bluuebunny/crossref_metadata_2025 huggingface dataset:
Adapting the Vulnerable Elders Survey‐13 to Predict Mortality Using Responses to the Medicare Health Outcomes Survey
Authors: Beckett Megan K. , Elliott Marc N. , Ritenour Douglas , Giordano Laura A. , Grace Susan C. , Malinoff Rochelle , Saliba Debra
Published: April 2017

Objectives

To use items from the Medicare Health Outcomes Survey (HOS) to adapt or validate a simple method for identifying community‐dwelling older adults at greater risk of death and to extend the method to identify a very high‐risk group.

Design

Analysis of longitudinal data.

Setting

National sample of beneficiaries from Medicare Advantage plans with 500 or more enrollees.

Participants

Medicare beneficiaries aged 65 and older responding to 2009 baseline and 2011 follow‐up HOS (N = 238,687).

Measurements

Bivariate and multivariate analyses of the HOS; adaptation and validation of a previously validated Vulnerable Elders Survey‐13 (VES‐13) scoring system that uses age and self‐reported function to predict mortality.

Results

A modified predictive model, that uses substitutes for several items in the previously validated VES‐13, predicted 2‐year mortality; 10.6% of those scoring 3 or more, and 2.4% of those scoring less than 3 died within 2 years (relative risk of death 4.4, similar to 4.2 for the original VES‐13 sample), and 15.5% of those scoring 7 or more died within 2 years (relative risk of death (relative to scores <3) of 6.5). Sixteen percent of HOS beneficiaries were missing some data; 2‐year mortality for those with missing items was 9.5%, versus 7.1% for those with no missing items (P < .001). Imputation of median values for missing VES‐13 items results in valid predictions of mortality for those with partially missing data.

Conclusion

The VES‐13 algorithm is robust to substitution of functional items and can be used to identify very high‐risk older adults. Multiple imputation of missing items reduces loss‐to‐follow‐up bias and increases sample size.
Home‐ and Community‐Based Occupational Therapy Improves Functioning in Frail Older People: A Systematic Review
Authors: De Coninck Leen , Bekkering Geertruida E. , Bouckaert Leen , Declercq Anja , Graff Maud J. L. , Aertgeerts Bert
Published: April 2017

Objectives

The objective is to assess the effectiveness of occupational therapy to improve performance in daily living activities in community‐dwelling physically frail older people.

Design

We conducted a systematic review and meta‐analysis. We included randomized controlled trials reporting on occupational therapy as intervention, or as part of a multidisciplinary approach. This systematic review was carried out in accordance with the Cochrane methods of systematic reviews of interventions.

Measurements

Meta‐analyses were performed to pool results across studies using the standardized mean difference. The primary outcome measures were mobility, functioning in daily living activities, and social participation. Secondary outcome measures were fear of falling, cognition, disability, and number of falling persons.

Results

Nine studies met the inclusion criteria. Overall, the studies were of reasonable quality with low risk of bias. There was a significant increase in all primary outcomes. The pooled result for functioning in daily living activities was a standardized mean difference of −0.30 (95% CI −0.50 to −0.11; P = .002), for social participation −0.44 (95% CI −0.69, −0.19; P = .0007) and for mobility −0.45 (95% CI −0.78 to −0.12; P = .007). All secondary outcomes showed positive trends, with fear of falling being significant. No adverse effects of occupational therapy were found.

Conclusion

There is strong evidence that occupational therapy improves functioning in community‐dwelling physically frail older people.
End‐of‐Life Care Transition Patterns of Medicare Beneficiaries
Authors: Wang Shi‐Yi , Aldridge Melissa D. , Gross Cary P. , Canavan Maureen , Cherlin Emily , Bradley Elizabeth
Published: April 2017

Objectives

To characterize the patterns of transitions in care and factors associated with multiple transitions in the last 6 months of life of U.S. decedents (N = 660,132).

Design

Retrospective study.

Setting

United States.

Participants

Medicare beneficiaries aged 66 and older who died from July to December 2011.

Measurements

Transitions between healthcare settings (e.g., hospital, skilled nursing facility, inpatient hospice, home hospice, home without hospice) in the last 6 months of life. A count variable for number of transitions was summarized, and Sankey diagrams were produced to illustrate the sequences of healthcare transitions. Multivariable analyses were used to identify factors associated with likelihood of having four or more transitions.

Results

More than 80% decedents (n = 556,437) had at least one transition within the last 6 months of life; 218,731 had four or more transitions within the last 6 months of life. The most‐frequent transition pattern (19.3% of all decedents; n = 127,435) was home to hospital, back to home or skilled nursing facility, to hospital again, and then to settings other than hospital, ending with four or more transitions. The average number of transitions in the last 6 months of life varied substantially across states, ranging from 1.8 in Alaska to 3.1 in New Jersey. Transitions became more intensive for decedents approaching death. In multivariable analyses, women, blacks, individuals younger than 85, and individuals without dementia were more likely to have four or more transitions (all P < .05).

Conclusion

Approximately one‐third of the Medicare beneficiaries who died in 2011 had four or more transitions within their last 6 months of life. Identifying interventions that can facilitate care transitions consistent with beneficiaries’ preferences is warranted.
Patient Satisfaction With Maternity Waiting Homes in Liberia: A Case Study During the Ebola Outbreak
Authors: Lori Jody R. , Munro‐Kramer Michelle L. , Shifman Jordan , Amarah Patricia N. M. , Williams Garfee
Published: April 2017

Introduction

Liberia in West Africa has one of the highest maternal mortality ratios in the world (990/100,000 live births). Many women in Liberia live in rural, remote villages with little access to safe maternity services. The World Health Organization has identified maternity waiting homes (MWHs) as one strategy to minimize the barrier of distance in accessing a skilled birth attendant. However, limited data exist on satisfaction with MWHs or maternal health care in Liberia.

Methods

This mixed‐methods case study examines women's satisfaction with their stay at a MWH and compares utilization rates before and during the Ebola outbreak. From 2012 to 2014, 650 women who stayed at one of 6 MWHs in rural Liberia during the perinatal or postnatal period were surveyed. Additionally, 60 semi‐structured interviews were conducted with traditional providers, skilled birth attendants, and women utilizing the MWHs. Quantitative analyses assessed satisfaction rates before and during the Ebola outbreak. Content analysis of semi‐structured interviews supplemented the quantitative data and provided a lens into the elements of satisfaction with the MWHs.

Results

The majority of women who utilized the MWHs stated they would suggest the MWH to a friend or relative who was pregnant (99.5%), and nearly all would utilize the home again (98.8%). Although satisfaction with the MWHs significantly decreased during the Ebola outbreak (P < .001), participants were satisfied overall with the MWHs. Content analysis identified areas of satisfaction that encompassed the themes of restful and supportive environment as well as areas for improvement such as lacking necessary resources and loneliness.

Discussion

This case study demonstrated that women using MWHs in Bong County, Liberia are generally satisfied with their experience and plan to use an MWH again during future pregnancies to access a skilled birth attendant for birth. Women are also willing to encourage family and friends to use MWHs.
Molecular mechanisms underlying protective effects of quercetin against mitochondrial dysfunction and progressive dopaminergic neurodegeneration in cell culture and MitoPark transgenic mouse models of Parkinson's Disease
Authors: Ay Muhammet , Luo Jie , Langley Monica , Jin Huajun , Anantharam Vellareddy , Kanthasamy Arthi , Kanthasamy Anumantha G.
Published: April 2017

Quercetin, one of the major flavonoids in plants, has been recently reported to have neuroprotective effects against neurodegenerative processes. However, since the molecular signaling mechanisms governing these effects are not well clarified, we evaluated quercetin's effect on the neuroprotective signaling events in dopaminergic neuronal models and further tested its efficacy in the MitoPark transgenic mouse model of Parkinson's disease (PD). Western blot analysis revealed that quercetin significantly induced the activation of two major cell survival kinases, protein kinase D1 (PKD1) and Akt inMN9D dopaminergic neuronal cells. Furthermore, pharmacological inhibition or siRNAknockdown ofPKD1 blocked the activation of Akt, suggesting thatPKD1 acts as an upstream regulator of Akt in quercetin‐mediated neuroprotective signaling. Quercetin also enhanced cAMP response‐element binding protein phosphorylation and expression of the cAMP response‐element binding protein target gene brain‐derived neurotrophic factor. Results fromqRT‐PCR, Western blot analysis, mtDNAcontent analysis, and MitoTracker assay experiments revealed that quercetin augmented mitochondrial biogenesis. Quercetin also increased mitochondrial bioenergetics capacity and protectedMN9D cells against 6‐hydroxydopamine‐induced neurotoxicity. To further evaluate the neuroprotective efficacy of quercetin against the mitochondrial dysfunction underlyingPD, we used the progressive dopaminergic neurodegenerative MitoPark transgenic mouse model ofPD. Oral administration of quercetin significantly reversed behavioral deficits, striatal dopamine depletion, andTHneuronal cell loss in MitoPark mice. Together, our findings demonstrate that quercetin activates thePKD1‐Akt cell survival signaling axis and suggest that further exploration of quercetin as a promising neuroprotective agent for treatingPDmay offer clinical benefits.

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Contrast‐induced nephropathy in patients undergoing endovascular peripheral vascular intervention: Incidence, risk factors, and outcomes as observed in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium
Authors: Grossman P. Michael , Ali Syed S. , Aronow Herbert D. , Boros Michael , Nypaver Timothy J. , Schreiber Theodore L. , Park Yeo Jung , Henke Peter K. , Gurm Hitinder S.
Published: April 2017

Background

The incidence, risk factors, and outcomes associated with Contrast‐induced nephropathy (CIN) after Percutaneous Vascular Intervention (PVI) in contemporary medical practice are largely unknown.

Methods

A total of 13 126 patients undergoing PVI were included in the analysis. CIN was defined as an increase in serum creatinine from pre‐PVI baseline to post‐PVI peak Cr of ≥0.5 mg/dL.

Results

CIN occurred in 3% (400 patients) of the cohort, and 26 patients (6.5%) required dialysis. Independent predictors of CIN were high and low body weight, diabetes, heart failure, anemia, baseline renal dysfunction, critical limb ischemia, and a higher acuity of the PVI procedure and a contrast dose that was greater than three times the calculated creatinine clearance (CCC) (adjusted OR 1.4, 95% CI: 1.1‐1.8, P = 0.003). CIN was strongly associated with adverse outcome including in‐hospital death (adjusted OR 18.1, CI 10.7‐30.6, P < 0.001), myocardial infarction (adjusted OR 16.2, CI 8.9‐29.5, P < 0.001), transient ischemic attack/stroke (adjusted OR 5.5, CI 3.2‐14.9, P = 0.001), vascular access complications (adjusted OR 3.4, CI 2.3‐5, P < 0.001), and transfusion (adjusted OR 7, CI 5.4‐9, P < 0.001). Hospital stay was longer in patients who developed CIN versus those who did not.

Conclusions

CIN is not an uncommon complication associated with PVI, can be reliably predicted from pre‐procedural variables, including a contrast dose of greater than three times the CCC and is strongly associated with the risk of in‐hospital death, MI, stroke, transfusion, and increased hospital length of stay.
Why do people stay in or leave Fukushima?
Authors: Horie Shinya , Managi Shunsuke
Published: April 2017

From the originally constructed survey data from 2011 Fukushima incident, this paper empirically assessed the sources of failures in disaster risk mitigation in short run. Although residential relocation from the cites at risk is one of the effective risk reduction measures, the relocation incurs mobility costs of developing social capital such as communities or searching public services such as education and medical institutions. The estimation results showed that the residents in the disaster cites of 2011 Fukushima incident can tolerate higher risks of radiation exposure when they have attachment to the original residence or higher demands for the public services, and can stay in the cites at risks consequently. Because the tolerance level can depend on the information associated with the risks, the results imply that the authorities’ providing the correct information is one of the keys for the disaster risk reduction in short run.
Glucose‐6‐phosphate dehydrogenase (G6PD)‐deficient infants: Enzyme activity and gene variants as risk factors for phototherapy in the first week of life
Authors: Wong Fei‐Liang , Ithnin Azlin , Othman Ainoon , Cheah Fook‐Choe
Published: April 2017

Aim

Glucose‐6‐phosphate dehydrogenase (G6PD) deficiency is a recognised cause of severe neonatal hyperbilirubinaemia, and identifying which infants are at risk could optimise care and resources. In this study, we determined if G6PD enzyme activity (EA) and certain gene variants were associated with neonatal hyperbilirubinaemia requiring phototherapy during the first week after birth.

Methods

Newborn infants with G6PD deficiency and a group with normal results obtained by the fluorescent spot test were selected for analyses of G6PD EA and the 10 commonly encountered G6PD mutations in this region, relating these with whether the infants required phototherapy before discharge from the hospital in the first week.

Results

A total of 222 infants with mean gestation and birth weight of 38.3 ± 1.8 weeks and 3.02 ± 0.48 kg, respectively, were enrolled. Of these, n = 121 were deficient with EA ≤6.76 U/g Hb, and approximately half (43%) received phototherapy in the first week after birth. The mean EA level was 3.7 U/g Hb. The EA had good accuracy in predicting phototherapy use, with area under the receiver‐operating‐characteristic curve of 0.81 ± 0.05. Infants on phototherapy more commonly displayed World Health Organization Class II mutations (<10% residual EA). Logistic regression analysis showed that deficiency in EA and mutation at c.1388G>A (adjusted odds ratio, 1.5 and 5.7; 95% confidence interval: 1.31–1.76 and 1.30–25.0, respectively) were independent risk factors for phototherapy.

Conclusion

Low G6PD EA (<6.76 U/g Hb) and the G6PD gene variant, c.1388G>A, are risk factors for the need of phototherapy in newborn infants during the first week after birth.
Chloroplast overexpression of rice caffeic acid O‐methyltransferase increases melatonin production in chloroplasts via the 5‐methoxytryptamine pathway in transgenic rice plants
Authors: Choi Geun‐Hee , Lee Hyoung Yool , Back Kyoungwhan
Published: April 2017

Recent analyses of the enzymatic features of various melatonin biosynthetic genes from bacteria, animals, and plants have led to the hypothesis that melatonin could be synthesized via the 5‐methoxytryptamine (5‐MT) pathway. 5‐MT is known to be synthesized in vitro from serotonin by the enzymatic action of O‐methyltransferases, including N‐acetylserotonin methyltransferase (ASMT) and caffeic acid O‐methyltransferase (COMT), leading to melatonin synthesis by the subsequent enzymatic reaction with serotonin N‐acetyltransferase (SNAT). Here, we show that 5‐MT was produced and served as a precursor for melatonin synthesis in plants. When rice seedlings were challenged with senescence treatment, 5‐MT levels and melatonin production were increased in transgenic rice seedlings overexpressing the rice COMT in chloroplasts, while no such increases were observed in wild‐type or transgenic seedlings overexpressing the rice COMT in the cytosol, suggesting a 5‐MT transport limitation from the cytosol to chloroplasts. In contrast, cadmium treatment led to results different from those in senescence. The enhanced melatonin production was not observed in the chloroplast COMT lines relative over the cytosol COMT lines although 5‐MT levels were equally induced in all genotypes upon cadmium treatment. The transgenic seedlings with enhanced melatonin in their chloroplasts exhibited improved seedling growth vs the wild type under continuous light conditions. This is the first report describing enhanced melatonin production in chloroplasts via the 5‐MT pathway with the ectopic overexpression of COMT in chloroplasts in plants.
Clinical Characteristics of Adult Dogs More Than 5 Years of Age at Presentation for Patent Ductus Arteriosus
Authors: Boutet B.G. , Saunders A.B. , Gordon S.G.
Published: April 2017

Background

The median age at presentation for dogs with patent ductus arteriosus (PDA) is <6 months of age, and closure is associated with a decrease in heart size and increased survival time, which are not well described in older dogs.

Objectives

To describe the clinical characteristics of dogs withPDA≥5 years of age at the time of presentation to a veterinary referral hospital.

Animals

35 client‐owned dogs.

Methods

Retrospective case series.

Results

PDAwas diagnosed at a median age of 7.4 years (range, 5.1–12.3 years). Females represented 23/35 (65.7%) of the patients. Concurrent heart disease included degenerative mitral valve disease (DMVD; 13), arrhythmias (11), pulmonary hypertension (7), and other congenital defects (2). Cardiomegaly was documented in the majority of dogs consisting of left ventricular enlargement (91%) and left atrial enlargement (86%). Median vertebral heart size in 24 dogs was 12.9 (range, 10.7–18.2). ThePDAshunt direction was left‐to‐right in 33 and bidirectional in 2 dogs. Closure was performed in 26 dogs, including 4 with pulmonary hypertension. In 10 dogs receiving furosemide pre‐operatively for management of heart failure, furosemide was discontinued (8) or the dosage decreased (2) at the time of discharge.

Conclusions and Clinical Importance

Adult dogs can present with a left‐to‐right shuntingPDAthat results in cardiomegaly and clinical signs that can improve or resolve withPDAclosure. This improvement is also apparent in dogs withPDAcomplicated byDMVD. Pulmonary hypertension that does not result in complete right‐to‐left shunting should not be considered a contraindication to closure.
Prognostic Factors Associated with Recovery of Ambulation and Urinary Continence in Dogs with Acute Lumbosacral Spinal Cord Injury
Authors: Shaw T.A. , De Risio L. , Laws E.J. , Rose J.H. , Harcourt‐Brown T.R. , Granger N.
Published: April 2017

Background

Limited information is available about prognostic factors for recovery after spinal cord injury (SCI) to the L4‐S3 segments. Previous research suggests that L4‐S3 SCI does not have a worse prognosis than T3‐L3 SCI.

Hypothesis/Objectives

To elucidate prognostic factors for regaining urinary continence and ambulation in dogs with L4‐S3 SCI and compare prognosis to T3‐L3 SCI.

Animals/Methods

A retrospective study on 61 nonambulatory dogs with L4‐S3 SCI, matched to dogs with T3‐L3 SCI, compared 3 weeks after onset. Prognostic factors explored using logistic regression and used for matching: nonchondrodystrophic dogs >15 kg versus dogs that were chondrodystrophic or <15 kg; compressive versus noncompressive lesions; presence versus absence of conscious pain perception (CPP); and lower vs upper motor neuron (LMN/UMN) incontinence.

Results

Fewer L4‐S3 dogs regained continence compared to T3‐L3 dogs (64 vs 85%, P = .0033), but no difference existed for regaining ambulation (66 vs 75%, P = .1306). In L4‐S3 SCI dogs, fewer dogs regained continence with loss of CPP (P < .001), LMN incontinence (P = .004), and noncompressive lesions (P = .006). Negative prognostic factors for regaining ambulation included absent CPP (P < .001) and large nonchondrodystrophic breed (P = .022).

Conclusions and Clinical Importance

Dogs with L4‐S3 SCI have a poorer short‐term prognosis than do dogs with T3‐L3 SCI. Dogs with L4‐S3 SCI had a poor prognosis with loss of CPP, or noncompressive lesions combined with LMN incontinence. Small‐breed or chondrodystrophic dogs with retained CPP, compressive lesions, and UMN incontinence had an excellent prognosis. These findings may help guide decision‐making in L4‐S3 SCI.
Tissue regeneration in dentistry: Can salamanders provide insight?
Authors: Sader F , Denis J‐F , Roy S
Published: April 2017

The ability to regenerate damaged tissues would be of tremendous benefit for medicine and dentistry. Unfortunately, humans are unable to regenerate tissues such as teeth and fingers or to repair injured spinal cord. With an aging population, health problems are more prominent and dentistry is no exception as loss of bone tissue in the orofacial sphere from periodontal disease is on the rise. Humans can repair oral soft tissues exceptionally well; however, hard tissues, such as bone and teeth, are devoid of the ability to repair well or at all. Fortunately, Mother Nature has solved nearly every problem that we would like to solve for our own benefit and tissue regeneration is no exception. By studying animals that can regenerate, like Axolotls (Mexican salamander), we hope to find ways to stimulate regeneration in humans. We will discuss the role of the transforming growth factor beta cytokines as they are central to wound healing in humans and regeneration in Axolotls. We will also compare wound healing in humans (skin and oral mucosa) to Axolotl skin wound healing and limb regeneration. Finally, we will address the problem of bone regeneration and present results in salamanders which indicate that in order to regenerate bone you need to recruit non‐bone cells. Fundamental research, such as the work being performed in animals that can regenerate, offers insight to help understand why some treatments are successful while others fail when it comes to specific tissues such as bones.
Prognostic implication of left atrial sphericity in atrial fibrillation patients undergoing radiofrequency catheter ablation
Authors: Moon Jeonggeun , Lee Hye‐Jeong , Yu Jongwook , Pak Hui‐Nam , Ha Jong‐Won , Lee Moon‐Hyoung , Kim Young Jin , Joung Boyoung
Published: April 2017

Background

Left atrial (LA) sphericity can predict recurrence of atrial fibrillation (AF) after radiofrequency catheter ablation (RFCA). We sought to reconfirm the prognostic role of atrial sphericity after RFCA of atrial fibrillation (AF), assess any relationship between the atrial pressure and sphericity, and determine the characteristics of the patients for whom atrial sphericity was most highly predictive.

Methods

All 148 nonvalvular AF patients (57 ± 11 years, 121 men, 95 paroxysmal AF [PaAF]) who underwent RFCA were enrolled. The LA volume (LAV) was determined and LA sphericity assessed from three‐dimensional computed tomographic images. The preprocedural mean LA pressure (mLAP) was measured.

Results

After a 3‐month blanking period, AF/atrial tachycardia (AT) recurrences within 1 year were documented in 38 patients (26%). Patients with recurrence had a greater LAV (124 ± 35 mL vs 151 ± 45 mL, P < 0.001) and LA sphericity (0.669 ± 0.040 vs 0.684 ± 0.038, P = 0.041). In patients with smaller LAs (LAV < 125 mL), LA sphericity predicted AF/AT recurrences (odds ratio [OR]: 1.030 [for each 0.001 increase], 95% confidence interval [CI]: 1.008–1.053, P = 0.007), whereas the LAV did not. In patients with larger LAs (LAV ≥ 125 mL), the LAV could predict recurrence (OR: 1.021, 95% CI: 1.001–1.041, P = 0.036), while the LA sphericity could not. The LA sphericity and mLAP are linearly correlated (r = 0.345, P < 0.022) in persistent AF, but not PaAF.

Conclusions

LA spherical change precedes severe LA enlargement in AF. It predicts 1‐year AF/AT recurrence after RFCA and is more important than the LA size in patients with less severe LA enlargement.
Validation of Adapted Dartmouth Operative Conditions Scale for sedation during pediatric esophagogastroduodenoscopy
Authors: Chandran Vanmathi , Jagadisan Barath , Ganth Barani
Published: April 2017

Aims

Pediatric esophagogastroduodenoscopy requires deep sedation as it involves stimulation of the airway. Frequency of adverse events is higher with esophagogastroduodenoscopy. Hence, monitoring needs sedation scales like the Dartmouth Operative Condition Scale that identifies safe states of sedation. This study aims at validating the Adapted Dartmouth Operative Condition Scale for sedation rating by pediatricians during pediatric esophagogastroduodenoscopy.

Methods

Items in the Dartmouth Operating Conditions Scale were adapted for pediatric esophagogastroduodenoscopy. Videos of 35 procedures were recorded. The recording started 10 min before sedation and continued till recovery. The videos were split into preprocedure videos, intraprocedure videos, and recovery videos, and further split into 30‐s clips. Twenty representative intraprocedure videos clips were selected. Ten raters scored the videos with the Adapted Dartmouth Operating Conditions Scale and modified‐COMFORT score. The Adapted Dartmouth Operating Conditions Scale scoring was repeated after a month. The preprocedure videos, intraprocedure videos, and recovery videos of ten patients (six clips each) were scored by one rater to assess responsiveness.

Results

The Adapted Dartmouth Operating Conditions Scale detected nonoptimal sedation states including laryngospasm due to undersedated states. It showed fair interrater reliability at timeline‐1 (intraclass correlation coefficient = 0.45) and timeline‐2 (intraclass correlation coefficient = 0.65) but poor intrarater reliability (intraclass correlation coefficient = 0.32). There was significant positive correlation with modified‐COMFORT (Spearman's rank order correlation, r = 0.150). Responsiveness was demonstrated by the difference in the preprocedure videos, intraprocedure videos, and recovery videos scores (F = 126.50).

Conclusion

The Adapted Dartmouth Operating Conditions Scale detects nonoptimal sedation states during pediatric‐esophagogastroduodenoscopy. It shows good criterion validity, interrater reliability, and responsiveness. Poor intrarater reliability seen in our study could be due to item ambiguity arising from the mode of training of the raters in the Dartmouth Operating Conditions Scale.
Elevated auxin and reduced cytokinin contents in rootstocks improve their performance and grafting success
Authors: Li Wei , Fang Chu , Krishnan Sanalkumar , Chen Junmei , Yu Hao , Murphy Angus S. , Merewitz Emily , Katin‐Grazzini Lorenzo , McAvoy Richard J. , Deng Ziniu , Zale Janice , Li Yi
Published: April 2017

Plant grafting is an important technique for horticultural and silvicultural production. However, many rootstock plants suffer from undesirable lateral bud outgrowth, low grafting success rates or poor rooting. Here, we used a root‐predominant gene promoter (SbUGT) to drive the expression of a tryptophan‐2‐monooxygenase gene (iaaM) from Agrobacterium tumefaciens to increase auxin levels in tobacco. The transgenic plants, when used as a rootstock, displayed inhibited lateral bud outgrowth, enhanced grafting success rate and improved root initiation. However, root elongation and biomass of SbUGT::iaaM transgenic plants were reduced compared to those of wild‐type plants. In contrast, when we used this same promoter to drive CKX (a cytokinin degradation gene) expression, the transgenic tobacco plants displayed enhanced root elongation and biomass. We then made crosses between the SbUGT::CKX and SbUGT::iaaM transgenic plants. We observed that overexpression of the CKX gene neutralized the negative effects of auxin overproduction on root elongation. Also, the simultaneous expression of both the iaaM and CKX genes in rootstock did not disrupt normal growth and developmental patterns in wild‐type scions. Our results demonstrate that expression of both the iaaM and CKX genes predominantly in roots of rootstock inhibits lateral bud release from rootstock, improves grafting success rates and enhances root initiation and biomass.
Metabolic adaptations for isopod specialization in three species of Dysdera spiders from the Canary Islands
Authors: Toft Søren , Macías‐Hernández Nuria
Published: April 2017

The spider genus Dysdera is considered to comprise specialist isopod feeders, although the degree of specialization varies between species, depending on morphological (shape of chelicerae), behavioural (attack tactics) and metabolic (food quality of prey) adaptations. Dysdera has radiated extensively in the Canary Islands (currently 47 endemic species are described) and codistributed species have different cheliceral shapes and body sizes indicating different feeding niches. In the present study, we investigate the existence of metabolic adaptations to feeding on isopods by three endemic species (Dysdera insulana Simon, Dysdera macra Simon and Dysdera verneaui Simon) from Tenerife. We hypothesize that there is enhanced extraction efficiency of fundamental macronutrients from isopods compared with control prey in species with special morphological and behavioural adaptations for this prey type. We measure quantitatively spider growth, dry mass consumption, lipid and nitrogen consumption, and calculate growth efficiency and efficiency of utilization of dry mass, lipid and nitrogen. The results show that all three species are able to utilize both prey types, indicating that none of them are strict isopod specialist. Dysdera insulana shows enhanced growth efficiency and D. macra shows enhanced nitrogen extraction efficiency compared with D. verneaui when feeding on Porcellio rather than on Musca. Both traits indicate likely adaptations for the utilization of isopods. Spider species, sex and prey type all affect lipid and nitrogen extraction efficiencies, indicating that spiders do not simply extract nutrients in the proportions available. The results support the hypothesis that adaptations for enhanced digestion of focal prey evolve in species that already have adaptations for enhanced capture success.
Transitional care interventions: Relevance for nursing in the community
Authors: Coffey Alice , Mulcahy Helen , Savage Eileen , Fitzgerald Serena , Bradley Colin , Benefield Lazelle , Leahy‐Warren Patricia
Published: April 2017

Objectives

The coordination and integration of health care is compromised by complex challenges related to transitions between care settings, greater prevalence of chronic health conditions, and older individuals with increasing levels of dependency. Transitional care incorporates a broad range of services designed to provide care continuity. This systematic review aims to synthesize and present findings regarding the relevance of transitional care interventions to community nursing.

Design and Sample

A systematic search of electronic databases was conducted as part of a larger review to identify evidence‐based interventions to support a model to guide nursing and midwifery in the community in Ireland. All relevant empirical studies published in English between 2010 and 2015 were included.

Measures

Studies were assessed based on inclusion criteria. The Cochrane Risk of Bias and AMSTAR tools were used to assess the methodological quality of studies. Key themes and concepts were extracted and synthesized.

Results

Transitional care interventions had significant positive effects in reducing all‐cause readmissions, mortality, and heart failure‐related rehospitalizations.

Conclusion

Effective transitional care requires excellent communication between acute and primary care providers. This has implications for integration and organization of care across settings and nursing competence.
Photosynthetic acclimation of Chlorella saccharophila to heat stress
Authors: Patil Smita , Pandit Reena , Lali Arvind
Published: April 2017

Photosynthesis is one of the most important metabolic processes of algae; which is altered as a stress response. During mass cultivation of algae, temperature rise and high light are major factors that affect biomass productivity. High temperature affects photosystem II (PSII) complex irreversibly, damaging intermolecular interactions in it. However, the impact of high temperature on photosynthesis is highly variable among different algal species, depending on the prior acclimation to environmental conditions they were exposed to. The acclimation plays an important role in combating high temperature stress via regulation of photosynthetic responses. Chlorophyll a fluorescence is a highly sensitive, non‐destructive and reliable tool for such measurements of photosynthetic parameters, which provides information about algal photosynthetic performance under given conditions. To understand the effect of heat stress on the responses of high light acclimated alga Chlorella saccharophila, chlorophyll a fluorescence transients were measured after heat exposure at 40°C. Our study demonstrates that rise in temperature for short duration; during open field cultivation reversibly affects the efficiency of PSII in light acclimated alga C. saccharophila. The effects of heat stress on chlorophyll a fluorescence in this alga, grown under high light (max‐1600 μmol photons m−2 s−1) are presented here; they are used to infer changes in photosynthetic process during its exposure to heat, as well as their recovery after 72 h. We speculate that heat resistance may have been acquired due to prior exposures to high light.
Symbiotic green algae in eggs of Hynobius nigrescens, an amphibian endemic to Japan
Authors: Muto Kiyoaki , Nishikawa Kanto , Kamikawa Ryoma , Miyashita Hideaki
Published: April 2017

The egg capsules of some amphibians' eggs are known to become green colored before hatching. This is due to the increase of green symbionts in the egg capsule surrounding the embryo. The green symbionts in North American amphibian eggs were reported to be unicellular green algae in the Oophila‐clade of Volvocales, Chlorophyceae. However, it remains unclear whether this is also the case in other parts of the world. In this study, we analyzed the green symbionts in green‐colored eggs of Hynobius nigrescens, an amphibian endemic to Japan, obtained from five distinct locations. Microscopic observations revealed that the green symbionts were similar in appearance to Oophila amblystomatis, which was reported in some amphibian eggs in North America, in which non‐motile cells of the algae had thick cell walls with reticulate protuberances. PCR‐DGGE followed by phylogenetic analyses of partial 18S rRNA sequences revealed that the symbionts from the five locations were identical and most likely unialgal in each egg capsule. They formed an independent subclade within the Oophila‐clade, indicating that H. nigrescens has a unique symbiont. Our data are consistent with the previous report on North American amphibian eggs and support the specific symbiotic relationships between Oophila‐clade symbionts and the eggs of amphibians. This is the first report on the specific symbiont‐and‐host association between an Oophila‐clade symbiont and an amphibian outside of North America. We also discuss several possibilities regarding the origin of green symbionts (vertical transmission or invasion) on the basis of the discovery and detailed observation of H. nigrescens eggs without any green symbionts.
The creation and dissemination of downloadable information on dementia and driving from a social health perspective
Authors: Arai Yumiko , Arai Asuna , Mizuno Yoko , Kamimura Naoto , Ikeda Manabu
Published: April 2017

Background

Driving cessation is a likely consequence of progressive dementia. Patients and families can benefit from support through this transition, both to safeguard the patient and public and to help preserve healthy social activity of the patient.

Methods

To provide appropriate supportive information, we developed a 35‐page manual (‘Supporting family caregivers of older drivers with dementia’) available as a free download from our department website. We then informed municipal governments of its availability, tracked website access metrics, and followed up 7 months later with a postal survey to the heads of each municipal government’s department of welfare for older citizens.

Results

From February to September 2010, the manual was accessed 33 494 times. Of the 1750 municipalities sent surveys, we received 1067 responses (61%). The responses showed that 943 professionals (94.6%) were able to obtain information they needed from the manual, 247 (23%) had used the manual to help residents during the 7 months, and 89% of those who used the manual used it to provide relevant advice to family caregivers. The responses also showed that significantly more use occurred in towns and villages as opposed to cities, consistent with the limited public transportation options in smaller municipalities (P = 0.002).

Conclusions

We anticipate that use of this manual will raise general awareness of this social health issue and facilitate collaborations to provide more social support for those with dementia and their family members.
The association between objective income and subjective financial need and depressive symptoms in South Koreans aged 60 and older
Authors: Kim Woorim , Kim Tae Hyun , Lee Tae‐Hoon , Ju Yeong Jun , Park Eun‐Cheol
Published: April 2017

Aim

This study aimed to investigate the effect of the gap between objective income and subjective financial need on depressive symptoms in individuals aged 60 and older.

Methods

Data from the 2011 and 2013 Korean Retirement and Income Study were used. A total of 4891 individuals aged 60 and older were included at baseline. The Generalized Estimating Equation model was used to examine the association between the gap in objective income and subjective financial need and the presence of depressive symptoms, which were measured using the Center for Epidemiological Studies Depression Scale.

Results

Compared to individuals in the middle objective income‐middle subjective financial need group, individuals in the low‐low category (odds ratio (OR): 1.30, 95% confidence interval (CI): 1.04–1.61) and the low‐middle category (OR: 1.26, 95%CI: 1.09–1.45) showed a statistically significant higher likelihood of having depressive symptoms. In contrast, participants in the middle‐low (OR: 0.74, 95%CI: 0.54–0.99), high‐low (OR: 0.50, 95%CI: 0.34–0.73), high‐middle (OR: 0.74, 95%CI: 0.63–0.87), and high‐high categories (OR: 0.74, 95%CI: 0.55–0.99) were less likely to exhibit depressive symptoms. Additionally, the lower likelihood of depressive symptoms found in middle‐ and high‐income groups with lower levels of subjective financial need was strong among individuals with chronic disease.

Conclusions

Differences in the prevalence of depressive symptoms generally exist between individuals of the same income category depending on perceived income adequacy. Therefore, it is important to consider discrepancies in objective income and subjective financial need when assessing risk factors for depressive symptoms in older populations.
Transforming Latin America—One Innovation at a Time
Authors: Benavides Abraham David
Published: April 2017

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Discrimination between wave‐ravinement surfaces and bedset boundaries in Pliocene shallow‐marine deposits, Crotone Basin, southern Italy: An integrated sedimentological, micropalaeontological and mineralogical approach
Authors: Zecchin Massimo , Caffau Mauro , Catuneanu Octavian , Lenaz Davide
Published: April 2017

The lower Pliocene Belvedere Formation, cropping out in the Crotone Basin, southern Italy, exhibits a metre‐scale to decametre‐scale shallow‐marine cyclicity that shares features of both high‐frequency sequences linked to shoreline shifts and controlled by minor relative sea‐level and/or sediment supply changes, and sedimentological cycles unrelated to shoreline shifts. In order to better understand the high‐frequency sequence stratigraphic framework of this succession, an integration of sedimentological, micropalaeontological (micro‐foraminifera assemblages) and mineralogical (heavy mineral abundance) data is used. From a sedimentological/stratigraphic point of view, wave‐ravinement surfaces bounding high‐frequency sequences, and associated substrate‐controlled ichnofacies, are prominent in outcrop and document environmental and water‐depth changes, whereas bedset boundaries separating sedimentological cycles have a more subtle field appearance and are only associated with changes of environmental energy. Moreover, condensed deposits are present only above wave‐ravinement surfaces, and the high‐frequency sequences bounded by these surfaces have a thickness that is an order of magnitude greater than that of the bedsets. Micro‐foraminifera assemblages may change, and the content of heavy minerals usually increases, across wave‐ravinement surfaces, whereas both parameters do not change significantly across bedset boundaries. The abundance of heavy minerals is systematically higher, with respect to the underlying and overlying deposits, in the condensed shell beds that overlie wave‐ravinement surfaces. An integrated sedimentological, micropalaeontological and mineralogical approach represents a powerful tool to discriminate between wave‐ravinement surfaces bounding high‐frequency sequences and bedset boundaries, and in general to investigate at the intra high‐frequency sequence scale. This integrated approach is expected to be very useful in the study of potentially all shallow‐marine successions composed of small‐scale cycles, in order to delineate a detailed sequence stratigraphic framework and understand the factors that controlled the cyclicity.
Interpreting flash flood palaeoflow parameters from antidunes and gravel lenses: An example from Montserrat, West Indies
Authors: Froude Melanie J. , Alexander Jan , Barclay Jenni , Cole Paul
Published: April 2017

The wavelength of stationary water‐surface waves and their associated antidune bedforms are related to the mean velocity and depth of formative flow. In past published sand‐bed flume experiments, it was found that lens structures were preserved during antidune growth and change, and the dimension of the lenses was empirically related to antidune wavelength, and thus could be used to estimate flow velocity and depth. This study is the first to compare observations of formative flow conditions and resulting sedimentary structures in a natural setting, testing the previously published relationship at a field‐scale. Trains of stationary and upstream migrating water‐surface waves were prevalent during the flash flood in October 2012 in the Belham Valley, Montserrat, West Indies. Wave positions and wavelengths were assessed at 900 sec intervals through the daylight hours of the event within a monitored reach. The wave data indicate flow depths up to 1·3 m and velocity up to 3·6 m sec−1. Sedimentary structures formed by antidune growth and change were preserved in the event deposit. These structures include lenses of clast‐supported gravel and massive sand, with varying internal architecture. The lenses and associated low‐angle strata are comparable to sand‐bed structures formed from stationary and upstream migrating waves in flume experiments, confirming the diagnostic value of these structures. Using mean lens length in the event deposit underestimated peak flow conditions during the flood and implied that the lenses were preserved during waning flow.
Microcirculation after Achilles tendon rupture correlates with functional and patient‐reported outcomes
Authors: Praxitelous P. , Edman G. , Ackermann P. W.
Published: April 2017

Patients with acute Achilles tendon rupture (ATR) display an extended healing process with varying clinical outcome. Poor microcirculatory blood flow has been suggested to be a significant factor for the healing process. However, whether microcirculation may predict healing outcome has been mostly unknown. Therefore, we investigated whether blood flow in the Achilles tendon may be associated with patient‐reported and functional outcomes after ATR. In vivo laser‐Doppler flowmetry was used to assess microvascular blood flow bilateral in the Achilles tendons, during post‐occlusive reactive hyperemia, of nine patients with acute total ATR at 2 weeks post‐operatively. At 3 months post‐operatively, patient‐reported outcome was assessed using Achilles tendon Total Rupture Score (ATRS). At 1 year a uniform outcome score, Achilles Combined Outcome Score (ACOS), was obtained by combining validated, independent, patient‐reported (ATRS), and functional outcome (heel‐rise test) measures. An improved combined patient‐reported and functional outcome, ACOS, at 1 year was significantly correlated with higher maximum blood flow (r=.777, P=.040) in the injured limb. Furthermore, enhanced patient‐reported outcome, ATRS, at 3 months, was associated with an elevated ratio of maximum to resting blood flow (r=.809, P=.015) in the uninjured limb. Blood flow in early tendon healing is associated with long‐term patient‐reported and functional outcomes after ATR. The microcirculatory blood flow of both the healing and contralateral Achilles tendon seems to determine the healing potential after injury.
The social context of hoarding behavior: Building a foundation for sociological study
Authors: Shaeffer Megan
Published: April 2017

This paper aims to build a foundation from which sociologists can effectively address hoarding as a social problem embedded in a wider economic, cultural, and historic context. By focusing on practices of consumerism, interior design, collecting and waste disposal, we can see how socially constructed attitudes toward objects are linked with three primary hoarding behaviors: the acquisition of objects, clutter within the home, and difficulty discarding items. The transformation of shopping into a leisurely pastime has created a cultural context in which the acquisition of objects is normal and expected. Arrangement of objects within the home can be used to create of a sense of class membership, and collecting as a hobby and a lifestyle has been socially and economically encouraged since the late 1800s. Finally, a look at disposal practices reveals that the way we get rid of objects can be just as socially dictated as the way we use them. The behaviors associated with hoarding have been historically developed and are actively encouraged in contemporary western society. By examining the social context of hoarding behaviors, we can move toward an understanding of the ways that hoarders and nonhoarders alike navigate the social and economic landscape using material culture.