bluuebunny/crossref_metadata_2025 huggingface dataset:
Interleukin-9 over-expression and T helper 9 polarization in systemic sclerosis patients
Authors: Guggino G , Lo Pizzo M , Di Liberto D , Rizzo A , Cipriani P , Ruscitti P , Candore G , Gambino C M , Sireci G , Dieli F , Giacomelli R , Triolo G , Ciccia F
Published: July 2017

T helper 9 (Th9) cells and interleukin (IL)-9 are involved in the pathogenesis of several autoimmune diseases. The exact role of IL-9 and Th9 cells in patients with systemic sclerosis (SSc) have not yet been studied adequately. IL-9, IL-9R, transcription factor PU.1 (PU.1), IL-4, thymic stromal lymphopoietin (TSLP) and transforming growth factor (TGF)-β expression were assessed in skin and kidney biopsies of SSc patients and healthy controls (HC) by immunohistochemistry (IHC). The cellular source of IL-9 was also analysed by confocal microscopy analysis. Peripheral IL-9-producing cells were also studied by flow cytometry. The functional relevance of IL-9 increased expression in SSc was also investigated. Our results demonstrated a strong expression of IL-9, IL-9R, IL-4, TSLP and TGF-β in skin tissues of patients with both limited and diffuse SSc. IL-9 expression was observed mainly in the context of skin infiltrating mononuclear cells and keratinizing squamous epithelium. IL-9 over-expression was also observed in renal biopsies of patients with SSc. IL-9 producing cells in the skin were identified as Th9 cells. Similarly, Th9 cells were expanded and were the major source of IL-9 among SSc peripheral blood mononuclear cells (PBMC), their percentage being correlated directly with the modified Rodnan skin score. Infiltrating mononuclear cells, mast cells and neutrophils expressed IL-9R. In in-vitro studies stimulation with rIL-9 significantly induced NET (neutrophil extracellular traps) release by dying cells (NETosis) in neutrophils, expansion of mast cells and increase of anti-systemic scleroderma 70 (Scl70) production by B cells. Our findings suggest that Th9 cells and IL-9 could be implicated in the pathogenesis of SSc.
An overdue alignment of risk and resilience? A conceptual contribution to community resilience
Authors: Mochizuki Junko , Keating Adriana , Liu Wei , Hochrainer‐Stigler Stefan , Mechler Reinhard
Published: July 2017

A systematic review of literature on community resilience measurement published between 2005 and 2014 revealed that the profound lack of clarity on risk and resilience is one of the main reasons why confusion about terms such as adaptive capacity, resilience, and vulnerability persists, despite the effort spared to operationalise these concepts. Resilience is measured in isolation in some cases, where a shock is perceived to arise external to the system of interest. Problematically, this contradicts the way in which the climate change and disaster communities perceive risk as manifesting itself endogenously as a function of exposure, hazard, and vulnerability. The common conceptualisation of resilience as predominantly positive is problematic as well when, in reality, many undesirable properties of a system are resilient. Consequently, this paper presents an integrative framework that highlights the interactions between risk drivers and coping, adaptive, and transformative capacities, providing an improved conceptual basis for resilience measurement.
A case of complete double aortic arch visualized by transthoracic echocardiography
Authors: Saito Naka , Kato Shingo , Saito Noritaka , Nakachi Tatsuya , Fukui Kazuki , Iwasawa Tae , Kosuge Masami , Kimura Kazuo
Published: July 2017

A case of double aortic arch that was well visualized using transthoracic echocardiography is reported. A 38‐year‐old man underwent transthoracic echocardiography for the evaluation of dyspnea. A suprasternal view of transthoracic echocardiography showed the ascending aorta bifurcate to left and right aortic arches, with blood flow from the ascending aorta to bilateral aortic arches. The diagnosis of right side–dominant double aortic arch was made, and the patient's symptom was conceivably related to compression of the trachea due to a vascular ring. This report indicates the potential usefulness of transthoracic echocardiography for noninvasive detection of double aortic arch in adults.
Optimal image reconstruction using multidetector‐row computed tomography to facilitate cardiac resynchronization therapy
Authors: Izawa Yu , Mori Shumpei , Nishii Tatsuya , Matsuzoe Hiroki , Imada Hiroshi , Suehiro Hideya , Nakayama Kazuhiko , Matsumoto Kensuke , Tanaka Hidekazu , Fujiwara Sei , Fukuzawa Koji , Hirata Ken‐ichi
Published: July 2017

Preprocedural recognition of the segment of latest mechanical contraction along with the anatomy of the coronary venous system is important for successful and effective cardiac resynchronization therapy. We present a case of ischemic cardiomyopathy who underwent implantation of a cardiac resynchronization therapy device with a defibrillator, which was facilitated by preprocedural computed tomographic images reconstructed to visualize the left ventricular slab and the coronary venous system simultaneously on the cardiac contour. The present reconstruction method using computed tomography is optimal and feasible method to incorporate the echocardiographic findings into the procedure performed under fluoroscopy appropriately.
Factors associated with aortic root dilatation after surgically repaired ventricular septal defect
Authors: Saito Chihiro , Fukushima Noritoshi , Fukushima Keiko , Matsumura Goki , Ashihara Kyomi , Hagiwara Nobuhisa
Published: July 2017

Background

Aortic root dilatation (ARD) in congenital heart disease is related to aortic aneurysm, rupture, and dissection. This study aimed to investigate the factors associated with ARD in patients with surgically repaired ventricular septal defect (VSD).

Methods

This cross‐sectional study included 152 patients with surgically repaired VSD. Two definitions of ARD were used: (1) observed Valsalva diameter to body surface area (BSA) ratio >2.1 cm/m2 and (2) absolute value of Valsalva diameter ≥4.0 cm. Odds ratios (ORs) and 95% confidence intervals (CIs) of ARD presence were calculated using multivariate logistic regressions.

Results

The prevalence of ARD ranged between 8.6% and 32.9%. Using the definition of observed aortic root diameter/BSA >2.1 cm/m2, patients with nonsubarterial VSD type were more likely to have ARD (OR 5.65, 95% CI; 1.83–17.44, P=.003) than those with subarterial type, and patients with preoperative right‐ or noncoronary cusp prolapse (R/NCCP) were more likely to have ARD (OR 3.68, 95% CI; 1.20–11.23, P=.022) than patients without preoperative R/NCCP after adjustment for sex, age at repair (ie, shunt duration), VSD size, and postoperative follow‐up period. Using the definition of absolute Valsalva diameter ≥4 cm, nonsubarterial VSD type and presence of R/NCCP were also significantly associated with ARD after adjustment for the same covariates.

Conclusions

Anatomical and morphological features (nonsubarterial type and presence of preoperative R/NCCP) are independently correlated with ARD in patients with VSD regardless of the different definitions of ARD. Patients with surgically repaired VSD may need careful monitoring for potential ARD development.
Contractile reserve and cardiopulmonary exercise parameters in patients with dilated cardiomyopathy, the two dimensions of exercise testing
Authors: Moneghetti Kegan J. , Kobayashi Yukari , Christle Jeffrey W. , Ariyama Miyuki , Vrtovec Bojan , Kouznetsova Tatiana , Wilson Andrew , Ashley Euan , Wheeler Matthew T. , Myers Johnathan , Haddad Francois
Published: July 2017

Background

Left ventricular (LV) contractile reserve assessed using imaging and cardiopulmonary exercise testing (CPX) has been shown to predict outcome in patients with dilated cardiomyopathy (DCM). Few clinical studies have, however, analyzed the relationship between them.

Methods

A cohort of 75 ambulatory patients with DCM underwent stress treadmill echocardiography with CPX. LV contractile reserve was calculated as absolute change (ΔLVEF=LVEFpeak−LVEFrest) and percent change (%LVEF=[(LVEFpeak−LVEFrest)/LVEFpeak)]×100) in LVEF, circumferential and longitudinal strain (LS). Exercise capacity was measured as peak oxygen uptake (peak VO2) and ventilatory efficiency as the slope of minute ventilation to CO2 production (VE/VCO2 slope). Values of contractile reserve were compared to matched controls. We also explored which metric of ventricular response (absolute or percent change) was less dependent on baseline LV function.

Results

Patients with DCM had a mean age, rest and peak LVEF of 44±10 years, 42±10% and 50±12%, respectively. Among parameters of contractile reserve, peak cardiac output was the strongest parameter associated with peak VO2 (r=.63, P<.001). Along with age, sex, and BMI, it explained more than 70% of the variance in peak VO2. In contrast, LVEF and LS were only weakly related to peak VO2. With regard to ventilatory efficiency, the strongest parameter that emerged was right atrial volume index (r=.36, P<.001). Percent change in LVEF was more independent of baseline function than absolute change.

Conclusion

Echocardiographic contractile reserve and CPX provide complementary information. Percent change in contractile reserve was most independent of baseline function, therefore may be preferred when analyzing the ventricular response to exercise.
Evaluation of the congenital supravalvular aortic stenosis by different imaging modalities
Authors: Guner Ahmet , Havan Nuri , Gunduz Sabahattin , Akgun Taylan , Guvendi Busra , Kahveci Gokhan
Published: July 2017

A 36‐year‐old female was admitted to hospital exhibiting chest pain, dyspnea, and a heart murmur on the right upper sternal border, radiating to both carotid arteries. The blood pressure of the patient's right arm exceeded the pressure in the left by 25 mm Hg (Coanda effect). In spite of laboratory results that did not fall outside the expected range, the left ventricle was revealed to be hypertrophic following electrocardiography. Transthoracic echocardiography revealed a severe supravalvular aortic stenosis (SVAS) with a peak Doppler velocity of 6.04 cm/s and an estimated mean pressure gradient of 89 mm Hg, with moderate aortic and mitral regurgitation. Contrast‐enhanced computed tomography (CCT) indicated a partial hourglass‐shaped narrowing of the ascending aorta. Lesions associated with supravalvular stenosis of the pulmonary artery, patent ductus arteriosus, and aortic coarctation were ruled out by the CCT. Congenital SVAS is a rare heart condition, and three anatomically distinct forms have been described. The most common type is the “hourglass,” which produces a marked thickening and disorganization of the aortic tissue, producing a constricting annular ridge at the superior margin of the sinuses of Valsalva.
Influence of decision aids on oral anticoagulant prescribing among physicians: a randomised trial
Authors: Baicus Cristian , Delcea Caterina , Dima Alina , Oprisan Emilia , Jurcut Ciprian , Dan Gheorghe Andrei
Published: July 2017

Background

Oral anticoagulants (OAC) are underused in treatment of atrial fibrillation (AF), with differences in patient and physician preferences. For risk communication, the graphic showing risks on treatment contains all the information, therefore, the graphic showing risks without treatment may not be necessary. Here, our objective was to assess whether decision aids require information of risks without treatment and specifically whether presentation of 5‐year stroke risk in patients with AF increases use of OACs compared with presentation of 1‐year risk and whether decisions on treatment are different when physicians decide their own treatment vs. that of the patient.

Design

Randomised controlled trial with 23 factorial design, performed at 12 university hospitals, one internal medicine course and one national medical conference.

Results

Of 968 physicians who participated, 83·3% prescribed anticoagulation therapy. Treatment decisions were not influenced by the number of graphics or by the time frame of risk estimation, with risk differences of 0·5% (95% confidence interval, −4·0% to 5·4%) and 3·4% (−1·3% to 8·1%). However, physician‐to‐patient prescription rates were 5·4% (0·2–10·6%) more frequent after seeing the 5‐year risk graphic. Physician‐to‐self intentions to prescribe occurred less frequently, with risk difference of 15·4% (10·8–20%). Physicians considered the baseline risk and the absolute risk reduction only when prescribing to patients but not to themselves.

Conclusions

Risks could be communicated using decision aids with only one graphic. Showing the risk of stroke at 5 years could increase the prescription of OACs to patients with AF. Faced with the same risk of stroke, physicians prescribed less to themselves than to patients.
Strategic delegation in asymmetric tax competition
Authors: Ogawa Hikaru , Susa Taiki
Published: July 2017

This study examines asymmetric tax competition under representative democracy systems. The findings show that the degree of asymmetry between countries affects the result of elections in each country, where the citizens select a policy‐maker to set a tax rate for the country. In particular, under certain conditions, a decisive voter in the election can select a citizen whose share of the country's capital is higher than the decisive voter's own share.
Feasibility study suggests no impact from protected engagement time on adverse events in mental health wards for older adults
Authors: Smith Toby , Clark Allan , Dodd Emily , Khoo Mary‐Ellen , Heneker Sarah , Cross Jane , Cheston Rik , Gray Richard , Fox Chris , Nolan Fiona
Published: July 2017

Hospital adverse events, such as falls, violence and aggression, security, self‐harm, and suicide, are difficult to manage in older people with dementia. The purpose of the present study was to determine whether protected engagement time (PET) resulted in lower adverse events and incidents compared to comparable non‐PET wards for people admitted to inpatient older people's mental health wards. Ten inpatient wards for older people were included. Five followed a PET‐management pathway, while five continued usual care. All adverse events and incidents were recorded in routine hospital records over 72 weeks. Data were gathered from these records and analysed as rate per person per week to assess differences in frequency and type of adverse events between wards. A total of 4130 adverse events were recorded. In the PET wards, a mean of 0.38 adverse events occurred per person per week compared to 0.40 in non‐PET wards. No statistically‐significant differences were found between PET and non‐PET wards for adverse events (P = 0.93), or for adverse events of any particular type (P ≥ 0.15). Therefore, there is no evidence to suggest that PET has any impact on adverse events in older people's mental health wards. Further investigation with a larger cohort is warranted, using a definitive, phase 3, clinical trial.
Communicating about death and dying: Developing training for staff working in services for people with intellectual disabilities
Authors: Tuffrey‐Wijne Irene , Rose Tracey , Grant Robert , Wijne Astrid
Published: July 2017

Background

Many people with intellectual disabilities are affected by death, yet conversations about death are often avoided by staff working with them. This study aimed to assess staff training needs and to develop, trial and evaluate a training course on communicating about death and dying.

Method

(i) Semi‐structured interviews with 20 staff in residential/supported living services to establish training needs; (ii) three‐one‐day courses were attended by 114 staff and evaluated through questionnaires. The course consisted of World Café sessions, presentations and feedback by people with intellectual disabilities, and an expert teaching session.

Results

Staff fear, cultural influences and inexperience with death‐related conversations were major communication barriers. Evaluation of the course was overwhelmingly positive.

Conclusions

Intellectual disabilities services must have clear staff training strategies around death, dying and communication. More work is needed to assess the resource implications and impact on practice of different training methods and other support strategies.
Blood pressure control and mortality in US‐ and foreign‐born blacks in New York City
Authors: Gyamfi Joyce , Butler Mark , Williams Stephen K. , Agyemang Charles , Gyamfi Lloyd , Seixas Azizi , Zinsou Grace Melinda , Bangalore Sripal , Shah Nirav R. , Ogedegbe Gbenga
Published: July 2017

This retrospective cohort study compared blood pressure (BP) control (BP <140/90 mm Hg) and all‐cause mortality between US‐ and foreign‐born blacks. We used data from a clinical data warehouse of 41 868 patients with hypertension who received care in a New York City public healthcare system between 2004 and 2009, defining BP control as the last recorded BP measurement and mean BP control. Poisson regression demonstrated that Caribbean‐born blacks had lower BP control for the last BP measurement compared with US‐ and West African–born blacks, respectively (49% vs 54% and 57%; P<.001). This pattern was similar for mean BP control. Caribbean‐ and West African–born blacks showed reduced hazard ratios of mortality (0.46 [95% CI, 0.42–0.50] and 0.28 [95% CI, 0.18–0.41], respectively) compared with US‐born blacks, even after adjustment for BP. BP control rates and mortality were heterogeneous in this sample. Caribbean‐born blacks showed worse control than US‐born blacks. However, US‐born blacks experienced increased hazard of mortality. This suggests the need to account for the variations within blacks in hypertension management.
Practitioner Review: Therapist variability, patient‐reported therapeutic alliance, and clinical outcomes in adolescents undergoing mental health treatment – a systematic review and meta‐analysis
Authors: Murphy Regina , Hutton Paul
Published: July 2017

Background

Previous meta‐analyses have only found small correlations (r = .10 tor = .19) between therapeutic alliance and clinical outcomes in samples of adolescents receiving psychological therapy. Although study‐level variables have been found to moderate this, little is known about the impact of therapist variability. The present meta‐analysis aimed to address this gap by using patient‐therapist ratio as a moderator variable.

Methods

Contrary to previous reviews of adolescent alliance, individual effect sizes were extracted using a preregistered conceptual hierarchy. Controlling for treatment‐level confounds, a random effects meta‐analysis assessed the moderating effect of patient‐therapist ratio on the alliance‐outcome relationship in predefined single‐predictor and multipredictor meta‐regressions.

Results

The alliance‐outcome relationship was found to be larger than previously thought (k = 28,N = 2,911,r = .29, 95% Confidence Interval 0.21, 0.37;p < .0001,I2 = 80%). When study samples exceeding the adolescent 12–19 age range were removed, the correlation rose (k = 15,N = 1,797,r = .34, 95% Confidence Interval 0.23, 0.45;p < .0001,I2 = 83%). In contrast to research with adults, patient‐therapist ratio did not moderate this relationship in either single‐predictor (p = .26) or multi‐predictor (p = .22) models.

Conclusions

The alliance‐outcome relationship for adolescents was larger than previously thought, and comparable to estimates in adult samples. The failure of patient‐therapist ratio to moderate its strength, however, challenges the hypothesis that variability in therapist characteristics is an important determinant of the alliance‐outcome effect in this age group.
Association of atopy and tentative diagnosis of skin cancer – results from occupational skin cancer screenings
Authors: Schäfer I. , Mohr P. , Zander N. , Fölster‐Holst R. , Augustin M.
Published: July 2017

Background

The relationship between atopic conditions and carcinoma of the skin has been described inconsistently. Population‐based data providing information on atopic diseases as well as on skin cancer are sparse.

Objective

To determine the correlation between atopy and prevalence of precanceroses, non‐melanoma skin cancer and malignant melanoma (MM), while taking into account known risk factors for skin cancer.

Methods

Data from occupational skin cancer screenings were analysed in a cross‐sectional study. Dermatologists performed whole body examinations and collected medical histories. Subjects comprised all employees (16–70 years) examined from 2006 to 2014. ‘Atopy’ was defined by clinical screening diagnosis and/or by participant‐reported, pre‐existing atopic dermatitis, allergic asthma or other specified allergies confirmed by a physician. Tentative screening diagnoses of skin cancer related to actinic keratosis, basal cell carcinoma and malignant melanoma.

Results

The study cohort comprised 90 265 employees (mean age 43 ± 11 years, 58.5% male), 30.7% of whom were ever diagnosed with an atopic disease. Persons with atopic conditions recorded in their medical history and at the time of screening had a significantly lower prevalence of actinic keratosis (AK), basal cell carcinoma (BCC) and MM. After controlling for age, sex and relevant risk factors (skin type, childhood sun burns), atopy remained significantly protective against BCC (OR 0.77) and MM (OR 0.53).

Conclusion

Design limitations of the study include that all findings of skin cancer were based on clinical examination only and must therefore be considered tentative diagnoses. Furthermore, owing to the cross‐sectional study design, causal pathways cannot be proven. However, analyses of data from such a large and general population‐based cohort afford valuable insights into the relationship between atopic diseases and skin cancer. They provide the grounds for prospective cohort studies to evaluate and dissect the underlying mechanism.
How Hospital Clinicians Select Patients for Skilled Nursing Facilities
Authors: Burke Robert E. , Lawrence Emily , Ladebue Amy , Ayele Roman , Lippmann Brandi , Cumbler Ethan , Allyn Rebecca , Jones Jacqueline
Published: July 2017

Objective

To understand how hospital‐based clinicians evaluate older adults in the hospital and decide who will be transferred to a skilled nursing facility (SNF) for postacute care.

Design

Semistructured interviews paired with a qualitative analytical approach informed by Social Constructivist theory.

Setting

Inpatient care units in three hospitals. Purposive sampling was used to maximize variability in hospitals, units within hospitals, and staff on those units.

Participants

Clinicians (hospitalists, nurses, therapists, social workers, case managers) involved in evaluation and decision‐making regarding postacute care (N = 25).

Measurements

Central themes related to clinician evaluation and discharge decision‐making.

Results

Clinicians described pressure to expedite evaluation and discharge decisions, resulting in the use of SNFs as a “safety net” for older adults being discharged from the hospital. The lack of hospital‐based clinician knowledge of SNF care practices, quality, or patient outcomes resulted in lack of a standardized evaluation process or a clear primary decision‐maker.

Conclusion

Hospital clinician evaluation and decision‐making about postacute care in SNFs may be characterized as rushed, without a clear system or framework for making decisions and uninformed by knowledge of SNF or patient outcomes in those discharged to SNFs. This leads to SNFs being used as a “safety net” for many older adults. As hospitals and SNFs are increasingly held jointly accountable for outcomes of individuals transitioning between hospitals and SNFs, novel solutions for improving evaluation and decision‐making are urgently needed.
Selecting a Skilled Nursing Facility for Postacute Care: Individual and Family Perspectives
Authors: Gadbois Emily A. , Tyler Denise A. , Mor Vincent
Published: July 2017

Objectives

To describe individuals' experiences during the hospital discharge planning and skilled nursing facility (SNF) selection process.

Design

Semistructured interviews focusing on discharge planning and nursing facility selection, including how facilities were chosen, who was involved, and what factors were important in decision‐making.

Setting

14 SNFs in five cities across the United States.

Participants

Newly admitted, previously community‐dwelling SNF residents (N = 98) and their family members.

Measurement

Semistructured interviews were qualitatively coded to identify underlying themes.

Results

Most respondents reported receiving only a list of SNF names and addresses from discharge planners and that hospital staff were minimally involved. Proximity to home and prior experience with the facility most often influenced choice of SNF. Most respondents reported being satisfied with their placement, although many stated that they would have been willing to travel further to another SNF were it recommended. Many reported feeling rushed and unprepared, stating that they did not know where or how to get help.

Conclusion

SNF placement is a stressful transition, occurring when people are physically vulnerable and with limited guidance from discharge planners. Therefore, most people select a facility based on its location, perhaps because they are provided with no other information. Given Centers for Medicare and Medicaid Services' proposed changes to the discharge planning process, this research highlights the value of providing people and family caregivers with quality data and assistance in interpreting it.
ARR12 promotes de novo shoot regeneration in Arabidopsis thaliana via activation of WUSCHEL expression
Authors: Dai Xuehuan , Liu Zhenhua , Qiao Meng , Li Juan , Li Shuo , Xiang Fengning
Published: July 2017

Auxin and cytokinin direct cell proliferation and differentiation during the in vitro culture of plant cells, but the molecular basis of these processes, especially de novo shoot regeneration, has not been fully elucidated. Here, we describe the regulatory control of shoot regeneration in Arabidopsis thaliana (L.) Heynh, based on the interaction of ARABIDOPSIS RESPONSE REGULATOR12 (ARR12) and WUSCHEL (WUS). The major site of ARR12 expression coincided with the location where the shoot apical meristem (SAM) initiated. The arr12 mutants showed severely impaired shoot regeneration and reduced responsiveness to cytokinin; consistent with this, the overexpression of ARR12 enhanced shoot regeneration. Certain shoot meristem specification genes, notably WUSCHEL (WUS) and CLAVATA3, were significantly downregulated in the arr12 explants. Chromatin immunoprecipitation (ChIP) and transient activation assays demonstrated that ARR12 binds to the promoter of WUS. These observations indicate that during shoot regeneration, in vitro, ARR12 functions as a molecular link between cytokinin signaling and the expression of shoot meristem specification genes.
The effect of cutaneous prostaglandin application on nail growth, nail brittleness, and intraocular pressure
Authors: Palmer David J. , Scheman Andrew , Tanna Angelo P. , Bueno Alex
Published: July 2017

Background

Bimatoprost has known adnexal activity and was observed to increase nail growth at two clinical centers.

Objectives

In this randomized, double‐blinded, placebo‐controlled pilot study, we examine the effect of bimatoprost (Lumigan 0.01%), applied bid to the proximal nail fold on nail growth, nail brittleness, and intraocular pressure.

Methods

Bimatoprost drops were placed on the proximal nail folds of 45 subjects on one hand (medication group) and vehicle drops to the other hand (control group). Baseline and final nail growth measurements, Goldmann applanation tensions of both eyes, and photos at 30 days were performed. Nail brittleness was subjectively graded.

Results

For the 38 subjects completing the study, the final mean nail growth of the hands, the net individual nail growth of the digits (excluding chipped nails), nail brittleness, and eye pressure readings were NS at P<.05. Photos revealed no increased hirsutism, but one subject with increased skin pigmentation. The drops were well tolerated without adverse effects. Nail chipping was a limitation of the study.

Conclusions

Despite the negative results in this pilot study on nail growth and brittleness, further studies with higher bimatoprost concentration (0.03%) are warranted. We recommend monitoring nail growth by etching or marking the nail rather than measuring the full nail length due to our chipped nail findings.
Reasons women do not seek health care for dysmenorrhea
Authors: Chen Chen X , Shieh Carol , Draucker Claire B , Carpenter Janet S
Published: July 2017

Aims and objectives

To identify and describe reasons women do not seek health care for dysmenorrhea symptoms.

Background

Although dysmenorrhea is highly prevalent among women, can cause significant disruptions in their daily lives, and may increase their risk for future chronic pain conditions, few women seek health care for dysmenorrhea. A better understanding of why women do not seek health care is necessary to develop strategies that facilitate care seeking and optimal symptom management.

Design

A qualitative descriptive design was used to guide the study and summarise text responses to an open‐ended survey question.

Methods

Participants in an online survey study who had not sought health care for dysmenorrhea (N = 509) were asked to write about their reasons for not seeking care. Data were collected in January and February 2015. Participants’ text responses were analysed using qualitative content analysis.

Results

Nine categories of reasons were identified as follows: assuming symptoms are normal, preferring to self‐manage symptoms, having limited resources, thinking providers would not offer help, being unaware of treatment options, considering symptoms to be tolerable, being wary of available treatments, feeling embarrassed or afraid to seek care and not seeking health care generally.

Conclusions

Findings can guide the development of strategies to promote care seeking and inform policy and clinical practice to improve dysmenorrhea management.

Relevance to clinical practice

Findings underscore the need to provide routine screening for dysmenorrhea, avoid dismissing dysmenorrhea symptoms, initiate discussions and provide education about dysmenorrhea, provide treatments options based on evidence and women's preferences and raise public awareness of dysmenorrhea and its impact.
Ideator Expertise and Cocreator Inputs in Crowdsourcing‐Based New Product Development
Authors: Zhu John Jianjun , Li Stella Yiyan , Andrews Michelle
Published: July 2017

Crowdsourcing‐based new product development (NPD) involves consumers in contributing ideas as ideators in the ideation phase, and providing inputs as cocreators in self‐selected subtasks in the product development phase. The novelty of this NPD approach furnishes little understanding about the effect of crowds' self‐select participation into ideation and development subtasks, and this study aims to bridge this gap. This article draws on the attention allocation perspective of online knowledge sharing to identify the domains of ideator expertise based on the types of development subtasks they self‐selected to perform as cocreators in prior projects. It separately examines the impact of different domains of ideator expertise (marketing and engineering) and the interaction between ideators' expertise and cocreators' inputs on crowdsourcing‐based NPD outcomes. Large‐scale, longitudinal data from a crowdsourcing‐based NPD platform reveal that ideators' engineering expertise helps convert ideas into final products more than ideators' marketing expertise. In contrast, ideators' marketing expertise helps these products achieve more sales than ideators' engineering expertise. Moreover, final products achieve more sales if ideators' marketing expertise embedded in initial product ideas is later augmented with either marketing or engineering‐related development inputs by crowd cocreators. However, ideas generated by ideators with engineering expertise achieve fewer product sales when those ideas are complemented by more marketing‐related development inputs by cocreators. These findings extend crowdsourcing‐based NPD theory and furnish insight on managing crowdsourcing‐based NPD platforms.
The influence of light on copper‐limited growth of an oceanic diatom,Thalassiosira oceanica(Coscinodiscophyceae)
Authors: Kim Jun‐Woo , Price Neil M.
Published: July 2017

Thalassiosira oceanica(CCMP1005) was grown over a range of copper concentrations at saturating and subsaturating irradiance to test the hypothesis that Cu and light were interacting essential resources. Growth was a hyperbolic function of irradiance in Cu‐replete medium (263 fmol Cu′ · L−1) with maximum rates achieved at 200 μmol photons · m−2 · s−1. Lowering the Cu concentration at this irradiance to 30.8 fmol Cu′ · L−1decreased cellular Cu quota by 7‐fold and reduced growth rate by 50%. Copper‐deficient cells had significantly slower (P < 0.0001) rates of maximum, relative photosynthetic electron transport (rETRmax) than Cu‐sufficient cells, consistent with the role of Cu in photosynthesis in this diatom. In low‐Cu medium (30.8 fmol Cu′ · L−1), growth rate was best described as a positive, linear function of irradiance and reached the maximum value measured in Cu‐replete cells when irradiance increased to 400 μmol photons · m−2 · s−1. Thus, at high light, low‐Cu concentration was no longer limiting to growth: Cu concentration and light interacted strongly to affect growth rate ofT. oceanica(P < 0.0001). RelativeETRmaxand Cu quota of cells grown at low Cu also increased at 400 μmol photons · m−2 · s−1to levels measured in Cu‐replete cells. Steady‐state uptake rates of Cu‐deficient and sufficient cells were light‐dependent, suggesting that faster growth ofT. oceanicaunder high light and low Cu was a result of light‐stimulated Cu uptake.
Changes of Bladder M1,3 Muscarinic Receptor Expression in Rats Fed with Short‐Term/Long‐Term High‐Fat Diets
Authors: LIN Chian‐Shiung , WU Tony T.‐L. , CHANG Chin‐Hong , CHENG Juei‐Tang , TONG Yat‐Ching
Published: July 2017

Objectives

To investigate the effect of high‐fat diet (HFD) on bladder M1,3 muscarinic receptor expression and contractile function in the rat.

Methods

Eight‐week‐old male rats were divided into two groups including one with HFD for 8 weeks (short‐term) and the other for 24 weeks (long‐term). Each group was compared to age‐matched rats fed with normal chow as controls. The body weight, food intake amount and blood biochemistry were monitored. Bladder muscle contractile responses to acetylcholine (0.1–10 μM), bethanechol (10 μM) and KCl (50 mM) were studied in an organ bath set‐up. Bladder M1 and M3 muscarinic receptor protein expressions were measured by Western blotting analysis.

Results

Increase in body weight as well as blood triglyceride, cholesterol and sugar levels compared to controls were noted in both 8‐ and 24‐week HFD rats. Eating appetite change with increased food and water intakes was noted in the HFD rats. Significantly decreased bladder contractile responses to acetylcholine and bethanechol were shown in both HFD groups. On the other hand, decreased bladder contractile response to KCl was demonstrated in the 24‐week group but not the 8‐week group. The expressions of bladder M1 and M3 muscarinic receptor proteins were significantly and progressively decreased by HFD feeding from 8 to 24 weeks.

Conclusions

High‐fat diet induces obesity and polyphagia in rats. Short‐term and long‐term HFD feeding decrease rat bladder M1 and M3 receptor expressions as well as contractile responses to the agonistic stimulation. In addition, bladder muscle dysfunction develops after long‐term HFD feeding.
Transcutaneous sacral nerve stimulation for intraoperative verification of internal anal sphincter innervation
Authors: Kauff D. W. , Moszkowski T. , Wegner C. , Heimann A. , Hoffmann K.‐P. , Krüger T. B. , Lang H. , Kneist W.
Published: July 2017

Background

The current standard for pelvic intraoperative neuromonitoring (pIONM) is based on intermittent direct nerve stimulation. This study investigated the potential use of transcutaneous sacral nerve stimulation for non‐invasive verification of pelvic autonomic nerves.

Methods

A consecutive series of six pigs underwent low anterior rectal resection. For transcutaneous sacral nerve stimulation, an array of ten electrodes (cathodes) was placed over the sacral foramina (S2 to S4). Anodes were applied on the back, right and left thigh, lower abdomen, and intra‐anally. Stimulation using the novel method and current standard were performed at different phases of the experiments under electromyography of the autonomic innervated internal anal sphincter (IAS).

Key Results

Transcutaneous stimulation induced increase of IAS activity could be observed in each animal under specific cathode‐anode configurations. Out of 300 tested configurations, 18 exhibited a change in the IAS activity correlated with intentional autonomic nerve damage. The damage resulted in a significant decrease of the relative area under the curve of the IAS frequency spectrum (P<.001). Comparison of the IAS spectra under transcutaneous and direct stimulation revealed no significant difference (after rectal resection: median 5.99 μV•Hz vs 7.78 μV•Hz, P=.12; after intentional nerve damage: median −0.27 μV•Hz vs 3.35 μV•Hz, P=.29).

Conclusions and Inferences

Non‐invasive selective transcutaneous sacral nerve stimulation could be used for verification of IAS innervation.
An R2R3‐MYB transcription factor represses the transformation of α‐ and β‐branch carotenoids by negatively regulating expression of CrBCH2 and CrNCED5 in flavedo of Citrus reticulate
Authors: Zhu Feng , Luo Tao , Liu Chaoyang , Wang Yang , Yang Hongbin , Yang Wei , Zheng Li , Xiao Xue , Zhang Mingfei , Xu Rangwei , Xu Jianguo , Zeng Yunliu , Xu Juan , Xu Qiang , Guo Wenwu , Larkin Robert M. , Deng Xiuxin , Cheng Yunjiang
Published: July 2017

Although the functions of carotenogenic genes are well documented, little is known about the mechanisms that regulate their expression, especially those genes involved in α ‐ and β‐branch carotenoid metabolism.

In this study, an R2R3‐MYB transcriptional factor (CrMYB68) that directly regulates the transformation of α‐ and β‐branch carotenoids was identified using Green Ougan (MT), a stay‐green mutant of Citrus reticulata cv Suavissima. A comprehensive analysis of developing and harvested fruits indicated that reduced expression of β‐carotene hydroxylases 2 (CrBCH2) and 9‐cis‐epoxycarotenoid dioxygenase 5 (CrNCED5) was responsible for the delay in the transformation of α‐ and β‐carotene and the biosynthesis of ABA. Additionally, the expression of these genes was negatively correlated with the expression of CrMYB68 in MT.

Further, electrophoretic mobility shift assays (EMSAs) and dual luciferase assays indicated that CrMYB68 can directly and negatively regulate CrBCH2 and CrNCED5. Moreover, transient overexpression experiments using leaves of Nicotiana benthamiana indicated that CrMYB68 can also negatively regulate NbBCH2 and NbNCED5.

To overcome the difficulty of transgenic validation, we quantified the concentrations of carotenoids and ABA, and gene expression in a revertant of MT. The results of these experiments provide more evidence that CrMYB68 is an important regulator of carotenoid metabolism.
A social media program to increase adolescent seat belt use
Authors: Drake Stacy A. , Zhang Ni , Applewhite Courtney , Fowler Katherine , Holcomb John B.
Published: July 2017

In response to motor vehicle crashes remaining the leading cause of death for teenagers in the United States, a nursing clinical group (n = 10) in conjunction with a local hospital injury prevention program created an educational campaign to bolster seat belt use. The nursing students created an Instagram account to serve as an educational tool to promote seat belt use among teenagers aged 14–19, and the program was presented at three high school health fairs. In all, 135 postings were made to the account over a 3‐month period. The number of likes posted by high school students was the unit of analysis. The most significant result (p = .01) was the difference between postings most liked (celebrities wearing seat belts) and least liked (postings made at the high school health fair), otherwise, differences among postings liked (humor postings, response requests, pictures of celebrities, factual data) were not significant. Instagram user engagement, measured in number of likes, is indicative that social media provides platforms to promote injury prevention efforts. Further research is needed to identify measurable elements of social media and to follow‐up on behavioral changes following participation.
Impacts of artisanal gold mining systems on soil and woody vegetation in the semi‐arid environment of northern Ethiopia
Authors: Meaza Hailemariam , Ali Mushir , Tesfamariam Zbelo , Abebe Niguse
Published: July 2017

Gold mining is a tremendously important economic activity in rural districts of Ethiopia. We assessed the impacts of artisanal gold mining on soil and woody vegetation in northern Ethiopia. Estimation of soil loss, plant inventory, group discussions and transect studies were used to address the research questions. We employed t‐test to compare woody species and soil loss between mined and unmined sites. Moreover, we ran one‐way ANOVA to compare the average volume of soil loss among the mining sites. The study shows that gold mining removed colossal volumes of soil from the mining landscape with a significant difference among gold mining sites (P ≤ 0.05). Soil loss between the mined and unmined sites was also significant (P ≤ 0.05). Moreover, gold mining destroyed massive tracts of vegetation. Woody species encountered at plot level decreased from artisanal gold mined to unmined sites (P ≤ 0.05). Moreover, dead trees and exposed tree roots were higher in mined than the unmined areas (P ≤ 0.05). This discouraged regeneration and recruitment of woody vegetation. To conclude, gold mining system converted vegetated sites and farmlands into dysfunctional landscape. Therefore, we suggest that combined rehabilitation efforts are required to overcome the challenges of artisanal gold mining on sustainable land management in northern Ethiopia.
Does Socio‐Spatial Segregation Matter? ‘Islands’ of High Romany Fertility in Slovakia
Authors: Šprocha Branislav , Bleha Branislav
Published: July 2017

The level of fertility in the majority of European countries is deeply below the replacement level. On the other hand, in the case of some ethnic groups, fertility continues to be on an above‐average level. One such example is the Romany population of Slovakia, especially those in very poor, segregated settlements. Very likely, there are strong interconnections between regional disparities, social and cultural segregation and reproduction of Romany. The study tries to discover them. We perform factor and cluster analyses in order to identify major factors which differentiate and create clusters in the set of 79 Slovak local administrative unit (LAU‐1) districts from the view point of above‐replacement fertility levels. Using the transversal and cohort approaches, another aim is to identify major specificities of Romany reproduction and the range of lag behind the majority population in terms of demographic transition. The concept of ‘high fertility trap’ is presented in this respect.
Much Ado About Something? An Appraisal of the Relationship Between Smart City and Smart Specialisation Policies
Authors: Caragliu Andrea , Del Bo Chiara
Published: July 2017

Smart policies at the urban (smart city initiatives) and the regional (smart specialisation Strategies, S3) level, both fostered by the need to better spend the reduced budget available for EU policy‐making, have recently gained much attention. While some attempts have been made to explore the growth potential of the two policies separately, no empirical analysis has considered their joint contribution to regional growth. This paper identifies two types of development (measured as 2008–2010 GDP growth) effects associated to smart policies: one, short‐run, associated to urban smartness initiatives, and a second, long run, linked to S3. Instrumental variables estimates are used to support the conceptual framework suggested for the link between these two types of policies, which are both found to have a positive impact on regional economic performance.
Epidemiological trends of HIV‐1 infection in blood donors from Catalonia, Spain (2005‐2014)
Authors: Bes Marta , Piron Maria , Casamitjana Natàlia , Gregori Josep , Esteban Juan Ignacio , Ribera Esteban , Quer Josep , Puig Lluís , Sauleda Sílvia
Published: July 2017

BACKGROUND

Human immunodeficiency virus 1 (HIV‐1) subtype B is predominant in Spain. However, the recent arrival of immigrant populations has increased the prevalence of non‐B subtypes and circulating recombinant forms. The objective of this study was to determine the prevalence of HIV‐1 subtypes and transmitted drug‐resistance mutations in blood donors from the Catalonian region (northeastern Spain).

STUDY DESIGN AND METHODS

HIV‐1–positive blood donors identified in Catalonia from 2005 to 2014 were included. Demographic variables and risk factors for HIV‐1 acquisition were recorded. HIV‐1 subtyping was carried out by HIV‐1 DNA polymerase region sequencing, and phylogenetic analyses were performed using the neighbor‐joining method.

RESULTS

During the study period, 2.8 million blood donations were screened, and 214 HIV‐1–positive donors were identified, yielding an overall prevalence of 7.7 per 100,000 donations (89% men; mean age, 34 ± 10 years). Most HIV‐1–positive donors were native to Spain (81%), and 61% were regular blood donors. When risk factors were known, 62% reportedly were men who had sex with men. HIV‐1 subtyping was possible in 176 HIV‐1–positive individuals: 143 (81%) had HIV‐1 subtype B, and 33 (19%) had non‐B subtypes. Most HIV‐1 non‐B subtypes were circulating recombinant forms (n = 20; 61%). Factors associated with HIV‐1 subtype B were male sex (p = 0.007) and men who had sex with men (p < 0.001). The overall prevalence of transmitted drug‐resistance mutations was 14%.

CONCLUSION

Non‐B subtypes, circulating recombinant forms, and transmitted drug‐resistance mutation sequences circulate among HIV‐1–positive blood donors in Catalonia. Continuous local epidemiological surveillance is required to implement optimal prevention strategies for controlling transfusion‐transmitted HIV and to improve health policies regarding HIV infection.
Optimal hematocrit in an artificial microvascular network
Authors: Piety Nathaniel Z. , Reinhart Walter H. , Stutz Julianne , Shevkoplyas Sergey S.
Published: July 2017

BACKGROUND

Higher hematocrit increases the oxygen‐carrying capacity of blood but also increases blood viscosity, thus decreasing blood flow through the microvasculature and reducing the oxygen delivery to tissues. Therefore, an optimal value of hematocrit that maximizes tissue oxygenation must exist.

STUDY DESIGN AND METHODS

We used viscometry and an artificial microvascular network device to determine the optimal hematocrit in vitro. Suspensions of fresh red blood cells (RBCs) in plasma, normal saline, or a protein‐containing buffer and suspensions of stored red blood cells (at Week 6 of standard hypothermic storage) in plasma with hematocrits ranging from 10 to 80% were evaluated.

RESULTS

For viscometry, optimal hematocrits were 10, 25.2, 31.9, 37.1, and 37.5% for fresh RBCs in plasma at shear rates of 3.2 or less, 11.0, 27.7, 69.5, and 128.5 inverse seconds. For the artificial microvascular network, optimal hematocrits were 51.1, 55.6, 59.2, 60.9, 62.3, and 64.6% for fresh RBCs in plasma and 46.4, 48.1, 54.8, 61.4, 65.7, and 66.5% for stored RBCs in plasma at pressures of 2.5, 5, 10, 20, 40, and 60 cm H2O.

CONCLUSION

Although exact optimal hematocrit values may depend on specific microvascular architecture, our results suggest that the optimal hematocrit for oxygen delivery in the microvasculature depends on perfusion pressure. Therefore, anemia in chronic disorders may represent a beneficial physiological response to reduced perfusion pressure resulting from decreased heart function and/or vascular stenosis. Our results may help explain why a therapeutically increasing hematocrit in such conditions with RBC transfusion frequently leads to worse clinical outcomes.