bluuebunny/crossref_metadata_2025 huggingface dataset:
QT interval, corrected for heart rate, is associated with HbA1c concentration and autonomic function in diabetes
Authors: Stern K. , Cho Y. H. , Benitez‐Aguirre P. , Jenkins A. J. , McGill M. , Mitchell P. , Keech A. C. , Donaghue K. C.
Published: January 2016

Aims

To examine QT intervals corrected for heart rate (QTc) in adolescents with Type 1 diabetes compared with control subjects, and to determine associations with metabolic control and autonomic function.

Methods

Resting electrocardiogram recordings of 142 adolescents with Type 1 diabetes [mean (sd) age 15.3 (2.0) years, diabetes duration 9.0 (3.5) years, HbA1c 71 (17) mmol/mol or 8.7 (1.6)%] and 125 control subjects [mean (sd) age 15.7 (2.5) years] were used to calculate QTc duration and derive mean heart rate and heart rate variability (HRV) values. Linear and logistic regression models were used to examine the associations between QTc, metabolic control and autonomic function (HRV and pupillary function).

Results

QTc duration was not significantly different between subjects with Type 1 diabetes and control subjects (mean duration 392 vs 391 ms; P = 0.65). In the Type 1 diabetes group, QTc was positively associated with HbA1c [β = 4 (95% CI 2, 6); P < 0.001] and inversely associated with severe hypoglycaemic events [β = ‐10 (95% CI ‐20,‐2); P = 0.01], less insulin/kg [β = ‐12 (95% CI ‐22, ‐2); P = 0.024] and less HRV. In the Type 1 diabetes group, QTc in the highest quintile (≥409 ms) vs quintiles 1–4 had more pupillary abnormalities (83 vs 56%; P = 0.03), lower pupillary maximum constriction velocity (4.8 vs 5.3 mm/s; P = 0.04), higher heart rate (78 vs 72 beats per min; P = 0.02) and lower HRV (standard deviation of mean NN intervals 4.0 vs 4.3 ms, P = 0.004 and root‐mean‐square difference of successive NN intervals 3.7 vs 4.1 ms; P = 0.004).

Conclusions

Although there are concerns about hypoglycaemia in general in people with Type 1 diabetes, chronic hyperglycaemia, rather than intermittent hypoglycaemia, appears to be more deleterious to autonomic cardiac function, even in adolescence. Longer QTc was associated with higher HbA1c concentration, lower risk of hypoglycaemia and autonomic dysfunction. Longitudinal studies are warranted.
Climate refugia and migration requirements in complex landscapes
Authors: Roberts David R. , Hamann Andreas
Published: January 2016

All of today's species have proven their ability to cope with climate change during the glacial‐interglacial cycles of the Quaternary, but future migration requirements may be different regarding speed, direction, geographic barriers, and availability of nearby climate refugia. Here, we contribute a landscape‐level climatic analysis of postglacial vs. projected future migration requirements for 24 common western North American tree species. Using a recently developed velocity of climate change algorithm, we quantify required migration velocities for all populations of species to track climate habitat, based on projections from general circulation models for the 2080s and the last glacial maximum, 21 000 yr ago. Specifically, we ask if nearby climate refugia exist for at least some populations within species ranges and whether the current landscape position of species imply qualitatively different migration requirements in the future compared to those during glacial‐interglacial cycles. Results showed that velocities to reach the nearest climate refugia in the future still exceed the fastest reconstructed post‐glacial migration requirements, but not by orders of magnitude. Regarding landscape positions, we find a low correlation among past and future migration requirements (r = 0.38), suggesting that qualitatively different migration patterns may emerge in the future for some species. Species identified as occupying landscape positions requiring disproportionally faster migration requirements in the future include whitebark pine, pinyon pine, and coast redwood. We discuss uncertainties of our analytical approach as well as implications for human‐assisted migration and conservation action to address climate change.
Impact of the lower third molar and injury mechanism on the risk of mandibular angle and condylar fractures
Authors: Antic Svetlana , Milicic Biljana , Jelovac Drago B. , Djuric Marija
Published: January 2016

Background

Previous studies have shown the influence of the mandibular third molar on mandibular angle and condylar fractures, but have not comparatively analyzed the impact of the injury mechanism on these fractures. The purpose of this study was to evaluate the influence of the lower third molar (M3) and injury‐related factors (fracture etiology and site of impact of the traumatic force) on the risk of mandibular angle and condylar fractures.

Material and methods

The study included 615 patients who sustained a mandibular fracture in a 13‐year period (from January 2000 to December 2013). The independent variables were presence, position and the root number of the M3, fracture etiology, and site of impact of the force. The outcome variables were mandibular angle and condylar fractures. Other variables included in the study were patients' gender and age. The data were analyzed using the chi‐square test. Univariate and multivariate binary logistic regression analyses were used to evaluate the relationship between angle and condylar fractures and to show potential determinants.

Results

Angle fractures were significantly influenced by the M3, site of impact, and age, but the main predictors were the eruption status and vertical position of the M3 (classified by Pell and Gregory) and site of impact of the force. Condylar fractures were significantly influenced by the M3 and site of impact of the force, but only the last showed as a predictor.

Conclusions

Factors related to the M3 showed more significant influence on angle fractures than on condylar fractures.
Real‐life experience with liver iron concentration R2 MRI measurement in patients with hemoglobinopathies: baseline data from LICNET
Authors: Vitrano Angela , Calvaruso Giuseppina , Tesé Lorenzo , Gioia Francesco , Cassarà Filippo , Campisi Saveria , Butera Franco , Commendatore Valeria , Rizzo Michele , Santoro Vincenzo , Cigna Valeria , Quota Alessandra , Bagnato Sabrina , Argento Crocetta , Fidone Carmelo , Schembari Dario , Gerardi Calogera , Barbiera Filippo , Bellisssima Giuseppe , Giugno Giovanni , Polizzi Gesualdo , Rosso Rosamaria , Abbate Giovanna , Caruso Vincenzo , Chiodi Elisabetta , Gamberini Maria Rita , Giorgi Benedetta , Putti Maria Caterina , Filosa Aldo , De Ritis Maria Rosaria , Oliva Esther , Arcadi Nicola , Fustaneo Maria , Mistretta Laura , Di Maggio Rosario , Sacco Massimiliano , Veronica Di Salvo , Giangreco Antonino , Maggio Aurelio
Published: January 2016

Background

Real‐life data on the use of R2 MRI for the assessment of liver iron concentration (LIC) remain limited.

Methods

We conducted a cross‐sectional analysis on 363 patients (mean age 35.6 yr, 44.1% men) with hemoglobinopathies (204 β‐thalassemia major [TM], 102 β‐thalassemia intermedia [TI], and 57 sickle cell disease [SCD]) that were evaluated with R2 MRI as part of LICNET, an MRI network of 13 Italian treatment centers.

Results

The mean LIC was 7.8 mg/g (median: 4.0), with high LIC (>7 mg/g) noted in both transfused (TM, TI 37%; SCD 38%) and non‐transfused (TI 20%) patients. Ferritin levels correlated with LIC in both transfused (TM, TI, SCD) and non‐transfused (TI) patients (P < 0.001), although lower values predicted high LIC in non‐transfused patients (1900 vs. 650 ng/mL in TM vs. non‐transfused TI). A correlation between LIC and ALT levels was only noted in HCV‐negative patients (rs = 0.316, P < 0.001). The proportion of patients with high LIC was significantly different between iron chelators used (P = 0.023), with the lowest proportion in deferasirox (30%) and highest in deferiprone (53%)‐treated patients.

Conclusions

High LIC values persist in subgroups of patients with hemoglobinopathy, warranting closer monitoring and management optimization, even for non‐transfused patients with relatively low ferritin levels.
Analgesic effects evoked by a CCR2 antagonist or an anti‐CCL2 antibody in inflamed mice
Authors: Llorián‐Salvador María , Pevida Marta , González‐Rodríguez Sara , Lastra Ana , Fernández‐García María‐Teresa , Hidalgo Agustín , Baamonde Ana , Menéndez Luis
Published: January 2016

Chemokine CCL2, also known as monocyte chemoattractant protein‐1 (MCP‐1), is a molecule that in addition to its well‐established role in chemotaxis can also act as nociceptor sensitizer. The upregulation of this chemokine in inflamed tissues could suggest its involvement in inflammatory hypernociception. Thus, we have measured CCL2 levels in mice with acute or chronic inflammation due to the intraplantar (i.pl.) injection of carrageenan or complete Freund's adjuvant (CFA), respectively, and we have studied whether inflammatory hyperalgesia or allodynia could be attenuated by blocking CCR2 receptors or neutralizing CCL2 with an anti‐CCL2 antibody. A remarkable increase in CCL2 concentration was detected by ELISA in paw homogenates coming from carrageenan‐ or CFA‐inflamed mice, being its expression mainly localized in macrophages, as shown by immunohistochemical assays. The s.c. (0.3–3 mg/kg) or i.pl. (0.3–3 μg) administration of the CCR2 antagonist, RS 504393, dose dependently inhibited thermal hyperalgesia measured in acutely or chronically inflamed mice, whereas s.c. administration of this drug did not reduce inflammatory mechanical allodynia. Furthermore, the inhibition of inflammatory hyperalgesia after the administration of an anti‐CCL2 antibody (0.1–1 μg; i.pl.) suggests that CCL2 could be the endogenous chemokine responsible for CCR2‐mediated hyperalgesic effects. Besides, the acute administration of the highest antihyperalgesic dose of RS 504393 assayed did not reduce paw tumefaction or modify the presence of inflammatory cells. These results indicate that the blockade of the CCL2/CCR2 system can counteract inflammatory hyperalgesia, being this antinociceptive effect unrelated to a decrease in the inflammatory reaction.
Anthocyanidins but not anthocyanins inhibit P‐glycoprotein‐mediated calcein extrusion – possible implication for orally administered drugs
Authors: Vrzal Radim
Published: January 2016

P‐glycoprotein (P‐gp) inhibition represents a promising therapeutic strategy for oncologic patients. The inhibition by naturally occurring anthocyans would bring certain benefits. Unfortunately, due to the low bioavailability and consequently low blood level, they cannot be used for cancer therapy. However, due to the food supplementation, significant concentration can raise up in the intestine, where P‐gp is abundantly expressed. As many drugs are orally taken, simultaneous administration might affect the concentration of these drugs in the blood. Here, we found that anthocyanidins (aglycons) but not anthocyanins (glycosides) can significantly inhibit P‐gp up to 60% of positive control, verapamil. This inhibitory activity was observed for 500 μm concentrations of malvidin and pelargonidin. We conclude that these compounds may be the source of food–drug interactions either for orally taken drugs or for intravenously administered drugs eliminated via biliary excretion which are the substrates of P‐gp.
Neuropsychological phenotype and psychopathology in seven adult patients with Phelan‐McDermid syndrome: implications for treatment strategy
Authors: Egger J. I. M. , Zwanenburg R. J. , van Ravenswaaij‐Arts C. M. A. , Kleefstra T. , Verhoeven W. M. A.
Published: January 2016

Phelan‐McDermid syndrome presents with specific deficits in neurocognition, cerebellar regulatory functioning and enhanced vulnerability for the development of atypical bipolar disorder.
Modelling carbon stocks and fluxes in the wood product sector: a comparative review
Authors: Brunet‐Navarro Pau , Jochheim Hubert , Muys Bart
Published: January 2016

In addition to forest ecosystems, wood products are carbon pools that can be strategically managed to mitigate climate change. Wood product models (WPMs) simulating the carbon balance of wood production, use and end of life can complement forest growth models to evaluate the mitigation potential of the forest sector as a whole.WPMs can be used to compare scenarios of product use and explore mitigation strategies. A considerable number ofWPMs have been developed in the last three decades, but there is no review available analysing their functionality and performance. This study analyses and compares 41WPMs. One surprising initial result was that we discovered the erroneous implementation of a few concepts and assumptions in some of the models. We further described and compared the models using six model characteristics (bucking allocation,industrial processes,carbon pools,product removal,recyclingandsubstitution effects)and three model‐use characteristics (system boundaries,model initializationandevaluation of results). Using a set of indicators based on the model characteristics, we classified models using a hierarchical clustering technique and differentiated them according to their increasing degrees of complexity and varying levels of user support. For purposes of simulating carbon stock in wood products, models with a simple structure may be sufficient, but to compare climate change mitigation options, complex models are needed. The number of models has increased substantially over the last ten years, introducing more diversity and accuracy. Calculation of substitution effects and recycling has also become more prominent. However, the lack of data is still an important constraint for a more realistic estimation of carbon stocks and fluxes. Therefore, if the sector wants to demonstrate the environmental quality of its products, it should make it a priority to provide reliable life cycle inventory data, particularly regarding aspects of time and location.
Cerebrospinal fluid inflammatory markers in amnestic mild cognitive impairment
Authors: Rizzi Liara , Roriz‐Cruz Matheus
Published: January 2016

Aims

Inflammatory processes might play a significant role at the pathophysiology of Alzheimer's disease (AD). Neuroinflammation is characterized by activation of microglia and the release of inflammatory cytokines, such as interleukin (IL)‐1β, IL‐6 and tumor necrosis factor‐α. Although, it is unknown what the real contribution of these inflammatory markers in the development of AD is. The purpose of the present study was to assess the possible relationship between inflammatory markers in the cerebrospinal fluid (CSF) of amnestic mild cognitive impairment patients (aMCI), aged 60 years or older, and compare with aged healthy controls.

Methods

We examined concentrations of IL‐1β, IL‐6 and tumor necrosis factor‐α in the CSF of aMCI patients and controls by enzyme immunoassay. aMCI diagnoses were based on anamnesis and Petersen criteria, corroborated by the Clinical Dementia Rating. Cognitive function was assessed by neuropsychological tests.

Results

CSF levels of IL‐1β (13.735 vs 22.932 pg/mL; P < 0.001) and tumor necrosis factor‐α (1.913 vs 2.627 pg/mL; P = 0.002), but not IL‐6 (4.178 vs 5.689 pg/mL; P = 0.106), were significantly reduced in the aMCI samples as compared with controls. Individuals with IL‐1β < 17 pg/mL were at a 7.2 (CI 1.5–36; P: 0.016) increased odds of aMCI. There was a positive correlation between IL‐1β levels and the Consortium to Establish a Registry for Alzheimer's Disease word list score (rs = 0.299; P = 0.046). Linear regression analysis showed that IL‐1β levels might explain 13.7% (β = 24.545; P = 0.012) of the variance on this Consortium to Establish a Registry for Alzheimer's Disease subscore.

Conclusion

The present results show a pattern of cytokines expression in the CSF of aMCI patients that might be relevant to the pathogeny of prodromal AD. Geriatr Gerontol Int 2017; 17: 239–245.
Predictive factors of mortality and deterioration in performance of activities of daily living after hip fracture surgery in Kagoshima, Japan
Authors: Ishidou Yasuhiro , Koriyama Chihaya , Kakoi Hironori , Setoguchi Takao , Nagano Satoshi , Hirotsu Masataka , Yamamoto Takuya , Yokouchi Masahiro , Komiya Setsuro
Published: January 2016

Aim

Given that different hospitals achieve different outcomes, optimal evaluation of treatment outcomes in the local community requires evaluation of many institutions in that area. We carried out a prospective multicenter cohort study in Kagoshima Prefecture to identify factors that contribute to deterioration in activities of daily living performance and patient mortality 1 year after surgical treatment of hip fractures.

Methods

We prospectively enrolled 387 patients who underwent surgery for hip fractures in 33 registered facilities within a 6‐month period from February to July 2007. Logistic regression analysis was carried out to identify factors that contribute to deterioration in activities of daily living performance and death within 1 year after surgery.

Results

An increased risk of Barthel Index (BI) deterioration was associated with increased age (P for trend = 0.003), worse pre‐injury BI (P for trend = 0.021), trochanteric fractures (OR 2.07, 95% CI 1.31–3.27), worse BI at discharge (P for trend < 0.001) and postoperatively developed cognitive impairment (OR 6.34, 95% CI 2.15–18.7). The OR for BI deterioration in patients with newly‐diagnosed disease after discharge was approximately 9.16 (95% CI 4.03–20.8). No factors except age and sex were statistically significant as the preoperative indicators of mortality risk. Only BI at discharge was a significant determinant of mortality risk (P for trend = 0.013) after adjusting for the effects of age and sex.

Conclusions

Patients with poor activities of daily living performance at the time of hospital discharge were likely to show poor functional recovery and a high 1‐year postoperative mortality. Geriatr Gerontol Int 2017; 17: 391–401.
Performance Indicators in Indonesian Universities: The Perception of Academics
Authors: Gaus Nurdiana , Hall David
Published: January 2016

This study aimed to explore the perceptions of Indonesian academics towards the implementation of Performance Indicators (PIs) on teaching and research. The study was a case study using semi‐structured interviews, conducted with 30 academics in three state universities in Indonesia. The results of the study revealed academics believed that outcome indicators used in PIs for control mechanisms have neglected the humane side of the teaching and learning process, and scientific research. Academics also perceived that PIs are valuable for improving daunting workplace conditions and poor institutional culture if they are used for the improvement of internal management. The findings of this study, if seriously considered, may provide information for policy makers to revisit and refine the existing indicators used to measure academics’ teaching and research performance. This can be implemented by taking into account the collegial nature, organised anarchy, of a bottom‐up approach that emphasises the emancipation of academics to determine what elements of their teaching and research should be covered and be measured. This research argues that indicators used for PIs can be a blend of quantitative and qualitative measures, which compensate for each other.
First report of ‘mining’ as a feeding behaviour among Australian manna‐feeding birds
Authors: Case Samuel B. , Edworthy Amanda B.
Published: January 2016

The Forty‐spotted Pardalote Pardalotus quadragintus is an endangered songbird endemic to the forests of Tasmania, Australia. Forty‐spotted Pardalotes forage predominantly in the foliage of White (or Manna) Gums Eucalyptus viminalis for invertebrates, lerps (the protective coverings produced by psyllids) and manna, a crystallized exudate produced by certain Eucalyptus species. Although many Australian birds feed on manna, this study reports the first observations of birds actively stimulating manna production rather than feeding on it opportunistically. In light of these observations, we also compared rates of manna production across tree species and sizes, and quantified the relative importance of manna in nestling diet. Adult Forty‐spotted Pardalotes stimulated manna production by clipping leaf stalks with their bills, creating small incisions in the stem surface. We experimentally mimicked this behaviour and found that, in 53.7% of incisions of E. viminalis, manna flow was released within 3 days. However, none of the other three common tree species at our sites produced manna in response to the same experimental damage. There was no effect of tree size on manna production by E. viminalis. To determine the importance of manna and other food sources in nestling diet, we videotaped provisioning trips by adults to nests and surveyed food availability in E. viminalis foliage within territories. Manna was the most important food item, comprising 84.2% of identified food items provided to nestlings, and it was selected over 50 times more frequently than expected given its relative availability in the foliage. As a manna miner, the Forty‐spotted Pardalote is the first Australian bird to join the small number of bird species that mine sap or other exudates of trees. Their preference for manna as a food source, especially in nestling diet, provides an explanation for the species’ specialization on E. viminalis, the only manna‐producing tree at our sites. Our results suggest that E. viminalis forests provide critical food supply for developing nestlings, and that restoration of E. viminalis forests will be critical to the long‐term viability of Forty‐spotted Pardalote populations.
Association between XPG polymorphisms and stomach cancer susceptibility in a Chinese population
Authors: Chen Yun‐Zhi , Guo Fang , Sun Hong‐Wei , Kong Hong‐Ru , Dai Sheng‐Jie , Huang Shi‐Hao , Zhu Wen‐Wei , Yang Wen‐Jun , Zhou Meng‐Tao
Published: January 2016

Xeroderma pigmentosum group G (XPG) protein plays an important role in the DNA repair process by cutting the damaged DNA at the 3′ terminus. Previous studies have indicated some polymorphisms in the XPG gene are associated with stomach cancer susceptibility. We performed this hospital‐based case–control study to evaluate the association of four potentially functional XPG polymorphisms (rs2094258 C>T, rs751402 C>T, rs2296147 T>C and rs873601G>A) with stomach cancer susceptibility. The four single nucleotide polymorphisms (SNPs) were genotyped in 692 stomach cancer cases and 771 healthy controls. Logistic regression analysis was conducted, and odds ratios (ORs) and 95% confidence intervals (CIs) were used to assess the association of interest. Of the studied SNPs, XPG rs873601G>A polymorphism was found to significantly associate with stomach cancer susceptibility (AA versus GG/AG: OR = 1.31, 95% CI = 1.03–1.66, P = 0.027). Combined analysis of all SNPs revealed that the individuals with two of risk genotypes had a significantly increased stomach cancer risk (OR = 1.52, 95% CI = 1.13–2.06). In the stratification analysis, the association between the rs873601AA genotype and stomach cancer risk was observed in older group (>59 year), as well as patients with non‐cardia stomach cancer. Further combined analysis indicated men, smokers, or non‐drinkers more than one risk genotypes had a significantly increased stomach cancer risk. Our results indicate that XPG rs873601G>A polymorphism may be associated with the risk of stomach cancer. Further prospective studies with different ethnicities and large sample sizes are needed to validate our findings.
First record of the genus Jenynsia from marine water on the coast of Punta del Este, Maldonado, Uruguay (Cyprinodontiformes: Anablepidae)
Authors: Calviño P. , Alonso F.
Published: January 2016

The first report of the genus Jenynsia occurring in marine waters is presented here. The evolution of high salinity tolerance within Anablepidae is discussed and a hypothesis is proposed that this characteristic is a plesiomorphic trait in Jenynsia which was probably present in the common ancestor of the Anablepidae.
Neocortical GABA release at high intracellular sodium and low extracellular calcium: an anti‐seizure mechanism
Authors: Rassner Michael P. , Moser Andreas , Follo Marie , Joseph Kevin , van Velthoven‐Wurster Vera , Feuerstein Thomas J.
Published: January 2016

In epilepsy, the GABA and glutamate balance may be disrupted and a transient decrease in extracellular calcium occurs before and during a seizure. Flow Cytometry based fluorescence activated particle sorting experiments quantified synaptosomes from human neocortical tissue, from both epileptic and non‐epileptic patients (27.7% vs. 36.9% GABAergic synaptosomes, respectively). Transporter‐mediated release of GABA in human and rat neocortical synaptosomes was measured using the superfusion technique for the measurement of endogenous GABA. GABA release was evoked by either a sodium channel activator or a sodium/potassium‐ATPase inhibitor when exocytosis was possible or prevented, and when the sodium/calcium exchanger was active or inhibited. The transporter‐mediated release of GABA is because of elevated intracellular sodium. A reduction in the extracellular calcium increased this release (in both non‐epileptic and epileptic, except Rasmussen encephalitis, synaptosomes). The inverse was seen during calcium doubling. In humans, GABA release was not affected by exocytosis inhibition, that is, it was solely transporter‐mediated. However, in rat synaptosomes, an increase in GABA release at zero calcium was only exhibited when the exocytosis was prevented. The absence of calcium amplified the sodium/calcium exchanger activity, leading to elevated intracellular sodium, which, together with the stimulation‐evoked intracellular sodium increment, enhanced GABA transporter reversal. Sodium/calcium exchange inhibitors diminished GABA release. Thus, an important seizure‐induced extracellular calcium reduction might trigger a transporter‐ and sodium/calcium exchanger‐related anti‐seizure mechanism by augmenting transporter‐mediated GABA release, a mechanism absent in rats. Uniquely, the additional increase in GABA release because of calcium‐withdrawal dwindled during the course of illness in Rasmussen encephalitis.

image

Seizures cause high Na+ influx through action potentials. A transient decrease in [Ca2+]e (seizure condition) increases GABA transporter (GAT)‐mediated GABA release because of elevated [Na+]i. This amplifies the Sodium‐Calcium‐Exchanger (NCX) activity, further increasing [Na+]i and GABA release. The reduction in [Ca2+]e triggers a GAT‐NCX related anti‐seizure mechanism by augmenting GAT‐mediated GABA release. This mechanism, obvious in humans, is absent in rats.
Short‐term intervention to reduce anxiety before coronary artery bypass surgery – a randomised controlled trial
Authors: Heilmann Claudia , Stotz Ulrike , Burbaum Christina , Feuchtinger Johanna , Leonhart Rainer , Siepe Matthias , Beyersdorf Friedhelm , Fritzsche Kurt
Published: January 2016

Aims and objectives

The aim of this study was to evaluate an intervention with individualised information and emotional support before coronary artery bypass grafting in a controlled randomised trial.

Background

Anxiety is a typical phenomenon in patients who are to undergo cardiac surgery. Preoperative anxiety has been shown to correlate to adverse postoperative outcomes. Emotional support could be an effective measure to reduce preoperative anxiety.

Design and methods

Patients with planned first coronary artery bypass grafting were randomised into an intervention group (n = 139) and a control group (n = 114). The patients of the control group were routinely informed as usual. The patients of the intervention group received a dialogue with individualised information and emotional support one day before surgery in addition to standard care. This intervention of ~30 minutes was based on a supportive psychotherapy model and was delivered by trained nurses. The primary outcome was the change in anxiety before operation. The secondary outcomes consisted of changes in postoperative anxiety, time on intensive care unit and in‐hospital mortality.

Results

Significantly reduced anxiety was found in the intervention group patients compared to control patients before coronary artery bypass grafting (p < 0·001) and five days after surgery (p < 0·001). Both groups did not differ in in‐hospital mortality and duration of stay in the intensive care unit.

Conclusions

Our short‐term psychosocial intervention in patients undergoing coronary artery bypass grafting had a beneficial effect on reducing pre‐ and postoperative anxiety that was better than routine information alone.

Relevance to clinical practice

These results advocate training for nurses and physicians to provide emotional support to patients before coronary artery bypass grafting.
On duty all the time: health and quality of life among immigrant parents caring for a child with complex health needs
Authors: Kvarme Lisbeth Gravdal , Albertini‐Früh Elena , Brekke Idunn , Gardsjord Ragnhild , Halvorsrud Liv , Liden Hilde
Published: January 2016

Aims and objectives

To provide knowledge about how immigrant parents of children with complex health needs manage their family lives and how this affects their own health and quality of life.

Background

Caregivers of children with complex health needs have additional risk for general health problems and mental health problems and immigrant parents may be more vulnerable to mental distress and failing health and quality of life.

Design

This qualitative study used an exploratory design with individual and focus group interviews. Data collection and analysis followed phenomenological hermeneutic guidelines.

Methods

Individual and group interviews with 27 parents: 18 mothers and 9 fathers from Pakistan, Poland and Vietnam.

Results

Immigrant parents of children with complex health needs experience their own health and quality of life challenges. They described the burden of dealing with their child's needs and special care, which affects their sleep and physical and mental health. Single mothers are particularly vulnerable.

Conclusion

Parents reported positive and negative effects of their caregiving experience that may affect their health and quality of life. Mothers were the primary caregivers and reported more health problems than did fathers. The lack of respite care, social networks and support impacted maternal health. Immigrant parents struggle to access resources for their child with complex health needs.

Relevance to clinical practice

Hospital nurses, schools and community health care can play a valuable role in supporting the parents of children with complex health needs. It is important that parents are informed about their rights and receive a coordinator and interdisciplinary group to ensure that their needs are met with assistance and respite care. That maternal health was worse in this sample implies that health care professionals should pay more attention to reducing stress among these caregivers.
Communication between office‐based primary care providers and nurses working within patients' homes: an analysis of process data from CAPABLE
Authors: Smith Patrick D , Boyd Cynthia , Bellantoni Julia , Roth Jill , Becker Kathleen L , Savage Jessica , Nkimbeng Manka , Szanton Sarah L
Published: January 2016

Aims and Objectives

To examine themes of communication between office‐based primary care providers and nurses working in private residences; to assess which methods of communication elicit fruitful responses to nurses’ concerns.

Background

Lack of effective communication between home health care nurses and primary care providers contributes to clinical errors, inefficient care delivery and decreased patient safety. Few studies have described best practices related to frequency, methods and reasons for communication between community‐based nurses and primary care providers.

Design

Secondary analysis of process data from ‘Community Aging in Place: Advancing Better Living for Elders (CAPABLE)’.

Methods

Independent reviewers analysed nurse documentation of communication (phone calls, letters and client coaching) initiated for 70 patients and analysed 45 letters to primary care providers to identify common concerns and recommendations raised by CAPABLE nurses.

Results

Primary care providers responded to 86% of phone calls, 56% of letters and 50% of client coaching efforts. Primary care providers addressed 86% of concerns communicated by phone, 34% of concerns communicated by letter and 41% of client‐raised concerns. Nurses’ letters addressed five key concerns: medication safety, pain, change in activities of daily living, fall safety and mental health. In letters, CAPABLE nurses recommended 58 interventions: medication change; referral to a specialist; patient education; and further diagnostic evaluation.

Conclusions

Effective communication between home‐based nurses and primary care providers enhances care coordination and improves outcomes for home‐dwelling elders. Various methods of contact show promise for addressing specific communication needs.

Relevance to clinical practice

Nurses practicing within patients’ homes can improve care coordination by using phone calls to address minor matters and written letters for detailed communication. Future research should explore implementation of Situation, Background, Assessment and Recommendation in home care to promote safe and efficient communication. Nurses should empower patients to address concerns directly with providers through use of devices including health passports.
A feasibility and efficacy randomised controlled trial of swaddling for controlling procedural pain in preterm infants
Authors: Ho Lai Ping , Ho Simone SM , Leung Doris YP , So Winnie KW , Chan Carmen WH
Published: January 2016

Aims and objectives

This study aimed to investigate the feasibility and efficacy of swaddling to control procedural pain among preterm infants.

Background

Swaddling has been recommended for controlling neonatal pain. However, the feasibility for use is uncertain and insufficient evidence is available among preterm infants.

Design

A two‐arm randomised controlled trial with repeated measures.

Method

The study was conducted in a 21‐bed neonatal intensive care unit of a regional hospital in Hong Kong. Preterm infants who required heelstick procedure were eligible. Fifty‐four preterm infants between 30–37 gestational weeks were randomly assigned to swaddling (n = 27) and control (standard care, n = 27) groups. Pain assessment was performed pre, during, immediate, two, four, six and eight minutes after heelstick procedure using the Premature Infant Pain Profile.

Results

The mean Premature Infant Pain Profile scores were significantly reduced in the intervention group compared to the control group during, immediate, two, four, and six minutes after the heelstick procedure. The mean changes of heart rate and oxygen saturation in the intervention group were significantly lower than that of the control group at all measured time points. Notably, the swaddled infants quickly resumed to the baseline level at two minutes whereas the control group reached the stable state at an extended period of six minutes.

Conclusion

The findings show that swaddling is feasible and efficacious in controlling pain for heelstick procedure among preterm infants. No adverse effects were observed.

Relevance to clinical practice

This article presents the feasibility and efficacy of swaddling as a non‐pharmacological and non‐invasive intervention to relieve pain during the heelstick procedures among preterm infants. Swaddling can contribute to control minor procedural pain in neonates as one of the simple, safe, cost effective, humanistic and natural analgesia alternatives.
Undefined and unpredictable responsibility: a focus group study of the experiences of informal caregiver spouses of patients with severe COPD
Authors: Bove Dorthe Gaby , Zakrisson Ann‐Britt , Midtgaard Julie , Lomborg Kirsten , Overgaard Dorthe
Published: January 2016

Aims and objectives

To explore how spouses of patients with severe chronic obstructive pulmonary disease experience their role as informal caregiver.

Background

Informal caregiver spouses are of pivotal importance in the way that patients with chronic obstructive pulmonary disease cope with their daily life, including their opportunity to stay at home and avoid hospitalisations in the last stages of the disease. However, caregiving is associated with increased morbidity and mortality among caregivers. Further understanding of the role as an informal caregiver spouse of patients with severe chronic obstructive pulmonary disease is needed to develop supportive interventions aimed at reducing the caregiver burden.

Design

The study had a qualitative exploratory design. The data collection and analysis were based on framework method. Framework method is a thematic methodology and consists of five key stages: familiarisation, identifying a thematic framework, indexing, charting and mapping & interpretation.

Methods

Three focus groups were conducted in November 2013 with 22 spouses of patients with severe chronic obstructive pulmonary disease.

Results

Undefined and unpredictable responsibility was found to be the overarching theme describing the informal caregiver role. Underlying themes were: being constantly in a state of alertness, social life modified, maintaining normality, ambivalence in the relationship and a willingness to be involved.

Conclusions

The informal caregiver spouses experienced ambiguity about expectations from their private and the health professionals’ surroundings. The informal caregiver spouses wanted to provide meaningful care for their partners, but sought knowledge and support from the health professionals.

Relevance to clinical practice

We recommend that nurses take on the responsibility for including the informal caregiver spouses in those aspects of decision‐making that involve the common life of the patients and their spouses.
Successful angioplasty during pregnancy for renal artery stenosis
Authors: Margueritte François , Velasco Stephane , Pourrat Olivier , Pierre Fabrice
Published: January 2016

Renal artery stenosis can be diagnosed during pregnancy and treated at the same time. A 30‐year‐old woman had a sudden, severe but asymptomatic hypertensive crisis at 21 weeks of gestation. The diagnosis of renal artery stenosis suspected on Doppler ultrasonography was confirmed and treated by renal angioplasty, which reduced her blood pressure. At 27 weeks of gestation, her blood pressure increased again, associated with significant proteinuria, suggesting pre‐eclampsia. A cesarean section was performed giving birth to a healthy 940‐g child. Renal artery stenosis should be considered when sudden and early‐onset hypertension appears during pregnancy.
Risk Factors and Clinical Impacts of Peri‐Stent Contrast Staining After Second‐Generation Drug‐Eluting Stent Implantation
Authors: Tokuda Takahiro , Yamawaki Masahiro , Mori Shinsuke , Takimura Hideyuki , Sakamoto Yasunari , Kobayashi Norihiro , Araki Motoharu , Hirano Keisuke , Ito Yoshiaki
Published: January 2016

Background

Peri‐stent contrast staining (PSS) after sirolimus‐eluting stent implantation is associated with target lesion revascularization (TLR) and very late stent thrombosis. However, the risk factors and clinical sequelae of PSS after second‐generation DES implantation remain unclear.

Methods and Results

This study comprised 2,090 patients with 2,883 lesions treated with second‐generation DES from April 2009 to February 2013. Angiographic findings and clinical outcomes were compared between PSS and non‐PSS groups. Follow‐up angiography was available for 2,411 lesions. PSS was observed in 23 lesions: 4 in biolimus‐eluting stents, 4 in zotarolimus‐eluting stents (ZES), and 15 in everolimus‐eluting stents (EES). Right coronary artery lesions, chronic total occlusion (CTO), and lesions with severe angulation (>90°) were more frequent in the PSS group compared with the non‐PSS group. Lesions were longer and the cumulative TLR incidence at 3 years was higher in the PSS group than those in the non‐PSS group (27.9 mm vs. 19.4 mm, P < 0.0001; 27.4% vs. 8.6%, P = 0.0002). There was no significant difference in stent thrombosis between the two groups. Multivariable analysis identified CTO [odds ratio (OR) 3.75, 95%CI 1.52–8.88, P = 0.005] as an independent predictor of PSS.

Conclusions

PSS after second‐generation DES implantation was associated with an increased risk of subsequent TLR. CTO was the independent predictor of PSS. (J Interven Cardiol 2016;29:179–187)
Salivary duct carcinoma: a Danish national study
Authors: Breinholt Helle , Elhakim Mohammad Talal , Godballe Christian , Andersen Lisbeth Juhler , Primdahl Hanne , Kristensen Claus A. , Bjørndal Kristine
Published: January 2016

Background

To present the first national series of salivary duct carcinoma patients, including survival rates and an analysis of prognostic factors.

Methods

By merging three Danish nationwide registries that encompass an entire population, 34 patients diagnosed with salivary duct carcinoma from 1990 to 2005 were identified. Histological slides were reviewed, and data concerning demographics, tumour site, clinical stage, treatment profiles and follow‐up were retrieved. Survival estimates and prognostic factors were evaluated by comparing Kaplan–Meier plots using the Mantel–Haenszel log‐rank test.

Results

Salivary duct carcinoma showed an incidence of 0.04/100.000 inhabitants/year. Distant recurrence was seen in 52% of patients. Five‐year overall survival, disease‐specific survival and recurrence‐free survival were 32%, 42% and 35%, respectively. Univariate analyses suggested that overall stage (III/IV) and vascular invasion have a negative impact on all survival measures. Involved resection margins correlated with a poorer overall survival and disease‐specific survival, whereas adjuvant radiotherapy improved overall survival and recurrence‐free survival.

Conclusions

Salivary duct carcinoma incidence averages to two episodes per year in the entire Kingdom of Denmark. With half of patients in this study experiencing distant recurrences and only a third surviving at 5 years, prognosis is dismal. Advanced overall stage, vascular invasion and involved resection margins all seem to correlate with a poorer survival, while adjuvant radiotherapy significantly improved outcome. Extensive T‐site surgery, neck dissection and adjuvant radiotherapy are therefore recommended.
Aragonite infill in overgrown conceptacles of coralline Lithothamnion spp. (Hapalidiaceae, Hapalidiales, Rhodophyta): new insights in biomineralization and phylomineralogy
Authors: Krayesky‐Self Sherry , Richards Joseph L. , Rahmatian Mansour , Fredericq Suzanne
Published: January 2016

New empirical and quantitative data in the study of calcium carbonate biomineralization and an expanded coralline psbA framework for phylomineralogy are provided for crustose coralline red algae. Scanning electron microscopy (SEM) and energy dispersive spectrometry (SEM‐EDS) pinpointed the exact location of calcium carbonate crystals within overgrown reproductive conceptacles in rhodolith‐forming Lithothamnion species from the Gulf of Mexico and Pacific Panama. SEM‐EDS and X‐ray diffraction (XRD) analysis confirmed the elemental composition of these calcium carbonate crystals to be aragonite. After spore release, reproductive conceptacles apparently became overgrown by new vegetative growth, a strategy that may aid in sealing the empty conceptacle chamber, hence influencing the chemistry of the microenvironment and in turn promoting aragonite crystal growth. The possible relevance of various types of calcium carbonate polymorphs present in the complex internal structure and skeleton of crustose corallines is discussed. This is the first study to link SEM, SEM‐EDS, XRD, Microtomography and X‐ray microscopy data of aragonite infill in coralline algae with phylomineralogy. The study contributes to the growing body of literature characterizing and speculating about how the relative abundances of carbonate biominerals in corallines may vary in response to changes in atmospheric pCO2, ocean acidification, and global warming.
Changes in Body Mass Index and the Trajectory of Depressive Symptoms Among Rural Men and Women
Authors: Chang Jen Jen , Salas Joanne , Tabet Maya , Kasper Zachary , Elder Keith , Staley Holly , Brownson Ross C.
Published: January 2016

Purpose

This study examined the association between body mass index (BMI) changes over time and the risk of elevated depressive symptoms in a cohort of Midwestern rural adults.

Methods

The longitudinal study used data from a telephone survey in 2005 including 1,475 men and women enrolled in the Walk the Ozarks to Wellness Project from 12 rural communities in Missouri, Arkansas, and Tennessee. Multilevel random intercept mixed models were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for the association between BMI calculated from self‐reported height and body weight and elevated depressive symptoms, adjusting for sociodemographic, behavioral, and medical variables.

Findings

Elevated depressive symptoms were common in this rural population (17%‐19%) and the mean BMI was 28 kg/m2. For each unit increase in BMI over time, representing an average increase of about 5.8 pounds from baseline weight, there was a 6% increased odds of elevated depressive symptoms (aOR: 1.06, 95% CI: 1.02‐1.12).

Conclusions

Our findings hold important public health implications given the increasing rates of overweight and obesity over the past couple of decades, particularly among rural adults.
Metabolic and Hormonal Response to a Feed‐challenge Test in Lean and Overweight Dogs
Authors: Söder J. , Wernersson S. , Hagman R. , Karlsson I. , Malmlöf K. , Höglund K.
Published: January 2016

Background

Obese dogs risk poor life quality, creating a need for increased knowledge of metabolism in overweight dogs.

Objectives

Investigate postprandial metabolic and hormonal responses to a high‐fat mixed‐meal in dogs and responses of lean versus overweight dogs.

Animals

Twenty‐eight healthy intact male Labrador Retrievers were included.

Methods

Prospective observational study. Twelve dogs were grouped as lean (body condition score (BCS 4–5), 10 as slightly overweight (BCS 6), and 6 as overweight (BCS 6.5–8) on a 9‐point scale. After an overnight fast, urine and blood samples were collected. Dogs were then fed a high‐fat mixed‐meal, and blood was collected hourly for 4 hours and urine after 3 hours.

Results

Postprandial concentrations of insulin and glucagon were increased at 1 hour (both P < 0.0001), triglycerides at 2 hours (P < 0.0001), and glucose at 3 hours (P = 0.004); and all remained increased throughout the feed‐challenge in all dogs. Postprandial urine cortisol/creatinine ratio was higher than fasting values (P = 0.001). Comparing between groups, there was an overall higher triglyceride response in overweight compared to lean (P = 0.001) and slightly overweight (P = 0.015) dogs. Overweight dogs also had higher fasting cortisol/creatinine ratio compared to lean dogs (P = 0.024).

Conclusions and Clinical Importance

Postprandial responses of dogs to a high‐fat mixed‐meal were similar to those previously reported in people. The higher postprandial triglyceride response and fasting cortisol/creatinine ratio in the overweight dogs could be early signs of metabolic imbalance. Thus, although overweight dogs often appear healthy, metabolic alterations might be present.