enzyme IDI1. Lack of IDI1 reduced the concentration of carotenoids in fruits, flowers and cotyledons, but not in mature leaves. These results indicate that the plastidial IDI plays an important function in carotenoid biosynthesis, thus highlighting its role in optimizing the ratio between IDP and DMADP as precursors for different downstream isoprenoid pathways.
Kit receptor tyrosine kinase dysregulations in feline splenic mast cell tumours
Authors: Sabattini S. , Barzon G. , Giantin M. , Lopparelli R. M. , Dacasto M. , Prata D. , Bettini G.
Published: June 2016

This study investigated Kit receptor dysregulations (cytoplasmic immunohistochemical expression and/orc‐KITmutations) in cats affected with splenic mast cell tumours. Twenty‐two cats were included. Median survival time was 780 days (range: 1–1219). An exclusive splenic involvement was significantly (P= 0.042) associated with longer survival (807 versus 120 days). Eighteen tumours (85.7%) showed Kit cytoplasmic expression (Kit pattern 2, 3). Mutation analysis was successful in 20 cases. Fourteen missense mutations were detected in 13 out of 20 tumours (65%). Eleven (78.6%) were located in exon 8, and three (21.6%) in exon 9. No mutations were detected in exons 11 and 17. Seven mutations corresponded to the same internal tandem duplication in exon 8 (c.1245_1256dup). Although the association between Kit cytoplasmic expression and mutations was significant, immunohistochemistry cannot be considered a surrogate marker for mutation analysis. No correlation was observed betweenc‐Kitmutations and tumour differentiation, mitotic activity or survival.
MOBILITY PREDICTION METHOD FOR VEHICULAR NETWORK USING MARKOV CHAIN
Authors: Hasbollah Arfah , H. S. Ariffin Sharifah , Fisal N.
Published: June 2016

This paper proposes mobility prediction technique via Markov Chains with an input of user’s mobile data traces to predict the user’s movement in wireless network. The main advantage of this method is prediction will give knowledge of user’s movement in advance even in fast moving vehicle. Furthermore, the information from prediction result will be use to assist handover procedure by reserve resource allocation in advance in vehicular network. This algorithm is simple and can be computed within short time; thus the implementation of this technique will give the significant impact especially on higher speed vehicle. Finally, an experiment is performed using real mobile user data traces as input for Markov chain to predict next user movement. To evaluate the effectiveness of the proposed method, MATLAB simulations are carried out with several users under same location zone.  The results show that the proposed method predicts have good performance which is 30% of mobile users achieved 100% of prediction accuracy.
AN ONLINE EXPERT SYSTEM FOR CONSULTATION SERVICES USING A MOBILE APPLICATION INTERFACE
Authors: Istiadi Istiadi , Rofii Faqih , Qustoniah Anis , Marisa Fitri , Putra Guntur Dharma
Published: June 2016

An expert system service that deals with public problems or wide ranges of users basically requires an alternative medium, which is accessible. This paper proposes interface expansion for Web and WAP based expert system consulting application using an Android application interface. An open and accessible web service is developed to provide an access to the Android application to reach the knowledge base in the form of a decision tree stored in a particular database. The Android application employs HTTP for accessing data in a JSON format through web service. Then, the consultation mechanism would run interactively following an available path in the decision tree model from initial symptom identification to reach a conclusion.
Closed-Loop Fluid Resuscitation Control Via Blood Volume Estimation
Authors: Bighamian Ramin , Kim Chang-Sei , Reisner Andrew T. , Hahn Jin-Oh
Published: June 2016

This paper presents a closed-loop control of fluid resuscitation to overcome hypovolemia based on model-based estimation of relative changes in blood volume (BV). In this approach, the control system consists of a model-based relative BV (RBV) estimator and a feedback controller. The former predicts relative changes in the BV response to augmented fluid by analyzing an arterial blood pressure (BP) waveform and the electrocardiogram (ECG). Then, the latter determines the amount of fluid to be augmented by comparing target versus predicted relative changes in BV. In this way, unlike many previous methods for fluid resuscitation based on controlled variable(s) nonlinearly correlated with the changes in BV, fluid resuscitation can be guided by a controlled variable linearly correlated with the changes in BV. This paper reports initial design of the closed-loop fluid resuscitation system and its in silico evaluation in a wide range of hypovolemic scenarios. The results suggest that closed-loop fluid resuscitation guided by a controlled variable linearly correlated with the changes in BV can be effective in overcoming hypovolemia: across 100 randomly produced hypovolemia cases, it resulted in the BV regulation error of 7.98 ± 171.6 ml, amounting to 0.18 ± 3.04% of the underlying BV. When guided by pulse pressure (PP), a classical controlled variable nonlinearly correlated with the changes in BV; the same closed-loop fluid resuscitation system resulted in persistent under-resuscitation with the BV regulation error of −779.1 ± 147.4 ml, amounting to −13.9 ± 2.65% of the underlying BV.
Ultrasensitive interferometric on-chip microscopy of transparent objects
Authors: Terborg Roland A. , Pello Josselin , Mannelli Ilaria , Torres Juan P. , Pruneri Valerio
Published: June 2016

An optical reader made of consumer electronics components interferometrically detects ultrathin glass and protein patterns.
Domain morphology, boundaries, and topological defects in biophotonic gyroid nanostructures of butterfly wing scales
Authors: Singer Andrej , Boucheron Leandra , Dietze Sebastian H. , Jensen Katharine E. , Vine David , McNulty Ian , Dufresne Eric R. , Prum Richard O. , Mochrie Simon G. J. , Shpyrko Oleg G.
Published: June 2016

Coherent X-rays reveal defects in photonic crystals of butterfly wings.
Role of scaffold network in controlling strain and functionalities of nanocomposite films
Authors: Chen Aiping , Hu Jia-Mian , Lu Ping , Yang Tiannan , Zhang Wenrui , Li Leigang , Ahmed Towfiq , Enriquez Erik , Weigand Marcus , Su Qing , Wang Haiyan , Zhu Jian-Xin , MacManus-Driscoll Judith L. , Chen Long-Qing , Yarotski Dmitry , Jia Quanxi
Published: June 2016

The tuning of functional properties in thick oxide films via nanoscaffolds induced large vertical lattice strain.
Time-gated FRET nanoassemblies for rapid and sensitive intra- and extracellular fluorescence imaging
Authors: Afsari Hamid Samareh , Cardoso Dos Santos Marcelina , Lindén Stina , Chen Ting , Qiu Xue , van Bergen en Henegouwen Paul M. P. , Jennings Travis L. , Susumu Kimihiro , Medintz Igor L. , Hildebrandt Niko , Miller Lawrence W.
Published: June 2016

The time-gated FRET technique is used for rapid, sensitive intra- and extracellular imaging.
The new world atlas of artificial night sky brightness
Authors: Falchi Fabio , Cinzano Pierantonio , Duriscoe Dan , Kyba Christopher C. M. , Elvidge Christopher D. , Baugh Kimberly , Portnov Boris A. , Rybnikova Nataliya A. , Furgoni Riccardo
Published: June 2016

The world atlas of zenith artificial night sky brightness is modelled with VIIRS DNB data and calibrated with more than 35,000 observations.
Membrane messengers: Extracellular vesicles
Authors: Perkel Jeffrey M.
Published: June 2016

For many years, it seems, researchers have had only a limited understanding of cellular communication. That cells could talk to one another via secreted hormones and growth factors was well known. That they also communicate using elaborate vesicular messages written in nucleic acids, proteins, and lipids was not. These vesicles play key roles in both development and disease. Now, researchers are developing new tools and strategies to study them and to exploit their potential in both diagnostics and therapeutics.

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Bridging indigenous and scientific knowledge
Authors: Mistry Jayalaxshmi , Berardi Andrea
Published: June 2016

Local ecological knowledge must be placed at the center of environmental governance
Oligodendrocyte heterogeneity in the mouse juvenile and adult central nervous system
Authors: Marques Sueli , Zeisel Amit , Codeluppi Simone , van Bruggen David , Mendanha Falcão Ana , Xiao Lin , Li Huiliang , Häring Martin , Hochgerner Hannah , Romanov Roman A. , Gyllborg Daniel , Muñoz-Manchado Ana B. , La Manno Gioele , Lönnerberg Peter , Floriddia Elisa M. , Rezayee Fatemah , Ernfors Patrik , Arenas Ernest , Hjerling-Leffler Jens , Harkany Tibor , Richardson William D. , Linnarsson Sten , Castelo-Branco Gonçalo
Published: June 2016

One size does not fit all

Oligodendrocytes are best known for their ability to myelinate brain neurons, thus increasing the speed of signal transmission. Marques
et al.
surveyed oligodendrocytes of developing mice and found unexpected heterogeneity. Transcriptional analysis identified 12 populations, ranging from precursors to mature oligodendrocytes. Transcriptional profiles diverged as the oligodendrocytes matured, building distinct populations. One population was responsive to motor learning, and another, with a different transcriptome, traveled along blood vessels.

Science
, this issue p.
1326
Phasins, Multifaceted Polyhydroxyalkanoate Granule-Associated Proteins
Authors: Mezzina Mariela P. , Pettinari M. Julia
Published: June 2016

Phasins are the major polyhydroxyalkanoate (PHA) granule-associated proteins. They promote bacterial growth and PHA synthesis and affect the number, size, and distribution of the granules. These proteins can be classified in 4 families with distinctive characteristics. Low-resolution structural studies and
in silico
predictions were performed in order to elucidate the structure of different phasins. Most of these proteins share some common structural features, such as a preponderant α-helix composition, the presence of disordered regions that provide flexibility to the protein, and coiled-coil interacting regions that form oligomerization domains. Due to their amphiphilic nature, these proteins play an important structural function, forming an interphase between the hydrophobic content of PHA granules and the hydrophilic cytoplasm content. Phasins have been observed to affect both PHA accumulation and utilization. Apart from their role as granule structural proteins, phasins have a remarkable variety of additional functions. Different phasins have been determined to (i) activate PHA depolymerization, (ii) increase the expression and activity of PHA synthases, (iii) participate in PHA granule segregation, and (iv) have both
in vivo
and
in vitro
chaperone activities. These properties suggest that phasins might play an active role in PHA-related stress protection and fitness enhancement. Due to their granule binding capacity and structural flexibility, several biotechnological applications have been developed using different phasins, increasing the interest in the study of these remarkable proteins.
Approved Antiviral Drugs over the Past 50 Years
Authors: De Clercq Erik , Li Guangdi
Published: June 2016

Since the first antiviral drug, idoxuridine, was approved in 1963, 90 antiviral drugs categorized into 13 functional groups have been formally approved for the treatment of the following 9 human infectious diseases: (i) HIV infections (protease inhibitors, integrase inhibitors, entry inhibitors, nucleoside reverse transcriptase inhibitors, nonnucleoside reverse transcriptase inhibitors, and acyclic nucleoside phosphonate analogues), (ii) hepatitis B virus (HBV) infections (lamivudine, interferons, nucleoside analogues, and acyclic nucleoside phosphonate analogues), (iii) hepatitis C virus (HCV) infections (ribavirin, interferons, NS3/4A protease inhibitors, NS5A inhibitors, and NS5B polymerase inhibitors), (iv) herpesvirus infections (5-substituted 2′-deoxyuridine analogues, entry inhibitors, nucleoside analogues, pyrophosphate analogues, and acyclic guanosine analogues), (v) influenza virus infections (ribavirin, matrix 2 protein inhibitors, RNA polymerase inhibitors, and neuraminidase inhibitors), (vi) human cytomegalovirus infections (acyclic guanosine analogues, acyclic nucleoside phosphonate analogues, pyrophosphate analogues, and oligonucleotides), (vii) varicella-zoster virus infections (acyclic guanosine analogues, nucleoside analogues, 5-substituted 2′-deoxyuridine analogues, and antibodies), (viii) respiratory syncytial virus infections (ribavirin and antibodies), and (ix) external anogenital warts caused by human papillomavirus infections (imiquimod, sinecatechins, and podofilox). Here, we present for the first time a comprehensive overview of antiviral drugs approved over the past 50 years, shedding light on the development of effective antiviral treatments against current and emerging infectious diseases worldwide.
Comparison of Enzyme Immunoassays for Detection of Antibodies to Hepatitis D Virus in Serum
Authors: Chow Siu-Kei , Atienza Ederlyn E. , Cook Linda , Prince Harry , Slev Patricia , Lapé-Nixon Mary , Jerome Keith R.
Published: June 2016

Serology remains critical for diagnosing hepatitis D virus (HDV) infection, which affects 15 to 20 million people worldwide, but the literature on characterizing commercial enzyme immunoassays (EIAs) dates back to 15 years ago. We evaluated 2 commercial EIAs currently available for detecting anti-HDV antibodies. The DiaSorin assay demonstrated 100% sensitivity and specificity. Using a modified cutoff value, the Cusabio assay demonstrated a sensitivity of 81.3% and specificity of 90.9%. Our data show that recently developed EIAs are reliable for anti-HDV antibody detection.
Unique Inflammatory Mediators and Specific IgE Levels Distinguish Local from Systemic Reactions after Anthrax Vaccine Adsorbed Vaccination
Authors: Garman Lori , Smith Kenneth , Muns Emily E. , Velte Cathy A. , Spooner Christina E. , Munroe Melissa E. , Farris A. Darise , Nelson Michael R. , Engler Renata J. M. , James Judith A.
Published: June 2016

Although the U.S. National Academy of Sciences concluded that anthrax vaccine adsorbed (AVA) has an adverse event (AE) profile similar to those of other adult vaccines, 30 to 70% of queried AVA vaccinees report AEs. AEs appear to be correlated with certain demographic factors, but the underlying immunologic pathways are poorly understood. We evaluated a cohort of 2,421 AVA vaccinees and found 153 (6.3%) reported an AE. Females were more likely to experience AEs (odds ratio [OR] = 6.0 [95% confidence interval {CI} = 4.2 to 8.7];
P
< 0.0001). Individuals 18 to 29 years of age were less likely to report an AE than individuals aged 30 years or older (OR = 0.31 [95% CI = 0.22 to 0.43];
P
< 0.0001). No significant effects were observed for African, European, Hispanic, American Indian, or Asian ancestry after correcting for age and sex. Additionally, 103 AEs were large local reactions (LLRs), whereas 53 AEs were systemic reactions (SRs). In a subset of our cohort vaccinated 2 to 12 months prior to plasma sample collection (
n
= 75), individuals with LLRs (
n
= 33) had higher protective-antigen (PA)-specific IgE levels than matched, unaffected vaccinated individuals (
n
= 50;
P
< 0.01). Anti-PA IgE was not associated with total plasma IgE, hepatitis B-specific IgE, or anti-PA IgG in individuals who reported an AE or in matched, unaffected AVA-vaccinated individuals. IP-10 was also elevated in sera of individuals who developed LLRs (
P
< 0.05). Individuals reporting SRs had higher levels of systemic inflammation as measured from C-reactive protein (
P
< 0.01). Thus, LLRs and SRs are mediated by distinct pathways. LLRs are associated with a vaccine-specific IgE response and IP-10, whereas SRs demonstrate increased systemic inflammation without a skewed cytokine profile.
Monoclonal Antibodies to Shigella Lipopolysaccharide Are Useful for Vaccine Production
Authors: Lin Jisheng , Smith Mark A. , Benjamin William H. , Kaminski Robert W. , Wenzel Heather , Nahm Moon H.
Published: June 2016

There is a significant need for an effective multivalent
Shigella
vaccine that targets the most prevalent serotypes. Most
Shigella
vaccines under development utilize serotype-specific lipopolysaccharides (LPSs) as a major component based on protection and epidemiological data. As vaccine formulations advance from monovalent to multivalent, assays and reagents need to be developed to accurately and reproducibly quantitate the amount of LPSs from multiple serotypes in the final product. To facilitate this effort, we produced 36 hybridomas that secrete monoclonal antibodies (MAbs) against the O antigen on the LPS from
Shigella flexneri
2a,
Shigella flexneri
3a, and
Shigella sonnei
. We used six of these monoclonal antibodies for an inhibition enzyme-linked immunosorbent assay (iELISA), measuring LPSs with high sensitivity and specificity. It was also demonstrated that the
Shigella
serotype-specific MAbs were useful for bacterial surface staining detected by flow cytometry. These MAbs are also useful for standardizing the serum bactericidal assay (SBA) for
Shigella
. Functional assays, such as the
in vitro
bactericidal assay, are necessary for vaccine evaluation and may serve as immunological correlates of immunity. An
S. flexneri
2a-specific monoclonal antibody killed
S. flexneri
2b isolates, suggesting that
S. flexneri
2a LPS may induce cross-protection against
S. flexneri
2b. Overall, the
Shigella
LPS-specific MAbs described have potential utility to the vaccine development community for assessing multivalent vaccine composition and as a reliable control for multiple immunoassays used to assess vaccine potency.
Laboratory Diagnosis of Infections in Cancer Patients: Challenges and Opportunities
Authors: Babady N. Esther
Published: June 2016

Infections remain a significant cause of morbidity and mortality in cancer patients. The differential diagnosis for these patients is often wide, and the timely selection of the right clinical tests can have a significant impact on their survival. However, laboratory findings with current methodologies are often negative, challenging clinicians and laboratorians to continue the search for the responsible pathogen. Novel methodologies are providing increased sensitivity and rapid turnaround time to results but also challenging our interpretation of what is a clinically significant pathogen in cancer patients. This minireview provides an overview of the most common infections in cancer patients and discusses some of the challenges and opportunities for the clinical microbiologist supporting the care of cancer patients.
Catch-up growth and metabolic outcomes in adolescents born preterm
Authors: Embleton Nicholas D , Korada Murthy , Wood Claire L , Pearce Mark S , Swamy Ravi , Cheetham Timothy D
Published: June 2016

Background

Accelerated infant weight gain in individuals born full term is linked to cardiovascular risk in adulthood, but data in those born preterm are inconsistent.

Objective

To investigate the association between weight gain in infancy and childhood with later markers of the metabolic syndrome in adolescents who were born preterm.

Study design

Longitudinal cohort study.

Setting

Children born preterm with regular assessments of infant growth had auxology, body composition (dual X-ray absorptiometry), blood pressure, insulin sensitivity and lipid profile determined in adolescence.

Results

We reviewed 153 children (mean gestation 30.8 weeks, median birth weight 1365 g) of whom 102 consented to venepuncture at a median age of 11.5 years. Adolescent height and weight standard deviation scores (SDS) were similar to population averages (0.01±0.92 and 0.3±1.2, respectively) and did not differ between infants when grouped according to degree of catch-up in weight gain in the immediate postdischarge period to 12 weeks of age. There were no significant associations between infant weight gain (change in weight SDS adjusted for length) and later metabolic outcome. However, there were strong associations between more rapid childhood weight gain (after 1 year of age) and subsequent body composition (higher fat mass %, fat mass index and waist circumference) and metabolic markers (higher fasting insulin, blood pressure and lower insulin sensitivity).

Conclusions

The association of rapid weight gain on health is time critical in those born preterm; in early infancy, this does not impact on metabolic status in adolescence, in contrast to rapid weight gain in childhood, which should be discouraged. However, given the critical importance of brain growth in the neonatal period and infancy, further research is needed before strategies that discourage infant weight gain or catch-up can be recommended for infants born preterm.
Effect of high-speed running on hamstring strain injury risk
Authors: Duhig Steven , Shield Anthony J , Opar David , Gabbett Tim J , Ferguson Cameron , Williams Morgan
Published: June 2016

Background

Hamstring strain injuries (HSIs) are common within the Australian Football League (AFL) with most occurring during high-speed running (HSR). Therefore, this study investigated possible relationships between mean session running distances, session ratings of perceived exertion (s-RPE) and HSIs within AFL footballers.

Methods

Global positioning system (GPS)-derived running distances and s-RPE for all matches and training sessions over two AFL seasons were obtained from one AFL team. All HSIs were documented and each player's running distances and s-RPE were standardised to their 2-yearly session average, then compared between injured and uninjured players in the 4 weeks (weeks −1, −2, −3 and −4) preceding each injury.

Results

Higher than ‘typical’ (ie, z=0) HSR session means were associated with a greater likelihood of HSI (week −1: OR=6.44, 95% CI=2.99 to 14.41, p<0.001; summed weeks −1 and −2: OR=3.06, 95% CI=2.03 to 4.75, p<0.001; summed weeks −1, −2 and −3: OR=2.22, 95% CI=1.66 to 3.04, p<0.001; and summed weeks −1, −2, −3 and −4: OR=1.96, 95% CI=1.54 to 2.51, p<0.001). However, trivial differences were observed between injured and uninjured groups for standardised s-RPE, total distance travelled and distances covered whilst accelerating and decelerating. Increasing AFL experience was associated with a decreased HSI risk (OR=0.77, 95% CI 0.57 to 0.97, p=0.02). Furthermore, HSR data modelling indicated that reducing mean distances in week −1 may decrease the probability of HSI.

Conclusions

Exposing players to large and rapid increases in HSR distances above their 2-yearly session average increased the odds of HSI. However, reducing HSR in week −1 may offset HSI risk.
Effectiveness of physical therapy treatment of clearly defined subacromial pain: a systematic review of randomised controlled trials
Authors: Haik M N , Alburquerque-Sendín F , Moreira R F C , Pires E D , Camargo P R
Published: June 2016

Aim

To summarise the current evidence regarding the effectiveness of physical therapy on pain, function and range of motion in individuals with subacromial pain syndrome (SAPS).

Design

Systematic review.

Data sources

PubMed, Web of Science, CINAHL, Cochrane, Embase, Lilacs, Ibecs and Scielo databases.

Eligibility criteria for selecting studies

Randomised controlled trials (RCTs) investigating physical therapy modalities for SAPS on pain, function/disability or range of motion were included.

Results

64 high-quality RCTs were included. Exercise therapy provided high evidence of being as effective as surgery intervention and better than no treatment or placebo treatment to improve pain, function and range of motion in the short, mid and long terms. The combination of mobilisation and exercises provided high evidence to decrease pain and improve function in the short term. There is limited evidence for improvements on the outcomes with the isolated application of manual therapy. High level of evidence was synthesised regarding the lack of beneficial effects of physical resources such as low-level laser, ultrasound and pulsed electromagnetic field (PEMF) on pain, function or range of motion in the treatment of SAPS. There is limited evidence for microwave diathermy and transcutaneous electrical nerve stimulation. There is moderate evidence to no benefits with taping in the short term. Effects of diacutaneous fibrolysis and acupuncture are not well established yet.

Conclusions

Exercise therapy should be the first-line treatment to improve pain, function and range of motion. The addition of mobilisations to exercises may accelerate reduction of pain in the short term. Low-level laser therapy, PEMF and taping should not be recommended.
Injuries in world junior ice hockey championships between 2006 and 2015
Authors: Tuominen Markku , Stuart Michael J , Aubry Mark , Kannus Pekka , Parkkari Jari
Published: June 2016

Background

Detailed injury data are not available for international ice hockey tournaments played by junior athletes. We report the incidence, type, mechanism and severity of injuries in males under ages 18 and 20 at junior ice hockey World Championships during 2006–2015.

Methods

All injuries in the International Ice Hockey Federation World Junior under-20 (WJ U20) Championship and under-18 (WJ U18) Championship were collected over a 9-year period using a strict injury definition, a standardised injury reporting system and diagnoses made by a team physician.

Results

633 injuries were recorded in 1326 games over a 9-year period, resulting in an injury rate (IR) of 11.0 per 1000 player-games and 39.8/1000 player-game hours. The IRs in all tournaments were 4.3/1000 player-games for the head and face, 3.2 for the upper body, 2.6 for the lower body and 1.0 for the spine and trunk. A laceration was the most common injury type followed by a sprain. Lacerations accounted for 80% (IR 3.6) of facial injuries in WJ U20 tournaments. The shoulder was the most common injury site (IR 2.0) in WJ U18 tournaments. Board contact was the mechanism for 59% of these shoulder injuries. Concussion was the most common head and face injury (46%; IR 1.2) in WJ U18 tournaments.

Conclusions and recommendations

The risk of injury among male junior ice hockey players was lower than the reported rates in adult men but higher than that in women. Facial lacerations were common in U20 junior players (WJ U20) since most wear only partial facial protection (visor). The IR for shoulder injuries was high in U18 junior players (WJ U18). Suggested strategies for injury prevention include full facial protection for all players and flexible board and glass for all junior tournaments.
Do glycemic marker levels vary by race? Differing results from a cross-sectional analysis of individuals with and without diagnosed diabetes
Authors: Carson April P , Muntner Paul , Selvin Elizabeth , Carnethon Mercedes R , Li Xuelin , Gross Myron D , Garvey W Timothy , Lewis Cora E
Published: June 2016

Objective

It is well known that A1c varies by race. However, racial differences in other biomarkers of hyperglycemia are less well characterized. The objective of this study was to determine whether average levels of glycemic markers differ by race in adults with and without diagnosed diabetes, before and after accounting for postchallenge glucose.

Research design and methods

This cross-sectional study included 2692 middle-aged men and women (5.5% with diagnosed diabetes; 44% African-American; and 56% white) from the Coronary Artery Risk Development in Young Adults Study (2005–2006) who had fasting glucose, 2-hour postchallenge glucose, A1c, glycated albumin, fructosamine, and 1,5-anhydroglucitol (1,5-AG) measured. Multiple linear regression was used to evaluate racial differences in mean levels of each glycemic marker stratified by the diabetes status and adjusted for sociodemographics, cardiovascular factors, and postchallenge glucose.

Results

Among those with diagnosed diabetes, racial differences were not observed for any of the glycemic markers. In contrast, among those without diagnosed diabetes, African-Americans had higher mean levels than whites of A1c (β=0.19% points; 95% CI 0.14 to 0.24), glycated albumin (β=0.82% points; 95% CI 0.68 to 0.97), fructosamine (β=8.68 μmol/L; 95% CI 6.68 to 10.68), and 2-hour glucose (β=3.50 mg/dL; 95% CI 0.10 to 6.90) after multivariable adjustment, whereas there were no statistically significant racial difference in 1,5-AG. The racial differences observed for A1c, glycated albumin, and fructosamine persisted after further adjustment for fasting and 2-hour glucose and were of similar magnitude (SD units).

Conclusions

Racial differences in glycemic marker levels were evident among middle-aged adults without diagnosed diabetes even after adjustment for postchallenge glucose. Whether these racial differences in biomarkers of hyperglycemia affect the risk of complications warrants additional study.
Dietary flavonoid intake and the risk of stroke: a dose-response meta-analysis of prospective cohort studies
Authors: Tang Zhenyu , Li Min , Zhang Xiaowei , Hou Wenshang
Published: June 2016

Objective

To clarify and quantify the potential association between intake of flavonoids and risk of stroke.

Design

Meta-analysis of prospective cohort studies.

Data source

Studies published before January 2016 identified through electronic searches using PubMed, Embase and the Cochrane Library.

Eligibility criteria for selecting studies

Prospective cohort studies with relative risks and 95% CIs for stroke according to intake of flavonoids (assessed as dietary intake).

Results

The meta-analysis yielded 11 prospective cohort studies involving 356 627 participants and more than 5154 stroke cases. The pooled estimate of the multivariate relative risk of stroke for the highest compared with the lowest dietary flavonoid intake was 0.89 (95% CI 0.82 to 0.97; p=0.006). Dose-response analysis indicated that the summary relative risk of stroke for an increase of 100 mg flavonoids consumed per day was 0.91 (95% CI 0.77 to 1.08) without heterogeneity among studies (I2=0%). Stratifying by follow-up duration, the relative risk of stroke for flavonoid intake was 0.89 (95% CI 0.81 to 0.99) in studies with more than 10 years of follow-up.

Conclusions

Results from this meta-analysis suggest that higher dietary flavonoid intake may moderately lower the risk of stroke.
Empirical evaluation of the Q-Genie tool: a protocol for assessment of effectiveness
Authors: Sohani Z N , Sarma S , Alyass A , de Souza R J , Robiou-du-Pont S , Li A , Mayhew A , Yazdi F , Reddon H , Lamri A , Stryjecki C , Ishola A , Lee Y K , Vashi N , Anand S S , Meyre D
Published: June 2016

Introduction

Meta-analyses of genetic association studies are affected by biases and quality shortcomings of the individual studies. We previously developed and validated a risk of bias tool for use in systematic reviews of genetic association studies. The present study describes a larger empirical evaluation of the Q-Genie tool.

Methods and analysis

MEDLINE, Embase, Global Health and the Human Genome Epidemiology Network will be searched for published meta-analyses of genetic association studies. Twelve reviewers in pairs will apply the Q-Genie tool to all studies in included meta-analyses. The Q-Genie will then be evaluated on its ability to (i) increase precision after exclusion of low quality studies, (ii) decrease heterogeneity after exclusion of low quality studies and (iii) good agreement with experts on quality rating by Q-Genie. A qualitative assessment of the tool will also be conducted using structured questionnaires.

Discussion

This systematic review will quantitatively and qualitatively assess the Q-Genie's ability to identify poor quality genetic association studies. This information will inform the selection of studies for inclusion in meta-analyses, conduct sensitivity analyses and perform metaregression. Results of this study will strengthen our confidence in estimates of the effect of a gene on an outcome from meta-analyses, ultimately bringing us closer to deliver on the promise of personalised medicine.

Ethics and dissemination

An updated Q-Genie tool will be made available from the Population Genomics Program website and the results will be submitted for a peer-reviewed publication.
Does employee participation in workplace health promotion depend on the working environment? A cross-sectional study of Danish workers
Authors: Jørgensen Marie Birk , Villadsen Ebbe , Burr Hermann , Punnett Laura , Holtermann Andreas
Published: June 2016

Objectives

To investigate if participation in workplace health promotion (WHP) depends on the work environment.

Methods

Questionnaire data on participation in WHP activities (smoking cessation, healthy diet, exercise facilities, weekly exercise classes, contact with health professionals, health screenings) and the work environment (social support, fatiguing work, physical, quantitative and emotional demands, job control and WHP availability setting) were collected cross-sectionally in 2010 in a representative sample (n=10 605) of Danish workers. Binary regression analyses of the association between work environment characteristics and participation in WHP were conducted and adjusted for age, gender and industry.

Results

WHP offered during leisure time was associated with lower participation in all measured activities compared with when offered during working hours. Low social support and fatiguing work were associated with low participation in WHP. No associations with participation in WHPs were observed for physical work or quantitative demands, work pace or job strain. However, high physical demands/low job control and high emotional demands/low job control were associated with low participation.

Conclusions

Lower participation in WHP was associated with programmes during leisure, low social support, very fatiguing work and high physical or emotional demands with low job control. This suggests that to obtain proper effect of health promotion in a workplace setting, a good work environment is essential.
What is the relationship between renal function and visit-to-visit blood pressure variability in primary care? Retrospective cohort study from routinely collected healthcare data
Authors: Lasserson Daniel S , Scherpbier de Haan Nynke , de Grauw Wim , van der Wel Mark , Wetzels Jack F , O'Callaghan Christopher A
Published: June 2016

Objective

To determine the relationship between renal function and visit-to-visit blood pressure (BP) variability in a cohort of primary care patients.

Design

Retrospective cohort study from routinely collected healthcare data.

Setting

Primary care in Nijmegen, the Netherlands, from 2007 to 2012.

Participants

19 175 patients who had a measure of renal function, and 7 separate visits with BP readings in the primary care record.

Outcome measures

Visit-to-visit variability in systolic BP, calculated from the first 7 office measurements, including SD, successive variation, absolute real variation and metrics of variability shown to be independent of mean. Multiple linear regression was used to analyse the influence of estimated glomerular filtration rate (eGFR) on BP variability measures with adjustment for age, sex, diabetes, mean BP, proteinuria, cardiovascular disease, time interval between measures and antihypertensive use.

Results

In the patient cohort, 57% were women, mean (SD) age was 65.5 (12.3) years, mean (SD) eGFR was 75.6 (18.0) mL/min/1.73m2and SD systolic BP 148.3 (21.4) mm Hg. All BP variability measures were negatively correlated with eGFR and positively correlated with age. However, multiple linear regressions demonstrated consistent, small magnitude negative relationships between eGFR and all measures of BP variability adjusting for confounding variables.

Conclusions

Worsening renal function is associated with small increases in measures of visit-to-visit BP variability after adjustment for confounding factors. This is seen across the spectrum of renal function in the population, and provides a mechanism whereby chronic kidney disease may raise the risk of cardiovascular events.
Effect of antenatal education in small classes versus standard auditorium-based lectures on use of pain relief during labour and of obstetric interventions: results from the randomised NEWBORN trial
Authors: Brixval Carina Sjöberg , Thygesen Lau Caspar , Axelsen Solveig Forberg , Gluud Christian , Winkel Per , Lindschou Jane , Weber Tom , Due Pernille , Koushede Vibeke
Published: June 2016

Objective

To examine the effect of an antenatal education programme in small classes versus standard auditorium-based lectures.

Design

Randomised trial using random-generated web-based 1:1 allocation.

Setting

The largest birth site in the Capital Region of Denmark, from August 2012 to May 2014.

Participants

1766 pregnant women. Inclusion criteria ≥18 years, pregnant with a single child, and able to speak and understand Danish. Women were enrolled in the trial from 10+0 to 20+0 weeks of gestation.

Interventions

The intervention programme consisted of three times 2.5 hours of antenatal education in small classes (n=6–8 women), and focused on improving information and problem-solving skills for expectant parents in order to ease birth and the transition to parenthood. The control group received standard auditorium-based lectures consisting of two times 2 hours in an auditorium with participation of ∼250 people.

Main outcome measures

The primary trial outcome was use of epidural analgesia. Other types of pain relief and obstetric interventions were analysed as explorative outcomes.

Results

There was no statistically significant difference in use of epidural analgesia between participants in the intervention group (30.9%) versus the control group (29.1%), adjusted OR 1.10 (95% CI 0.87 to 1.34). Also, the two groups did not differ regarding other types of pain relief or obstetric interventions. Concomitant birth preparation was common in both groups and highest in the control group, but did not seem to influence our results noticeably.

Conclusions

Antenatal education in small groups versus standard auditorium-based lectures did not differ regarding use of epidural analgesia, other pain relief, or obstetric interventions.

Trial registration number

NCT01672437; Results.
Making patient values visible in healthcare: a systematic review of tools to assess patient treatment priorities and preferences in the context of multimorbidity
Authors: Mangin Dee , Stephen Gaibrie , Bismah Verdah , Risdon Cathy
Published: June 2016

Objectives

To identify studies of existing instruments available for clinicians to record overall patient preferences and priorities for care, suitable for use in routine primary care practice in patients with multimorbidity. To examine the data for all identified tools with respect to validity, acceptability and effect on health outcomes.

Design

Systematic Review.

Data sources

MEDLINE, EMBASE and Cochrane databases, each with a predefined search strategy.

Eligibility criteria

Citations were included if they reported a tool used to record patient priorities or preferences for treatment, and quantitative or qualitative results following administration of the tool.

Results

Our search identified 189 potential studies of which 6 original studies and 2 discussion papers were included after screening for relevance. 5 of 6 studies (83%) were of cross-sectional design and of moderate quality. All studies reported on the usability of a tool in order to elicit patient preferences. No studies reported on changes to patient-specific healthcare outcomes as a consequence of recording preferences and priorities. 1 of 6 studies reported on eliciting patient preference in the context of multimorbidity. No studies incorporated patient preferences into an electronic medical record.

Conclusions

Given the importance of eliciting patient priorities and preferences in providing patient-centred care in the context of multimorbidity and polypharmacy, we found surprisingly few relevant tools. Some aspects of the tools used for single-disease contexts may also be useful in the context of multimorbidity. There is an urgent need to develop ways to make patient priorities explicitly visible in the clinical record and medical decision-making and to test the effect on patient-relevant outcomes.
Following young people with perinatal HIV infection from adolescence into adulthood: the protocol for PHACS AMP Up, a prospective cohort study
Authors: Tassiopoulos Katherine , Patel Kunjal , Alperen Julie , Kacanek Deborah , Ellis Angela , Berman Claire , Allison Susannah M , Hazra Rohan , Barr Emily , Cantos Krystal , Siminski Suzanne , Massagli Michael , Bauermeister Jose , Siddiqui Danish Q , Puga Ana , Van Dyke Russell , Seage George R
Published: June 2016

Introduction

The first generation of adolescents born with HIV infection has reached young adulthood due to advances in treatment. It is important to continue follow-up of these individuals to assess their long-term medical, behavioural and mental health and ability to successfully transition to adulthood while coping with a chronic, potentially stigmatising condition. To accomplish this, and to maintain their interest in long-term research participation, we need to accommodate the changing lifestyles and interests of young adult study participants while ensuring valid data collection. We report the protocol for Pediatric HIV/AIDS Cohort Study (PHACS) Adolescent Master Protocol (AMP) Up, a prospective cohort study enrolling young adult participants for long-term follow-up.

Methods and analysis

AMP Up is recruiting 850 young men and women 18 years of age and older—600 perinatally HIV-infected and a comparison group of 250 perinatally HIV-exposed, uninfected—at 14 clinical research sites in the USA and Puerto Rico. Recruitment began in April 2014 and is ongoing, with 305 participants currently enrolled. Planned follow-up is ≥6 years. Data are collected with a flexible hybrid of online and in-person methods. Outcomes include: transition to adult clinical care and retention in care; end-organ diseases; malignancies; metabolic complications; sexually transmitted infections; reproductive health; mental health and neurocognitive functioning; adherence to antiretroviral treatment; sexual behaviour and substance use; hearing and language impairments; and employment and educational achievement.

Ethics and dissemination

The study received ethical approval from the Harvard T.H. Chan School of Public Health's institutional review board (IRB), and from the IRBs of each clinical research site. All participants provide written informed consent; for cognitively impaired individuals with legally authorised representatives, legal guardian permission and participant assent is obtained. Findings will be disseminated through peer-reviewed journals, conference presentations and participant summaries.
Prescribing antibiotics to ‘at-risk’ children with influenza-like illness in primary care: qualitative study
Authors: Ashdown Helen F , Räisänen Ulla , Wang Kay , Ziebland Sue , Harnden Anthony ,   for the ARCHIE investigators*
Published: June 2016

Objectives

National Institute for Health and Care Excellence guidelines recommend immediate antibiotic treatment of respiratory tract infections in ‘at-risk’ individuals with comorbidities. Observational evidence suggests that influenza particularly predisposes children to bacterial complications. This study investigates general practitioners’ (GPs’) accounts of factors influencing their decision-making about antibiotic prescribing in the management of at-risk children with influenza-like illness (ILI).

Design

Qualitative interview study using a maximum variation sample with thematic analysis through constant comparison.

Setting

Semistructured telephone interviews with UK GPs using a case vignette of a child with comorbidities presenting with ILI.

Participants

There were 41 GPs (41.5% men; 40 from England, 1 from Northern Ireland) with a range of characteristics including length of time in practice, paediatrics experience, practice setting and deprivation.

Results

There was considerable uncertainty and variation in the way GPs responded to the case and difference of opinion about how long-term comorbidities should affect their antibiotic prescribing pattern. Factors influencing their decision included the child's case history and clinical examination; the GP's view of the parent's ability to self-manage; the GP's own confidence and experiences of managing sick children and assessment of individual versus abstract risk. GPs rarely mentioned potential influenza infection or asked about immunisation status. All said that they would want to see the child; views about delayed prescribing varied in relation to local health service provision including options for follow-up and paediatric services.

Conclusions

The study demonstrates diagnostic uncertainty and wide variation in GP decision-making about prescribing antibiotics to children with comorbidity. Future guidelines might encourage consideration of a specific diagnosis such as influenza, and risk assessment tools could be developed to allow clinicians to quantify the levels of risk associated with different types of comorbidity. However, the wide range of clinical and non-clinical factors involved in decision-making during these consultations should also be considered in future guidelines.