bluuebunny/crossref_metadata_2025 huggingface dataset:
Extended periprostatic nerve distributions on the prostate surface confirmed using diffusion tensor imaging
Authors: Sievert Karl‐Dietrich , Hennenlotter Jörg , Dillenburg Thomas , Toomey Patricia , Wöllner Jens , Zweers Peter , Pannek Jürgen , Andersson Karl‐Erik , Amend Bastian
Published: August 2018

Objective

To perform a descriptive microscopic study of prostatectomy specimens from 19 patients which anatomically characterizes the distributions of periprostatic nerve qualities, and to visualize these using diffusion tensor imaging (DTI).

Materials and Methods

Serial whole‐mounted sections were stained for cholinergic (neuronal nitric oxide synthase), adrenergic (tyrosine hydroxylase) and sensory (calcitonin gene‐related peptide) nerves. Extracapsular stained nerves were counted by prostate surface sector, and classified by diameter. Stain‐related relative density was calculated, and distribution patterns were evaluated. To better visualize the reported neuronal structures and independently confirm our findings, nerve concordance in five male volunteers was investigated using a 3‐Tesla magnetic resonance imaging‐DTI system.

Results

At the base, cholinergic nerves were distributed from the anterolateral to posterior sectors, continuing posterolaterally (mid‐section) into the posterolateral‐posterior sector toward the apex. Adrenergic nerves were distributed across the anterolateral‐posterior sectors at the base, with the course narrowing to the posterolateral‐posterior sectors at the mid‐ and apical levels. Sensory fibres were found posterolaterally posteriorly at the base, continuing posterolaterally over the mid‐ and apical levels. Although it was not possible to determine the different nerve qualities, DTI confirmed histological findings from the base to the apex.

Conclusions

Different types of nerve fibres were found to vary in distribution. When linked to possible functional aspects of the different nerve types, this morphological evidence may be of importance to further protect function after radical prostatectomy (RP). To our knowledge, this is the first time that DTI has confirmed reported histological findings in nerve‐sparing RPs. DTI could be an important tool with which to correlate nerves to tumour for better preoperative planning and to incorporate imaging into treatment.
Involvement of Akt in mitomycin C and its analog triggered cytotoxicity in MCF‐7 and K562 cancer cells
Authors: Cheng Shu‐Yuan , Vargas Anayatzinc , Lee Ji‐Young , Clement Cristina C. , Champeil Elise
Published: August 2018

Mitomycin C (MC) is a well‐known DNA alkylating agent. MC analog, 10‐decarbamoyl mitomycin C (DMC), unlike MC, has stronger effects on cancer with p53 mutation. We previously demonstrated that MC/DMC could activate p21WAF1/CIP1 in MCF‐7 (p53‐proficient) and K562 (p53‐deficient) cells in a p53‐independent mode. This study aimed to elucidate the upstream signaling pathway of p21WAF1/CIP1 activation triggered by MC/DMC. Besides p53, Akt plays an important role on deactivating p21WAF1/CIP1. The results showed that MC/DMC inhibited Akt in MCF‐7 cells, but not in K562 cells. By knocking down p53, the Akt inhibition in MCF‐7 cells was alleviated. This implied that the deactivated Akt caused by MC/DMC was p53‐dependent. With Akt activator (SC79), p21WAF1/CIP1 activation triggered by MC/DMC in MCF‐7 cells was not reduced. This indicated that Akt inhibition triggered by MC/DMC was not associated with MC/DMC‐induced p21WAF1/CIP1 activation. Label‐free quantitative proteomic profiling analysis revealed that DMC has a stronger effect on down‐regulating the PI3K/Akt signaling pathway in MCF‐7 cells as compared to MC. No significant effect of MC/DMC on PI3K/Akt in K562 cells was observed. In summary, MC/DMC regulate Akt activation in a p53‐dependent manner. This Akt deactivation is not associated with p21WAF1/CIP1 activation in response to MC/DMC.
Oral health and performance impacts in elite and professional athletes
Authors: Gallagher Julie , Ashley Paul , Petrie Aviva , Needleman Ian
Published: August 2018

Objectives

To measure dental caries, erosive tooth wear (ETW), periodontal health, self‐reported oral health problems and performance impacts in a representative sample of UK elite athletes from different sports using standardized conditions clearly defined clinical indices and a measure of impact on performance with evidence of validity in sport.

Methods

Cross‐sectional study, with single, calibrated examiner, conducted in the local facilities of elite and professional UK athletes (UCL ethics number 6388/001). Main oral measures: dental caries (ICDAS), erosive tooth wear (BEWE), periodontal health (BPE) and athlete‐reported performance impacts.

Results

We recruited 352 athletes from eleven sports. The mean age was 25 years (range 18‐39), and 67.0% were male. We found caries (ICDAS code ≥3) in 49.1% of athletes, ETW (BEWE score of ≥7) in 41.4%, gingival bleeding on probing/presence of calculus (BPE score 1 or 2) in 77.0% and pocket probing depths of at least 4 mm (BPE score 3 or 4) in a further 21.6%. One in five athletes reported previous wisdom teeth problems. The odds of having caries were 2.4 times greater in team sport than endurance sport (95% CI 1.3‐3.2). The odds of having erosion were 2.0 times greater in team sport than endurance sport (95% CI 1.3‐3.1). Overall, 32.0% athletes reported an oral health‐related impact on sport performance: oral pain (29.9%), difficulty participating in normal training and competition (9.0%), performance affected (5.8%) and reduction in training volume (3.8%). Other impacts were difficulty with eating (34.6%), relaxing (15.1%) and smiling (17.2%). Several oral health problems were associated with performance impacts.

Conclusions

This is the first large representative sample study of oral health in athletes from different sports at elite level. Although experience of oral disease differs by sport, the prevalence, in UK elite and professional athletes, is substantial, with common self‐reported performance impacts. Regular screening and use of effective oral health promotion strategies may minimize performance impacts from poor oral health.
Missing, delayed, and old: The status of ESA recovery plans
Authors: Malcom Jacob W. , Li Ya‐Wei
Published: August 2018

Recovery planning is an essential part of implementing the U.S. Endangered Species Act (ESA), but conservationists and government agencies recognize challenges with the current planning process. Using data from all U.S. domestic and transboundary ESA‐listed species, we quantify the completeness, timeliness, age, and other variation among ESA recovery plans over the past 40 years. Among eligible listed taxa (n = 1,548), nearly one‐fourth lack final recovery plans; half of plans have taken >5 years to finalize after listing; half of recovery plans are more than 20 years old; and there is significant variation in planning between agencies, and among regions and taxonomic groups. These results are not unexpected given dwindling budgets and an increasing number of species requiring protection, but underscore the need for systematic improvements to recovery planning. We discuss solutions—some already underway—that may address some of the shortcomings and help improve recovery action implementation for threatened and endangered species.
FBXW7 suppresses epithelial‐mesenchymal transition and chemo‐resistance of non‐small‐cell lung cancer cells by targeting snai1 for ubiquitin‐dependent degradation
Authors: Xiao Guodong , Li Yuan , Wang Meng , Li Xiang , Qin Sida , Sun Xin , Liang Rui , Zhang Boxiang , Du Ning , Xu Chongwen , Ren Hong , Liu Dapeng
Published: August 2018

Objectives

FBXW7 acts as a tumour suppressor by targeting at various oncoproteins for ubiquitin‐mediated degradation. However, the clinical significance and the involving regulatory mechanisms of FBXW7 manipulation of NSCLC regeneration and therapy response are not clear.

Materials and Methods

Immunohistochemical staining and qRT‐PCR were applied to detect FBXW7 and Snai1 expression in 100 samples of NSCLC and matched tumour‐adjacent tissues. FBXW7 manipulation of cancer biological functions were studied by using MTT assay, immunoblotting, flow cytometry, transwells, wound healing assay, and sphere‐formation assays. Immunofluorescence and co‐immunoprecipitation were used to analyse the possible interaction between Snai1 and FBXW7.

Results

We detected the decreased FBXW7 expression in majority of the NSCLC tissues, and lower FBXW7 level was correlated with advanced TNM stage. Furthermore, those patients with decreased FBXW7 expression tend to have both poorer 5‐year survival outcomes, and shorter disease‐free survival, comparing to those with higher FBXW7 levels. Functionally, we found that FBXW7 enforcement suppressed NSCLC progression by inducing cell growth arrest, increasing chemo‐sensitivity and inhibiting Epithelial‐mesenchymal Transition (EMT) progress. Results further showed that FBXW7 could interact with Snai1 directly to degrade its expression through ubiquitylating alternation in NSCLC, which could be partially abrogated by restoring Snai1 expression.

Conclusions

FBXW7 conduction of tumour suppression was partly through degrading Snai1 directly for ubiquitylating regulation in NSCLC
Tetrahedral DNA nanostructures facilitate neural stem cell migration via activating RHOA/ROCK2 signalling pathway
Authors: Ma Wenjuan , Xie Xueping , Shao Xiaoru , Zhang Yuxin , Mao Chenchen , Zhan Yuxi , Zhao Dan , Liu Mengting , Li Qianshun , Lin Yunfeng
Published: August 2018

Objectives

The main purpose of current study was to explore the effects of tetrahedral DNA nanostructures (TDNs) on neuroectodermal (NE‐4C) stem cells migration and unveil the potential mechanisms.

Materials and methods

The successfully self‐assembled TDNs were also determined by dynamic light scattering (DLS). A bidirectional wound‐healing assay and transwell chamber assay were employed to test the migrating behaviour of NE‐4C stem cells cultured under different conditions.

Results

Through an in vitro study, we found that stem cells could internalize TDNs quickly, and the cells’ parallel and vertical migration was promoted effectively. Besides, the effects of TDNs were found being exerted by upregulating the gene and protein expression levels of RhoA, Rock2 and Vinculin, indicating that the RHOA/ROCK2 pathway was activated by the TDNs during the cell migration.

Conclusions

In conclusion, TDNs could enter NSCs without the aid of other transfection reagents in large amounts, whereas only small amounts of ssDNA could enter the cells. TDNs taken up by NSCs activated the RHOA/ROCK2 signalling pathway, which had effects on the relevant genes and proteins expression, eventually promoting the migration of NE‐4C stem cells. These findings suggested that TDNs have great potential in application for the repair and regeneration of neural tissue.
Enterically delivered insulin tregopil exhibits rapid absorption characteristics and a pharmacodynamic effect similar to human insulin in conscious dogs
Authors: Gregory Justin M. , Lautz Margaret , Moore Lindsey M. , Williams Phillip E. , Reddy Praveen , Cherrington Alan D.
Published: August 2018

Aims

Current therapy fails to emulate rapid (first‐phase) insulin release in relation to a meal, a key defect in types 1 and 2 diabetes. We aimed to quantify the pharmacokinetic (PK) and pharmacodynamic (PD) profile of insulin tregopil, an enterically‐absorbed insulin analog that restores the normal distribution of insulin between the hepatic portal and peripheral circulations.

Materials and methods

The PK and PD profiles of insulin tregopil were studied in overnight‐fasted, catheterized, conscious canines using four approaches: (1) equimolar intraportal infusions of tregopil vs human insulin; (2) escalating doses of oral tregopil; (3) identical, consecutive enteric doses of tregopil; and (4) comparison of oral tregopil to inhaled and subcutaneous human insulin administration.

Results

Equimolar intraportal infusions of tregopil and human insulin resulted in very similar PK profiles and PD profiles were nearly identical. Enteric delivery of tregopil brought about rapid absorption with tmax= 20 minutes in most cases. Median tmaxwas 20 minutes for oral tregopil and inhaled insulin and 88 minutes for subcutaneous human insulin. The time required for arterial plasma insulin levels to return to baseline was approximately 90, 210 and 360 minutes for oral tregopil, inhaled insulin and subcutaneous insulin, respectively.

Conclusions

Enterically delivered tregopil is rapidly absorbed and restores a portal‐to‐peripheral vascular distribution. These characteristics should improve postprandial hyperglycaemia in types 1 and 2 diabetes.
A near infrared index to assess effects of soil texture and organic carbon content on soil water content
Authors: Soltani I. , Fouad Y. , Michot D. , Bréger P. , Dubois R. , Cudennec C.
Published: August 2018

Characterization of soil hydrodynamic properties is important for assessing the soil water regime. Ex situ measurements are costly and time consuming. Reflectance spectroscopy can rapidly estimate several soil properties, including soil water content (SWC). Here, we evaluated the ability of visible (vis) and near‐infrared (NIR) spectroscopy to assess the effects of soil texture and soil organic carbon (SOC) content on SWC. Thirteen undisturbed soil surface blocks were sampled in 2014 across the Brittany region, western France. Textural classes ranged from sandy loam to sandy clay loam texture, and SOC content ranged from 8.12 g kg−1 to 62.3 g kg−1. Aggregates of 3–4‐cm width and 5–6‐cm height were extracted and set at 10 matric potentials from saturation to permanent wilting point (1585 kPa). At given pressure heads, soil samples were scanned in triplicate to acquire reflectance spectra between 350 and 2500 nm. Spectra were converted into continuum removal and we focused on the absorption band near 1920 nm, which is linked to combination vibrations of water. We defined a new index based on the full width at half maximum (FWHM) of the absorption feature near 1920 nm. Results showed a linear relation between this NIR index and the volumetric SWC (R2 > 0.9) for every soil aggregate. The slope and the intercept of the line were correlated well with soil texture and SOC content. Results indicated that the parameters of this linear relation offer a new way to study SWC and water retention properties of soils in relation to their physical properties.

Highlights

We used vis–NIR spectroscopy to assess effects of texture and SOC content on soil water content.

Formulated a new spectral index based on absorption feature of water near 1920 nm.

Linear relation between SWC and NIR index; its parameters are related to texture and SOC content.

Vis–NIR spectroscopy can be relevant to assess effects of texture and SOC content on SWC.
Cognitive disorders in normal pressure hydrocephalus with initial parkinsonism in comparison with de novo Parkinson's disease
Authors: Picascia M. , Pozzi N. G. , Todisco M. , Minafra B. , Sinforiani E. , Zangaglia R. , Ceravolo R. , Pacchetti C.
Published: August 2018

Background and purpose

The clinical differentiation between parkinsonism in idiopathic normal pressure hydrocephalus (iNPH) and Parkinson's disease (PD) remains challenging in the initial phase. Whether an early cognitive profiling might support the differential diagnosis of early iNPH and PD was addressed.

Methods

Neuropsychological tests of 40 iNPH subjects with early symptoms resembling parkinsonism were retrospectively evaluated together with 47 de novoPD patients (dnPD). Only neuropsychological tests performed within 1 year from the first motor symptom were included. The cognitive spectrum of iNPH and dnPD was also compared with a sample of 70 normal controls.

Results

A clear difference in the cognitive profile of iNPH, dnPD patients and normal controls was shown. 65% of iNPH subjects showed a diffuse cognitive impairment, including memory, visuospatial abilities, fronto‐executive functioning and attention, whereas only 25.5% of the dnPD patients presented an executive dysfunction. 35% of iNPH and 74.5% of PD patients performed within the normal range (P < 0.05).

Conclusion

Subjects with iNPH showed an early and diffuse alteration of cognition with respect to dnPD patients. Performing a prompt and accurate neuropsychological evaluation might support the differential diagnosis of these two conditions of parkinsonism.
Management of chronic foot lameness with 2% ammonium chloride on the palmar digital nerves
Authors: Dau S. L. , Azevedo M. S. , de La Corte F. D. , Brass K. E. , Ceni F. , Cantareli C.
Published: August 2018

This case series describes the analgesic effect of 2% ammonium chloride (2% AC) in horses with chronic foot pain. Ten horses with foot pain related to chronic laminitis (n = 1), bruised sole (n = 1), distal interphalangeal joint (DIPJ; n = 1), podotrochlear apparatus (PA; n = 4) and PA associated with DIPJ (PA + DIPJ; n = 3) received perineural injections with 3 mL of 2% AC on the palmar digital nerves. A Five horses with pain related to PA + DIPJ (n = 3), PA (n = 1) and DIPJ (n = 1) were treated with saline as control. The analgesic effect was evaluated as lameness improvement (LI) rate (%) using a body‐mounted inertial sensor system, and was assessed at 5, 12, 19, 35, 47 and 62 days after treatment. Horses treated with 2% AC demonstrated a mean LI rate above 50% from Day 12 (63% ± 26) to Day 62 (65% ± 26). Control horses has a overall LI of 28% (± 23%) and a LI above 50% was evidenced in horses with PA + DIPJ (n = 2) and PA pain (n = 1) at different times. Horses with PA pain presented higher LI rates (72% ± 23) than that presented by horses with PA + DIPJ (51% ± 9) or DIPJ (51% ± 19). Horses with severe radiographic lesions of the navicular bone and DIPJ had the lowest LI rates after treatment. The 2% AC is a useful treatment to be included in the clinical management of chronic foot pain involving the podotrochlear apparatus with mild radiographic lesions.
MAP4 regulates Tctex‐1 and promotes the migration of epidermal cells in hypoxia
Authors: Chen Xin , Zhou Xin , Shi Xiaohua , Xia Xin , Zhang Yiming , Fan Dongli
Published: August 2018

After acute wound formation, the oxygen supply is reduced, which results in the formation of an acute hypoxic microenvironment; whether this hypoxic microenvironment enhances epidermal cell migration and the underlying regulatory molecular mechanism of this effect are unclear. In this study, HaCaT cells were maintained under hypoxic (1% oxygen) or normoxic conditions. Methods including immunofluorescence staining, wound scratch assays, transwell assays, Western blotting and high‐ and low‐expression lentiviral vector transfection were utilized to observe the changes in cell migration, microtubule dynamics and the expression levels of microtubule‐associated protein (MAP) 4 and the light chain protein DYNLT1 (Tctex‐1). The possible mechanisms were studied and discussed. The results showed that epidermal cell migration was enhanced during early hypoxia. Further experiments revealed that MAP4 regulates microtubule dynamics and promotes epidermal cell migration through Tctex‐1. MAP4 and Tctex‐1 play important roles in regulating the migration of epidermal cells under hypoxia. This evidence will provide a basis for further revealing the cellular and molecular mechanisms of local wound hypoxia and for promoting wound healing.
Functional characterization of the extranasal OR2A4/7 expressed in human melanocytes
Authors: Wojcik Sebastian , Weidinger Daniel , Ständer Sonja , Luger Thomas , Hatt Hanns , Jovancevic Nikolina
Published: August 2018

Olfactory receptors (ORs) were first described as specialized chemoreceptors in the nasal epithelium. In the last two decades, ORs have also been detected to be functionally expressed and active in different nonolfactory tissues of the human body, because they used to react to specific odour stimuli. In this study, we conducted a characterization of the extranasal OR2A4/7 expressed in primary human melanocytes and sections of the human skin. OR2A4/7 expression could be demonstrated at the transcript and protein level. We uncovered elevated intracellular cAMP and Ca2+ levels accompanied by elevated p38 and reduced p42/44 MAPK phosphorylation following odourant (cyclohexyl salicylate; CHS) stimulation of melanocytes. These results were associated with enhanced melanin biosynthesis in conjunction with the growth inhibition and differentiation of melanocytes. Our findings highlight the participation of OR2A4/7 in human primary melanocyte physiology and suggest an alternate mechanism that regulates melanogenesis.
Prevalence and outcomes of accidental hypothermia among elderly patients in Japan: Data from the J‐Point registry
Authors: Morita Sachiko , Matsuyama Tasuku , Ehara Naoki , Miyamae Nobuhiro , Okada Yohei , Jo Takaaki , Sumida Yasuyuki , Okada Nobunaga , Watanabe Makoto , Nozawa Masahiro , Tsuruoka Ayumu , Fujimoto Yoshihiro , Okumura Yoshiki , Kitamura Tetsuhisa , Hayashi Yasuyuki
Published: August 2018

Aim

We aimed to evaluate the prevalence and outcomes of accidental hypothermia (AH) among elderly patients in Japan.

Methods

This was a multicenter chart review study of patients with AH (Japanese accidental hypothermia network registry; J‐Point registry) that included patients with a body temperature ≤35 °C and those aged ≥18 years who visited the emergency department of 12 institutions in Japan from 1 April 2011 to 31 March 2016. The patients were classified into three groups: adult (aged 18–64 years), young‐old (aged 65–79 years) and old‐old (aged ≥80 years). The association between each age category and in‐hospital mortality from AH was examined through a multivariable logistic regression analysis.

Results

In total, 572 patients were registered in the J‐Point registry database, of which 537 were included. The proportion of individuals who developed AH in an indoor setting was higher in the old‐old group than in the adult group (86.9% [226/260] vs 61.1% [87/113]). The in‐hospital mortality rates of the adult, young‐old and old‐old groups were 15.0% (17/113), 21.3% (35/164) and 30.4% (79/260), respectively. In the multivariable analysis, the in‐hospital mortality rate was higher in the young‐old and old‐old groups than in the adult group (young‐old vs adult, adjusted odds ratio: 2.31 and 95% confidence interval 1.16–4.64; old‐old vs adult, adjusted odds ratio: 2.91 and 95% confidence interval 1.41–6.02).

Conclusions

Approximately 80% of patients with AH were aged ≥65 years. The in‐hospital mortality rate of patients aged ≥65 years was significantly higher than that of those aged <65 years. Geriatr Gerontol Int 2018; 18: 1427–1432.
Gender‐diverse audit partners and audit fee premium: The case of mandatory joint audit
Authors: Nekhili Mehdi , Javed Fahim , Chtioui Tawhid
Published: August 2018

This study empirically investigates the impact of auditor gender on audit fees in a unique audit regulatory environment, namely France, where joint audit is mandatory by law. Apart from the fact that male and female auditor engagement partners have distinctive behaviors and style, the question also arises at to whether coordination problems between two competing audit firms are exacerbated or mitigated by the presence of a female auditor in the joint auditor pair composition. This issue could be more challenging in the context of International Financial Reporting Standards adoption, which increases audit task complexity, audit risk, and audit effort required for an audit engagement. Using a matched sample of firms from the CAC All‐Shares Index listed on Euronext Paris from 2002 to 2010, we find that, when a female auditor is paired with a male auditor, the difference in audit fees stems not only from the presence of the female auditor partner but also from male–female interaction within the joint auditor pair composition. In a supplementary analysis, we show that the impact on audit fees of both the presence of a female partner and male–female auditor interaction is dependent, but in a different way, on the number of Big 4 audit firms in the auditor pair composition.
Changes in the amount of sleep and daytime sleepiness: A follow‐up study of schoolchildren from ages 10 to 15 years
Authors: Gustafsson Marja‐Liisa , Laaksonen Camilla , Salanterä Sanna , Löyttyniemi Eliisa , Aromaa Minna
Published: August 2018

Aim

This study examines the amount of sleep and daytime sleepiness, and how these change in a follow‐up cohort study of school‐aged children.

Methods

A total of 1351 schoolchildren (aged 10) and their parents were invited to participate in the study and were studied again at ages 12 and 15 years. A survey put forth by the Health Behaviour of Schoolchildren research network was used.

Results

The amount of sleep during weekdays dropped significantly from age 10 to 15. At weekends, the amount of sleep increased significantly. During weekdays, the proportion of children reporting having slept enough dropped from 71% at age 10 to 19% at age 15. Frequent daytime sleepiness occurred in 13% of children at age 10 and increased to 24% at the age of 15.

Conclusions

It is essential to promote adequate amount of sleep and prevent daytime sleepiness in children growing from age 10 to 15 years. Nurses and other health care professionals should systematically assess and promote healthy sleeping habits while caring for children between these ages.
Hospitalisation rates and characteristics for adult and childhood immunoglobulin A vasculitis in Western Australia
Authors: Nossent Johannes , Raymond Warren , Keen Helen , Inderjeeth Charles , Preen David B.
Published: August 2018

Background

Immunoglobulin A vasculitis (IgAV) is a systemic small‐vessel vasculitis of unknown aetiology. Although commonest in children, onset in adulthood is not unusual.

Aim

As Australian data are lacking, we investigated longitudinal hospitalisation rates and characteristics for both adult and paediatric IgAV patients in Western Australia (WA).

Methods

Data were extracted from a state‐wide register for all first hospital contacts in WA between 1980 and 2015 for patients with a primary diagnosis of IgAV. Paediatric cases were defined as those <20 years and compared with adult cases for admission rates per 100 000, demographics, complications, length of stay (LOS) and readmission rates.

Results

The study cohort included 476 children (median age 5 years; interquartile range (IQR) 3–7) and 144 adults (median age 50 years; IQR 36–77). Childhood admission rates declined from 3.85 to 0.31 over time (P < 0.001) but age at admission and LOS remained unchanged. For adults, admission rates declined from 0.40 to 0.17 (P = 0.02) while age at admission (43 vs 63 years, P = 0.01) and LOS (5 vs 9 days, P = 0.02) increased. More adults had renal (11.8 vs 1.3%, P < 0.01), intestinal (3.5 vs 0.8%, P = 0.04) and infectious (14.6% vs 5.3%, P < 0.01) complications. Readmission was more frequent in childhood cases (23.1% vs 7.6%, P < 0.05) occurring mostly within 30 days of discharge.

Conclusion

Hospitalisation rates for adults with IgAV now nearly equal those in children as adult IgAV leads to more complications. The sharp decline in childhood IgAV admissions suggests that confidence to manage children with IgAV outside the hospital setting has increased.
Missed opportunities for earlier diagnosis of human immunodeficiency virus infection among adults presenting to Auckland District Health Board hospital services
Authors: Hopkins Chris , Reid Murray , Gilmour Judy , Werder Suzanne , Briggs Simon
Published: August 2018

Background

Earlier diagnosis of human immunodeficiency virus (HIV) infection improves health outcomes and reduces transmission. In New Zealand, half of new HIV diagnoses between 2005 and 2010 had a cluster of differentiation 4 count below 350 cells/mm3. HIV screening is already offered in antenatal settings in New Zealand, but not universally in hospital settings.

Aims

To assess the impact of missed opportunities to diagnose HIV infection in adults presenting to hospital services at Auckland District Health Board (ADHB).

Methods

Retrospective cohort analysis of all new diagnoses of HIV infection in adults aged 15–64 years residing within the ADHB catchment area over a 7‐year period. Those who had contact with hospital services prior to diagnosis, but within their estimated window of undiagnosed infection, were compared with those without such contact.

Results

Of 201 newly diagnosed patients, 68 had prior hospital contact within their estimated window of HIV infection, 68% of whom were men who have sex with men. These patients could potentially have been diagnosed earlier by a median of 12 months (range 1–84). Missed opportunity visits occurred across a wide range of hospital services, and included visits for conditions that indicated risk for, or actual, HIV infection. Thirteen patients had HIV‐associated illnesses at the time of diagnosis that could have been prevented if diagnosed earlier.

Conclusion

Our current risk‐based HIV screening strategy commonly results in late diagnosis, negative health impacts and possibly avoidable transmissions. Further study is warranted to model the feasibility and potential impact of universal HIV screening at ADHB.
Constructing continuities in virtual work environments: A multiple case study of two firms with differing degrees of virtuality
Authors: Asatiani Aleksandre , Penttinen Esko
Published: August 2018

In this paper, we study how continuities are constructed in virtual work environments by comparing two firms with differing degrees of virtuality. Using Organizational Discontinuity Theory and drawing on a qualitative study of two accounting firms operating in Finland, we observe virtual work discontinuities in the two firms and identify constructed continuities. We find that in constructing continuities, virtual organizations need to balance rigid and flexible approaches regarding governance structure, the role of technology, communication management, and workflow management. Our main contributions are an empirical application of Organizational Discontinuity Theory to the comparison of virtual work environments and a set of propositions regarding how firms approach continuity construction in different virtuality contexts.
A novel metaheuristic approach for collaborative learning group formation
Authors: Lambić Dragan , Lazović Bojana , Djenić Aleksandar , Marić Miroslav
Published: August 2018

In this paper, a new approach for the formation of four‐member collaborative learning groups is presented. Group formation is presented by the mathematical optimization problem. Based on the proposed approach and the variable neighbourhood search (VNS) algorithm, the application that solves the presented problem and provides the appropriate division into groups is created. The proposed approach considers the scores of a pretest, interpersonal relationships, and prosocial behaviour/openness skill of students. In order to validate our approach, an experiment was designed with 108 first‐year university students of Belgrade Business School—Higher Educational Institution for Applied Studies. Experimental and control groups were divided into four‐member groups. The experimental group was divided by using the proposed method and the control group by student selection and random selection. Multilevel analysis is used to determine whether there is a significant difference in learning outcomes between the two groups. The experimental results showed that students from the experimental group achieved significantly higher success than the students from the control group. In addition, computational results obtained with the proposed VNS algorithms are compared and verified with the results obtained by random (Monte Carlo) method.
Nicotine induces endothelial dysfunction and promotes atherosclerosis via GTPCH1
Authors: Li Jingyuan , Liu Shangming , Cao Guangqing , Sun Yuanyuan , Chen Weiqian , Dong Fajin , Xu Jinfeng , Zhang Cheng , Zhang Wencheng
Published: August 2018

Smoking is a major preventable risk factor for atherosclerosis. However, the causative link between cigarette smoke and atherosclerosis remains to be established. The objective of this study is to characterize the role of GTP cyclohydrolase 1 (GTPCH1), the rate‐limiting enzyme for de novo tetrahydrobiopterin (BH4) synthesis, in the smoking‐accelerated atherosclerosis and the mechanism involved. In vitro, human umbilical vein endothelial cells were treated with nicotine, a major component of cigarette smoke, which reduced the mRNA and protein levels of GTPCH1 and led to endothelial dysfunction. GTPCH1 overexpression or sepiapterin could attenuate nicotine‐reduced nitric oxide and ‐increased reactive oxygen species levels. Mechanistically, human antigen R (HuR) bound with the adenylateuridylate‐rich elements of the GTPCH1 3′ untranslated region and increased its stability; nicotine inhibited HuR translocation from the nucleus to cytosol, which downregulated GTPCH1. In vivo, nicotine induced endothelial dysfunction and promoted atherosclerosis in ApoE−/− mice, which were attenuated by GTPCH1 overexpression or BH4 supplement. Our findings may provide a novel and promising approach to atherosclerosis treatment.
Sirtuin3 protects aged human mesenchymal stem cells against oxidative stress and enhances efficacy of cell therapy for ischaemic heart diseases
Authors: Zhang Dong‐Yang , Zhang Chun‐Feng , Fu Bi‐Cheng , Sun Lu , Wang Xue‐Qing , Chen Wei , Liu Wei , Liu Kai‐Yu , Du Guo‐Qing , Ma Chong‐Yi , Jiang Shu‐Lin , Li Ren‐Ke , Tian Hai
Published: August 2018

Sirtuin3 (SIRT3) is associated with oxidative stress and lifespan. However, the possible mechanisms underlying its influence are unknown. We hypothesized that SIRT3 increases the antioxidant capacity of aged cells and improves the efficacy of human mesenchymal stem cell (hMSC) therapy for ischaemic heart diseases in aged patients. In vitro, the antioxidant capacity of old hMSCs (O‐hMSCs) was increased after SIRT3 overexpression using a gene transfection technique, while the antioxidant capacity of young hMSCs (Y‐hMSCs) was decreased by SIRT3 silencing. The levels of forkhead box O3a (FoxO3a) in the nucleus, and antioxidant enzymes Mn‐superoxide dismutase (MnSOD) and catalase (CAT) increased in SIRT3‐overexpressed O‐hMSCs while they decreased in SIRT3‐silenced Y‐hMSCs after oxidative stress. Following myocardial infarction in adult rats in vivo, infarct size decreased and cardiac function was significantly enhanced after cell transplantation with SIRT3 overexpressed O‐hMSCs. The number of apoptotic cells decreased and the survival rate of transplanted cells increased following SIRT3 overexpression in O‐hMSCs. SIRT3 protects aged hMSCs against oxidative stress by positively regulating antioxidant enzymes (MnSOD and CAT) via increasing the expression of FoxO3a in the nucleus. The efficacy of aged hMSC transplantation therapy for ischaemic heart diseases can be improved by SIRT3 overexpression.
The effectiveness of fishery net dips: Advice for the improvement of biosecurity measures
Authors: Tidbury Hannah J. , Joiner Claire L. , Rimmer Georgina S. E. , Potter Holly V. , Taylor Nick G. H.
Published: August 2018

Disease poses a major threat to aquaculture and commercial and recreational fisheries globally. Biosecurity measures have been implemented; however, empirical evidence of their efficacy in situ is lacking. Here, we present the results from a study conducted to examine the effectiveness of disinfectant net dips. Samples were collected from disinfectant net dips at 25 recreational fisheries in south‐west England and assessed to determine (a) the level of bacterial contamination and (b) the reduction in titre of a target virus (infectious pancreatic necrosis virus, IPNV) following a contact time of 2 and 5 min. In addition, the study examined the reduction in target virus titre following exposure to laboratory prepared Virkon®, representing “clean,” “dirty” and “diluted and dirty” conditions, for 2 and 5 min. Bacterial contamination was high in 64% of disinfectant samples, and, 76% of disinfectant samples did not effectively reduce the target virus titre in 2 or 5 min. Virus titre was successfully reduced following exposure to laboratory prepared Virkon® for 2 or 5 min, although dilution and contamination reduced the effectiveness. These results suggest that disinfectant net dips may not be working effectively on a high proportion of fishery sites. We provide recommendations for improving biosecurity.
Burden of Invasive Methicillin‐Resistant Staphylococcus aureus Infections in Nursing Home Residents
Authors: Grigg Cheri , Palms Danielle , Stone Nimalie D. , Gualandi Nicole , Bamberg Wendy , Dumyati Ghinwa , Harrison Lee H. , Lynfield Ruth , Nadle Joelle , Petit Susan , Ray Susan , Schaffner William , Townes John , See Isaac
Published: August 2018

Objectives

To describe the epidemiology and incidence of invasive methicillin‐resistant Staphylococcus aureus (MRSA) infections in nursing home (NH) residents, which has previously not been well characterized.

Design

Retrospective analysis of public health surveillance data.

Setting

Healthcare facilities in 33 U.S. counties.

Participants

Residents of the surveillance area.

Measurements

Counts of NH‐onset and hospital‐onset (HO) invasive MRSA infections (cultured from sterile body sites) identified from the Centers for Disease Control and Prevention Emerging Infections Program (EIP) population‐based surveillance from 2009 to 2013 were compared. Demographic characteristics and risk factors of NH‐onset cases were analyzed. Using NH resident‐day denominators from the Centers for Medicare and Medicaid Services Skilled Nursing Facility Cost Reports, incidence of NH‐onset invasive MRSA infections from facilities in the EIP area was determined.

Results

A total of 4,607 NH‐onset and 4,344 HO invasive MRSA cases were reported. Of NH‐onset cases, median age was 74, most infections were bloodstream infections, and known risk factors for infection were common: 1,455 (32%) had previous MRSA infection or colonization, 1,014 (22%) had decubitus ulcers, 1,098 (24%) had recent central venous catheters, and 1,103 (24%) were undergoing chronic dialysis; 2,499 (54%) had been discharged from a hospital in the previous 100 days. The in‐hospital case‐fatality rate was 19%. The 2013 pooled mean incidence of NH‐onset invasive MRSA infections in the surveillance area was 2.4 per 100,000 patient‐days.

Conclusion

More NH‐onset than HO cases occurred, primarily in individuals with known MRSA risk factors. These data reinforce the importance of infection prevention practices during wound and device care in NH residents, especially those with a history of MRSA infection or colonization.
Degree of Implementation of the Interventions to Reduce Acute Care Transfers (INTERACT) Quality Improvement Program Associated with Number of Hospitalizations
Authors: Huckfeldt Peter J. , Kane Robert L. , Yang Zhiyou , Engstrom Gabriella , Tappen Ruth , Rojido Carolina , Newman David , Reyes Bernardo , Ouslander Joseph G.
Published: August 2018

Objectives

To determine whether degree of implementation of the Interventions to Reduce Acute Care Transfers (INTERACT) program is associated with number of hospitalizations and emergency department (ED) visits of skilled nursing facility (SNF) residents.

Design

Secondary analysis from a randomized controlled trial.

Setting

SNFs from across the United States (N=264).

Participants

Two hundred of the SNFs from the randomized trial that provided baseline and intervention data on INTERACT use.

Interventions

During a 12‐month period, intervention SNFs received remote training and support for INTERACT implementation; control SNFs did not, although most control facilities were using various components of the INTERACT program before and during the trial on their own.

Measurements

INTERACT use data were based on monthly self‐reports for SNFs randomized to the intervention group and pre‐ and postintervention surveys for control SNFs. Primary outcomes were rates of all‐cause hospitalizations, potentially avoidable hospitalizations (PAHs), ED visits without admission, and 30‐day hospital readmissions.

Results

The 65 SNFs (32 intervention, 33 control) that reported increases in INTERACT use had reductions in all‐cause hospitalizations (0.427 per 1,000 resident‐days; 11.2% relative reduction from baseline, p<.001) and PAHs (0.221 per 1,000 resident‐days; 18.9% relative reduction, p<.001). The 34 SNFs (12 intervention, 22 control) that reported consistently low or moderate INTERACT use had statistically insignificant changes in hospitalizations and ED visit rates.

Conclusion

Increased reported use of core INTERACT tools was associated with significantly greater reductions in all‐cause hospitalizations and PAHs in both intervention and control SNFs, suggesting that motivation and incentives to reduce hospitalizations were more important than the training and support provided in the trial in improving outcomes. Further research is needed to better understand the most effective strategies to motivate SNFs to implement and sustain quality improvement programs such as INTERACT.
Effect of Medicare Part D on Ethnoracial Disparities in Antidementia Medication Use
Authors: Lind Kimberly E. , Hildreth Kerry , Lindrooth Richard , Morrato Elaine , Crane Lori A. , Perraillon Marcelo Coca
Published: August 2018

Objectives

To examine ethnoracial disparities in antidementia medication use, accounting for implementation of Part D, and to evaluate the role of prescription drug coverage as a cause of antidementia medication disparities.

Design

Rotating panel of Medicare beneficiaries who participated in the Medicare Current Beneficiary Survey from 2003 to 2013.

Setting

Nationally representative sample of Medicare fee‐for‐service (FFS) beneficiaries with dementia.

Participants

Community‐dwelling FFS Medicare beneficiaries with dementia (N=4,304).

Measurements

Antidementia medication use, defined as at least one prescription fill in a given year.

Results

Unadjusted antidementia medication use was 10–percentage points lower for ethnoracial minority beneficiaries before Part D was implemented in 2006 (p=.01). This difference was attenuated after adjusting for demographic and socioeconomic factors (6–percentage points; p=.10). Part D was associated with a 6–percentage point increase in use (p<.01). The increase in use associated with Part D was higher although not statistically significantly so in ethnoracial minority beneficiaries (8–percentage points, p=.08). Analyses of each ethnoracial group found a significant effect of Part D only in Hispanic/Latino beneficiaries (18–percentage points; p<.01, adjusted).

Conclusion

Antidementia medication disparities were reduced with expanded prescription drug coverage through Medicare Part D. Increases in antidementia medication use for minority beneficiaries started after Part D was implemented, with the largest increases in use observed in Hispanic/Latino beneficiaries.
Burden of Depressive Symptoms Over 2 Decades and Risk of Nursing Home Placement in Older Women
Authors: Byers Amy L. , Lui Li‐Yung , Vittinghoff Eric , Covinsky Kenneth E. , Ensrud Kristine E. , Taylor Brent , Yaffe Kristine
Published: August 2018

Objectives

To determine the association between cumulative burden of depressive symptoms and risk of nursing home (NH) placement over 2 decades.

Design

Prospective cohort study with data linked to Medicare claims files.

Setting

Clinic sites in Baltimore, Maryland; Minneapolis, Minnesota; and the Monongahela Valley near Pittsburgh, Pennsylvania.

Participants

Initially community‐dwelling women aged 65 and older (N=3,646).

Measurements

Depressive symptom burden was determined using the Geriatric Depression Scale measured over 18 years to calculate accumulation of burden. NH placement was determined using Medicare claims data.

Results

In Fine‐Gray proportional hazards analyses including demographic characteristics, medical comorbidities, functional impairment, and recent depression exposure and accounting for competing risk of death, women with low depressive symptom burden were twice as likely to experience NH placement as those with minimal burden (hazard ratio (HR) = 1.92, 95% confidence interval (CI) = 1.16–3.20), women with moderate burden were more than twice as likely (HR = 2.62, 95% CI = 1.59–4.31), and women with high burden (HR = 3.08, 95% CI = 1.87–5.08) were three times as likely. The addition of antidepressant use to this model attenuated the risk only slightly.

Conclusion

In older women, cumulative burden of depressive symptoms over nearly 2 decades is associated with greater risk of transitioning from community‐living to a NH irrespective of recent depression exposure, medical comorbidities, functional impairment, and the competing risk of death. This work supports the need for improving recognition, monitoring, and treatment of depressive symptoms early, which may reduce or delay NH placement.
Adherence to the Healthy Nordic Food Index and the incidence of acute myocardial infarction and mortality among patients with stable angina pectoris
Authors: Puaschitz N. G. , Assmus J. , Strand E. , Karlsson T. , Vinknes K. J. , Lysne V. , Drevon C. A. , Tell G. S. , Dierkes J. , Nygård O.
Published: August 2018

Background

The Healthy Nordic Food Index (HNFI) has been associated with beneficial effects on markers of cardiovascular disease (CVD). Whether such effects are present among patients with established coronary heart disease is unknown. In the present study, we investigated the association between adherence to the HNFI and the risk of acute myocardial infarction (AMI) (fatal or nonfatal) and death among patients with stable angina pectoris.

Methods

In the Western Norway B‐vitamin Intervention Trial, participants completed a 169‐item semi‐quantitative food frequency questionnaire. The HNFI was calculated from six food groups (fish, cabbage, apples/pears, root vegetables, whole grain bread and oatmeal), scoring 0–6. Three adherence groups were defined: 0–1 points (low), 2–3 points (medium) or 4–6 points (high). Cox regression analyses investigated associations between adherence to the HNFI and outcomes.

Results

Among 2019 men (79.7%) and women with mean age of 61.7 years, 307 patients experienced an AMI event during a median (25th and 75th percentiles) follow‐up of 7.5 (6.3 and 8.7) years. Median follow‐up for total mortality was 10.5 (9.3 and 11.7) years; 171 patients died from CVD and 380 from any cause. No association between HNFI and the risk of AMI was detected. However, the HNFI was associated with a reduced risk of all‐cause death, both by linear estimates [hazard ratio (95% confidence interval = 0.91 (0.84–0.98)] and by comparison of the highest with the lowest adherence group [hazard ratio (95% confidence interval = 0.70 (0.52–0.95)].

Conclusions

The results of the present study suggest that a Healthy Nordic diet may reduce mortality in patients with established CVD.