bluuebunny/crossref_metadata_2025 huggingface dataset:
Low Back Pain With Impact at 17 Years of Age Is Predicted by Early Adolescent Risk Factors From Multiple Domains: Analysis of the Western Australian Pregnancy Cohort (Raine) Study
Authors: Smith Anne , Beales Darren , O'Sullivan Peter , Bear Natasha , Straker Leon
Published: September 2017

Study Design

Prospective cohort study of the Western Australian Pregnancy Cohort (Raine) Study.

Background

Low back pain (LBP) commonly develops in adolescence and is a significant risk factor for adult LBP. A broad range of factors have been associated with the development of adolescent LBP, but prior literature has limitations related to characterization of LBP and the scope of risk factors considered.

Objective

This study aimed to identify potential factors contributing to the development of LBP, with and without impact, at 17 years of age, utilizing a broad range of exposures at 14 years of age.

Methods

Data from 1088 participants (52.1% female) with “no LBP,” “LBP with minimal impact,” and “LBP with impact” at 17 years of age and a range of measures from multiple domains, including spinal pain, physical, psychological, social, and lifestyle, at 14 years of age were collected for the study. Multivariable multinomial logistic regression was used to estimate the association of potential mechanistic factors at 14 years of age with LBP at 17 years of age.

Results

Female sex and back pain at 14 years of age were strongly associated with LBP at 17 years of age. Potential mechanistic factors for LBP outcomes at 17 years of age included exposures from the pain (neck/shoulder pain) and physical domains (standing posture subgroup membership, back muscle endurance, throwing distance), psychological domain (somatic complaints, aggressive behavior), social domain (socioeconomic area), and lifestyle domain (exercise out of school).

Conclusion

The findings support the multidimensional nature of adolescent LBP and highlight the challenge this presents for epidemiological research, clinical practice, and prevention initiatives in the general population.

Level of Evidence

Prognosis, level 1b. J Orthop Sports Phys Ther 2017;47(10):752–762. doi:10.2519/jospt.2017.7464
Measuring Musculoskeletal Pain in Infants, Children, and Adolescents
Authors: Michaleff Zoe A. , Kamper Steven J. , Stinson Jennifer N. , Hestbaek Lise , Williams Christopher M. , Campbell Paul , Dunn Kate M.
Published: September 2017

Synopsis

Accurate, reliable, and timely assessment of pain is critical for effective management of musculoskeletal pain conditions. The assessment of pain in infants, children, and adolescents with and without cognitive impairment can be particularly challenging to clinicians for a number of reasons, including factors related to the consultation (eg, heterogeneous patient population, time constraints), the clinician (eg, awareness/knowledge of available pain scales), standardized assessment scales (eg, availability, psychometric properties, and application of each scale), the patient (eg, developmental stage, ability to communicate), and the context in which the interaction took place (eg, familiarity with the setting and physiological and psychological state). As a result, pain is frequently not assessed or measured during the consultation and, in many instances, underestimated and undertreated in this population. The purpose of this article is to provide clinicians with an overview of scales that may be used to measure pain in infants, children, and adolescents. Specifically, the paper reviews the various approaches to measure pain intensity; identifies factors that can influence the pain experience, expression, and assessment in infants, children, and adolescents; provides age-appropriate suggestions for measuring pain intensity in patients with and without cognitive impairment; and identifies ways to assess the impact of pain using multidimensional pain scales. J Orthop Sports Phys Ther 2017;47(10):712–730. doi:10.2519/jospt.2017.7469
Does Motor Development in Infancy Predict Spinal Pain in Later Childhood? A Cohort Study
Authors: Kamper Steven J. , Williams Christopher M. , Hestbaek Lise
Published: September 2017

Study Design

Longitudinal cohort study.

Background

Spinal pain is responsible for a huge personal and societal burden, but its etiology remains unclear. Deficits in motor control have been associated with spinal pain in adults, and delayed motor development is associated with a range of health problems and risks in children.

Objective

To assess whether there is an independent relationship between the age at which infants first sit and walk without support and spinal pain at 11 years of age.

Methods

Data from the Danish National Birth Cohort were analyzed, using the age at which children first sat and first walked without support as predictors. Parents reported the predictors when the children were 6 months and 18 months of age, and also provided information in response to a comprehensive list of covariates, including child sex, birth weight, and cognitive development; socioeconomic indicators; and parental health variables. Outcomes were measured at 11 years of age using the Young Spine Questionnaire, which assesses the presence and intensity of spinal pain. Data were analyzed using multivariable logistic regression models to estimate determinants of neck, thoracic, lumbar, and multisite pain.

Results

The analyses included data from approximately 23 000 children and their parents. There were no consistent independent associations between the age at first sitting or walking and spinal pain at the age of 11. Odds ratios were between 0.95 and 1.00 for the various pain sites.

Conclusion

The age at which a child first sits or walks without support does not influence the likelihood that he or she will experience spinal pain in later childhood.

Level of Evidence

Prognosis, level 4. J Orthop Sports Phys Ther 2017;47(10):763–768. doi:10.2519/jospt.2017.7484
Hypermobility in Adolescent Athletes: Pain, Functional Ability, Quality of Life, and Musculoskeletal Injuries
Authors: Schmidt Heidi , Pedersen Trine Lykke , Junge Tina , Engelbert Raoul , Juul-Kristensen Birgit
Published: September 2017

Study Design

Cross-sectional.

Background

Generalized joint hypermobility (GJH) may increase pain and likelihood of injuries and also decrease function and health-related quality of life (HRQoL) in elite-level adolescent athletes.

Objective

To assess the prevalence of GJH in elite-level adolescent athletes, and to study the association of GJH with pain, function, HRQoL, and musculoskeletal injuries.

Methods

A total of 132 elite-level adolescent athletes (36 adolescent boys, 96 adolescent girls; mean ± SD age, 14.0 ± 0.9 years), including ballet dancers (n = 22), TeamGym gymnasts (n = 57), and team handball players (n = 53), participated in the study. Generalized joint hypermobility was classified by Beighton score as GJH4 (4/9 or greater), GJH5 (5/9 or greater), and GJH6 (6/9 or greater). Function of the lower extremity, musculoskeletal injuries, and HRQoL were assessed with self-reported questionnaires, and part of physical performance was assessed by 4 postural-sway tests and 2 single-legged hop-for-distance tests.

Results

Overall prevalence rates for GJH4, GJH5, and GJH6 were 27.3%, 15.9%, and 6.8%, respectively, with a higher prevalence of GJH4 in ballet dancers (68.2%) and TeamGym gymnasts (24.6%) than in team handball players (13.2%). There was no significant difference in lower extremity function, injury prevalence and related factors (exacerbation, recurrence, and absence from training), HRQoL, or lengths of hop tests for those with and without GJH. However, the GJH group had significantly larger center-of-pressure path length across sway tests.

Conclusion

For ballet dancers and TeamGym gymnasts, the prevalence of GJH4 was higher than that of team handball players. For ballet dancers, the prevalence of GJH5 and GJH6 was higher than that of team handball players and the general adolescent population. The GJH group demonstrated larger sway in the balance tests, which, in the current cross-sectional study, did not have an association with injuries or HRQoL. However, the risk of having (ankle) injuries due to larger sway for the GJH group must be studied in future longitudinal studies. J Orthop Sports Phys Ther 2017;47(10):792–800. doi:10.2519/jospt.2017.7682
PEREMPUAN DAN PENDIDIKAN: GERAKAN PEREMPUAN DALAM PUISI “TJOEMBOEAN” (1919) DAN “ADJAKAN” (1931) (Women and Education: Women Movement in the Poem “Tjoemboean” [1919] and “Adjakan” [1931])
Authors: Sari Sartika , Priatna Aquarini , Muhtadin Teddi
Published: September 2017

Penelitian ini membicarakan isu perempuan dan pendidikan yang ditampilkan dalam puisi “Tjoemboean” yang terbit dalam surat kabar Perempoean Bergerak (1919) dan “Adjakan (Doenia Istri)” yang terbit dalam surat kabar Bintang Karo (1931). Kedua puisi dalam surat kabar tersebut diedarkan di wilayah Sumatera bagian Utara yang ketika itu meliputi Sumatera Utara dan Aceh. Melalui analisis menggunakan pandangan Brooks (1967) dan pengkajian isu dengan pemikiran Beauvoir (2003) serta Wollstonecraft (2014), penelitian ini menemukan bahwa puisi “Tjoemboean” dan “Adjakan” dijadikan sebagai alat artikulasi kritis perempuan terhadap isu-isu yang berkenaan dengan kehidupannya. Secara khusus, kedua puisi tersebut menampilkan bahwa pendidikan perempuan memiliki relasi yang kuat dengan persoalan harta, orang tua, dan cinta. Pendidikan juga digambarkan sebagai sarana untuk memperbaiki kualitas diri perempuan agar terbebas dari subordinasi gender.AbstrakThis research examines how issues of education and women are presented in the poem “Tjoemboean” published in the newspaper “Perempuan Bergerak” (1919) and “Adjakan” (Doenia Istri)” published in the newspaper “Bintang Karo” (1931). Both newspapers were printed and published in Northern Sumatera which for that moment regionally covered North Sumatera and Aceh. Through analysis of Brooks’ theory (1967), issues study of Beauvoir’s thought (2003), and Wollstonecraft’s (2014), the research finds that “Tjoemboean” and “Adjakan” serve as a means of women’s critical articulation of issues concerning their lives. Both poems specifically represent that the issue of women’s education is strongly connected to the issues of wealth, parents, and love. Education is also described as a medium to reform the quality of women’s selves;hence, they are free of gender subordination.
Las bodegas tradicionales: patrimonio olvidado en la cultura del vino en la denominación de origen de Cigales (Castilla y León, España)
Authors: Fernández Portela Julio , García Velasco Miguel Ángel
Published: September 2017

Las bodegas tradicionales forman parte del patrimonio artístico y etnográfico existente en algunas localidades de Castilla y León. En el caso de los municipios que componen la Denominación de Origen(D.O.) de Cigales, este tipo de instalaciones ha adquirido un peso muy representativo debido a su abundancia con más de 1.200 bodegas repartidas por el territorio. En la actualidad, estas bodegas han sufrido una serie de cambios muy importantes que están modificando el paisaje tradicional en el que se ubican. Si se pasea por los característicos barrios de bodegas de estos municipios se pueden observar todas las intervenciones realizadas por el hombre, y que en la mayoría de los casos no han seguido unos patrones comunes y acordes con el paisaje. Aspectos que no han contribuido más que a la pérdida de identidad de estos espacios, haciendo necesario plantear una serie de propuestas encaminadas a conservar estos barrios tan característicos.
Valoración biogeográfica de los paisajes forestales de Artikutza (Navarra), a partir de la aplicación del método de valoración (LANBIOEVA)
Authors: Lozano Valencia Peio José , Latasa Zaballos Itxaro , Dorronsoro Loiarte Beñat
Published: September 2017

El presente artículo se basa en un trabajo de investigación desarrollado desde hace más de 20 años y que persigue consolidar un método de inventariación y valoración biogeográfica de diferentes paisajes vegetales en latitudes medias y altas. Hasta la fecha, se ha ido aplicando a diferentes ecosistemas ubicados dentro de la Península Ibérica. No obstante y, de cara a valorar la robustez del método, en los dos últimos años se ha aplicado a otros ámbitos. El presente artículo se centra, expone y analiza los resultados obtenidos en Artikutza, noroeste de Navarra. La metodología se basa en un inventariado sistemático de diferentes unidades junto a una valoración basada en criterios naturales, territoriales, culturales, de manejo, riesgos, etc. Los resultados, en este caso, otorgan una preponderancia clara a los bosques de ribera, seguidos de los robledales y los hayedos. En un segundo grupo se encontrarían los bosques de repoblación: pinares de pino silvestre, roble rojo americano y el abetal-falso cupresal.
Evaluation of prescription pattern and efficacy of anti-diabetic drugs in Coimbatore, India
Authors: Govindasamy Nagarajaperumal , Sellappan Mohan
Published: September 2017

In this present study, 1500 Diabetes Mellitus (DM) patients were included from Coimbatore zone, Tamil Nadu, India. The blood glucose levels were monitored to correlate the glycemic control with the antidiabetic drug treatment. This study addressed many variabilities in such treatments including the prescribing pattern of various novel entities along with existing drugs for glycemic control, diabetic vascular complexities on Coimbatore zone, lack of relevant scientific data, occurrences of prescription errors, less awareness of the DM patients, the insufficient number of local hospitals and high cost of the medicine. Data analysis was carried out by segregating the DM patients under study according to their blood glucose level. Results demonstrated that brand names of anti-diabetic drugs were taken more frequently by outpatients when contrasted with inpatients. Also, the number of drugs prescribed under generic names were significantly less than prescribe brand names. Prescribed formulations results indicated that tablets were preferred over other formulations. Frequently prescribed twenty-one brands and their combination results demonstrated the popularity of the insulin human Mixtard® injection 30-40 IU. Moreover, frequently prescribed 21 branded drugs' cost were analyzed. It can be concluded from the current work that appropriate steps should be taken to raise awareness of the DM patients in Coimbatore zone so that they can follow the specialists' instruction for better hyperglycemia control. Finally, it can be suggested that the Tamil Nadu Government should put more effort on improving health care support in Coimbatore zone.Govindasamy and Sellappan, International Current Pharmaceutical Journal, April 2017, 6(5): 27-33http://www.icpjonline.com/documents/Vol6Issue5/01.pdf
Structure-Dependent Interfacial Properties of Chaplin F from Streptomyces coelicolor
Authors: Dokouhaki Mina , Prime Emma , Hung Andrew , Qiao Greg , Day Li , Gras Sally
Published: September 2017

Chaplin F (Chp F) is a secreted surface-active peptide involved in the aerial growth of Streptomyces. While Chp E demonstrates a pH-responsive surface activity, the relationship between Chp F structure, function and the effect of solution pH is unknown. Chp F peptides were found to self-assemble into amyloid fibrils at acidic pH (3.0 or the isoelectric point (pI) of 4.2), with ~99% of peptides converted into insoluble fibrils. In contrast, Chp F formed short assemblies containing a mixture of random coil and β-sheet structure at a basic pH of 10.0, where only 40% of the peptides converted to fibrils. The cysteine residues in Chp F did not appear to play a role in fibril assembly. The interfacial properties of Chp F at the air/water interface were altered by the structures adopted at different pH, with Chp F molecules forming a higher surface-active film at pH 10.0 with a lower area per molecule compared to Chp F fibrils at pH 3.0. These data show that the pH responsiveness of Chp F surface activity is the reverse of that observed for Chp E, which could prove useful in potential applications where surface activity is desired over a wide range of solution pH.
Air Quality Impacts of Petroleum Refining and Petrochemical Industries
Authors: Ragothaman Aiswarya , Anderson William
Published: September 2017

Though refineries and petrochemical industries meet society’s energy demands and produce a range of useful chemicals, they can also affect air quality. The World Health Organization (WHO) has identified polluted air as the single largest environmental risk, and hence it is necessary to strive for and maintain good air quality. To manage potential health impacts, it is important to implement proper air quality management by understanding the link between specific pollutant sources and resulting population exposures. These industries release pollutants such as Volatile Organic Compounds, greenhouse gases and particulate matter, from various parts of their operations. Air quality should be monitored and controlled more meticulously in developing nations where increased energy demands, industrialization and overpopulation has led to more emissions and lower air quality. This paper presents a review of findings and highlights from various studies on air quality impacts of petroleum refining and petrochemical plants in many regions in the world.
Evaluation of Tannins and Anthocyanins in Marquette, Frontenac, and St. Croix Cold-Hardy Grape Cultivars
Authors: Rice Somchai , Koziel Jacek , Dharmadhikari Murlidhar , Fennell Anne
Published: September 2017

Cold-hardy grape cultivars have become popular in northern regions. Wines from these cultivars are low in tannins and lighter in color compared to Vitis vinifera. The northern regions are striving to enhance desired ″full body″ and red color qualities in the wine produced from cold-hardy grapes. The objective of this study was to compare tannin and pigment content in skins and seeds of three cold-hardy red grape cultivars, at two time points, from two locations, using the Adams-Harbertson (A-H) assay. The A-H assay is based on protein precipitation and spectrophotometry. Total tannin concentrations detected in Frontenac, Marquette, and St. Croix berries, ranged from 0.29 to 0.66 mg/berry catechin equivalents (CE). Bitter seed tannins were most abundant in Marquette berries (0.54 ± 0.66 mg/berry CE). Softer skin tannins were most abundant in St. Croix berries (0.24 ± 0.19 mg/berry CE). Monomeric anthocyanins contributed to over 60% of the total color at pH 4.9 and were highest in St. Croix skins (74.21% of the total color at pH 4.9). Varying amounts of short polymeric pigments and long polymeric pigments were present in grape skins, indicating that pigmented tannins had already formed by harvest. This is the first evaluation of tannins and pigments in Frontenac, Marquette, and St. Croix berries.
Surface Functionalization of “Rajshahi Silk” Using Green Silver Nanoparticles
Authors: Mahmud Sakil , Sultana Mst. , Pervez Md. , Habib Md. , Liu Hui-Hong
Published: September 2017

In this study, a novel functionalization approach has been addressed by using sodium alginate (Na-Alg) assisted green silver nanoparticles (AgNPs) on traditional “Rajshahi silk” fabric via an exhaustive method. The synthesized nanoparticles and coated silk fabrics were characterized by different techniques, including ultraviolet–visible spectroscopy (UV–vis spectra), scanning electron microscopy (SEM), transmission electron microscopy (TEM), energy dispersive X-ray spectroscopy (EDS), X-ray diffraction (XRD), thermogravimetric analysis (TGA), and Fourier transform infrared spectroscopy (FT-IR), which demonstrated that AgNPs with an average size of 6–10 nm were consistently deposited in the fabric surface under optimized conditions (i.e., pH 4, temperature 40 °C, and time 40 min). The silk fabrics treated with AgNPs showed improved colorimetric values and color fastness properties. Moreover, the UV-protection ability and antibacterial activity, as well as other physical properties—including tensile properties, the crease recovery angle, bending behavior, the yellowness index, and wettability (surface contact angle) of the AgNPs-coated silk were distinctly augmented. Therefore, green AgNPs-coated traditional silk with multifunctional properties has high potential in the textile industry.
Can Diet Help Non-Obese Individuals with Non-Alcoholic Fatty Liver Disease (NAFLD)?
Authors: Merchant Hamid
Published: September 2017

Subjects diagnosed with non-alcoholic fatty liver disease (NAFLD) or hepatic steatosis are usually obese or overweight. NAFLD has also been reported in many non-obese healthy subjects as an incidental finding during imaging. Subjects with early-stage NAFLD who are otherwise healthy are often left unmanaged in current clinical practice; it is not clear if an early intervention in those individuals would be of any benefit in preventing NAFLD progression to more serious conditions. Since many of these subjects are non-alcoholic and have a normal body mass index (BMI), an intensive lifestyle change program is not usually recommended. This report presents an otherwise healthy non-alcoholic subject with incidental NAFLD having a normal BMI and a waist circumference below 90 cm who successfully reversed his condition by undertaking a lifestyle intervention. The case report is expected to encourage large cohort studies to substantiate the benefits of dietary interventions in alleviating hepatic steatosis among non-obese individuals.
Novel Low Cost 3D Surface Model Reconstruction System for Plant Phenotyping
Authors: Liu Suxing , Acosta-Gamboa Lucia , Huang Xiuzhen , Lorence Argelia
Published: September 2017

Accurate high-resolution three-dimensional (3D) models are essential for a non-invasive analysis of phenotypic characteristics of plants. Previous limitations in 3D computer vision algorithms have led to a reliance on volumetric methods or expensive hardware to record plant structure. We present an image-based 3D plant reconstruction system that can be achieved by using a single camera and a rotation stand. Our method is based on the structure from motion method, with a SIFT image feature descriptor. In order to improve the quality of the 3D models, we segmented the plant objects based on the PlantCV platform. We also deducted the optimal number of images needed for reconstructing a high-quality model. Experiments showed that an accurate 3D model of the plant was successfully could be reconstructed by our approach. This 3D surface model reconstruction system provides a simple and accurate computational platform for non-destructive, plant phenotyping.
miR-1290 Contributes to Colorectal Cancer Cell Proliferation by Targeting INPP4B
Authors: Ma Qingzhu , Wang Yan , Zhang Hualing , Wang Fengqiang
Published: September 2017

Colorectal cancer (CRC) is one of the most common oncological conditions worldwide, to date. MicroRNA-1290 (miR-1290) has been demonstrated to regulate its progression. We studied the role of miR-1290 in CRC progression. The gene was upregulated in CRC tissues and cells. Its overexpression
promoted CRC cell proliferation analyzed by MTT assay, colony formation assay, and soft agar growth assay. In addition, miR-1290 knockdown inhibited CRC cell proliferation. We also found that miR-1290 overexpression reduced the p27 level and increased cyclin D1 at both the mRNA and protein
levels, whereas miR-1290 knockdown increased p27 and reduced cyclin D1, confirming miR-1290 promoted CRC cell proliferation. Inositol polyphosphate 4-phosphatase B (INPP4B) was the target of miR-1290. Luciferase reporter assay revealed that miR-1290 directly bound to the 3′-UTR of INPP4B;
the mutated seed sites in miR-1290 abrogated this effect. Double knockdown of INPP4B and miR-1290 promoted CRC cell proliferation, suggesting miR-1290 promoted CRC cell proliferation by targeting INPP4B.
Increased YAP Activation Is Associated With Hepatic Cyst Epithelial Cell Proliferation in ARPKD/CHF
Authors: Jiang Lu , Sun Lina , Edwards Genea , Manley Michael , Wallace Darren P. , Septer Seth , Manohar Chirag , Pritchard Michele T. , Apte Udayan
Published: September 2017

Autosomal recessive polycystic kidney disease/congenital hepatic fibrosis (ARPKD/CHF) is a rare but fatal genetic disease characterized by progressive cyst development in the kidneys and liver. Liver cysts arise from aberrantly proliferative cholangiocytes accompanied by pericystic
fibrosis and inflammation. Yes-associated protein (YAP), the downstream effector of the Hippo signaling pathway, is implicated in human hepatic malignancies such as hepatocellular carcinoma, cholangiocarcinoma, and hepatoblastoma, but its role in hepatic cystogenesis in ARPKD/CHF is unknown.
We studied the role of the YAP in hepatic cyst development using polycystic kidney (PCK) rats, an orthologous model of ARPKD, and in human ARPKD/CHF patients. The liver cyst wall epithelial cells (CWECs) in PCK rats were highly proliferative and exhibited expression of YAP. There was increased
expression of YAP target genes, Ccnd1 (cyclin D1) and Ctgf (connective tissue growth factor), in PCK rat livers. Extensive expression of YAP and its target genes was also detected in human ARPKD/CHF liver samples. Finally, pharmacological inhibition of YAP activity with verteporfin
and short hairpin (sh) RNA-mediated knockdown of YAP expression in isolated liver CWECs significantly reduced their proliferation. These data indicate that increased YAP activity, possibly through dysregulation of the Hippo signaling pathway, is associated with hepatic cyst growth in ARPKD/CHF.
MicroCT imaging as a tool to study vessel endings in situ
Authors: Wason Jay W. , Huggett Brett A. , Brodersen Craig R.
Published: September 2017

PREMISE OF THE STUDY:

Despite the strong influence of the frequency and distribution of vessel endings on both hydraulic safety and efficiency, detailed anatomical descriptions or measurements of these structures are generally lacking.

METHODS:

Here we used high‐resolution x‐ray microcomputed tomography (microCT) to identify and describe xylem vessel endings within Acer rubrum root segments (1.0–2.1 mm diameter, ∼2 mm long). We then compared vessel‐lumen diameter, pit density, vessel element length, and perforation plate angle between non‐ending vessels (those that traverse an entire segment) and those that end within a segment using three‐dimensional image analysis.

KEY RESULTS:

We found 214 vessel endings, 37 complete vessels, and 385 non‐ending vessels within four A. rubrum root segments. Vessels that ended within the segments tended to have more acute perforation plate angles and had a smaller diameter than those that did not end within the segments. Most vessel diameters tapered within the last few vessel elements, but the perforation plate angle apparently changed over longer distances. Intervessel pit density and vessel element length did not differ between ending and non‐ending vessels.

CONCLUSIONS:

Vessel endings were surprisingly frequent in A. rubrum roots despite the common perception that root vessels are longer than vessels in other tissues. MicroCT proved to be a useful tool for studying the three‐dimensional arrangement of vessel endings within xylem networks, and these data will be helpful in developing a better understanding of vessel ending microstructure and function.
Associations Between Lifestyle Factors And Parkinson’s Disease In An Urban Sri Lankan Clinic Study
Authors: Wijeyekoon Ruwani , Suriyakumara Vindika , Gamage Ranjanie , Fernando Tharushi , Jayasuriya Amila , Amarasinghe Dhanusha , Gunasekara Harsha , Sirisena Dharshana , Amaratunga Dhammika , Muthukuda Chanaka , Barker Roger A , Williams-Gray Caroline , De Silva Ranil
Published: September 2017

Background- Information on lifestyle factors (eg. coffee /tea drinking, smoking) and Parkinson’s Disease(PD) in South Asia is limited. The objective of this study was to determine associations between lifestyle factors and PD in a clinic-based study in Sri Lanka.

Methods–Demographic and lifestyle factor data was collected from an unselected cohort of PD patients and age and gender-matched controls attending clinics in Greater Colombo, Sri Lanka.

Findings–Of 229 patients with parkinsonism, 144 had Idiopathic PD. Controls numbered 102. Coffee drinkers and smokers were significantly less likely to have PD (coffee, p<0.001; OR=0.264; smoking, p=0.043; OR=0.394). Coffee drinkers were older at PD onset(p<0.001). Similar trends seen with tea drinking were not statistically significant.

Conclusions -This is the first formal study of PD and these lifestyle factors in South Asia. It demonstrates an association between coffee drinking, smoking and a decreased prevalence of PD, and coffee drinking and later age of PD onset.  This is in line with other studies done worldwide, suggesting biological associations with global relevance.
Swaziland National Health Research Agenda: The Formulation Process
Authors: Kirigia Joses Muthuri , Ota Martin O. , Shongwe Babazile
Published: September 2017

Background: The objectives of this article are to describe the process followed in development of the Swaziland’s national health research agenda (NHRA); and to provide an overview of the health research priorities that emerged from that process.Discussion: Swaziland followed a fourteen step process to develop it’s NHRA, namely: search and review of the existing health research priority setting guidelines; situation analysis included review of Swaziland’s socio-economic indicators; identification of research stakeholders; identification of the preliminary main broad research themes; development of questionnaire on ranking of main research themes; workshops with each of the eight stakeholders; ranking of major health themes and identification of sub-themes; identification of research gaps under each sub-theme and main research areas; scoring of research areas; research areas were grouped by sub-themes and ranked; collating research areas ranked as number one in each sub-theme; providing content to the agenda; preparation of the zero NHRA draft report; preparation of the first NHRA draft report taking into account critical inputs from stakeholders; and stakeholder’s final validation of the NHRA draft report. The paper provides an overview of communicable diseases, non-communicable diseases, sexual and reproductive health, injuries and health system research gaps under four categories of research: situation (burden and determinants); improvement of existing interventions; effectiveness of interventions; and feasibility of developing new capacities (tools and products).Conclusion: The National Health Research Department, with the support of the National Health Research Review Board, will be responsible for dissemination, preparation of rolling annual action plans to secure government funds for implementation of NHRA, promoting adherence among stakeholders, establishing a registry of R4H, establishing a knowledge translation platform, building of public-private-partnerships for research, mobilization of external resources, coordination and monitoring of the implementation of the NHRA.

KeywordsSwaziland, National Health Research Agenda, Health Research Priorities, Research Stakeholders, Research Gaps
The Meaning of the Elderly Sexuality in the Nursing Consultation Context
Authors: Saraiva Renata Jabour , Rosas Ann Mary Machado Tinoco Feitosa , Valente Geilsa Soraia Cavalcanti , Marques Ermelinda Maria Bernardo Gonçalves
Published: September 2017

Objective: Comprehend the meaning of the elderly sexuality in the nursing consultation context.

Method: A qualitative research, of Alfred Schutz’s phenomenological sociological approach. 41 participants, being Brazilian and Portuguese elderly. The used scene was the teaching-assistance academic unit Institute of Health Care São Francisco de Assis – Rio de Janeiro – Brazil and Health School – Polytechnical Institute of Guarda – Portugal. 

Results: The analysis of the contextualization of the reason-why and its categories: Interpretations of sexuality and sex between elderly; Cultural aspects involved among the elderly.

Conclusion: The lack of correct interpretation between the sexuality meaning and sex contributes to the insight of preventive clinical care, just as for sex-related pathologies.

Keywords: Nursing; Consultation; Elderly; Teaching; Education; Sexuality; Sex.
Quality Of Care As Perceived By Patients In A Brazilian Hospital: A Non-Randomized Interventional Study
Authors: Taets Gunnar Glauco De Cunto , Lopes Camila Mendonça de Moraes , Borba-Pinheiro Claudio Joaquim , Dantas Estelio Henrique Martin
Published: September 2017

Objective: To assess patients’ perceptions of the quality of care delivered by staff who underwent training about humanized care in a private hospital in Rio de Janeiro, Brazil.

Method: This was an exploratory study. The convenience sample consisted of 30 patients, and data were collected via pre-intervention questionnaires, followed by post-intervention questionnaires after a training sessions with 44 employees working in a cardiac intensive unit of a private general hospital in Rio de Janeiro, Brazil. Dependent variables were analyzed using McNemar’s nonparametric test for repeated measures, considered suitable because of the nominal scale. Percentage differences were calculated using the following equation: ∆%=[(post-test – pre-test)*100/test] with significance set at  <0.05.

Results: Improvements were observed in quality of patient care (Δ% = 38.1%, p = 0.031) and clarification of patients’ clinical condition (Δ% = 25%, p = 0.021), in addition to perceived room temperature (Δ % = 40%, p = 0.008) and ambient noise (Δ% = 52.6%, p = 0.002).

Conclusion: Quality of care improved significantly after staff training, demonstrating the essential nature of ongoing education.
COMMUNITY ACTION: VALUE OR INSTRUMENT? AN ETHICS AND PLANNING CRITICAL REVIEW
Authors: TRICARICO Luca
Published: September 2017

The community concept has maintained a constant and growing interest in urban studies and many related fields. The origin of this continuing interest seems to derive from the importance of the concept of community within diverse forms of political language and interpretations within different planning practices. In this contribution, through the analysis of different ethical and planning theories, we want to provide an update framework on community action. According to this objective, the argumentation will proceed through a literature review on four ethics theories and three key aspects related to spatial planning, as well as matching this theoretical analysis with exemplifying practices. The final objective is to provide an original analysis on drivers and outcomes of different forms of community, raising general issues that refer to spatial planning, social organization and regulation.
Time-dependent Occurrence Rate of Electromagnetic Cyclotron Waves in the Solar Wind: Evidence for the Effect of Alpha Particles?
Authors: Zhao G. Q. , Feng H. Q. , Wu D. J. , Chu Y. H. , Huang J.
Published: September 2017

Previous studies revealed that electromagnetic cyclotron waves (ECWs) near the proton cyclotron frequency exist widely in the solar wind, and the majority of ECWs are left-handed (LH) polarized waves. Using the magnetic field data from the STEREO mission, this Letter carries out a survey of ECWs over a long period of 7 years and calculates the occurrence rates of ECWs with different polarization senses. Results show that the occurrence rate is nearly a constant for the ECWs with right-handed polarization, but it varies significantly for the ECWs with LH polarization. Further investigation of plasma conditions reveals that the LH ECWs take place preferentially in a plasma characterized by higher temperature, lower density, and larger velocity. Some considerable correlations between the occurrence rate of LH ECWs and the properties of ambient plasmas are discussed. The present research may provide evidence for the effect of alpha particles on the generation of ECWs.
Genetic Determinants of Radiographic Knee Osteoarthritis in African Americans
Authors: Liu Youfang , Yau Michelle S. , Yerges-Armstrong Laura M. , Duggan David J. , Renner Jordan B. , Hochberg Marc C. , Mitchell Braxton D. , Jackson Rebecca D. , Jordan Joanne M.
Published: September 2017

Objective.

The etiology of knee osteoarthritis (OA), the most common form of arthritis, is complex and may differ by race or ethnicity. In recent years, genetic studies have identified many genetic variants associated with OA, but nearly all the studies were conducted in European whites and Asian Americans. Few studies have focused on the genetics of knee OA in African Americans.

Methods.

We performed a genome-wide association study of radiographic knee OA in 1217 African Americans from 2 North American cohort studies: 590 subjects from the Johnston County Osteoarthritis Project and 627 subjects from the Osteoarthritis Initiative. Analyses were conducted in each cohort separately and combined in an inverse variance fixed effects metaanalysis, which were then included in pathway analyses. We additionally tested 12 single-nucleotide polymorphisms robustly associated with OA in European white populations for association in African Americans.

Results.

We identified a genome-wide significant variant inLINC01006(minor allele frequency 12%; p = 4.11 × 10−9) that is less common in European white populations (minor allele frequency < 3%). Five other independent loci reached suggestive significance (p < 1 × 10−6). In pathway analyses, dorsal/ventral neural tube patterning and iron ion transport pathways were significantly associated with knee OA in African Americans (false discovery rate < 0.05). We found no evidence that previously reported OA susceptibility variants in European whites were associated with knee OA in African Americans.

Conclusion.

These results highlight differences in the genetic architecture of knee OA between African American and European whites. This finding underscores the need to include more diverse populations in OA genetics studies.
Serologic Evidence of Gut-driven Systemic Inflammation in Juvenile Idiopathic Arthritis
Authors: Fotis Lampros , Shaikh Nurmohammad , Baszis Kevin W. , Samson Charles M. , Lev-Tzion Raffi , French Anthony R. , Tarr Phillip I.
Published: September 2017

Objective.

Accumulating evidence links juvenile idiopathic arthritis (JIA) to nonhost factors such as gut microbes. We hypothesize that children with new-onset JIA have increased intestinal bacterial translocation and circulating lipopolysaccharide (LPS).

Methods.

We studied systemic treatment-naive patients with JIA [polyarticular JIA, n = 22, oligoarticular JIA, n = 31, and spondyloarthropathies (SpA), n = 16], patients with established inflammatory bowel disease–related arthritis (IBD-RA, n = 11), and 34 healthy controls. We determined circulating IgG reactivity against LPS, LPS-binding protein (LBP), α-1-acid glycoprotein (α-1AGP), and C-reactive protein (CRP) in plasma or serum from these patients and controls. Juvenile Arthritis Disease Activity Score (JADAS-27) was calculated for patients with JIA.

Results.

Circulating anticore LPS antibody concentrations in patients with polyarticular JIA (p = 0.001), oligoarticular JIA (p = 0.024), and SpA (p = 0.001) were significantly greater than in controls, but there were no significant intergroup differences. Circulating LBP concentrations were also significantly greater in patients with polyarticular JIA (p = 0.001), oligoarticular JIA (p = 0.002), and SpA (p = 0.006) than controls, as were α-1AGP concentrations (p = 0.001, 0.001, and 0.003, respectively). No differences were observed between controls and patients with IBD-RA in any of the assays. Circulating concentrations of LBP and α-1AGP correlated strongly with CRP concentrations (r = 0.78 and r = 0.66, respectively). Anticore LPS antibody levels and CRP (r = 0.26), LBP (r = 0.24), and α-AGP (r = 0.22) concentrations had weaker correlations. JADAS-27 scores correlated with LBP (r = 0.66) and α-1AGP concentrations (r = 0.58).

Conclusion.

Children with polyarticular JIA, oligoarticular JIA, and SpA have evidence of increased exposure to gut bacterial products. These data reinforce the concept that the intestine is a source of immune stimulation in JIA.
Positron Emission Tomography/Computerized Tomography in Newly Diagnosed Patients with Giant Cell Arteritis Who Are Taking Glucocorticoids
Authors: Clifford Alison H. , Murphy Elana M. , Burrell Steven C. , Bligh Mathew P. , MacDougall Ryan F. , Heathcote J. Godfrey , Castonguay Mathieu C. , Lee Min S. , Matheson Kara , Hanly John G.
Published: September 2017

Objective.

Large vessel uptake on positron emission tomography/computerized tomography (PET/CT) supports the diagnosis of giant cell arteritis (GCA). Its value, however, in patients without arteritis on temporal artery biopsy and in those receiving glucocorticoids remains unknown. We compared PET/CT results in GCA patients with positive (TAB+) and negative temporal artery biopsies (TAB−), and controls.

Methods.

Patients with new clinically diagnosed GCA starting treatment with glucocorticoids underwent temporal artery biopsy and PET/CT. Using a visual semiquantitative approach, 18F-fluorodeoxyglucose (FDG) uptake was scored in 8 vascular territories and summed overall to give a total score in patients and matched controls.

Results.

Twenty-eight patients with GCA and 28 controls were enrolled. Eighteen patients with GCA were TAB+. Mean PET/CT scores after an average of 11.9 days of prednisone were higher in patients with GCA compared to controls, for both total uptake (10.34 ± 2.72 vs 7.73 ± 2.56; p = 0.001), and in 6 of 8 specific vascular territories. PET/CT scores were similar between TAB+ and TAB− patients with GCA. The optimal cutoff for distinguishing GCA cases from controls was a total PET/CT score of ≥ 9, with an area under the receiver-operating characteristic curve of 0.75, sensitivity 71.4%, and specificity 64.3%. Among patients with GCA, these measures correlated with greater total PET/CT scores: systemic symptoms (p = 0.015), lower hemoglobin (p = 0.009), and higher platelet count (p = 0.008).

Conclusion.

Vascular FDG uptake scores were increased in most patients with GCA despite exposure to prednisone; however, the sensitivity and specificity of PET/CT in this setting were lower than those previously reported.
Do Comorbidities Play a Role in Hand Osteoarthritis Disease Burden? Data from the Hand Osteoarthritis in Secondary Care Cohort
Authors: Damman Wendy , Liu Rani , Kroon Féline P.B. , Reijnierse Monique , Huizinga Tom W.J. , Rosendaal Frits R. , Kloppenburg Margreet
Published: September 2017

Objective.

Because the association and its clinical relevance between comorbidities and primary hand osteoarthritis (OA) disease burden is unclear, we studied this in patients with hand OA from our Hand OSTeoArthritis in Secondary care (HOSTAS) cohort.

Methods.

Cross-sectional data from the HOSTAS study were used, including consecutive patients with primary hand OA. Nineteen comorbidities were assessed: 18 self-reported (modified Charlson index and osteoporosis) and obesity (body mass index ≥ 30 kg/m2). Mean differences were estimated between patients with versus without comorbidities, adjusted for age and sex: for general disease burden [health-related quality of life (HRQOL), Medical Outcomes Study Short Form-36 physical component scale (0–100)] and disease-specific burden [self-reported hand function (0–36), pain (0–20; Australian/Canadian Hand OA Index), and tender joint count (TJC, 0–30)]. Differences above a minimal clinically important improvement/difference were considered clinically relevant.

Results.

The study included 538 patients (mean age 61 yrs, 86% women, 88% fulfilled American College of Rheumatology classification criteria). Mean (SD) HRQOL, function, pain, and TJC were 44.7 (8), 15.6 (9), 9.3 (4), and 4.8 (5), respectively. Any comorbidity was present in 54% (287/531) of patients and this was unfavorable [adjusted mean difference presence/absence any comorbidity (95% CI): HRQOL −4.4 (−5.8 to −3.0), function 1.9 (0.4–3.3), pain 1.4 (0.6–2.1), TJC 1.3 (0.4–2.2)]. Number of comorbidities and both musculoskeletal (e.g., connective tissue disease) and nonmusculoskeletal comorbidities (e.g., pulmonary and cardiovascular disease) were associated with disease burden. Associations with HRQOL and function were clinically relevant.

Conclusion.

Comorbidities showed clinically relevant associations with disease burden. Therefore, the role of comorbidities in hand OA should be considered when interpreting disease outcomes and in patient management.
Mortality and Functionality after Stroke in Patients with Systemic Lupus Erythematosus
Authors: Rossides Marios , Simard Julia F. , Svenungsson Elisabet , von Euler Mia , Arkema Elizabeth V.
Published: September 2017

Objective.

To investigate mortality and functional impairment after stroke in systemic lupus erythematosus (SLE).

Methods.

Using Swedish nationwide registers, we identified 423 individuals with SLE and 1652 people without SLE who developed a first-ever ischemic or hemorrhagic stroke (1998–2013) and followed them until all-cause death or for 1 year. HR for death after ischemic or hemorrhagic stroke and the risk ratio of functional impairment (dependence in either transferring, toileting, or dressing) 3 months after ischemic stroke were estimated.

Results.

One year after stroke, 22% of patients with SLE versus 16% of those without SLE died. After ischemic stroke, patients with SLE had an increased risk of death (HR 1.85, 95% CI 1.39–2.45), which was attenuated after controlling for SLE-related comorbidities (HR 1.41, 95% CI 1.04–1.91). Functional impairment at 3 months was increased in SLE by almost 2-fold (risk ratio 1.73, 95% CI 1.16–2.57). After hemorrhagic stroke, patients with SLE had an HR of 2.30 (95% CI 1.38–3.82) for death, which was increased even during the first month.

Conclusion.

Compared to subjects without SLE, mortality after ischemic stroke increases after the first month in individuals with SLE, and functionality is worse at 3 months. SLE is associated with all-cause death after hemorrhagic stroke even during the first month. A shift of focus to patient functionality and prevention of hemorrhagic strokes is required.
Comparative Effectiveness of Tumor Necrosis Factor Agents and Disease-modifying Antirheumatic Therapy in Children with Enthesitis-related Arthritis: The First Year after Diagnosis
Authors: Weiss Pamela F. , Xiao Rui , Brandon Timothy G. , Pagnini Ilaria , Wright Tracey B. , Beukelman Timothy , Morgan-DeWitt Esi , Feudtner Chris
Published: September 2017

Objective.

To characterize the effect of anti-tumor necrosis factor (TNF) therapy compared to conventional synthetic disease-modifying antirheumatic drugs (csDMARD) in children with enthesitis-related arthritis (ERA) over the first year after diagnosis.

Methods.

We conducted a multicenter retrospective comparative effectiveness study of children diagnosed with ERA. We estimated the effect of anti-TNF therapy on clinical variables (active joint count, tender entheses count) and patient-reported pain and global assessment of disease activity over the first year after diagnosis using state-of-the-art comparative effectiveness analytic methods.

Results.

During the study period, 217 patients newly diagnosed with ERA had a total of 965 clinic visits the first year after disease diagnosis. Children [median age 11.6 yrs, interquartile range 10–14] were treated with anti-TNF monotherapy (n = 33, 15.2%), csDMARD monotherapy (n = 73, 33.6%), or both (n = 52, 23.9%) in the first year after disease diagnosis. There was a statistically significant improvement in the primary outcome, active joint count, over time in children who received an anti-TNF drug versus those who did not (p = 0.03). Additionally, use of anti-TNF therapy versus no anti-TNF therapy was associated with less patient-reported pain (p < 0.01) and improved disease activity over time as assessed by the clinical Juvenile Arthritis Disease Activity Score (p < 0.01). The magnitude of estimated effect on clinical outcomes was uniformly greater, with the exception of tender entheses count, in children treated with an anti-TNF drug versus a csDMARD.

Conclusion.

During the first year after diagnosis, anti-TNF exposure was associated with benefits for several clinically meaningful outcomes in children with enthesitis-related arthritis.