bluuebunny/crossref_metadata_2025 huggingface dataset:
Leydig cell insufficiency in hypospermatogenesis: a paracrine effect of activin–inhibin signaling?
Authors: Winters S. J. , Moore J. P. , Clark B. J.
Published: February 2018

Clinical findings and a variety of experimental models indicate that Leydig cell dysfunction accompanies damage to the seminiferous tubules with increasing severity. Most studies support the idea that intratesticular signaling from the seminiferous tubules to Leydig cells regulates steroidogenesis, which is disrupted when hypospermatogenesis occurs. Sertoli cells seem to play a pivotal role in this process. In this review, we summarize relevant clinical and experimental observations and present evidence to support the hypothesis that testicular activin signaling and its regulation by testicular inhibin may link seminiferous tubular dysfunction to reduced testosterone biosynthesis.
Hemodynamic Effects of Connection to Continuous Renal Replacement Therapy in a Pediatric Animal Model
Authors: Fernández Lafever Sarah Nicole , Santiago Maria Jose , López Jorge , González Rafael , Solana María José , Urbano Javier , Lopez‐Herce Jesus
Published: February 2018

To assess the hemodynamic effects of connection to continuous renal replacement therapy (CRRT) in a pediatric experimental animal model. Prospective experimental study was performed using piglets between 2 and 3 months of age and 9–11 kg. CRRT with a PrismaflexR monitor and HF20 filter (surface of 0.2 m2) was started after monitoring and anesthetic induction with an initial blood flow at 20 mL/min with 10 mL/min increases every minute until the goal flow of 5 mL/kg/min was achieved. Heart rate, blood pressure, central venous pressure, cardiac index, and renal blood flow were registered at baseline, 5, 15, 30, 60, 120, 180, 240, and 360 min. IBM SPSS Statistics 20.0 package was used for analysis. A P value of <0.05 was considered statistically significant. Thirty‐four piglets were studied. Blood pressure, cardiac output, and systemic vascular resistance significantly decreased 5‐min after CRRT connection (mean arterial pressure from 85.5 to 70.8 mm Hg, P < 0.001, cardiac index from 3.6 to 3.3 L/min/m2 P = 0.024, and systemic vascular resistance index from 1759 to 1607 dyn.s/cm5 P = 0.012). No significant changes were found in renal blood flow or central venous pressure. All parameters gradually increased at 15 and 30 min after connection but complete recovery was never achieved. Connection to CRRT produces a significant decrease in arterial pressure, cardiac index, and peripheral vascular resistances in hemodynamically stable piglets.
Proactive telephone support provided to breastfeeding mothers of preterm infants after discharge: a randomised controlled trial
Authors: Ericson Jenny , Eriksson Mats , Hellström‐Westas Lena , Hoddinott Pat , Flacking Renée
Published: February 2018

Aim

The aim was to evaluate the effectiveness of proactive telephone support provided to breastfeeding mothers of preterm infants after discharge from neonatal intensive care units (NICU).

Methods

Between March 2013 and December 2015, a randomised controlled trial was conducted at six NICUs across Sweden. At each NICU, a breastfeeding support team recruited, randomised and delivered the support to participating mothers. The intervention group received a daily proactive telephone call up to 14 days after discharge from the support team. The control group could initiate telephone contact themselves. Primary outcome was exclusive breastfeeding eight weeks after discharge. Secondary outcomes were maternal satisfaction with breastfeeding, attachment, quality of life and parental stress.

Results

In total, 493 mothers were randomised, 231 to intervention group and 262 to control group. There were no differences between the groups for exclusive breastfeeding, odds ratio 0.96, 95% CI 0.66–1.38, nor for maternal satisfaction with breastfeeding, attachment or quality of life. The intervention group reported significantly less parental stress than the controls, t = 2.44, 95% CI 0.03–0.23, effect size d = 0.26.

Conclusion

In this trial, proactive telephone support was not associated with increased exclusive breastfeeding prevalence eight weeks following discharge. However, intervention group mothers showed significantly lower parental stress.
Nutritional therapy complications in children with ultra‐short bowel syndrome include growth deficiency but not cholestasis
Authors: Olszewska Katarzyna , Ksiazyk Janusz , Kozlowski Dariusz , Pajdowska Magdalena , Janusz Malgorzata , Jaworski Maciej
Published: February 2018

Aim

Children with ultra‐short bowel syndrome (USBS) have not been extensively studied to date because the condition is rare. The aim of the study was to assess the nutritional status of children with USBS receiving home parenteral nutrition, using citrulline serum concentration and cholestasis.

Methods

We studied 17 patients with USBS, with a median age of 6.6 years and median duration of parenteral nutrition of 6.6 years. The study was carried out at The Children's Memorial Health Institute, Warsaw, from January 2014 to January 2015.

Results

The median standard deviation score (SDS) was −1.2 for body mass according to chronological age, −1.72 according to height and −0.59 according to height for age. Patients requiring seven days per week parenteral nutrition had a citrulline concentration below 10 μmol/L. Decreased bone‐mineral density was observed in 87% of the patients. Low values of 25‐hydroxyvitamin D were found in 53% of the children. None of the patients had elevated conjugated bilirubin levels above 34.2 μmol/L.

Conclusion

Children with USBS were growth deficient according to their chronological age, with frequent abnormal bone mineralisation and vitamin D deficiency. Children requiring parenteral nutrition seven days a week had citrulline concentrations below 10 μmol/L. Cholestasis was not seen.
The free androgen index is inaccurate in women when the SHBG concentration is low
Authors: Keevil Brian G. , Adaway Jo , Fiers Tom , Moghetti Paolo , Kaufman Jean‐Marc
Published: February 2018

Objective/Context

The free androgen index (FAI) is known to give erroneous results in men, but it is still a commonly used test for the investigation of hyperandrogenism in women. This study aimed to compare the results of the FAI with the gold standard equilibrium dialysis method for free testosterone in women.

Design/Patients

Free serum testosterone T (ED‐T) and total serum T (T) were measured by equilibrium dialysis and LC‐MS/MS in patients with polycystic ovarian syndrome (n = 130), normal female controls (n = 53) and normal males (n = 120). Calculated free T (cFT) and free androgen index (FAI) were also measured in these patients. In addition, cFT was retrospectively calculated in 4223 female patients with a normal T (<1.6 nmol/L) routinely investigated for hyperandrogenism.

Results

The cFT showed good agreement with measured ED‐T, and the ratio cFT/ED‐T was stable across all SHBG concentrations. In contrast, the FAI/ED‐T ratio and the FAI/cFT ratio increased when the concentration of SHBG fell below 30 nmol/L.

Conclusions

The FAI is not a reliable indicator of free T when the SHBG concentration is low and would give misleading information in a large number of women being investigated for hyperandrogenism.
Novel mechanism and biomarker of chronic progressive multiple sclerosis
Authors: Oki Shinji
Published: February 2018

Recent progress in understanding the pathogenicity of multiple sclerosis (MS) has enabled us to develop new drug entities available in the clinic. However, we still have not succeeded in preventing conversion from relapsing–remitting MS to secondary progressive MS (SP‐MS), and in curing this intractable form of MS. Furthermore, diagnosis is usually retrospective, relying on gradual worsening of neurological signs/symptoms. This is due to the lack of understanding of the pathogenicity driving disease progression in MS and of reliable biomarkers reflecting the disease status. Two relevant components are involved in the brain pathology of SP‐MS: neurodegeneration and inflammation. Neurodegeneration can occur spontaneously in a neuron‐intrinsic manner under chronic inflammation, such as glutamate excitotoxicity, mitochondrial/oxidative injury with iron deposit in the brain and loss of trophic support. Meanwhile, inflammatory and/or immune cells stimulated after repeated relapses, including T cells, B cells, and myeloid cells of peripheral and central nervous system origin, could mediate the processes of neurodegeneration. Among them, a higher frequency of leptomeningeal follicle‐like structures observed in SP‐MS patients suggests that immune cells sheltered behind a blood–brain barrier are still active under smoldering central nervous system inflammation. Accordingly, our recent comparative analysis between MS and its animal model, experimental autoimmune encephalomyelitis, raises a new possibility that ectopic expression of eomesodermin in helper T cells constitutes a previously unappreciated subset of helper T cells with cytotoxic potential against neuronal cells. In the present review article, the mechanisms proposed in the pathogenesis of SP‐MS are summarized, and a new pathogenic mechanism for neurodegeneration mediated by unique cytotoxic helper T cells is proposed.
Expression of nerve growth factor carried by pseudotyped lentivirus improves neuron survival and cognitive functional recovery of post‐ischemia in rats
Authors: Cao Jia‐Yu , Lin Yong , Han Yan‐Fei , Ding Sheng‐Hao , Fan Yi‐Ling , Pan Yao‐Hua , Zhao Bing , Guo Qin‐Hua , Sun Wen‐Hua , Wan Jie‐Qing , Tong Xiao‐Ping
Published: February 2018

Aims

Nerve growth factor (NGF) has been reported to prevent neuronal damage and contributes to the functional recovery in animal brain injury models and human ischemic disease as well. We aimed to investigate a potential therapeutic effect of NGF gene treatment in ischemic stroke and to estimate the functional recovery both at the cellular and cognitive levels in an ischemia rat model.

Methods

After microinjection of pseudolentivirus‐delivered β‐NGF into an established ischemic stroke model in rats (tMCAO), we estimated neuronal cell apoptosis with TUNEL labeling and neurogenesis by cell proliferation marker Ki67 staining in both ischemic core and penumbra of striatum. Furthermore, we used behavioral functional tests, Morris water maze performance, to evaluate cognitive functional recovery in vivo and propose a potential underlying mechanism.

Results

We found that pseudolentivirus‐mediated delivery of β‐NGF gene into the brain induced high expression in striatum of the infarct core area after ischemia in rats. The β‐NGF overexpression in the striatal infarction core after ischemia not only improved neuronal survival by reducing cell apoptosis and increasing cell proliferation, but also rescued cognitive functional impairment through upregulation of GAP‐43 protein expression in tMCAO rat model of ischemia.

Conclusion

This study demonstrates a potential β‐NGF gene therapy by utilization of pseudolentivirus in ischemia and indicates future applications of NGF gene treatment in ischemic patients.
Effects of temperature and precipitation on grassland bird nesting success as mediated by patch size
Authors: Zuckerberg Benjamin , Ribic Christine A. , McCauley Lisa A.
Published: February 2018

Grassland birds are declining faster than any other bird guild across North America. Shrinking ranges and population declines are attributed to widespread habitat loss and increasingly fragmented landscapes of agriculture and other land uses that are misaligned with grassland bird conservation. Concurrent with habitat loss and degradation, temperate grasslands have been disproportionally affected by climate change relative to most other terrestrial biomes. Distributions of grassland birds often correlate with gradients in climate, but few researchers have explored the consequences of weather on the demography of grassland birds inhabiting a range of grassland fragments. To do so, we modeled the effects of temperature and precipitation on nesting success rates of 12 grassland bird species inhabiting a range of grassland patches across North America (21,000 nests from 81 individual studies). Higher amounts of precipitation in the preceding year were associated with higher nesting success, but wetter conditions during the active breeding season reduced nesting success. Extremely cold or hot conditions during the early breeding season were associated with lower rates of nesting success. The direct and indirect influence of temperature and precipitation on nesting success was moderated by grassland patch size. The positive effects of precipitation in the preceding year on nesting success were strongest in relatively small grassland patches and had little effect in large patches. Conversely, warm temperatures reduced nesting success in small grassland patches but increased nesting success in large patches. Mechanisms underlying these differences may be patch‐size‐induced variation in microclimates and predator activity. Although the exact cause is unclear, large grassland patches, the most common metric of grassland conservation, appears to moderate the effects of weather on grassland‐bird demography and could be an effective component of climate‐change adaptation.
Diverse actions of the modulatory peptide neurotensin on central synaptic transmission
Authors: Tschumi Christopher W. , Beckstead Michael J.
Published: February 2018

Neurotensin (NT) is a 13 amino acid neuropeptide that is expressed throughout the central nervous system and is implicated in the etiology of multiple diseases and disorders. Many primary investigations of NT‐induced modulation of neuronal excitability at the level of the synapse have been conducted, but they have not been summarized in review form in nearly 30 years. Therefore, the goal of this review is to discuss the many actions of NT on neuronal excitability across brain regions as well as NT circuit architecture. In the basal ganglia as well as other brain nuclei, NT can act through diverse intracellular signaling cascades to enhance or depress neuronal activity by modulating activity of ion channels, ionotropic and metabotropic neurotransmitter receptors, and presynaptic release of neurotransmitters. Further, NT can produce indirect effects by evoking endocannabinoid release, and recently has itself been identified as a putative retrograde messenger. In the basal ganglia, the diverse actions and circuit architecture of NT signaling allow for input‐specific control of reward‐related behaviors.
Novelty‐related behavior of young and adult dopamine transporter knockout rats: Implication for cognitive and emotional phenotypic patterns
Authors: Adinolfi A. , Carbone C. , Leo D. , Gainetdinov R. R. , Laviola G. , Adriani W.
Published: February 2018

Attention deficit hyperactivity disorder (ADHD) is a neuropsychiatric disorder characterized by a developmentally inappropriate, pervasive and persistent pattern of severe inattention, hyperactivity and impulsivity. Despite onset in early childhood, ADHD may continue into adulthood with substantial impairment in social, academic and occupational functioning. A new animal model of this disorder was developed in rats with genetic deletion of the dopamine transporter (DAT) gene (dopamine transporter knockout rats; DAT‐KO rats). We analyzed the behavior of DAT‐KO rats for a deeper phenotypical characterization of this model. We first tested rats of the 3 genotypes at different ages (preadolescent, adolescent and adult), in a novelty‐seeking test using a black/white box (Experiment 1). After that, we tested adult rats in a novelty‐preference test using a 3‐chamber apparatus with different shapes (Experiment 2). Experiment 1: as evidenced by analysis of time spent in the novel environment, adult DAT heterozygous (DAT‐HET) rats show an increased curiosity‐driven exploration compared with wild‐type (WT) controls while DAT‐KO rats did not recognize novelty. The locomotor activity data show a minimal difference between genotypes at adolescent age while the preadolescent and adult DAT‐KO rats have significantly increased activity rate compared with WT and DAT‐HET subjects. Experiment 2: in this case, due to more clearly evident spatial differences, time spent in novel environment was not significantly different among genotypes. During first 10 minutes, DAT‐KO rats showed a decreased hyperactivity, apparently related to curiosity and attention to the new environments. In conclusion, DAT‐KO rats may show some inattention while more novelty‐seeking traits appear in DAT‐HET rats.
Fabrication of graphitic carbon spheres and their application in Al2O3‐SiC‐C refractory castables
Authors: Li Saisai , Liu Jianghao , Wang Junkai , Zhu Qing , Zhao Xiaowei , Zhang Haijun , Zhang Shaowei
Published: February 2018

Graphitic carbon spheres (GCS) with an average diameter of about 0.8 μm were prepared via hydrothermal carbonization combined with catalytic graphitization using glucose and in situ formed Fe nanoparticles (NPs) as, respectively, a carbon precursor and catalyst. They were characterized by X‐ray diffraction (XRD), scanning electron microscopy (SEM), transmission electron microscopy (TEM), Raman spectroscopy, and thermogravimetric analysis/differential scanning calorimetry (TG/DSC). The optimal content of Fe catalyst for graphitization of amorphous CS was found to be 1.0 wt%, and the optimal temperature and soaking time were, respectively, 1473 K and 3 hours. The transformation from CS to GCS was considered to be dominated by the “dissolution‐precipitation” mechanism. Using as‐prepared GCS instead of flake graphite (FG) as a carbon source, not only reduced water demand for casting Al2O3‐SiC‐C samples and decreased their final apparent porosity, but also enhanced their modulus of rupture and cold crushing strength. In addition, castable samples using GCS showed better oxidation resistance than those using FG.
Remission of hyperglycemia after withdrawal of oral antidiabetic drugs in Japanese patients with early‐stage type 2 diabetes
Authors: Hirukawa Hidenori , Hashiramoto Mitsuru , Tanizawa Yukio , Kaku Kohei ,   Pioglitazone and Sulfonylurea Remission from Type 2 Diabetes Mellitus and Anti‐Atherosclerosis in Japan (PREVENT‐J) study group
Published: February 2018

Aims/Introduction

To assess whether intervention with oral antidiabetic drug in Japanese patients with the early stage of type 2 diabetes could provide a significant remission of the disease process.

Materials and Methods

Patients with diabetes duration <5 years were randomized to the lifestyle modification (LFS), pioglitazone (PIO) or sulfonylurea (SU) treatment group. In phase 1 as the on‐treatment period and in phase 2 as the off‐treatment period, the duration that glycated hemoglobin (HbA1c) was maintained at less than the target was compared among groups.

Results

A total of 278 patients were assigned to LFS (n = 84), PIO (n = 101) and SU (n = 93), and 212 patients completed phase 1. The number of patients that dropped out because of HbA1c elevation was larger in the LFS group, and the duration of HbA1c being maintained at <7.9% was longer in the SU group than the other groups. The duration of HbA1c being maintained at <7.4% in phase 2 was significantly shorter in the SU group than in the other groups. The proportion of patients who achieved HbA1c <6.9% or 6.2% at the end of phase 1 was obviously less in the LFS group than other groups. The duration of HbA1c being maintained at <6.2% in phase 2 was longer in the PIO group than other groups, although not significant statistically. An increase in serum adiponectin and decreases in high‐sensitivity C‐reactive protein and homeostatic model assessment of insulin resistance were shown in patients treated with PIO, but not LFS and SU, in phase 1, but were canceled in the drug‐off phase 2 period.

Conclusions

PIO treatment provided a prolonged remission of hyperglycemia after stopping the dosage in patients with the early stage of type 2 diabetes.
Use of medical photography among dermatologists: a nationwide online survey study
Authors: Milam E.C. , Leger M.C.
Published: February 2018

Background

Medical photography enhances patient care, medical education and research. Despite medical photography's widespread use, little is known about how dermatologists choose to implement photography in routine clinical practice, and how they approach issues of image storage, image security and patient consent.

Objective

To characterize dermatologists' medical photography habits and opinions.

Methods

A 32‐item anonymous, multiple‐choice SurveyMonkey questionnaire about medical photography practices was emailed to programme directors of the 117 United States (US) dermatology residency programmes between May and August 2015, with a request to forward to faculty and affiliated dermatologists. Only board‐certified dermatologists practicing in the United States were eligible. The Institutional Review Board exempted our study from full review.

Results

Our survey included 153 board‐certified dermatologists, primarily representing the north‐east (43.1%) and identifying as academic dermatologists (75.5%). Medical photography is prevalent: 61.8% report everyday use and 21.7% photograph every patient. Those reporting rare use (3.3%) were, on average, 20 years older. Dermatologists most commonly use photography to mark biopsy sites (87.5%), track disease (82.9%) and for education/teaching (72.4%). Nearly half (46%) use smartphone cameras. Emailing and texting photographs with patients or colleagues are common (69.1%). Most dermatologists (75.7%) always request patient consent for photographs. Only 23.7% adhere to a photography protocol and 73.9% desire more training opportunities.

Conclusion

Dermatologists value medical photography. While patterns of image acquisition, storage and consent are noted, a variety of methods and preferences exist. Clearer photography guidelines and increased educational resources are likely to improve image quality, exchangeability and confidentiality.
Sleep and dream habits in a sample of French college students who report no sleep disorders
Authors: Vallat Raphael , Eskinazi Mickael , Nicolas Alain , Ruby Perrine
Published: February 2018

There is a lack of up‐to‐date data on sleep and dream habits of college students. To fill in this gap, we used an online questionnaire sent to the student mailing lists of two major universities of Lyon (Lyon 1 and Lyon 2) for the recruitment of an functional magnetic resonance imaging study with sleep disorders as exclusion criteria. In the sample (1,137 French college students, 411 males, mean age = 22.2 ± 2.4 years, body mass index = 22.0 ± 3.2 kg m−2), on average, the participants reported spending about 8 hr in bed during weekdays, 9 hr during the weekends, and 90.9% of them reported no difficulty falling asleep. Less than 0.4% of students reported to have sleep‐walking episodes regularly, but nearly 7% reported regular sleep‐talking episodes. The average dream recall frequency was about 3 mornings per week with a dream in mind. Dream recall frequency was positively correlated with the clarity of dream content and the frequency of lucid dreaming, and was negatively correlated with age. Fourteen percent of the students reported frequent lucid dreams, and 6% reported frequent recurrent dreams. We found a gender effect for several sleep and dream parameters, including dream recall frequency and time in bed, both of which were higher in women than in men. We have also observed differences between academic disciplines, namely humanities students (Lyon 2) reported spending more time in bed than sciences students (Lyon 1). These results confirm a gender difference for several sleep and dream parameters, and suggest a link between academic disciplines and sleep duration.
The role of sleep in aesthetic perception and empathy: A mediation analysis
Authors: Peretti Sara , Tempesta Daniela , Socci Valentina , Pino Maria C. , Mazza Monica , Valenti Marco , De Gennaro Luigi , Di Dio Cinzia , Marchetti Antonella , Ferrara Michele
Published: February 2018

The ability to experience aesthetics plays a fundamental role in human social interactions, as well as the capacity to feel empathy. Some studies have shown that beauty perception shares part of the neural network underlying emotional and empathic abilities, which are also known to affect sleep quality and duration. In this study, we evaluated for the first time the effects of sleep on the relation between aesthetic perception and empathic abilities in healthy subjects using a mediation analysis approach. One‐hundred and twenty‐six subjects participated in this study. One‐hundred and one subjects slept at home (Sleep Group). The remaining 25 subjects were tested as controls after 1 night of sleep deprivation to assess the effects of lack of sleep on aesthetic perception and empathy (Sleep‐Deprived Group). All participants underwent one testing session in which they performed a battery of empathy tests and an aesthetic perception task (Golden Beauty). The results showed that sleep duration mediates the relationship between empathy and aesthetic perception in the sleep group. The mediation effect of sleep was more evident on the emotional empathy measures. Conversely, in the sleep deprivation group the lack of correlations among empathy, aesthetic perception and sleep variables did not allow to perform the mediation analysis. These results suggest that adequate sleep duration may play a significant role in improving cognitive and emotional empathic abilities as well as the capability to give accurate aesthetic judgements.
A comprehensive bioinformatic analysis of hepatitis D virus full‐length genomes
Authors: Delfino C. M. , Cerrudo C. S. , Biglione M. , Oubiña J. R. , Ghiringhelli P. D. , Mathet V. L.
Published: February 2018

In association with hepatitis B virus (HBV), hepatitis delta virus (HDV) is a subviral agent that may promote severe acute and chronic forms of liver disease. Based on the percentage of nucleotide identity of the genome,HDVwas initially classified into three genotypes. However, since 2006, the original classification has been further expanded into eight clades/genotypes. The intergenotype divergence may be as high as 35%‐40% over the entireRNAgenome, whereas sequence heterogeneity among the isolates of a given genotype is <20%; furthermore,HDVrecombinants have been clearly demonstrated. The genetic diversity ofHDVis related to the geographic origin of the isolates. This study shows the first comprehensive bioinformatic analysis of the complete available set ofHDVsequences, using both nucleotide and protein phylogenies (based on an evolutionary model selection, gamma distribution estimation, tree inference and phylogenetic distance estimation), protein composition analysis and comparison (based on the presence of invariant residues, molecular signatures, amino acid frequencies and mono‐ and di‐amino acid compositional distances), as well as amino acid changes in sequence evolution. Taking into account the congruent and consistent results of both nucleotide and amino acid analyses of GenBank available sequences (recorded as of January, 2017), we propose that the eight hepatitis D virus genotypes may be grouped into three large genogroups fully supported by their shared characteristics.
Current but not past hepatitis B virus infection is associated with a decreased risk of nonalcoholic fatty liver disease in the Chinese population: A case‐control study with propensity score analysis
Authors: Zhong G. C. , Wu Y. L. , Hao F. B. , Rao X. W. , Yuan X. W. , Zhao Y. , Gong J. P.
Published: February 2018

The relation between hepatitis B virus (HBV) infection and fatty liver has been addressed by several observational studies, but their results remain controversial. To date, no study has precisely investigated the association of current and past HBV infection with the risk of nonalcoholic fatty liver disease (NAFLD) in the Chinese population. Therefore, we conducted a hospital‐based case‐control study in southwestern China to clarify this issue. A total of 631 newly ultrasound‐diagnosed NAFLD cases and 2357 controls were selected from 123 243 consecutive patients admitted to a tertiary‐care hospital between January 2015 and December 2016. Multivariate logistic regression was employed to calculate adjusted odds ratios (ORs) and 95% confidence intervals (CIs). A propensity score was developed for adjustment and matching. Subgroup analysis was conducted to identify potential effect modifiers. Current and past HBV infection had an overall prevalence of 9.7% and 55.2%, respectively. In the fully adjusted model, current HBV infection was associated with a decreased risk of NAFLD (OR 0.64; 95% CI 0.42‐0.95). A similar inverse association was observed in both propensity‐score‐adjusted (OR 0.58; 95% CI 0.40‐0.86) and propensity‐score‐matched analyses (OR 0.61; 95% CI 0.40‐0.92).The inverse association was stronger in patients with hypertension than in those without (Pinteraction = .018).No significant association between past HBV infection and NAFLD risk was found. In conclusion, current but not past HBV infection is associated with a decreased risk of NAFLD in the Chinese population. The corresponding biological mechanisms remain to be elucidated.
Quality indicators in a community optometrist led cataract shared care scheme
Authors: Bowes Oliver M B , Shah Poonam , Rana Mrinal , Farrell Sarah , Rajan Madhavan S
Published: February 2018

Purpose

Cataract shared care schemes involving community optometrists show wide variation in practice. We report on defined key performance indicators (KPIs) which improve accountability between stakeholders.

Methods

In this prospective study over nine months at a UK public hospital, we evaluated the outcomes of consecutive direct cataract referrals from community optometrists against two KPIs agreed under a service‐level agreement between the Hospital Eye Service and community optometrists: (1) 85% of patients listed for cataract listing at first consultation; and (2) 90% postoperative feedback return rate on patients discharged to community optometrists. A detailed analysis on referral triage, surgical listing and postoperative form return rate is reported in this study.

Results

A total of 733 direct cataract referrals were received using a designated referral form of which 86% were listed for cataract surgery. The predominant reason for not listing was a failure to reach the visual threshold set by the local clinical commissioning guidelines. Out of 569 cataract surgical episodes, 402 (71%) patients were discharged on the same day of surgery to community optometrist follow up. Completed postoperative feedback was returned from 374 patients (93%).

Conclusion

Direct cataract referrals from accredited community optometrists led to a majority of patients receiving a definitive clinical decision during first consultation. Postoperative community follow up reduced hospital visits and allowed for convenient consultation closer to home following uncomplicated cataract surgery. A service‐level agreement with an accreditation scheme measured against KPIs enhances the accountability of stakeholders involved in the cataract shared care scheme.
Reduced prefrontal hemodynamic response in adult attention‐deficit hyperactivity disorder as measured by near‐infrared spectroscopy
Authors: Ueda Shotaro , Ota Toyosaku , Iida Junzo , Yamamuro Kazuhiko , Yoshino Hiroki , Kishimoto Naoko , Kishimoto Toshifumi
Published: February 2018

Aim

Recent developments in near‐infrared spectroscopy (NIRS) have enabled non‐invasive clarification of brain functions in psychiatric disorders. In pediatric attention‐deficit hyperactivity disorder (ADHD), reduced prefrontal hemodynamic responses have been observed with NIRS repeatedly. However, there are few studies of adult ADHD by multi‐channel NIRS. Therefore, in this study, we used multi‐channel NIRS to examine the characteristics of prefrontal hemodynamic responses during the Stroop Color–Word Task (SCWT) in adult ADHD patients and in age‐ and sex‐matched control subjects.

Methods

Twelve treatment‐naïve adults with ADHD and 12 age‐ and sex‐matched healthy control subjects participated in the present study after giving consent. We used 24‐channel NIRS to measure the oxygenated hemoglobin (oxy‐Hb) changes at the frontal lobes of participants during the SCWT. We compared the oxy‐Hb changes between adults with ADHD and control subjects by t‐tests with Bonferroni correction.

Results

During the SCWT, the oxy‐Hb changes observed in the ADHD group were significantly smaller than those in the control group in channels 11, 16, 18, 21, 22, 23, and 24, corresponding to the prefrontal cortex. At channels 16, 21, 23, and 24 of the ADHD group, there were negative correlations between the symptomatic severity and the oxy‐Hb changes.

Conclusion

The present study suggests that adults with ADHD have reduced prefrontal hemodynamic response as measured by NIRS.
Decreasing hospitalizations in patients on hemodialysis: Time for a paradigm shift
Authors: Golestaneh Ladan
Published: February 2018

Hospitalizations drive up to 35% of the astronomical costs of care for patients on hemodialysis and are associated with poor outcomes. We describe outpatient care‐sensitive categories of hospitalization risks in an effort to engage stakeholders and patients, as stakeholders, in mitigating hospitalizations. These categories include: (1) fluid (interdialytic weight gain (IDWG) and chronic volume status), (2) infection (vascular access and malnutrition/inflammation resilience), and c) psychosocial (poor social support, poor self‐efficacy, and mood disorders) risks. Barriers to improving hospitalization outcomes, especially as they relate to above risk categories, exist at multiple stakeholder levels and include: (1) dialysis facilities (strict shift changes, personnel challenges), (2) nephrologists (static dialysis prescriptions and protocols based on dialysis facility metrics), and (3) patients (lack of engagement and self‐efficacy). System‐level elements, such as payment models, help to propagate these barriers. In this article, we seek to shift the care paradigm discussion to patient trajectories and long‐term outcomes, and to active engagement of patients as self‐managers, through which we hope to impact on high inpatient resource utilization. We will also focus attention on the complex interplay of practices that have become acceptable care structures, but that may be deleterious to outcomes. Only after thorough consideration of these topics can we hope to impact on this important problem.
How Political Cultures Produce Different Antibiotic Policies in Agriculture: A Historical Comparative Case Study between the United Kingdom and Sweden
Authors: Begemann Stephanie , Perkins Elizabeth , Van Hoyweghen Ine , Christley Robert , Watkins Francine
Published: February 2018

The purpose of this article is to provide an understanding of how different countries formulate and regulate antibiotic use in animals raised for human consumption. A comparative case study was undertaken, analysing historical documents from the 1950s to the 1990s from the UK, the first country to produce a scientific report on the public health risks of agricultural antibiotic use; and Sweden, the first country to produce legislation on the growth promotor use of antibiotics in food animals. Sheila Jasanoff's concepts of ‘co‐production’ and ‘political cultures’ have been used to explore how both countries used different styles of scientific reasoning and justification of the risks of agricultural antibiotic use. It will be argued that national dynamics between policy, science and public knowledges co‐produced different risk classifications and patterns of agricultural antibiotic use between both countries. UK's political culture used ‘expert committees’ to remove the issue from public debate and to inform agricultural antibiotic policies. In contrast, the Swedish ‘consensus‐oriented’ political culture made concerns related to agricultural antibiotic use into a cooperative debate that included multiple discourses. Understanding how national policies, science and public knowledges interact with the risks related to agricultural antibiotic use can provide valuable insights in understanding and addressing countries agricultural use of antibiotics.
Still a weak occupational welfare in Southern Europe? Evidence from the Italian case
Authors: Ascoli Ugo , Natali David , Pavolini Emmanuele
Published: February 2018

The article focuses on Italy—a typical example of the Southern European model—and the recent evolution of occupational welfare (OW). It first provides up‐to‐date information on the spread of OW in the country. We then explain the persistent limited development of OW and its uneven diffusion—across policy areas (healthcare vs. pensions) and economic sectors (public vs. private sectors). The article focuses on the role of employers, trade unions, and policymakers. The state (as an employer) has not invested in OW for public employees—because of budgetary problems and a traditional lack of interest in the field—while private employers have started to invest in OW in line with broader business strategies. Trade unions have supported occupational health insurance, while they have resisted the spread of occupational pension funds. Such different strategies are related to the different role trade unions play in the two policies. Eventually, policymakers have followed different retrenchment strategies of statutory schemes in different policy fields: the more evident short‐term impact of reforms in healthcare has “crowded‐in” occupational schemes in the area, while the longer phase‐in period of pension reforms has led to the more limited role of occupational pensions.
Transfusion reactions after transfusion of platelets stored in PAS‐B, PAS‐C, or plasma: a nationwide comparison
Authors: van Hout Fabienne M.A. , van der Meer Pieter F. , Wiersum‐Osselton Johanna C. , Middelburg Rutger A. , Schipperus Martin R. , van der Bom Johanna G. , Kerkhoffs Jean‐Louis
Published: February 2018

BACKGROUND

Platelets (PLTs) stored in PLT additive solution (PAS) are associated with fewer allergic reactions than plasma‐stored PLTs. However, earlier studies could not provide conclusive evidence on febrile reactions and did not analyze other transfusion reactions separately due to limited sample size. We therefore compared incidences of all transfusion reactions of PAS‐B‐PLTs, PAS‐C‐PLTs, and plasma‐PLTs.

STUDY DESIGN AND METHODS

In this observational study, all transfusion reactions reported to the national hemovigilance office of the Netherlands from 2006 to 2015 were included.

RESULTS

During the study period, a total of 2407 transfusion reactions after PLT transfusions were reported. In that period 553,267 pooled buffy coat–derived PLT units were issued, of which 83,884 were stored in PAS‐B, 45,728 in PAS‐C, and 423,655 in plasma. Regarding transfusion‐related circulatory overload, transfusion‐related acute lung injury, and “other reactions” no significant differences were observed between the PLT products. When PAS‐B‐PLT transfusions were compared to plasma‐PLT transfusions, the overall relative risk (RR; 95% confidence interval [CI]) of transfusion reactions was 0.99 (0.88‐1.11); for allergic and febrile nonhemolytic transfusion reactions (FNHTRs) it was 0.66 (0.55‐0.80) and 1.54 (1.27‐1.86), respectively. When PAS‐C‐PLTs were compared to plasma‐PLTs, the RR (95% CI) was 0.56 (0.46‐0.68) for all transfusion reactions, 0.38 (0.28‐0.52) for allergic reactions, and 0.82 (0.59‐1.13) for FNHTRs. When PAS‐C‐PLTs were compared to PAS‐B‐PLTs, for all reactions the RR (95% CI) was 0.56 (0.45‐0.70) for allergic reactions 0.58 (0.40‐0.82), and for FNHTRs 0.53 (0.37‐0.75).

CONCLUSIONS

PAS‐C‐PLTs are associated with fewer transfusion reactions compared to plasma‐PLTs and compared to PAS‐B‐PLTs.
Neospora caninum and Ehrlichia canis co‐infection in a dog with meningoencephalitis
Authors: Aroch Itamar , Baneth Gad , Salant Harold , Nachum‐Biala Yaarit , Berkowitz Asaf , Shamir Merav , Chai Orit
Published: February 2018

An 8‐year‐old mixed‐breed dog was presented for acute, progressive weakness and ataxia, inappetence, and weight loss. The patient was mentally normal, but nonambulatory, with a right head tilt, right positional ventral strabismus, and slight head tremors. A neurologic lesion was localized to the cerebellum and right brainstem. Cerebrospinal fluid (CSF) analysis showed a markedly increased protein concentration and mixed pleocytosis, with eosinophil predominance (44%), intracytoplasmic inclusions within eosinophils, consistent with Ehrlichia canis (E canis) morulae, and Toxoplasma gondii (T gondii) or Neospora caninum (N caninum) tachyzoites within eosinophils and monocytes. A serum indirect immunofluorescent antibody test was positive for N caninum (titer 1:12 800) and negative for T gondii. Both blood and CSF PCR results were N caninum‐ and E canis‐positive and T gondii‐ and Anaplasma phagocytophilum‐negative, and blood PCR, but not CSF PCR, was Hepatozoon canis‐positive. The dog was treated for 30 days with clindamycin, sulfamethoxazole‐trimethoprim, doxycycline, prednisone, and cephalosporin, but did not improve neurologically, and was euthanized. Brain histopathology showed moderate multifocal, subacute meningoencephalitis with necrosis and gliosis. The neurologic disease was mostly attributed to central nervous system (CNS) neosporosis, with the possible contribution of ehrlichiosis, which was likely a manifestation of blood‐brain barrier disruption. Hepatozoonosis was probably a result or cause of underlying immunosuppression. To our knowledge, this is the first report of CNSN caninum and E canis co‐infection detected by both CSF PCR and cytology and E canis morulae identified within CSF eosinophils.
Effects of High Versus Low Protein Intake on Body Composition and Maximal Strength in Aspiring Female Physique Athletes Engaging in an 8-Week Resistance Training Program
Authors: Campbell Bill I. , Aguilar Danielle , Conlin Laurin , Vargas Andres , Schoenfeld Brad Jon , Corson Amey , Gai Chris , Best Shiva , Galvan Elfego , Couvillion Kaylee
Published: February 2018

Aspiring female physique athletes are often encouraged to ingest relatively high levels of dietary protein in conjunction with their resistance training programs. However, there is little to no research investigating higher versus lower protein intakes in this population. This study examined the influence of a high versus low-protein diet in conjunction with an 8-week resistance training program in this population. A total of 17 females (21.2 ± 2.1 years; 165.1 ± 5.1 cm; 61 ± 6.1 kg) were randomly assigned to a high-protein diet (HP: 2.5 g·kg−1·day−1; n = 8) or a low-protein diet (LP: 0.9 g·kg−1·day−1, n = 9) and were assessed for body composition and maximal strength prior to and after the 8-week protein intake and exercise intervention. Fat-free mass increased significantly more in the HP group as compared with the LP group (p = .009), going from 47.1 ± 4.5 to 49.2 ± 5.4 kg (+2.1 kg) and from 48.1 ± 2.7 to 48.7 ± 2 kg (+0.6 kg) in the HP and LP groups, respectively. Fat mass significantly decreased over time in the HP group (14.1 ± 3.6 to 13.0 ± 3.3 kg; p < .01), but no change was observed in the LP group (13.2 ± 3.7 to 12.5 ± 3.0 kg). Although maximal strength significantly increased in both groups, there were no differences in strength improvements between the two groups. In aspiring female physique athletes, a higher protein diet is superior to a lower protein diet in terms of increasing fat-free mass in conjunction with a resistance training program.
Gross Motor Skills and School Day Physical Activity: Mediating Effect of Perceived Competence
Authors: Fu You , Burns Ryan D.
Published: February 2018

The purpose of this study was to examine the relationship between gross motor skills and school day steps per minute, testing various motivational constructs as potential mediators. A convenience sample of 66 sixth-grade children (mean age = 11.6 ± 0.5 years; 30 boys, 36 girls) were recruited from one public “Zoom” school. Gross motor skills were assessed using the Test for Gross Motor Development-3rd Edition. Motivational constructs were assessed using a series of validated questionnaires. Children wore a pedometer for one school week. A bootstrap mediation analysis was employed using gross motor skills scores as the predictor variable and steps per minute as the outcome variable; the motivational constructs consisted of perceived competence, enjoyment, and self-efficacy as potential mediators. The results from a bootstrap mediation analysis yielded a statistically significant average causal mediation effect (ACME) using perceived competence as the mediator (ACME = 0.022, 95% CI [0.001, 0.054], p = .018). Perceived competence mediated 30.8% of the total effect between gross motor skill scores and steps per minute, with the entire model explaining approximately 13.6% of the variance. The relationship between gross motor skills and school day physical activity may be mediated through perceived competence in sixth-grade children.
PccD Regulates Branched-Chain Amino Acid Degradation and Exerts a Negative Effect on Erythromycin Production in Saccharopolyspora erythraea
Authors: Xu Zhen , Liu Yong , Ye Bang-Ce
Published: February 2018

Branched-chain amino acid (BCAA) degradation is a major source of propionyl coenzyme A (propionyl-CoA), a key precursor of erythromycin biosynthesis in
Saccharopolyspora erythraea
. In this study, we found that the
bkd
operon, responsible for BCAA degradation, was regulated directly by PccD, a transcriptional regulator of propionyl-CoA carboxylase genes. The transcriptional level of the
bkd
operon was upregulated 5-fold in a
pccD
gene deletion strain (Δ
pccD
strain) and decreased 3-fold in a
pccD
overexpression strain (WT/pIB-
pccD
), demonstrating that PccD was a negative transcriptional regulator of the operon. The deletion of
pccD
significantly improved the Δ
pccD
strain's growth rate, whereas
pccD
overexpression repressed WT/pIB-
pccD
growth rate, in basic Evans medium with 30 mM valine as the sole carbon and nitrogen source. The deletion of
gdhA1
and the BcdhE1 gene (genes in the
bkd
operon) resulted in lower growth rates of Δ
gdhA1
and ΔBcdhE1 strains, respectively, on 30 mM valine, further suggesting that the
bkd
operon is involved in BCAA degradation. Both
bkd
overexpression (WT/pIB-
bkd
) and
pccD
inactivation (Δ
pccD
strain) improve erythromycin production (38% and 64%, respectively), whereas the erythromycin production of strain WT/pIB-
pccD
was decreased by 48%. Lastly, we explored the applications of engineering
pccD
and
bkd
in an industrial high-erythromycin-producing strain.
pccD
deletion in industrial strain
S. erythraea
E3 (E3
pccD
) improved erythromycin production by 20%, and the overexpression of
bkd
in E3Δ
pccD
(E3Δ
pccD
/pIB-
bkd
) increased erythromycin production by 39% compared with
S. erythraea
E3 in an industrial fermentation medium. Addition of 30 mM valine to industrial fermentation medium further improved the erythromycin production by 23%, a 72% increase from the initial strain
S. erythraea
E3.

IMPORTANCE
We describe a
bkd
operon involved in BCAA degradation in
S. erythraea
. The genes of the operon are repressed by a TetR regulator, PccD. The results demonstrated that PccD controlled the supply of precursors for biosynthesis of erythromycin via regulating the BCAA degradation and propionyl-CoA assimilation and exerted a negative effect on erythromycin production. The findings reveal a regulatory mechanism in feeder pathways and provide new strategies for designing metabolic engineering to increase erythromycin yield.