bluuebunny/crossref_metadata_2025 huggingface dataset:
A journey through the lectin pathway of complement—MBL and beyond
Authors: Garred Peter , Genster Ninette , Pilely Katrine , Bayarri‐Olmos Rafael , Rosbjerg Anne , Ma Ying Jie , Skjoedt Mikkel‐Ole
Published: October 2016

Mannose‐binding lectin (MBL), collectin‐10, collectin‐11, and the ficolins (ficolin‐1, ficolin‐2, and ficolin‐3) are soluble pattern recognition molecules in the lectin complement pathway. These proteins act as mediators of host defense and participate in maintenance of tissue homeostasis. They bind to conserved pathogen‐specific structures and altered self‐antigens and form complexes with the pentraxins to modulate innate immune functions. All molecules exhibit distinct expression in different tissue compartments, but all are found to a varying degree in the circulation. A common feature of these molecules is their ability to interact with a set of serine proteases named MASPs (MASP‐1, MASP‐2, and MASP‐3). MASP‐1 and ‐2 trigger the activation of the lectin pathway and MASP‐3 may be involved in the activation of the alternative pathway of complement. Furthermore, MASPs mediate processes related to coagulation, bradykinin release, and endothelial and platelet activation. Variant alleles affecting expression and structure of the proteins have been associated with a variety of infectious and non‐infectious diseases, most commonly as disease modifiers. Notably, the severe 3MC (Malpuech, Michels, Mingarelli, and Carnevale) embryonic development syndrome originates from rare mutations affecting either collectin‐11 or MASP‐3, indicating a broader functionality of the complement system than previously anticipated. This review summarizes the characteristics of the molecules in the lectin pathway.
The complement and contact activation systems: partnership in pathogenesis beyond angioedema
Authors: Ghebrehiwet Berhane , Kaplan Allen P. , Joseph Kusumam , Peerschke Ellinor I. B.
Published: October 2016

The blood plasma contains four biologically important proteolytic cascades, which probably evolved from the same ancestral gene. This in part may explain why each cascade has very similar “initiating trigger” followed by sequential and cascade‐like downstream enzymatic activation pattern. The four cascades are: the complement system, the blood clotting cascade, the fibrinolytic system, and the kallikrein‐kinin system. Although much has been written about the interplay between all these enzymatic cascades, the cross‐talk between the complement and the kinin generating systems has become particularly relevant as this interaction results in the generation of nascent molecules that have significant impact in various inflammatory diseases including angioedema and cancer. In this review, we will focus on the consequences of the interplay between the two systems by highlighting the role of a novel molecular link called gC1qR. Although this protein was first identified as a receptor for C1q, it is now recognized as a multiligand binding cellular protein, which serves not only as C1q receptor, but also as high affinity (KD ≤ 0.8 nM) binding site for both high molecular weight kininogen (HK) and factor XII (FXII). At inflammatory sites, where atherogenic factors such as immune complexes and/or pathogens can activate the endothelial cell into a procoagulant and proinflammatory surface, the two pathways are activated to generate vasoactive peptides that contribute in various ways to the inflammatory processes associated with numerous diseases. More importantly, since recent observations strongly suggest an important role for both pathways in cancer, we will focus on how a growing tumor cluster can employ the byproducts derived from the two activation systems to ensure not only its survival and growth, but also its escape into distal sites of colonization.
Injury site‐specific targeting of complement inhibitors for treating stroke
Authors: Alawieh Ali , Tomlinson Stephen
Published: October 2016

Cumulative evidence indicates a role for the complement system in both pathology and recovery after ischemic stroke. Here, we review the current understanding of the dual role of complement in poststroke injury and recovery, and discuss the challenges of anti‐complement therapies. Most complement directed therapeutics currently under investigation or development systemically inhibit the complement system, but since complement is important for immune surveillance and is involved in various homeostatic activities, there are potential risks associated with systemic inhibition. Depending on the target within the complement pathway, other concerns are high concentrations of inhibitor required, low efficacy and poor bioavailability. To overcome these limitations, approaches to target complement inhibitors to specific sites have been investigated. Here, we discuss targeting strategies, with a focus on strategies developed in our lab, to specifically localize complement inhibition to sites of tissue injury and complement activation, and in particular to the postischemic brain. We discuss various injury site‐specific targeted complement inhibitors as potential therapeutic agents for the treatment of ischemic stroke treatment, as well as their use as investigative tools for probing complement‐dependent pathophysiological processes.
Endothelial cells: source, barrier, and target of defensive mediators
Authors: Roumenina Lubka T. , Rayes Julie , Frimat Marie , Fremeaux‐Bacchi Veronique
Published: October 2016

Endothelium is strategically located at the interface between blood and interstitial tissues, placing thus endothelial cell as a key player in vascular homeostasis. Endothelial cells are in a dynamic equilibrium with their environment and constitute concomitantly a source, a barrier, and a target of defensive mediators. This review will discuss the recent advances in our understanding of the complex crosstalk between the endothelium, the complement system and the hemostasis in health and in disease. The first part will provide a general introduction on endothelial cells heterogeneity and on the physiologic role of the complement and hemostatic systems. The second part will analyze the interplay between complement, hemostasis and endothelial cells in physiological conditions and their alterations in diseases. Particular focus will be made on the prototypes of thrombotic microangiopathic disorders, resulting from complement or hemostasis dysregulation‐mediated endothelial damage: atypical hemolytic uremic syndrome and thrombotic thrombocytopenic purpura. Novel aspects of the pathophysiology of the thrombotic microangiopathies will be discussed.
The immune system's role in sepsis progression, resolution, and long‐term outcome
Authors: Delano Matthew J. , Ward Peter A.
Published: October 2016

Sepsis occurs when an infection exceeds local tissue containment and induces a series of dysregulated physiologic responses that result in organ dysfunction. A subset of patients with sepsis progress to septic shock, defined by profound circulatory, cellular, and metabolic abnormalities, and associated with a greater mortality. Historically, sepsis‐induced organ dysfunction and lethality were attributed to the complex interplay between the initial inflammatory and later anti‐inflammatory responses. With advances in intensive care medicine and goal‐directed interventions, early 30‐day sepsis mortality has diminished, only to steadily escalate long after “recovery” from acute events. As so many sepsis survivors succumb later to persistent, recurrent, nosocomial, and secondary infections, many investigators have turned their attention to the long‐term sepsis‐induced alterations in cellular immune function. Sepsis clearly alters the innate and adaptive immune responses for sustained periods of time after clinical recovery, with immune suppression, chronic inflammation, and persistence of bacterial representing such alterations. Understanding that sepsis‐associated immune cell defects correlate with long‐term mortality, more investigations have centered on the potential for immune modulatory therapy to improve long‐term patient outcomes. These efforts are focused on more clearly defining and effectively reversing the persistent immune cell dysfunction associated with long‐term sepsis mortality.
Safety and Clinical Outcomes of Catheter Ablation of Atrial Fibrillation in Patients With Chronic Kidney Disease
Authors: ULLAL ADITYA J. , KAISER DANIEL W. , FAN JUN , SCHMITT SUSAN K. , THAN CLAIRE T. , WINKELMAYER WOLFGANG C. , HEIDENREICH PAUL A. , PICCINI JONATHAN P. , PEREZ MARCO V. , WANG PAUL J. , TURAKHIA MINTU P.
Published: October 2016

Catheter Ablation of AF in Chronic Kidney Disease

Introduction

Data regarding catheter ablation of atrial fibrillation (AF) in patients with chronic kidney disease (CKD) is limited. We therefore assessed the association of CKD with common safety and clinical outcomes in a nationwide sample of ablation recipients.

Methods

Using MarketScan® Commercial Claims and Medicare Supplemental Databases, we evaluated 30‐day safety and 1‐year clinical outcomes in patients who underwent a first AF ablation procedure between 2007 and 2011. We calculated frequency of common 30‐day complications and calculated frequencies, incidence rates, and Cox proportional hazards for outcomes at 1‐year postablation.

Results

Of 21,091 patients included, 1,593 (7.6%) had CKD. Patients with CKD were older (64 years vs. 59 years, P < 0.001) with higher CHA2DS2‐VASc scores (3.2 vs. 1.8, P < 0.001). At 30 days postablation, patients with CKD had similar rates of stroke/TIA (0.13% vs. 0.13%, P = 0.99), perforation/tamponade (3.2% vs. 3.1%, P = 0.83), and vascular complications (2.4% vs. 2.2%, P = 0.59) as patients without CKD, but were more likely to be hospitalized for heart failure (2.1% vs. 0.4%, P < 0.001). In multivariate analysis, there were no significant differences in hazards of AF hospitalization (adjusted HR: 1.02, 95%CI: 0.87–1.20), cardioversion (adjusted HR: 0.99, 95%CI: 0.87–1.12), or repeat AF ablation (adjusted HR: 0.89, 95%CI: 0.76–1.06) at 1 year.

Conclusions

Among patients selected for AF ablation, those with and without CKD had similar rates of postprocedural complications although they were more likely to be re‐admitted for heart failure. CKD was not independently associated with AF hospitalization, cardioversion, and repeat ablation. These findings can inform clinical decision‐making in patients with AF and CKD.
Hypertension Attitude PersPEctives and Needs (HAPPEN): A Real‐World Survey of Physicians and Patients With Hypertension in China
Authors: Feldman Ross D. , Liu Lisheng , Wu Zhaosu , Zhang Yuqing , Yu Xueqing , Zhang Xin‐Hua
Published: October 2016

The Hypertension Attitude PersPEctives and Needs (HAPPEN) survey was a real‐world survey of cardiologists, nephrologists, and patients with treated hypertension at level 3 hospitals in China. It aimed to characterize the attitudes and behavior of physicians and patients and to identify possible causes of poor blood pressure (BP) control. Randomly selected participants (100 cardiologists, 30 nephrologists, 400 patients) completed face‐to‐face interviews investigating BP control rates, consulting behavior, prescribing patterns, and attitudes toward hypertension management. Perceived levels of BP control were high; 70% of physicians and 85% of patients believed that BP targets were achieved, despite only 31% of patients achieving targets. Physician satisfaction with control rates and patient satisfaction with treatment were high. Differences in perceived and actual levels of BP control may be driving therapeutic inertia. In combination with inadequate patient evaluation and support services, therapeutic inertia may contribute to poor BP control among patients with treated hypertension in China.
HULC: an oncogenic long non‐coding RNA in human cancer
Authors: Yu Xin , Zheng Heyi , Chan Matthew T.V. , Wu William Ka Kei
Published: October 2016

Highly up‐regulated in liver cancer (HULC) was originally identified as the most overexpressed long non‐coding RNA in hepatocellular carcinoma. Since its discovery, the aberrant up‐regulation of HULC has been demonstrated in other cancer types, including gastric cancer, pancreatic cancer, osteosarcoma and hepatic metastasis of colorectal cancer. Recent discoveries have also shed new light on the upstream molecular mechanisms underlying HULC deregulation. As an oncogene, HULC promotes tumorigenesis by regulating multiple pathways, such as down‐regulation of EEF1E1, promotion of abnormal lipid metabolism, and up‐regulation of sphingosine kinase 1. Pertinent to clinical practice, a genetic variant in the HULC gene has been found to alter the risk for hepatocellular carcinoma and oesophageal cancer, whereas cancer patients with high or low expression of HULC exhibit different clinical outcome. These findings highlighted the pathogenic role and clinical utility of HULC in human cancers. Further efforts are warranted to promote the development of HULC‐directed therapeutics.
The Quality of Institutions and Organizational Form Decisions: Evidence from Within the Firm
Authors: Lafontaine Francine , Perrigot Rozenn , Wilson Nathan E.
Published: October 2016

In many retail and service sectors, firms have to establish a physical presence in a geographic market to access customers there. In countries where the quality of institutions is low, this can put assets at risk. We use data on the operations of a multinational, multibrand hotel company to show that in environments where local institutions are weaker—as proxied mainly by the World Bank's Checks index—the company eschews direct ownership. Rather than increasing its reliance on franchising, as predicted by some models, the company relies more on another form of organization commonly used in this industry, namely management contracts. We explain these patterns by emphasizing how the quality of the institutional environment affects the cost of using equity‐based organizational forms, per arguments in the current literature, but also the cost of enforcing the terms of franchise contracts.
Spatio‐temporal patterns of genetic variations in populations of yellowtail kingfish Seriola lalandi from the south‐eastern Pacific Ocean and potential implications for its fishery management
Authors: Sepúlveda F. A. , González M. T.
Published: October 2016

The genetic population structure and genetic diversity of yellowtail kingfish Seriola lalandi from the coastal south‐eastern Pacific Ocean (SEP) were evaluated at spatiotemporal scale in order to understand the ecology of this species. Between 2012 and 2015, temporal and spatial population genetic structure and a low genetic diversity were detected in S. lalandi from SEP. These results suggest that S. lalandi specimens arriving annually from offshore to the SEP coast could come from at least two genetically distinct populations, revealing a particular life strategy (i.e. reproductive or habitat segregation) for this fish species. Therefore, the SEP coast might constitute a point of population mixing for this species. Additionally, the low genetic diversity of S. lalandi in the SEP could be a result of a founder effect or overfishing. Regardless of the process explaining the genetic diversity and structure of S. lalandi in this geographical area, this new information should be considered in order to implement successful fishery management of this resource in the South Pacific.
Environmental drivers of diurnal visits by transient predatory fishes to Caribbean patch reefs
Authors: Harborne A. R. , Selwyn J. D. , Lawson J. M. , Gallo M.
Published: October 2016

Video cameras recorded the diurnal visitation rates of transient (large home range) piscivorous fishes to coral patch reefs in The Bahamas and identified 11 species. Visits by bar jack Caranx ruber, mutton snapper Lutjanus analis, yellowtail snapper Ocyurus chrysurus, barracuda Sphyraena barracuda and cero Scomberomorus regalis were sufficiently frequent to correlate with a range of biophysical factors. Patch‐reef visitation rates and fish abundances varied with distance from shore and all species except S. regalis were seen more frequently inshore. This pattern is likely to be caused by factors including close proximity to additional foraging areas in mangroves and on fore‐reefs and higher abundances close to inshore nursery habitats. Visitation rates and abundances of C. ruber, L. analis, O. chrysurus and S. regalis also varied seasonally (spring v. winter), possibly as fishes responded to temperature changes or undertook spawning migrations. The abundance of each transient predator species on the patch reefs generally exhibited limited diurnal variability, but L. analis was seen more frequently towards dusk. This study demonstrates that the distribution of transient predators is correlated spatially and temporally with a range of factors, even within a single lagoon, and these drivers are species specific. Transient predators are considered an important source of mortality shaping reef‐fish assemblages and their abundance, in combination with the biomass of resident predators, was negatively correlated with the density of prey fishes. Furthermore, transient predators are often targeted by fishers and understanding how they utilize seascapes is critical for protecting them within reserves.
Elevated carbon dioxide has limited acute effects on Lepomis macrochirus behaviour
Authors: Tix J. A. , Hasler C. T. , Sullivan C. , Jeffrey J. D. , Suski C. D.
Published: October 2016

The current study investigated the behavioural response of Lepomis macrochirus following exposures to elevated carbon dioxide (CO2). For this, L. macrochirus were held at ambient pCO2 (160 μatm pCO2) for 7 days, then exposed to elevated pCO2 (8300 μatm pCO2) for 5 days, and then returned to ambient conditions for a further 5 days to recover. At the end of each exposure period, several behavioural metrics were quantified (boldness, lateralization and activity). Data showed no change in lateralization and most metrics associated with performance and boldness. During the boldness test, however, average velocity, velocity in the thigmotaxis (outer) zone and proportion of activity in the thigmotaxis zone increased with pCO2 exposure. During post‐exposure, average velocity of L. macrochirus decreased. In addition, individual rank was repeatable during the pre‐exposure and post‐exposure period in three of the 17 metrics investigated (average velocity in the middle zone, average velocity near object and total shuttles to the object zone), but not during the CO2 exposure period, suggesting that elevated pCO2 disrupted some behavioural performances. Overall, this study found elevated pCO2 caused disruption to behaviours of freshwater fishes such as L. macrochirus and effects do not appear to be as serious as has been shown for marine fishes.
HFE p.C282Y homozygosity predisposes to rapid serum ferritin rise after menopause: A genotype‐stratified cohort study of hemochromatosis in Australian women
Authors: Warne Charles D , Zaloumis Sophie G , Bertalli Nadine A , Delatycki Martin B , Nicoll Amanda J , McLaren Christine E , Hopper John L , Giles Graham G , Anderson Greg J , Olynyk John K , Powell Lawrie W , Allen Katrina J , Gurrin Lyle C ,   for the HealthIron Study Investigators
Published: October 2016

Background and Aim

Women who are homozygous for the p.C282Y mutation in the HFE gene are at much lower risk of iron overload‐related disease than p.C282Y homozygous men, presumably because of the iron‐depleting effects of menstruation and pregnancy. We used data from a population cohort study to model the impact of menstruation cessation at menopause on serum ferritin (SF) levels in female p.C282Y homozygotes, with p.C282Y/p.H63D simple or compound heterozygotes and those with neither p.C282Y nor p.H63D mutations (HFE wild types) as comparison groups.

Methods

A sample of the Melbourne Collaborative Cohort Study was selected for the “HealthIron” study (n = 1438) including all HFE p.C282Y homozygotes plus a random sample stratified by HFE‐genotype (p.C282Y and p.H63D). The relationship between the natural logarithm of SF and time since menopause was examined using linear mixed models incorporating spline smoothing.

Results

For p.C282Y homozygotes, SF increased by a factor of 3.6 (95% CI (1.8, 7.0), P < 0.001) during the first 10 years postmenopause, after which SF continued to increase but at less than half the previous rate. In contrast, SF profiles for other HFE genotype groups increase more gradually and did not show a distinction between premenopausal and postmenopausal SF levels. Only p.C282Y homozygotes had predicted SF exceeding 200 μg/L postmenopause, but the projected SF did not increase the risk of iron overload‐related disease.

Conclusions

These data provide the first documented evidence that physiological blood loss is a major factor in determining the marked gender difference in expression of p.C282Y homozygosity.
The Patient Health Questionnaire‐9 as a Screening Tool for Depression in Individuals with Type 2 Diabetes Mellitus: The Maastricht Study
Authors: Janssen Eveline P. C. J. , Köhler Sebastian , Stehouwer Coen D. A. , Schaper Nicolaas C. , Dagnelie Pieter C. , Sep Simone J. S. , Henry Ronald M. A. , van der Kallen Carla J. H. , Verhey Frans R. , Schram Miranda T.
Published: October 2016

Objectives

To assess the psychometric properties and identify the best cutoff value of the Patient Health Questionnaire‐9 (PHQ‐9) for depression screening in individuals with type 2 diabetes mellitus (T2DM).

Design

Observational population‐based cohort study.

Setting

The Maastricht Study.

Participants

Individuals with and without T2DM (mean age 58.6 ± 8.1, 44.6% male) according to an oral glucose tolerance test (N = 2,997).

Measurements

Depressive disorder and depressive symptoms were measured using the Mini‐International Neuropsychiatric Interview (MINI) as the reference and the PHQ‐9. Cronbach alpha, Cohen's kappa and receiver operating characteristic (ROC) analyses were used. Differences in factorial structure between participants with and without T2DM were tested using multigroup confirmatory factor analysis.

Results

Based on the traditional PHQ‐9 cutoff value, 133 (4.4%) participants had depressive symptoms (PHQ‐9 score ≥10). Internal consistency of the PHQ‐9 was good (Cronbach α = 0.87 with T2DM, 0.82 without T2DM), the kappa of agreement between the PHQ‐9 and the MINI was moderate (0.40 with T2DM, 0.43 without T2DM). Area under the ROC curve for the PHQ‐9 was 0.87 in participants with T2DM and 0.88 in those without. A PHQ‐9 cutoff score of 5 provided the best sensitivity (92.3%), with acceptable specificity (70.4%), for T2DM, similar to sensitivity and specificity in individuals without T2DM. Factor analysis suggested a similar two‐factor structure in both groups (affective and somatic symptoms).

Conclusion

Patient Health Questionnaire‐9 performs well as a screening tool for depressive symptoms in individuals with and without T2DM based on the cutoff value of 5, indicating that the PHQ‐9 can be used in two‐stage screening in primary care to select individuals with T2DM for further psychological evaluation.
Frailty Levels in Residential Aged Care Facilities Measured Using the Frailty Index and FRAIL‐NH Scale
Authors: Theou Olga , Tan Edwin C.K. , Bell J. Simon , Emery Tina , Robson Leonie , Morley John E. , Rockwood Kenneth , Visvanathan Renuka
Published: October 2016

Objectives

To compare the FRAIL‐NH scale with the Frailty Index in assessing frailty in residential aged care facilities.

Design

Cross‐sectional.

Setting

Six Australian residential aged care facilities.

Participants

Individuals aged 65 and older (N = 383, mean aged 87.5 ± 6.2, 77.5% female).

Measurements

Frailty was assessed using the 66‐item Frailty Index and the FRAIL‐NH scale. Other measures examined were dementia diagnosis, level of care, resident satisfaction with care, nurse‐reported resident quality of life, neuropsychiatric symptoms, and professional caregiver burden.

Results

The FRAIL‐NH scale was significantly associated with the Frailty Index (correlation coefficient = 0.81, P < .001). Based on the Frailty Index, 60.8% of participants were categorized as frail and 24.4% as most frail. Based on the FRAIL‐NH, 37.5% of participants were classified as frail and 35.9% as most frail. Women were assessed as being frailer than men using both tools (P = .006 for FI; P = .03 for FRAIL‐NH). Frailty Index levels were higher in participants aged 95 and older (0.39 ± 0.13) than in those aged younger than 85 (0.33 ± 0.13; P = .008) and in participants born outside Australia (0.38 ± 0.13) than in those born in Australia (0.34 ± 0.13; P = .01). Both frailty tools were associated with most characteristics that would indicate higher care needs, with the Frailty Index having stronger associations with all of these measures.

Conclusion

The FRAIL‐NH scale is a simple and practical method to screen for frailty in residential aged care facilities.
Age Differences in Sequential Speech Production: Articulatory and Physiological Factors
Authors: Bilodeau‐Mercure Mylène , Tremblay Pascale
Published: October 2016

Objectives

To explore age differences in speech production in relation to orofacial physiology.

Design

Cross‐sectional quasi‐experimental group study.

Setting

General community.

Participants

Physically and cognitively healthy volunteers recruited from the community (N = 30), including 15 young (18–39) and 15 older (66–85) adults.

Measurements

Accuracy and speech rate were calculated during the production of sequences of syllables containing oral vowels, nasal vowels, or both. Lip and tongue muscular strength, muscular endurance, and tactile sensitivity were also measured.

Results

Older adults had a slower speech rate than younger adults and greater difficulty articulating nasal vowels. Analyses revealed that age‐related decline in lip endurance is associated with decline in accuracy during speech production.

Conclusion

Older adults are not just slower than younger adults, they also exhibit specific articulatory difficulties. Although many physiological changes in orofacial functions occur in aging, only muscular endurance of the lips is related to age‐related differences in speech production. This information is important for the development of speech interventions targeting older adults with speech motor disorders.
Fear of Falling in Older Mexican Americans: A Longitudinal Study of Incidence and Predictive Factors
Authors: Dierking Leah , Markides Kyriakos , Al Snih Soham , Kristen Peek M.
Published: October 2016

Objectives

To determine predictors of fear of falling in older Mexican Americans over time.

Design

Longitudinal study.

Setting

Community‐dwelling residents throughout California, Colorado, New Mexico, Arizona, and Texas.

Participants

Community‐dwelling Mexican Americans aged 72 and older participating in the Hispanic Established Populations for the Epidemiologic Study of the Elderly from 2000–01 to 2010–11 (N = 1,682).

Measurements

Fear of falling was measured at baseline and at each subsequent wave. Baseline demographic and clinical variables included social support, fall history, depression symptoms, Mini‐Mental State Examination (MMSE) score, activity of daily living (ADL) and instrumental ADL (IADL) limitations, and chronic health conditions.

Results

Nine hundred fifty three (56.7%) subjects reported fear of falling at baseline, 262 of whom reported severe fear of falling. The predictors of reporting any fear of falling over time included female sex, frequent familial interaction, depression, chronic health conditions, IADL limitations, higher MMSE score, and three or more falls in the last 12 months. Predictors of severe fear of falling included older age, female sex, married, depressive symptoms, chronic health conditions, IADL limitations, higher MMSE score, and fall history. Protective factors included frequent friend interaction and higher levels of education.

Conclusion

Fear of falling is prevalent in older Mexican‐American adults. The presence of friends nearby was shown to be protective against, whereas the presence of family nearby was shown to be predictive of fear of falling.
Shared Risk Factors for Constipation, Fecal Incontinence, and Combined Symptoms in Older U.S. Adults
Authors: Andy Uduak U. , Vaughan Camille P. , Burgio Kathryn L. , Alli Foluke M. , Goode Patricia S. , Markland Alayne D.
Published: October 2016

Objectives

To estimate the prevalence of constipation, fecal incontinence (FI), and combined symptoms and to identify shared factors associated with bowel symptoms in older U.S. men and women

Design

Population‐based cross‐sectional study.

Setting

National Health and Nutrition Examination Survey (2005–2010).

Participants

Women and men aged 50 and older.

Measurements

Constipation was defined as hard stool consistency on the validated Bristol Stool Form Scale or stool frequency of fewer than three bowel movements per week. FI was defined as at least monthly loss of solid, liquid, or mucus stool. Combined symptoms was defined as constipation and FI. Multinomial multivarible models adjusted for age, race, socioeconomic status, education, self‐rated health, depression, impairments in activities of daily living, and number of comorbidities.

Results

Women (n = 3,078) reported higher prevalence of bowel symptoms than men (constipation 11.8% vs 4.7%%, FI 11.2% vs 8.6%, combined symptoms 1.4% vs 0.4%). In adjusted models, women had greater odds of having constipation (odds ratio (OR) = 3.0, 95% confidence interval (CI) = 2.3–3.8), FI (OR = 1.4, 95% CI = 1.1–1.8), and combined symptoms (OR = 4.6, 95% CI = 2.0–10.2) than men. Shared risk factors included poor self‐rated health and depression symptoms (constipation: OR = 1.8, 95% CI = 1.4–2.4 and OR = 1.8, 95% CI = 1.0–3.2; FI: OR = 1.6, 95% CI = 1.2–2.2 and OR = 2.3 95% CI = 1.4–3.6; combined symptoms: OR = 2.6 95% CI = 1.5–4.8 and OR = 4.6, 95% CI = 1.3–16.4).

Conclusion

When defining constipation and FI using validated instruments, women had a much higher prevalence of constipation than men, whereas men had a higher prevalence of FI than constipation. Shared risk factors reflect the negative effect that bowel symptoms have on quality of life.
Age and Sex Distributions of Age‐Related Biomarker Values in Healthy Older Adults from the Long Life Family Study
Authors: Sebastiani Paola , Thyagarajan Bharat , Sun Fangui , Honig Lawrence S. , Schupf Nicole , Cosentino Stephanie , Feitosa Mary F. , Wojczynski Mary , Newman Anne B. , Montano Monty , Perls Thomas T.
Published: October 2016

Objectives

To determine reference values for laboratory tests in individuals aged 85 and older.

Design

Cross‐sectional cohort study.

Setting

International.

Participants

Long Life Family Study (LLFS) participants (N~5,000, age: range 25–110, median 67, 45% male).

Measurements

Serum biomarkers were selected based on association with aging‐related diseases and included complete blood count, lipids (triglycerides, high‐density lipoprotein cholesterol, low‐density lipoprotein cholesterol, total cholesterol), 25‐hydroxyvitamin D2 and D3, vitamin D epi‐isomer, diabetes mellitus–related biomarkers (adiponectin, insulin, insulin‐like growth factor 1, glucose, glycosylated hemoglobin, soluble receptor for advanced glycation endproduct), kidney disease–related biomarkers (albumin, creatinine, cystatin), endocrine biomarkers (dehydroepiandrosterone, sex‐hormone binding globulin, testosterone), markers of inflammation (interleukin 6, high‐sensitivity C‐reactive protein, N‐terminal pro b‐type natriuretic peptide), ferritin, and transferrin.

Results

Of 38 measured biomarkers, 34 were significantly correlated with age. Summary statistics were generated for all biomarkers according to sex and 5‐year age increments from 50 and up after excluding participants with diseases and treatments that were associated with biomarkers. A biomarker data set was also generated that will be useful for other investigators seeking to compare biomarker levels between studies.

Conclusion

Levels of several biomarkers change with older age in healthy individuals. The descriptive statistics identified herein will be useful in future studies and, if replicated in additional studies, might also become useful in clinical practice. The availability of the reference data set will facilitate appropriate calibration of biomarkers measured in different laboratories.
Provision of Patient‐Centered Transgender Care
Authors: Selix Nancy W. , Rowniak Stefan
Published: October 2016

Introduction

Transgender individuals have unique health care needs and experience health disparities. There is an increased need for transgender health care services and primary care for this underserved population. However, provision of appropriate health care services for transgender persons requires cultural competency and skill on the part of the health care provider, and providers need specific skills to address the needs of this population.

Methods

A review of the literature was performed by accessing CINAHL, PsycINFO, and PubMed databases. Pertinent research was extracted and reviewed for relevance. References in these publications were reviewed to identify additional publications that address primary prevention, secondary prevention, and tertiary care of transgender individuals. Articles that include prevention, screening, and treatment of health problems of transgender persons were identified.

Results

Research on the health needs of the transgender population is limited. Whenever available, research findings that address this unique population should be incorporated into clinical practice. When research evidence is not available to address the unique needs of transgender individuals, research and clinical care guidelines from the general population may be applied for health screening and maintenance.

Discussion

This article provides information about primary care services for transgender individuals and seeks to improve awareness of the health disparities this underserved population experiences. Simple solutions to modify clinical settings to enhance care are provided.
The American College of Nurse‐Midwives Clarity in Collaboration Project: Describing Midwifery Care in Interprofessional Collaborative Care Models
Authors: Freytsis Maria , Phillippi Julia C. , Cox Kim J. , Romano Amy , Cragin Leslie
Published: October 2016

In 2014, the American College of Nurse‐Midwives (ACNM) launched a project called Clarity in Collaboration to develop data definitions related to midwifery and maternity care delivery processes. These definitions are needed to ensure midwifery care delivered in collaborative care models is accurately and consistently captured in clinical documentation systems, data registries, and systems being developed as part of health care restructuring and payment reform. The Clarity in Collaboration project builds on the efforts of the Women's Health Registry Alliance (WHRA), which was recently established by the American College of Obstetricians and Gynecologists. Clarity in Collaboration mirrored the process used by ReVITALize, WHRA's first maternity data standardization project, which focused on establishing standardized clinical data definitions for obstetrics. The ACNM Clarity in Collaboration project brought together maternity and midwifery care experts to complete a year‐long consensus process, including a period of public comment, resulting in development of 20 concept definitions. These definitions can be used to describe midwifery care within the context of collaborative care models. This article provides a summary of the ACNM Clarity in Collaboration process with discussion of implications for maternity data collection.
Clinical Outcomes Following Covered Stent for the Treatment of Coronary Artery Perforation
Authors: Lee Wei‐Chieh , Hsueh Shu‐Kai , Fang Chih‐Yuan , Wu Chiung‐Jen , Hang Chi‐Ling , Fang Hsiu‐Yu
Published: October 2016

Background

This study aimed to evaluate short‐ and long‐term outcomes of polytetrafluoroethylene covered stent for patients with coronary artery perforation.

Methods

During April 2004 and February 2016, a total 48 patients underwent implantation using polytetrafluoroethylene‐covered JOSTENT GraftMaster stents (Abbott Vascular, Santa Clara, CA) in the native coronary arteries implantation for coronary artery perforation. Clinical outcomes such as target lesion revascularization (TLR), myocardial infarction (MI), definite or possible stent thrombosis, cardiovascular mortality, and all‐cause mortality were analyzed.

Results

The average age of study patients was 68.02 ± 13.49 years, and the majorities were men (76.6%). The most frequent devices cause of perforation were stents (37.5%). Eighteen patients (37.5%) experienced cardiac tamponade and 20 patients (41.7%) underwent emergent pericardiocentesis. Only 1 patient (2.1%) experienced emergent surgical repair after covered stent. At the 30‐day follow‐up, the rate of all‐cause mortality was 16.7% and cardiovascular mortality was 13.0%. At the 1‐year follow‐up, the rate of MI was 6.1%, the rate of TLR was 21.9%, the rate of definite or possible stent thrombosis was 15.6%, the rate of cardiovascular mortality was 22.0%, and the rate of all‐cause mortality was 26.2%. Between the patients with and without cardiac tamponade, patients with cardiac tamponade had higher cardiovascular mortality in 30‐day and also higher all‐cause mortality in 30‐day and 1‐year follow‐up.

Conclusion

The covered stent could solve emergent condition for patients with coronary artery perforation with high TLR and stent thrombosis rate at long‐term follow‐up. The patients with cardiac tamponade had worse clinical outcomes in 30‐day and 1‐year follow‐up.
Moving “Up and Out” Together: Exploring the Mother–Child Bond in Low‐Income, Single‐Mother‐Headed Families
Authors: Freeman Amanda L.
Published: October 2016

Bearing children is often viewed as negatively impacting the social mobility of low‐income single mothers. This analysis draws on 66 in‐depth interviews with low‐income, single‐mother participants in an antipoverty program in Boston. The author argues that the mother–child relationship is at the center of efforts by these single mothers to move out of poverty. Interviewees repeatedly expressed the primacy of their children's needs being met in order for them to move forward. Mothers tried to include their children in efforts to move out of poverty, thus fulfilling the role of a “good mother” while exhibiting proper behavior for a poor person trying to achieve economic independence. The data here highlight the limitations of policy initiatives that fail to acknowledge the centrality of children's well‐being to the lives of single mothers and suggest that the mother–child bond may be an untapped resource for policies and programs serving this community.
Paired Preference Tests: A signal detection based analysis with separate d′ values for segmentation
Authors: Zhang Xiaotian , Halim Jeremia , Wichchukit Sukanya , O'Mahony Michael , Hautus Michael J.
Published: October 2016

Consumers gave graded preference responses to potato chips in a paired preference test. The graded responses were given to both the target pair under consideration and putatively identical “placebo” pairs of chips. From these data, a novel Signal Detection analysis was used. A model was developed giving a “magnitude of preference” distribution, for those consumers who preferred the first type of chip in the target pair and a second distribution for those who preferred the second type of chip. A second pair of distributions was generated for the two placebo pairs that had also been presented to the consumers. Using a signal detection paradigm, a value of d′ was computed for each chip, representing the difference between the preference distribution for the target pair (Signal + Noise) and its corresponding placebo pair (Noise). The analysis has the advantage that these dʹ values are not distorted by the responses of those consumers who had reported preferences for the placebo pair. This advantage is not a feature of the regular computation of d′ values based on the 2‐AC test.

Practical applications

Paired preference tests are an important part of the measurement of consumer acceptance. Unfortunately, they are prone to response bias whereby consumers report preferences for putatively identical products; they are responding to the test conditions rather than the sensory properties of the products under assessment. Using identical products as a control, the effects of this on the results for the two different products to be assessed can be analyzed. There are various statistical approaches and models for solving this problem. This paper introduces an improved form of analysis based on signal detection/Thurstonian modeling. The method provides more meaningful information regarding segmentation.
Unlocking opportunities in food design for infants, children, and the elderly: Understanding milestones in chewing and swallowing across the lifespan for new innovations
Authors: Cichero Julie A. Y.
Published: October 2016

Intake of a variety of foods increases the likelihood of good general health. From as early as life in utero, humans are exposed to flavor. Further flavor imprinting occurs via breast milk, increasing the likelihood of acceptance of a variety flavors when solids are introduced. While first foods need to be smooth and runny, experience managing soft lumps is required for rudimentary development of chewing skills. Texture experiences are critical to providing building blocks for food acceptance and gradual increase in the range of food textures eaten. Persistence in offering flavors and textures on multiple occasions increases the likelihood of acceptance of new foods. Opportunities exist in novel food texture use and flavor bridging to improve food variety in children. During adulthood lifestyle changes impact on chewing and gastrointestinal efficiency affecting the variety of food consumed. Foods that are moist, and encourage the consumer to slow down and savor food may reduce diseases affecting the esophagus. The aging process sees an increase in medication use with an impact on reduction in saliva flow. Further, physiologic changes in taste and olfaction that occur with aging may see elders benefit from novel food design that utilizes the intact trigeminal system. New food design opportunities exist in the areas of carbonation, dissolvable solids, microencapsulation of flavor volatiles or pressurized carbon dioxide granules. The use of standardized nomenclature for food labeling, description, and measurement methods such as that used by the International Dysphagia Diet Standardisation Initiative is advocated to accelerate food oral processing research.

Practical application

The human feeding, chewing, and swallowing mechanism adapts and changes over the life span. There are opportunities to influence flavor development from as early as life in utero, and through milk feeds. Infants also need exposure to soft lumps to develop rudimentary chewing skills that lay the foundation for mature chewing. Melt‐in‐the‐mouth textures and familiar flavors can help children to bridge to new food and diminish development of picky eating. Similar textures can also be used for the elderly particularly if used with food flavors and compounds that excite the trigeminal system to promote increased food variety. Adults taking medication with dry mouth side effects benefit from moist foods. Special populations, such as those with swallowing difficulties, may benefit from use of micro encapsulated compounds that trigger the trigeminal pathway. Introduction of a food texture labeling system is advocated.
Hierarchical competitive ability and phenotypic investments in prey: inferior competitors compete and defend
Authors: Ramamonjisoa N. , Natuhara Y.
Published: October 2016

It is commonly assumed that prey must make growth–defense trade‐offs when in the presence of predators under resource‐limited conditions. Thus, it is predicted that prey will allocate limited resources either to competitive phenotypes to grow or to defensive phenotypes to defend, but not both. Evidence from plants, however, has suggested that under strong selection prey might evolve phenotypes that allow them to simultaneously compete and defend. In a controlled laboratory experiment, we investigated phenotypic investment in asymmetrically competing tadpoles of Rhacophorus schlegelii (RS) and Pelophylax nigromaculatus (PN) in the presence and absence of predatory dragonfly larvae. We predicted that, because of differences in resource acquisition abilities, tadpoles would invest in competitive and defensive phenotypes differently, depending on their relative competitive ability in the presence of predators. RS was the superior competitor and depressed the growth of PN whether predators were present or absent. As expected, the inferior competitor (PN) responded to competition by elongating its gut in predator‐free environments. In contrast, the superior competitor (RS) did not respond to competition. In the presence of predators, both tadpoles invested in larger tails, a common defensive trait, while the presence of competitors did not influence tail size. When reared alone in the presence of predators, PN grew faster and tended to have a longer gut. In contrast to theoretical predictions, however, in the presence of both predators and competitors the inferior competitor (PN) still maintained the competitive (long gut) and defensive (large tail) phenotypes despite being depressed in growth. Optimal digestion theory suggests that gut elongation should enhance assimilation efficiency and energy gain. In this view, when a competitive phenotype also serves to benefit prey in predator environments, prey may be able to both compete and defend.
Chance in Darwinian Evolutionary Theory and British Romanticism
Authors: Burkett Andrew
Published: October 2016

The following article investigates the unique epistemic changes in conceptions and representations of chance and causality that begin with the poetry and thought of Samuel Taylor Coleridge and William Wordsworth (and first‐generation British Romanticism) and that are elaborated and expressed ultimately in Charles Darwin's theories of organic variation and evolution through natural selection. I argue that both Coleridge's The Rime of the Ancyent Marinere (1798) and Wordsworth's The Prelude (1805) rely on a shift from describing chance as an ontological concern to chance as a discursive matter. Drawing on Darwin's statistical projects from the 1850s and selections from his correspondence in which he begins to articulate his developmental theory of organic variability, I then reveal that Darwin too makes a similar intellectual leap from characterizing chance as event to theorizing chance as idea. As I propose, chance – as an epistemological or discursive matter – radically reconfigures both literary and scientific representations of causality produced during this period. The essay thus concludes by suggesting that the idea of chance infiltrates Romantic and Victorian depictions of the natural world so thoroughly that these representations are impossible without a reorganization of the clauses and stipulations of causality.