bluuebunny/crossref_metadata_2025 huggingface dataset:
Long‐term outcome after surgery for Crohn's anal fistula
Authors: Graf W. , Andersson M. , Åkerlund J.‐E. , Börjesson L. ,   the Swedish Organization for Studies of Inflammatory Bowel Disease
Published: September 2015

Aim

Treatment of Crohn's anal fistula remains challenging and little is known about factors associated with healing. The aim of this study was to assess the rate of healing after surgical treatment and analyse clinical variables related to healing.

Method

A total of 119 patients [63 women, mean age 36 (±13.7) years] with histopathologically verified Crohn's disease underwent a surgical procedure for anal fistula at four main referral centres in Sweden, January 1998 to December 2009. Baseline and treatment‐related variables were recorded and analysed for correlation with fistula healing at a final follow‐up after a mean of 7.2 (median 7.1, 1.0–17.5) years.

Results

Of the 119 patients 62 (52%) were healed at final follow‐up. Fourteen healed after one procedure and the remaining 48 healed after a further median of 4.0 (2–20) procedures. Ten (8%) patients were subjected to a proctectomy. Final healing was more common in patients operated with a procedure aiming at eradicating the fistula (P = 0.0001), without proctitis (P = 0.02) and a shorter duration of Crohn's disease (P = 0.0019).

Conclusion

Long‐term healing of a Crohn's anal fistula can be expected in about half of the patients, usually after repeated surgical treatment. The probability for cure was higher when a curative operation was performed in a patient without proctitis and with a shorter duration of Crohn's disease. An attempt to close a Crohn's anal fistula is thus often worthwhile.
What is the Alternative? Youth, Entrepreneurship and the Developmental State in Urban Ethiopia
Authors: Di Nunzio Marco
Published: September 2015

This article investigates the implementation of small‐scale entrepreneurship programmes in inner‐city Addis Ababa. Drawing on eighteen months of ethnographic fieldwork, it discusses the failure of these programmes to open up opportunities for social improvement for young people. It also analyses how young people confronted with this failure suggest ways of conceptualizing ‘alternatives’ to established development concepts of poverty reduction, such as microfinance and small‐scale entrepreneurship. In doing this, the author does not pretend either to offer a grand solution or to invent a brand new developmental concept. Rather, the aim is to provide a critical commentary on the reasons why some of the current academic debate on alternatives to neoliberalism have, de facto, amounted to an endorsement Ethiopia's political authoritarianism.
Litigation against Political Organization? The Politics of Dalit Mobilization in Tamil Nadu, India
Authors: Carswell Grace , De Neve Geert
Published: September 2015

This article examines contemporary Dalit assertion in India through an ethnographic case study of a legal tool being mobilized by Tamil Nadu's lowest‐ranking Arunthathiyars in their struggle against caste‐based offences. The Arunthathiyars of western Tamil Nadu are increasingly taking recourse to the 1989 Prevention of Atrocities Act (PoA Act) in an attempt to bring members of higher castes to justice. The article explores how Arunthathiyars are employing the law and how their litigation is reshaping the politics of caste in this region. The authors document how a process of litigation by Arunthathiyars is countered by a politicization of caste by the dominant Gounders of the region, who recently entered electoral politics with a new caste‐based party. Even though the litigation route further antagonizes caste relations, it is argued that the PoA Act has provided Dalits with an invaluable tool to seek justice, democratize public space, and challenge the power of the dominant caste in the region. Dalit social movements, it is concluded, are more likely to be successful if they are backed by a legal weapon and accompanied by Dalits’ growing economic independence.
Screening attendance, age group and diabetic retinopathy level at first screen
Authors: Scanlon P. H. , Stratton I. M. , Leese G. P. , Bachmann M. O. , Land M. , Jones C. , Ferguson B ,   the Four Nations Diabetic Retinopathy Screening Study Group
Published: September 2015

Aims

To report on the relationships between age at diagnosis of diabetes, time from registration with the screening programme to first diabetic eye screening and severity of diabetic retinopathy.

Methods

Data were extracted from four English screening programmes and from the Scottish, Welsh and Northern Irish programmes. Time from diagnosis of diabetes to first screening and age at diagnosis were calculated.

Results

Time from registration with the screening programme to first screening episode is strongly related to age at registration. Within 18 months of registration 89% of 3958 young people under 18 years of age and 81% of 391 293 people over 35 years of age were seen. In 19 058 people between 18 and 34 years of age, 80% coverage was not reached until 2 years and 9 months. The time from diagnosis of diabetes to first screening is positively associated with severity of disease (P < 0.0001).

Conclusions

This report is the first that to demonstrate that those in the 18–34 year age group are least likely to attend promptly for screening after registration with a higher risk of referable diabetic retinopathy being present at the time of first screen. Date of diagnosis should be recorded and prodigious efforts made to screen all people promptly after diagnosis. Screening programmes should collect data on those who have not attended within one year of registration.
THE EFFECTS OF PERCEIVED AND ACTUAL FINANCIAL LITERACY ON FINANCIAL BEHAVIORS
Authors: Allgood Sam , Walstad William B.
Published: September 2015

A combined measure of financial literacy that includes both a test score of actual financial literacy and a self‐rating of overall financial literacy is used in this study. We find that the combined measure appears to provide greater understanding about how financial literacy affects financial behaviors. A large national survey of U.S. adults and households (n = 28,146) was used to investigate how this overall financial literacy is likely to change financial behaviors across five financial topics: credit cards, investments, loans, insurance, and financial advice. For each topic, we include 4–5 financial behaviors (22 in total) to demonstrate the consistency of the findings within and across topics. Although we are unable to identify a causal relationship, the results from the probit analysis show that both actual and perceived financial literacy appear to influence financial behaviors and that perceived financial literacy may be as important as actual financial literacy. (JEL D14, G00)
Action of fosetyl‐al and metalaxyl against Phytophthora austrocedri
Authors: Silva P. V. , Vélez M. L. , Hernández Otaño D. , Nuñez C. , Greslebin A. G.
Published: September 2015

Fosetyl‐Al and metalaxyl, the most commonly used systemic fungicides against Phytophthora, were evaluated for their efficacy to control Phytophthora austrocedri, the pathogen that causes a serious disease at the Austrocedrus chilensis forests in Patagonia. The effect of the chemicals on pathogen development in vitro and in planta was analysed. Both chemicals were shown to protect plants from the pathogen. In vitro assays showed that asexual reproduction was sensitive to both chemicals. However, mycelial growth and sexual reproduction, which were clearly sensitive to metalaxyl, were sensitive only to high concentrations of fosetyl‐Al. Fosetyl‐Al and metalaxyl had almost the same efficacy when applied preventively by soil drench to seedlings. This difference between in vitro and in planta results can be attributed to the dual action of fosetyl‐Al, not only inhibiting the pathogen but also stimulating host defence. In adult trees, preventive and curative treatments were tested, but only the fosetyl‐Al preventive treatment was effective in the assayed conditions. Interestingly, seedlings pretreated with both fungicides were less susceptible to the effectors secreted by the pathogen. Our results indicate that fosetyl‐Al and metalaxyl provide some resistance to the plant besides the fungistatic direct action on the pathogen. Further studies to elucidate a possible resistance‐inducing activity of these chemicals and the mechanisms involved are underway.
Quambalaria eucalypti a pathogen of Eucalyptus globulus newly reported in Portugal and in Europe
Authors: Bragança H. , Diogo E. L. F. , Neves L. , Valente C. , Araújo C. , Bonifácio L. , Phillips A. J. L.
Published: September 2015

The Eucalyptus pathogen Quambalaria eucalypti has been reported from several subtropical and tropical countries of the Southern Hemisphere. During the course of a nationwide monitoring programme aimed at the detection of pathogens in commercial eucalypt plantations in Portugal, Q. eucalypti was found affecting Eucalyptus globulus. The identity of the pathogen was confirmed by sequence analyses of the internal transcribed spacer (ITS) region of the rDNA operon, as well as morphological characteristics. Quambalaria eucalypti is widespread throughout the eucalypt‐producing areas of Portugal. Pathogenicity studies revealed that different host genotypes showed various degrees of susceptibility to the pathogen. To our knowledge, this is the first report of Q. eucalypti on Eucalyptus spp. in Portugal and in the Northern Hemisphere.
Can the predictive value of epileptiform electroencephalography abnormalities be assessed by a meta‐analysis?
Authors: Baldin E. , Hauser W. A.
Published: September 2015

Click here to view the accompanying paper in this issue.
A definition and classification of status epilepticus – Report of theILAETask Force on Classification of Status Epilepticus
Authors: Trinka Eugen , Cock Hannah , Hesdorffer Dale , Rossetti Andrea O. , Scheffer Ingrid E. , Shinnar Shlomo , Shorvon Simon , Lowenstein Daniel H.
Published: September 2015

The Commission on Classification and Terminology and the Commission on Epidemiology of the International League Against Epilepsy (ILAE) have charged a Task Force to revise concepts, definition, and classification of status epilepticus (SE). The proposed new definition ofSEis as follows:Status epilepticus is a condition resulting either from the failure of the mechanisms responsible for seizure termination or from the initiation of mechanisms, which lead to abnormally, prolonged seizures (after time point t1). It is a condition, which can have long‐term consequences (after time point t2), including neuronal death, neuronal injury, and alteration of neuronal networks, depending on the type and duration of seizures. This definition is conceptual, with two operational dimensions: the first is the length of the seizure and the time point (t1) beyond which the seizure should be regarded as “continuous seizure activity.” The second time point (t2) is the time of ongoing seizure activity after which there is a risk of long‐term consequences. In the case of convulsive (tonic–clonic)SE, both time points (t1at 5 min and t2at 30 min) are based on animal experiments and clinical research. This evidence is incomplete, and there is furthermore considerable variation, so these time points should be considered as the best estimates currently available. Data are not yet available for other forms ofSE, but as knowledge and understanding increase, time points can be defined for specific forms ofSEbased on scientific evidence and incorporated into the definition, without changing the underlying concepts. Anew diagnostic classification systemofSEis proposed, which will provide a framework for clinical diagnosis, investigation, and therapeutic approaches for each patient. There are four axes: (1) semiology; (2) etiology; (3) electroencephalography (EEG) correlates; and (4) age. Axis 1 (semiology) lists different forms ofSEdivided into those with prominent motor systems, those without prominent motor systems, and currently indeterminate conditions (such as acute confusional states with epileptiformEEGpatterns). Axis 2 (etiology) is divided into subcategories of known and unknown causes. Axis 3 (EEGcorrelates) adopts the latest recommendations by consensus panels to use the following descriptors for theEEG: name of pattern, morphology, location, time‐related features, modulation, and effect of intervention. Finally, axis 4 divides age groups into neonatal, infancy, childhood, adolescent and adulthood, and elderly.
Development of a bispecific antibody tetramerized through hetero‐associating peptides
Authors: Osaki Tomohiro , Fujisawa Shingo , Kitaguchi Masahiro , Kitamura Masaya , Nakanishi Takeshi
Published: September 2015

The specific assembly of self‐associating peptides can be useful in building a functional antibody complex from small antibody fragments. We have focused on the exceedingly specific heterotetrameric assembly of Lin‐2 and Lin‐7 (L27) domains, which work as protein–protein interaction modules in many scaffold proteins. Here, we describe a novel method for constructing a highly functional antibody based on the hetero‐association of L27 domains. In this study, we used a bacterial expression system to produce a bispecific antibody that was heterotetramerized through L27 domains and that targeted both epidermal growth factor receptor (EGFR) and Fcγ receptor III (FcγRIII or CD16). Gel electrophoresis, mass spectrometry and gel filtration analyses revealed that the constructed recombinant antibody was a disulfide‐linked heterotetramer. The tetramerized antibody bound to EGFR and CD16 simultaneously, according to results from flow cytometry and surface plasmon resonance spectroscopy, respectively. Furthermore, we demonstrated that the bispecific antibody showed cytotoxic activity against EGFR‐expressing tumor cells by using CD16‐positive lymphocytes as effectors, and its cytotoxicity was comparable to that of a commercial therapeutic antibody. Taken together, the results show that our method has high potential for the cost‐efficient production of highly active therapeutic antibodies.
Temperature, precipitation, and insolation effects on autumn vegetation phenology in temperate China
Authors: Liu Qiang , Fu Yongshuo H. , Zeng Zhenzhong , Huang Mengtian , Li Xiran , Piao Shilong
Published: September 2015

Autumn phenology plays a critical role in regulating climate–biosphere interactions. However, the climatic drivers of autumn phenology remain unclear. In this study, we applied four methods to estimate the date of the end of the growing season (EOS) across China's temperate biomes based on a 30‐year normalized difference vegetation index (NDVI) dataset from Global Inventory Modeling and Mapping Studies (GIMMS). We investigated the relationships of EOS with temperature, precipitation sum, and insolation sum over the preseason periods by computing temporal partial correlation coefficients. The results showed that the EOS date was delayed in temperate China by an average rate at 0.12 ± 0.01 days per year over the time period of 1982–2011. EOS of dry grassland in Inner Mongolia was advanced. Temporal trends of EOS determined across the four methods were similar in sign, but different in magnitude. Consistent with previous studies, we observed positive correlations between temperature and EOS. Interestingly, the sum of precipitation and insolation during the preseason was also associated with EOS, but their effects were biome dependent. For the forest biomes, except for evergreen needle‐leaf forests, the EOS dates were positively associated with insolation sum over the preseason, whereas for dry grassland, the precipitation over the preseason was more dominant. Our results confirmed the importance of temperature on phenological processes in autumn, and further suggested that both precipitation and insolation should be considered to improve the performance of autumn phenology models.
Impact of the combination of cognitive and balance training on gait, fear and risk of falling and quality of life in seniors with mild cognitive impairment
Authors: Hagovská Magdaléna , Olekszyová Zuzana
Published: September 2015

Aim

To investigate the effect of specific cognitive training with CogniPlus and balance training, affecting cognitive functioning, gait speed, risk and fear of falling, and quality of life in an elderly cohort with mild cognitive impairment.

Methods

The research sample was composed of 80 older adults with a mild cognitive deficit (mean age 67.07 years) divided into the experimental group (n = 40) and control group (n = 40). This was a randomized, controlled trial. The experimental group carried out selected exercises from the CogniPlus program combined with balance training. Patients participated in 20 sessions twice per week in an outpatient clinic. Both groups completed 30 min of balance training daily for 10 weeks. Cognitive functions were evaluated by the Mini‐Mental State Examination. The fear of falling was assessed by Falls Efficacy Scale‐I. The static and dynamic aspects of balance were assessed by the Tinetti test and functional stretching. Gait speed was assessed by four forms of the Timed Up & Go test. Quality of life was investigated according to Spitzer.

Results

The two groups showed significant differences recorded after training in the Mini‐Mental State Examination, Up and Go test with dual tasking, balance by Tinetti test and the quality of life in favor of the experimental group (P < 0.03–0.0001). There were no significant differences found between the groups in the assessment of fear of falling and other monitored parameters.

Conclusions

The combination of selected exercises from the CogniPlus program with balance training contributed to achieving better results than balance training alone for elderly people with mild cognitive impairment. Geriatr Gerontol Int 2016; 16: 1043–1050.
Enhancing homework adherence of Chinese older adults: A case study using Instrumental Reminiscence Intervention
Authors: Lou Vivian Wei Qun , Au Judith Wing Nam , Choy Jacky Chak Pui
Published: September 2015

Aim

The present study aimed to examine effective clinical strategies that facilitate homework adherence among Chinese older adults who participated in group therapy using Instrumental Reminiscence Intervention (IRI) to reduce depressive symptoms.

Methods

Examination was based on IRI for 15 groups of older adults, with four to eight participants in each group. Homework assignment was included as a core component of the intervention in each session, except the first session. Particular emphasis was put on both homework design and assignment strategies.

Results

Two effective strategies were developed. The first was the development of a tactic card as a tool for homework content and assignment. The second strategy was interventionist training. Clinical examples are used to illustrate how these strategies can enhance homework adherence in a Chinese context.

Conclusions

The two clinical strategies were found to be effective in enhancing homework adherence among Chinese older participants in a group therapy setting. These strategies are recommended for use in group clinical settings for Chinese participants. Geriatr Gerontol Int 2016; 16: 1153–1160.
Homotopy Perturbation Method‐Based Analytical Solution for Tide‐Induced Groundwater Fluctuations
Authors: Munusamy Selva Balaji , Dhar Anirban
Published: September 2015

The groundwater variations in unconfined aquifers are governed by the nonlinear Boussinesq's equation. Analytical solution for groundwater fluctuations in coastal aquifers under tidal forcing can be solved using perturbation methods. However, the perturbation parameters should be properly selected and predefined for traditional perturbation methods. In this study, a new dimensional, higher‐order analytical solution for groundwater fluctuations is proposed by using the homotopy perturbation method with a virtual perturbation parameter. Parameter‐expansion method is used to remove the secular terms generated during the solution process. The solution does not require any predefined perturbation parameter and valid for higher values of amplitude parameter A/D, where A is the amplitude of the tide and D is the aquifer thickness.
Spondyloarthropathy in inflammatory bowel disease patients on TNF inhibitors
Authors: Subramaniam K. , Tymms K. , Shadbolt B. , Pavli P.
Published: September 2015

Background

Musculoskeletal symptoms are the most common extra‐intestinal manifestation associated with inflammatory bowel disease (IBD). Spondyloarthritis (SpA) is an umbrella term applied to a group of rheumatic diseases with some features in common and others distinct from other inflammatory arthritides.

Aim

To determine self‐reported prevalence of SpA associated musculoskeletal manifestations in an IBD cohort on tumour necrosis factor (TNF) inhibitors using a questionnaire incorporating Assessment of SpondyloArthritis International Society (ASAS) criteria.

Methods

Consecutive IBD patients on TNF inhibitors attending a single IBD centre (May–September 2011) were asked to complete a SpA questionnaire. Data collected included SpA and IBD variables, demographics, concurrent medications, co‐morbidities and autoimmune serology.

Results

The 140‐patient cohort included 96 suffering from Crohn disease and 44 from ulcerative colitis. The mean age of disease onset was 29.3 years and 45% were men. Concurrent or past history of inflammatory back pain was reported by 29% subjects. Using the imaging and clinical arms of the ASAS criteria, 30% and 14% subjects respectively had axial SpA. Arthritis was reported by 34%, enthesitis 17%, dactylitis 4%, uveitis 6%, psoriasis 6% and a family history of SpA in 39%. Peripheral SpA was present in 41% by the ASAS criteria. There were no differences in these frequencies between Crohn disease and ulcerative colitis. A positive antinuclear antibodies (>1:80) was found in 19% before commencement of TNF inhibitor therapy and increased to 78% on therapy. Clinical drug‐induced lupus erythematosus was uncommon (4%) and was characterised by new clinical signs and symptoms, including arthralgia, rash with elevated dsDNA titres and positive antinuclear antibodies.

Conclusions

Inflammatory bowel disease patients on TNF inhibitors frequently reported musculoskeletal manifestations. Increased recognition of SpA occurred with use of an SpA self‐reported questionnaire in IBD patients: this could alter management and improve patient outcomes. Clinical drug‐induced lupus erythematosus was uncommon.
Hypertension Control Cascade: A Framework to Improve Hypertension Awareness, Treatment, and Control
Authors: Wozniak Gregory , Khan Tamkeen , Gillespie Cathleen , Sifuentes Lori , Hasan Omar , Ritchey Matthew , Kmetik Karen , Wynia Matthew
Published: September 2015

Evidence‐based interventions differ for increasing hypertension awareness, treatment, and control and should be targeted for specific patient panels. This study developed a hypertension control cascade to identify patients with a usual source of care represented at each level of the cascade using the 2007–2012 National Health and Nutrition Examination Survey. Overall, 10.7 million adults in the United States were unaware of their condition, 3.8 million were aware but untreated, and 15.8 million were treated but uncontrolled. The results also suggest that failure to attain hypertension control because of lack of awareness or lack of treatment despite awareness occurs mainly among younger individuals and those with no annual healthcare visits, while the elderly and minorities are more likely to remain uncontrolled when aware and treated. Opportunities to leverage population health management functions in electronic health information systems to align the specific patient subgroups facing barriers to hypertension control at each level of the cascade with targeted hypertension management interventions are discussed.
The IκB kinase inhibitor ACHP strongly attenuates TGFβ1‐induced myofibroblast formation and collagen synthesis
Authors: Mia Masum M. , Bank Ruud A.
Published: September 2015

Excessive accumulation of a collagen‐rich extracellular matrix (ECM) by myofibroblasts is a characteristic feature of fibrosis, a pathological state leading to serious organ dysfunction. Transforming growth factor beta1 (TGFβ1) is a strong inducer of myofibroblast formation and subsequent collagen production. Currently, there are no remedies for the treatment of fibrosis. Activation of the nuclear factor kappa B (NF‐κB) pathway by phosphorylating IκB with the enzyme IκB kinase (IKK) plays a major role in the induction of fibrosis. ACHP {2‐Amino‐6‐[2‐(cyclopropylmethoxy)‐6‐hydroxyphenyl]‐4‐(4‐piperidinyl)‐3 pyridinecarbonitrile}, a selective inhibitor of IKK, prohibits the activation of the NF‐κB pathway. It is not known whether ACHP has potential anti‐fibrotic properties. Using adult human dermal and lung fibroblasts we have investigated whether ACHP has the ability to inhibit the TGFβ1‐induced transition of fibroblasts into myofibroblasts and its excessive synthesis of ECM. The presence of ACHP strongly suppressed the induction of the myofibroblast markers alpha‐smooth muscle actin (αSMA) and SM22α, as well as the deposition of the ECM components collagen type I and fibronectin. Furthermore, post‐treatment with ACHP partly reversed the expression of αSMA and collagen type I production. Finally, ACHP suppressed the expression of the three collagen‐modifying enzymes lysyl hydroxylase (PLOD1, PLOD2 and PLOD3) in dermal fibroblasts, but did not do so in lung fibroblasts. We conclude that the IKK inhibitor ACHP has potent antifibrotic properties, and that the NF‐κB pathway plays an important role in myofibroblast biology.
Real‐life effectiveness of once‐daily calcipotriol and betamethasone dipropionate gel vs. ointment formulations in psoriasis vulgaris: final analysis of the 52‐week PRO‐long study
Authors: Lambert J. , Hol C.W. , Vink J.
Published: September 2015

Background

Topical therapies are the mainstay of treatment for psoriasis vulgaris. The fixed combination of calcipotriol (Cal) 50 μg/g plus betamethasone 0.5 mg/g (as dipropionate; BD) is a first‐line topical treatment and available as a gel or ointment. The use of these fixed combination products was compared in PRO‐long, a long‐term noninterventional study, for which interim results (4 and 12 weeks) have previously been reported.

Objective

To describe and compare patients’ perspectives on the fixed combination gel and ointment formulations; to include efficacy, adherence behaviour, treatment satisfaction and health‐related quality of life (HRQoL) aspects during long‐term real‐life psoriasis management.

Methods

PRO‐long was a multicentre, prospective, observational, 52‐week study of patients prescribed fixed combination Cal/BD gel or ointment in clinical practice. For final analysis the following were assessed at weeks 24, 36 and 52: differences in the proportion of patients with ‘mild’/‘very mild’ disease according to patient's global assessment of disease severity, adherence behaviour, treatment satisfaction (nine‐item treatment satisfaction questionnaire for medication) and HRQoL (Skindex‐29).

Results

Patients (n = 328) were prescribed once‐daily Cal/BD gel (n = 152) or ointment (n = 176). At week 52, a higher proportion of patients reported that the severity of their psoriasis was ‘mild’/‘very mild’ vs. baseline (gel: 60.2 vs. 47.1%; ointment: 58.8 vs. 42.4%), with greater treatment satisfaction reported in patients using gel vs. those using ointment. A higher proportion of patients found the gel ‘easy’ to use compared with the ointment (66.7 vs. 45.2%). Daily application of treatment took ≤5 min for 86.1% of patients using gel and 71.0% of patients using ointment.

Conclusion

This real‐life study has demonstrated similar effectiveness between the Cal/BD formulations. However, over a 52‐week treatment period, patients reported greater treatment satisfaction with the gel, which was considered easier to use, faster to apply and overall a more convenient product.
INDUSTRY MOMENTUM IN AN EARLIER TIME: EVIDENCE FROM THE COWLES DATA
Authors: Szakmary Andrew C. , Zhou Xiwen
Published: September 2015

Virtually all evidence on the efficacy of momentum strategies arises from the post‐1962 era, and momentum returns across different markets and asset classes are highly positively correlated. We examine industry momentum in an earlier time and find that these strategies would have earned gross returns over the 1900–1925 period that are at least equal to those in the modern era; however, there is little evidence of profitability before 1900. The paucity of industry coverage in the earlier years of the Cowles database likely does not explain this differential profitability. We also show that the market state dependence of momentum strategies in the 1900–1925 period is similar to the modern era.
Microvascular and Macrovascular Abnormalities and Cognitive and Physical Function in Older Adults: Cardiovascular Health Study
Authors: Kim Dae Hyun , Grodstein Francine , Newman Anne B. , Chaves Paulo H. M. , Odden Michelle C. , Klein Ronald , Sarnak Mark J. , Lipsitz Lewis A.
Published: September 2015

Objectives

To evaluate and compare the associations between microvascular and macrovascular abnormalities and cognitive and physical function

Design

Cross‐sectional analysis of the Cardiovascular Health Study (1998–1999).

Setting

Community.

Participants

Individuals with available data on three or more of five microvascular abnormalities (brain, retina, kidney) and three or more of six macrovascular abnormalities (brain, carotid artery, heart, peripheral artery) (N = 2,452; mean age 79.5).

Measurements

Standardized composite scores derived from three cognitive tests (Modified Mini‐Mental State Examination, Digit‐Symbol Substitution Test, Trail‐Making Test (TMT)) and three physical tests (gait speed, grip strength, 5‐time sit to stand)

Results

Participants with high microvascular and macrovascular burden had worse cognitive (mean score difference = −0.30, 95% confidence interval (CI) = −0.37 to −0.24) and physical (mean score difference = −0.32, 95% CI = −0.38 to −0.26) function than those with low microvascular and macrovascular burden. Individuals with high microvascular burden alone had similarly lower scores than those with high macrovascular burden alone (cognitive function: −0.16, 95% CI = −0.24 to −0.08 vs −0.13, 95% CI = −0.20 to −0.06; physical function: −0.15, 95% CI = −0.22 to −0.08 vs −0.12, 95% CI = −0.18 to −0.06). Psychomotor speed and working memory, assessed using the TMT, were only impaired in the presence of high microvascular burden. Of the 11 vascular abnormalities considered, white matter hyperintensity, cystatin C–based glomerular filtration rate, large brain infarct, and ankle–arm index were independently associated with cognitive and physical function.

Conclusion

Microvascular and macrovascular abnormalities assessed using noninvasive tests of the brain, kidney, and peripheral artery were independently associated with poor cognitive and physical function in older adults. Future research should evaluate the usefulness of these tests in prognostication.
Shared Environment Estimates for Educational Attainment: A Puzzle and Possible Solutions
Authors: Freese Jeremy , Jao Yu‐Han
Published: September 2015

Classical behavioral genetics models for twin and other family designs decompose traits into heritability, shared environment, and nonshared environment components. Estimates of heritability of adult traits are pervasively observed to be far higher than those of shared environment, which has been used to make broad claims about the impotence of upbringing. However, the most commonly studied nondemographic variable in many areas of social science, educational attainment, exhibits robustly high estimates both for heritability and for shared environment. When previously noticed, the usual explanation has emphasized family resources, but evidence suggests this is unlikely to explain the anomalous high estimates for shared environment of educational attainment. We articulate eight potential complementary explanations and discuss evidence of their prospective contributions to resolving the puzzle. In so doing, we hope to further consideration of how behavioral genetics findings may advance studies of social stratification beyond the effort to articulate specific genetic influences.
Career satisfaction of Pennsylvanian dentists and dental hygienists and their plans to leave direct patient care
Authors: Vick Brandon
Published: September 2015

Objective

The aim of this study is to explore a number of practice‐related dynamics between dentists and dental hygienists, including their career dissatisfaction, plans to leave direct patient care, hiring difficulties, and full‐time work.

Methods

Data come from the 2013 Pennsylvania Health Workforce Surveys, a sample of 5,771 dentists and 6,023 dental hygienists, and logistic regression is used to estimate the relationships between outcome areas – dissatisfaction, plans to leave patient care, and hiring/job outcomes – and a number of explanatory variables, including demographic and practice characteristics.

Results

Dentists working in practices that employ hygienists have lower odds of reporting overall dissatisfaction and of leaving patient care in the next 6 years than those that do not employ hygienists. Dental hygienists that work full‐time hours across two or more jobs have higher odds of dissatisfaction than those who work full‐time in one job only. Part‐time work in a single hygienist job is associated with higher odds of leaving the career, relative to having a single, full‐time job.

Conclusions

Results suggest that employment of dental hygienists is associated with lower career dissatisfaction and extended careers for dentists. However, a number of dentist characteristics are associated with difficulty hiring hygienists, including rural practice, nonwhite race, and solo ownership. Only 37.5 percent of hygienists work in a single, full‐time job, an outcome related to lower dissatisfaction and extended careers for hygienists. Characteristics associated with this job outcome include having an associate degree, having a local anesthesia permit, and not working for a solo practice.
Asynchronous spawning in sympatric populations of a hard coral reveals cryptic species and ancient genetic lineages
Authors: Rosser Natalie L.
Published: September 2015

Genetic subdivision within a species is a vital component of the evolution of biodiversity. In some species of Acropora corals in Western Australia, conspecific individuals spawn in two seasons 6 months apart, which has the potential to impede gene flow and result in genetic divergence. Genetic comparison of sympatric spring and autumn spawners of Acropora samoensis was conducted to assess the level of reproductive isolation and genetic divergence between the spawning groups based on multiple loci (13 microsatellite loci, the mitochondrial control region and two nuclear introns). Bayesian clustering and principal coordinate analysis of the microsatellite loci showed a high level of genetic differentiation between the spawning groups (F’ST = 0.30; P < 0.001), as did the sequence data from PaxC and Calmodulin (ΦST = 0.97 and 0.31, respectively). At the PaxC locus, the autumn and spring spawners were associated with two divergent lineages that were separated by an evolutionary distance of 1.7% and statistical tests indicate divergent selection in PaxC, suggesting this gene may play a role in coral spawning. This study indicates that the autumn and spring spawners represent two cryptic species, and highlights the importance of asynchronous spawning as a mechanism influencing speciation in corals.
MntR(Rv2788): a transcriptional regulator that controls manganese homeostasis in Mycobacterium tuberculosis
Authors: Pandey Ruchi , Russo Riccardo , Ghanny Saleena , Huang Xiaojuan , Helmann John , Rodriguez G. Marcela
Published: September 2015

The pathogenic mycobacterium Mycobacterium tuberculosis encodes two members of the DtxR/MntR family of metalloregulators, IdeR and SirR. IdeR represses gene expression in response to ferrous iron, and we here demonstrate that SirR (Rv2788), although also annotated as an iron‐dependent repressor, functions instead as a manganese‐dependent transcriptional repressor and is therefore renamed MntR. MntR regulates transporters that promote manganese import and genes that respond to metal ion deficiency such as the esx3 system. Repression of manganese import by MntR is essential for survival of M. tuberculosis under conditions of high manganese availability, but mntR is dispensable during infection. In contrast, manganese import by MntH and MntABCD was found to be indispensable for replication of M. tuberculosis in macrophages. These results suggest that manganese is limiting in the host and that interfering with import of this essential metal may be an effective strategy to attenuate M. tuberculosis.
A novel archaeal DNA repair factor that acts with the UvrABC system to repair mitomycin C‐induced DNA damage in a PCNA‐dependent manner
Authors: Giroux Xavier , MacNeill Stuart A.
Published: September 2015

The sliding clamp proliferating cell nuclear antigen (PCNA) plays a vital role in a number of DNA repair pathways in eukaryotes and archaea by acting as a stable platform onto which other essential protein factors assemble. Many of these proteins interact with PCNA via a short peptide sequence known as a PIP (PCNA interacting protein) motif. Here we describe the identification and functional analysis of a novel PCNA interacting protein NreA that is conserved in the archaea and that has a PIP motif at its C‐terminus. Using the genetically tractable euryarchaeon Haloferax volcanii as a model system, we show that the NreA protein is not required for cell viability but that loss of NreA (or replacement of the wild‐type protein with a truncated version lacking the C‐terminal PIP motif) results in an increased sensitivity to the DNA damaging agent mitomycin C (MMC) that correlates with delayed repair of MMC‐induced chromosomal DNA damage monitored by pulsed‐field gel electrophoresis. Genetic epistasis analysis in Hfx. volcanii suggests that NreA works together with the UvrABC proteins in repairing DNA damage resulting from exposure to MMC. The wide distribution of NreA family members implies an important role for the protein in DNA damage repair in all archaeal lineages.
Southern right whale (Eubalaena australis) calf mortality at Península Valdés, Argentina: Are harmful algal blooms to blame?
Authors: Wilson Cara , Sastre A. Viviana , Hoffmeyer Monica , Rowntree Victoria J. , Fire Spencer E. , Santinelli Norma H. , Ovejero Soledad Díaz , D'Agostino Valeria , Marón Carina F. , Doucette Gregory J. , Broadwater Margaret H. , Wang Zhihong , Montoya Nora , Seger Jon , Adler Frederick R. , Sironi Mariano , Uhart Marcela M.
Published: September 2015

Península Valdés (PV) in Argentina is an important calving ground for southern right whales (SRWs, Eubalaena australis). Since 2005, right whale mortality has increased at PV, with most of the deaths (~90%) being calves <3 mo old. We investigated the potential involvement of harmful algal blooms (HABs) in these deaths by examining data that include: timing of the SRW deaths, biotoxins in samples from dead SRWs, abundances of the diatom, Pseudo‐nitzschia spp., and the dinoflagellate, Alexandrium tamarense, shellfish harvesting closure dates, seasonal availability of whale prey at PV and satellite chlorophyll data. Evidence of the whales' exposure to HAB toxins includes trace levels of paralytic shellfish toxins (PSTs) and domoic acid (DA) in tissues of some dead whales, and fragments of Pseudo‐nitzschia spp. frustules in whale feces. Additionally, whales are present at PV during both closures of the shellfish industry (due to high levels of PSTs) and periods with high levels of Pseudo‐nitzschia spp. and A. tamarense. There is a positive statistical relationship between monthly Pseudo‐nitzschia densities (but not A. tamarense) and calf deaths in both gulfs of PV.
Severe Extravasation Injuries in Neonates: A Report of 34 Cases
Authors: Kostogloudis Nikolaos , Demiri Efterpi , Tsimponis Antonios , Dionyssiou Dimitrios , Ioannidis Sotirios , Chatziioannidis Ilias , Nikolaidis Nikolaos
Published: September 2015

Introduction

Extravasation injuries are a common and challenging problem in hospitalized newborns. Accidental infusion leakage into the surrounding tissues in immature infants may frequently result in skin necrosis, with significant risk of functional and cosmetic impairment.

Material and Methods

In the present study we reviewed 34 cases of severe extravasation injuries occurring in 1,409 neonates hospitalized in a single neonatal unit over 24 months (incidence 2.4%). Total parenteral nutrition solutions were involved in most cases. All patients were treated within 30 minutes after the injury was recorded using a flush‐out technique with normal saline irrigation and occlusive paraffin dressings of the infiltrated area.

Results

The majority of injuries affected preterm, low‐birthweight infants (mean gestation 32 wks + 6 days, mean birth weight 1,885 g), with a mean age at the time of injury of 11.6 days and a mean weight of 2,045 g. Neither gestational age (p = 0.87) or birthweight significantly affected (p = 0.07) the incidence of extravasation injuries, although the incidence of skin necrosis had a significant correlation with gestational age (p = 0.009) and birthweight (p < 0.001). All patients responded well to treatment and their wounds healed uneventfully within a maximum of 25 days without the need for secondary surgery for skin coverage.

Conclusion

Extravasation injuries in extremely preterm and low‐birthweight infants are more likely to lead to skin necrosis. Peripheral venous catheterization should be performed with caution in these patients to prevent such injuries. Immediate irrigation with normal saline is recommended to reduce toxic sequelae in the infiltrated area.
Extensive and Progressing Congenital Dermal Melanocytosis Leading to Diagnosis of GM1 Gangliosidosis
Authors: Vedak Priyanka , Sells Ryan , De Souza Aieska , Hoang Mai P. , Kroshinsky Daniela
Published: September 2015

Congenital dermal melanocytosis (CDM) is a birthmark composed of macular blue‐grey hyperpigmentation commonly observed in the lumbosacral region of infants. Generally resolving by childhood, it is traditionally considered a benign condition, but it may be a sign of underlying lysosomal storage disease. We report a case of biopsy‐confirmed CDM in a 2‐month‐old girl of Brazilian descent later diagnosed with infantile GM1 gangliosidosis.
Mosaic Neurofibromatosis Type 1: A Systematic Review
Authors: García‐Romero Maria Teresa , Parkin Patricia , Lara‐Corrales Irene
Published: September 2015

Confusion is widespread regarding segmental or mosaic neurofibromatosis type 1 (MNF1). Physicians should use the same terms and be aware of its comorbidities and risks. The objective of the current study was to identify and synthesize data for cases of MNF1 published from 1977 to 2012 to better understand its significance and associations. After a literature search in PubMed, we reviewed all available relevant articles and abstracted and synthetized the relevant clinical data about manifestations, associated findings, family history and genetic testing. We identified 111 articles reporting 320 individuals. Most had pigmentary changes or neurofibromas only. Individuals with pigmentary changes alone were identified at a younger age. Seventy‐six percent had localized MNF1 restricted to one segment; the remainder had generalized MNF1. Of 157 case reports, 29% had complications associated with NF1. In one large case series, 6.5% had offspring with complete NF1. The terms “segmental” and “type V” neurofibromatosis should be abandoned, and the correct term, mosaic NF1 (MNF1), should be used. All individuals with suspected MNF1 should have a complete physical examination, genetic testing of blood and skin, counseling, and health surveillance.
Recent Work on the Nature and Development of Delusions
Authors: Bortolotti Lisa , Miyazono Kengo
Published: September 2015

In this paper we review two debates in the current literature on clinical delusions. One debate is about what delusions are. If delusions are beliefs, why are they described as failing to play the causal roles that characterise beliefs, such as being responsive to evidence and guiding action? The other debate is about how delusions develop. What processes lead people to form delusions and maintain them in the face of challenges and counter‐evidence? Do the formation and maintenance of delusions require abnormal experience alone, or also reasoning biases or deficits? We hope to show that the focus on delusions has made a substantial contribution to the philosophy of the mind and continues to raise issues that are central to defining the concept of belief and gaining a better understanding of how people process information and learn about the world.
On the roles of distinctiveness and semantic expectancies in episodic encoding of emotional words
Authors: Kamp Siri‐Maria , Potts Geoffrey F. , Donchin Emanuel
Published: September 2015

We examined the factors that contribute to enhanced recall for emotionally arousing words by analyzing behavioral performance, the P300 as an index of distinctiveness, and the N400 as an index of semantic expectancy violation in a modified Von Restorff paradigm. While their EEG was recorded, participants studied three list types (1) neutral words including one emotionally arousing isolate (either positive or negative), (2) arousing, negative words including one neutral isolate, or (3) arousing, positive words including one neutral isolate. Immediately after each list, free recall was tested. Negative, but not positive, words exhibited enhanced recall when presented as isolates in lists of neutral words and elicited a larger P300 for subsequently recalled than not‐recalled words. This suggests that arousing, negative words stand out and that their distinctiveness contributes to their superior recall. Positive valence had an enhancing effect on recall only when the list contained mostly other positive words. Neutral isolates placed in either positive or negative lists elicited an N400, suggesting that semantic expectations developed in emotional word lists regardless of valence. However, semantic relatedness appeared to more strongly contribute to recall for positive than negative words. Our results suggest that distinctiveness and semantic relatedness contribute to episodic encoding of arousing words, but the impact of each factor depends on both a word's valence and its context.
Barriers and facilitators to dental care among HIV‐Infected adults
Authors: Parish Carrigan , Siegel Karolynn , Pereyra Margaret , Liguori Terri , Metsch Lisa
Published: September 2015

Oral health problems can significantly compromise HIV‐infected individuals’ general health and well‐being, yet many of them experience an unmet need for oral care. The barriers and facilitators of obtaining dental care in a sample of HIV‐infected adults, all of whom were eligible for Ryan White Part A funding for their treatment, were investigated through qualitative interviews with HIV‐positive individuals who had not received dental services in the prior 12 months (n = 44). Identified barriers were as follows: (1) dental anxiety and fear, (2) cumbersome administrative procedures, (3) long waits at the dental office, (4) problem focused care‐seeking behavior, (5) transportation difficulties, (6) dentists’ reluctance to treat people like them, and (7) psychological issues. Identified facilitating factors were as follows: (1) coverage for dental care, (2) being treated with respect and acceptance, and (3) having an assigned case manager or social worker. Many of the barriers uncovered in this qualitative study can be addressed and overcome by case management services, but other approaches are needed to address the additional psychological and stigma‐related factors that are impeding access to oral healthcare in this population.