bluuebunny/crossref_metadata_2025 huggingface dataset:
An autopsied case of corticobasal degeneration presenting with frontotemporal dementia followed by myoclonus
Authors: Iwasaki Yasushi , Mori Keiko , Ito Masumi , Mimuro Maya , Yoshida Mari
Published: July 2017

A Japanese woman developed frontotemporal dementia (FTD)‐like symptoms of abnormal behavior, such as stereotyped behavior and disinhibition. The patient developed these symptoms at the age of 59 years, although aphasia symptoms were not apparent at early disease stages. Progressive parkinsonism was dominant on the left side, and conspicuous myoclonus was recognized in the late disease stage. MRI indicated severe, right side‐dominant frontotemporal lobe atrophy with white matter degeneration. Brainstem and cerebellar atrophy were also observed. The patient underwent gastrostomy 7 years after the onset of her symptoms and died at the age of 70 years. Neuropathological examination showed diffuse neuron loss with gliosis and tissue rarefaction in the frontotemporal lobe, particularly in the right anterior portion of the frontal lobe. Spongiform changes and ballooned neurons were also observed in the frontotemporal cortex, particularly in the superficial layer and deeper layers, respectively. Gallyas‐Braak silver staining and anti‐phosphorylated tau immunostaining indicated numerous argyrophilic and tau‐positive structures, including pretangles, astrocytic plaques, coiled bodies and neuropil threads. We speculate that the myoclonus observed in the present case was at least partly caused by or related to the spongiform change and ballooned neurons in the cerebral cortex. The clinical phenotypes of corticobasal degeneration (CBD) vary considerably, and the clinical presentation of the present patient was compatible with frontal behavioral‐spatial syndrome in the early disease stage. However, in the later disease stages, her symptoms were reflective of corticobasal syndrome. Because it is not rare for the clinical phenotype to change along with disease progression in cases of CBD, we should consider CBD in cases presenting with FTD at symptom onset.
Human brown adipose tissue as a target for obesity management; beyond cold‐induced thermogenesis
Authors: Loh R.K.C. , Kingwell B.A. , Carey A.L.
Published: July 2017

Elevating energy expenditure via adaptive thermogenesis in brown adipose tissue (BAT) is a potential strategy to reverse obesity. Much early enthusiasm for this approach, based on rodent studies, was tempered by the belief that BAT was relatively inconsequential in healthy adult humans. Interest was reinvigorated a decade ago when a series of studies re‐identified BAT, primarily in upper thoracic regions, in adults. Despite the ensuing explosion of pre‐clinical investigations and identification of an extensive list of potential target molecules for BAT recruitment, our understanding of human BAT physiology remains limited, particularly regarding interventions which might hold therapeutic promise. Cold‐induced BAT thermogenesis (CIT) has been well studied, although is not readily translatable as an anti‐obesity approach, whereas little is known regarding the role of BAT in human diet‐induced thermogenesis (DIT). Furthermore, human studies dedicated to translating known pharmacological mechanisms of adipose browning from animal models are sparse. Several lines of recent evidence suggest that molecular regulation and physiology of human BAT differ to that of laboratory rodents, which form the majority of our knowledge base. This review will summarize knowledge on CIT and expand upon the current understanding and evidence gaps related to human adaptive thermogenesis via mechanisms other than cold.
Influence of neighbourhood safety on childhood obesity: a systematic review and meta‐analysis of longitudinal studies
Authors: An R. , Yang Y. , Hoschke A. , Xue H. , Wang Y.
Published: July 2017

Unsafe residential neighbourhoods are thought to be a risk factor for childhood obesity by discouraging physical activity while encouraging sedentary behaviours, but findings from cross‐sectional studies are susceptible to selection bias (e.g. children who are obese disproportionately reside in unsafe neighbourhoods). A literature search was conducted in the Cochrane Library, PubMed, Web of Science and Google Scholar for articles published until January 2017 that used baseline neighbourhood safety levels to predict future weight‐related behaviours and body‐weight status among children aged 17 years and younger. Twenty‐two prospective cohort studies conducted in seven countries were identified. The median sample size was 1,104, and the median follow‐up was 3.5 years. Sixteen studies used parent‐reported and/or child‐reported neighbourhood safety measures, and six adopted some objective measures (e.g. county crime rate and interviewers' block observations). The meta‐analysis found that living in unsafe neighbourhoods was associated with a reduction in children's physical activity by 0.13 h week−1. Living in unsafe neighbourhoods predicted a trivial (but statistically significant) gain in body mass index but no change in childhood overweight/obesity risk. Current research indicates a limited influence of neighbourhood safety on childhood obesity; this finding could be partially due to measurement problems. Future longitudinal studies should adopt validated neighbourhood safety measures.
Temporal carry‐over effects in sequential plant–soil feedbacks
Authors: Wubs E. R. Jasper , Bezemer T. Martijn
Published: July 2017

Plant–soil feedbacks (PSF) strongly influence plant performance. However, to what extent these PSF effects are persistent in the soil and how they are altered by species that subsequently condition the soil is unclear. Here we test how conspecific and heterospecific soil‐conditioning effects interact across different soil‐conditioning phases. We conducted a fully factorial glasshouse experiment where six plant species conditioned soils in two consecutive phases and measured the performance of Jacobaea vulgaris. The species that conditioned the soil during the second conditioning phase strongly determined the performance of J. vulgaris, but also the order and combination of species that conditioned the soil in the two phases accounted for a large part of the variance. For shoot biomass this interaction was the dominant variance component. We show that soil conditioning legacies carry‐over and interact with the conditioning effects of succeeding plants. In the field, species replacements at the patch level often appear to be unpredictable and we suggest that sequential feedbacks may explain these apparently unpredictable transitions.
Interventions for postoperative pain in children: An overview of systematic reviews
Authors: Boric Krste , Dosenovic Svjetlana , Jelicic Kadic Antonia , Batinic Marijan , Cavar Marija , Urlic Marjan , Markovina Nikolina , Puljak Livia
Published: July 2017

The aim of this study was to conduct an overview of systematic reviews that summarizes the results about efficacy and safety from randomized controlled trials involving the various strategies used for postoperative pain management in children. We searched the Cochrane Database of Systematic Reviews, CINAHL, Database of Reviews of Effect, Embase, MEDLINE, and PsycINFO from the earliest date to January 24, 2016. This overview included 45 systematic reviews that evaluated interventions for postoperative pain in children. Out of 45 systematic reviews that investigated various interventions for postoperative pain in children, 19 systematic reviews (42%) presented conclusive evidence of efficacy. Positive conclusive evidence was reported in 18 systematic reviews (40%) for the efficacy of diclofenac, ketamine, caudal analgesia, dexmedetomidine, music therapy, corticosteroid, epidural analgesia, paracetamol, and/or nonsteroidal anti‐inflammatory drugs and transversus abdominis plane block. Only one systematic review reported conclusive evidence of equal efficacy that involved a comparison of dexmedetomidine vs morphine and fentanyl. Safety of interventions was reported as conclusive in 14 systematic reviews (31%), with positive conclusive evidence for dexmedetomidine, corticosteroid, epidural analgesia, transversus abdominis plane block, and clonidine. Seven systematic reviews reported equal conclusive safety for epidural infusion, diclofenac intravenous vs ketamine added to opioid analgesia, bupivacaine, ketamine, paracetamol, and dexmedetomidine vs intravenous infusions of various opioid analgesics, oral suspension and suppository of diclofenac, only opioid, normal saline, no treatment, placebo, and midazolam. Negative conclusive statement for safety was reported in one systematic review for caudal analgesia vs noncaudal regional analgesia. More than half of systematic reviews included in this overview were rated as having medium methodological quality. Of 45 included systematic reviews, 10 were Cochrane reviews and they had higher methodological quality than non‐Cochrane reviews. As evidence concerning efficacy and safety is inconclusive for most of the analyzed interventions, our review points out the need for more rigorous trials concerning pain management in children.
Experiential acceptance and trait‐mindfulness as predictors of analogue post‐traumatic stress
Authors: Boelen Paul A. , Lenferink Lonneke I. M.
Published: July 2017

Objectives

Experiential acceptance and trait‐mindfulness are associated with post‐traumatic stress disorder (PTSD) after traumatic events. This study was a preliminary attempt to examine (1) associations of experiential acceptance and trait‐mindfulness with post‐traumatic stress (PTS) associated with negative, but not necessarily traumatizing, life events (‘analogue’ PTS), (2) the role of these variables in the context of neuroticism as well as worry and rumination – two other regulatory strategies associated with PTS, and (3) the impact of pre‐trauma tendencies towards experiential acceptance and mindfulness on analogue PTS.

Design

Data were obtained from two distinct student samples. A first sample provided cross‐sectional data. In a second sample, indices of acceptance, mindfulness, neuroticism, worry, and rumination were tapped at inclusion into the study, and analogue PTS and confrontation with stressful life events were subsequently assessed 1 year later.

Results

In the cross‐sectional sample, higher acceptance and mindfulness were associated with lower analogue PTS, even when controlling for neuroticism, worry, and rumination. In the prospective sample, pre‐trauma mindfulness (but not experiential acceptance, neuroticism, worry, and rumination) assessed at baseline predicted levels of analogue PTS 1 year later.

Conclusions

Findings suggest that experiential acceptance and trait‐mindfulness are incrementally related to PTS beyond neuroticism, worry, and rumination and that pre‐trauma trait‐mindfulness may be a resilience factor protecting against severe PTS.

Practitioner points

We examined associations of experiential acceptance and trait‐mindfulness with post‐traumatic stress (PTS) associated with negative life events (‘analogue’ PTS).

Experiential acceptance and trait‐mindfulness were associated with concurrent analogue PTS, over and above neuroticism, worry, and rumination.

Pre‐trauma trait‐mindfulness (but not pre‐trauma experiential acceptance) significantly predicted analogue PTS in prospective analyses.

Enhancing mindfulness skills could be a useful tool to reduce the risk of PTS in trauma‐exposed samples.
Hydraulic redistribution: limitations for plants in saline soils
Authors: Bazihizina Nadia , Veneklaas Erik J. , Barrett‐Lennard Edward G. , Colmer Timothy D.
Published: July 2017

Hydraulic redistribution (HR), the movement of water from wet to dry patches in the soil via roots, occurs in different ecosystems and plant species. By extension of the principle that HR is driven by gradients in soil water potential, HR has been proposed to occur for plants in saline soils. Despite the inherent spatial patchiness and salinity gradients in these soils, the lack of direct evidence of HR in response to osmotic gradients prompted us to ask the question: are there physical or physiological constraints to HR for plants in saline environments? We propose that build‐up of ions in the root xylem sap and in the leaf apoplast, with the latter resulting in a large predawn disequilibrium of water potential in shoots compared with roots and soil, would both impede HR. We present a conceptual model that illustrates how processes in root systems in heterogeneous salinity with water potential gradients, even if equal to those in non‐saline soils, will experience a dampened magnitude of water potential gradients in the soil–plant continuum, minimizing or preventing HR. Finally, we provide an outlook for understanding the relevance of HR for plants in saline environments by addressing key research questions on plant salinity tolerance.
Redox regulation at the site of primary growth: auxin, cytokinin and ROS crosstalk
Authors: Tognetti Vanesa B. , Bielach Agnieszka , Hrtyan Mónika
Published: July 2017

To maintain the activity of meristems is an absolute requirement for plant growth and development, and the role of the plant hormones auxin and cytokinin in apical meristem function is well established. Only little attention has been given, however, to the function of the reactive oxygen species (ROS) gradient along meristematic tissues and its interplay with hormonal regulatory networks. The interdependency between auxin‐related, cytokinin‐related and ROS‐related circuits controls primary growth and development while modulating plant morphology in response to detrimental environmental factors. Because ROS interaction with redox‐active compounds significantly affects the cellular redox gradient, the latter constitutes an interface for crosstalk between hormone and ROS signalling pathways. This review focuses on the mechanisms underlying ROS‐dependent interactions with redox and hormonal components in shoot and root apical meristems which are crucial for meristems maintenance when plants are exposed to environmental hardships. We also emphasize the importance of cell type and the subcellular compartmentalization of ROS and redox networks to obtain a holistic understanding of how apical meristems adapt to stress.
Hurricane preparedness among elderly residents in South Florida
Authors: Kleier Jo Ann , Krause Deirdre , Ogilby Terry
Published: July 2017

Objectives

The purpose of this study was to describe factors associated with hurricane preparation and to test a theoretical model of hurricane preparation decision process among a group of elderly residents living in a high‐risk geographical area.

Design and Sample

This is a descriptive, correlational study. A convenience sample consisted of 188 English‐speaking individuals who were aged 55 years or older.

Measures

In addition to demographic information, two survey instruments were used. Theoretical constructs were operationalized through Moon's Hurricane Preparation Questionnaire. Hurricane preparedness was measured by self‐reported responses to FEMA's inventory checklist, which addresses the recommended basic steps of preparation.

Results

The theoretical model of hurricane preparation decision process was supported. Main barriers to preparation are the need for cooperation from others and cost of preparation. Participants reported having taken many preparatory steps to shelter‐in‐place, but too few are prepared if their home were storm‐damaged or they should have to evacuate.

Conclusions

Findings are consistent with previous studies of samples drawn from similar populations. This report provides guidance as to how public health nurses can become involved with the population and develop interventions based on the constructs of the theoretical model.
Exogenous application of IAA alleviates effects of supplemental ultraviolet‐B radiation in the medicinal plant Withania somnifera Dunal
Authors: Takshak S. , Agrawal S. B.
Published: July 2017

Supplemental (s)‐UV‐B radiation has adverse effects on the majority of plants. The present study was conducted to evaluate the effects of exogenous application of the growth hormone indole acetic acid (IAA) on various morphological, physiological and biochemical characteristics of Withania somnifera, an indigenous medicinal plant, subjected to s‐UV‐B.

The s‐UV‐B‐treated plants received ambient + 3.6 kJm−2·day−1 biologically effective UV‐B, and IAA was applied at two doses (200 and 400 ppm) to s‐UV‐B‐exposed plants.

The plant was forced to compromise its growth, development and photosynthetic patterns to survive under s‐UV‐B by increasing concentrations of secondary metabolites and antioxidants (thiol, proline, ascorbic acid, α‐tocopherol, ascorbate peroxidase, catalase, glutathione reductase, peroxidase, polyphenol oxidase, superoxide dismutase) to counteract oxidative stress. Increases in secondary metabolites were evidenced as increased activity of phenylpropanoid pathway enzymes: phenylalanine ammonia lyase, cinnamyl alcohol dehydrogenase, 4‐coumarate CoA ligase, chalcone isomerase and dihydroflavonol reductase. Application of different IAA doses reversed the detrimental effects of s‐UV‐B on W. somnifera by improving growth and photosynthesis and reducing concentrations of secondary metabolites and non‐enzymatic antioxidants. Antioxidant enzymes, however, had a synergistic effect on s‐UV‐B treatment and IAA application.

The effects of s‐UV‐B on W. somnifera are ameliorated to varying degrees upon exogenous IAA application, and synergistic enhancement of antioxidant enzymes under s‐UV‐B+IAA treatment might be responsible for the partial recuperation of growth and plant protein content, as a UV‐B‐exposed plant is forced to allocate most of its photosynthate towards production of enzymes related to antioxidant defence.
The cascade of care to prevent mother‐to‐child transmission in Rio de Janeiro, Brazil, 1996–2013: improving but still some way to go
Authors: Hofer Cristina Barroso , Egger Matthias , Davies Mary‐Ann , Frota Ana Cristina Cisne , de Oliveira Ricardo Hugo , Abreu Thalita Fernandes , Araújo Lúcia Evangelista , Witthlin Bernardo Bastos , Carvalho Alice Weber , Cordeiro Janaína Rivas , Lima Giulia Pasqualini , Keiser Olivia
Published: July 2017

Objective

To describe the cascade of care to HIV mother‐to‐child transmission (PMTCT) in a Rio de Janeiro reference paediatric clinic and evaluate the main factors possibly associated with HIV transmission.

Methods

Data on antenatal care (ANC), perinatal and neonatal assistance to HIV‐infected and HIV‐exposed but uninfected children assisted in the clinic from 1996 to 2013 were collected. The cascade of care was graphically demonstrated, and possible factors associated with HIV infection were described using regression models for bivariate and multivariate analysis. We imputed missing values of explanatory variables for the final model.

Results

A total of 989 children were included in the analysis: 211 were HIV and 778 HEU. Graphically, the HIV PMTCT cascade of care improved from 1996/2000 to the later periods, but not from 2001/2006 to 2007/2013. The main factor independently associated with the HIV infection over time was breastfeeding. In the period 1996/2000, the lack of antiretroviral use during labour was associated HIV transmission. While in 2001/2007, other modes of delivery but elective Caesarean section, and lack of maternal antiretroviral use during ANC were associated with HIV transmission. In the last period, the main factor associated with transmission was the lack of maternal ANC.

Conclusions

The HIV PMTCT cascade improved over time, but HIV vertical transmission remains a problem, and better access to ANC is needed.
East not least for Pacific bluefin tuna
Authors: Madigan Daniel J. , Boustany Andre , Collette Bruce B.
Published: July 2017

More Pacific bluefin migrate across the ocean than previously recognized
Completed Genome Sequences of Borrelia burgdorferi
Sensu Stricto
B31(NRZ) and Closely Related Patient Isolates from Europe
Authors: Margos Gabriele , Hepner Sabrina , Mang Christoph , Sing Andreas , Liebl Bernhard , Fingerle Volker
Published: July 2017

Borrelia burgdorferi
sensu stricto
is a causative agent of human Lyme borreliosis in the United States and Europe. We report here the completed genome sequences of strain B31 isolated from a tick in the United States and two closely related strains from Europe, PAli and PAbe, which were isolated from patients with erythema migrans and neuroborreliosis, respectively.
Draft Genome Sequence of Eggerthia catenaformis Strain MAR1 Isolated from Saliva of Healthy Humans
Authors: Rahman M. Ajijur , Mullany Peter , Roberts Adam P.
Published: July 2017

Here, we report the draft genome sequence of
Eggerthia catenaformis
MAR1 isolated during a screen for
d
-cycloserine-resistant bacteria from the saliva of healthy humans. Analysis of the genome reveals that the strain has the potential to be a human pathogen and carries genes related to virulence and antibiotic resistance.
Use of cabergoline for the management of persistent Cushing’s disease in pregnancy
Authors: Sek Kathleen Su-Yen , Deepak Doddabele Srinivasa , Lee Kok Onn
Published: July 2017

Cushing’s disease (CD) is rare during pregnancy and is associated with significant maternal and fetal complications. It is important to control hypercortisolism during pregnancy, either surgically or medically, for a successful maternal and fetal outcome. We report a patient with recurrent CD who was treated with low-dose cabergoline (CAB) for persistent hypercortisolism throughout pregnancy. A 36-year-old woman was diagnosed with CD at the age of 23. She underwent trans-sphenoidal surgery with initial complete remission. However, 4 years after surgery, CD recurred and she underwent Gamma Knife radiosurgery (GKRS). Following GKRS, her cortisol levels remained elevated despite no evidence of visible tumour on pituitary MRI. Medical treatment was commenced with ketoconazole and cyproheptadine. This was changed to CAB as she was keen for pregnancy. She conceived spontaneously and was on CAB throughout pregnancy. She delivered a healthy male neonate, weighing 3195 g at 40 weeks of gestation.
Pituitary apoplexy: a rare complication of leuprolide therapy in prostate cancer treatment
Authors: Tanios Georges , Mungo Nicolas Andrews , Kapila Aaysha , Bajaj Kailash
Published: July 2017

Gonadotropin-releasing hormone agonists, used widely in the treatment of metastatic prostate cancer and hormone receptor-positive breast cancer, are associated with a rare but potentially fatal outcome of pituitary apoplexy (PA). An 85-year-old man presented with sudden onset of headache, left eye pain, sensitivity to light, nausea and vomiting. The symptoms started 4 hours after initiation of leuprolide therapy for treatment of recently diagnosed metastatic prostate carcinoma. Radiological imaging of the brain demonstrated a heterogeneously enlarged pituitary gland measuring 19×16×13 mm and T1-hyperintense signal compatible with pituitary haemorrhage. Hormone function tests were indicative of panhypopituitarism, confirming the diagnosis of PA. Due to age, the patient was started on hormonal replacement therapy and eventually symptoms improved.
Renal fistulae: different aetiologies, similar management
Authors: Bhaskar Ved , Sinha Rahul Janak , Purkait Bimalesh , Singh Vishwajeet
Published: July 2017

Iatrogenic renocolic fistulae, although have been described in literature, is a rare clinical complication. Recently its incidence is on rise due to advent of minimally invasive surgery and percutaneous surgery of kidney. It has been reported after percutaneous nephrolithotomy but its incidence after percutaneous nephrostomy is quite uncommon and rarely reported. Though spontaneous renocutaneous fistula has been reported, acquired renocutaneous fistula is very uncommon and fistula after gun shot injury has not been reported to the best of our knowledge. Herein, we present two different varieties of renal fistula with completely different history and presentation. But the interesting point is that both were managed conservatively in a similar fashion and both of them responded well
Complement factor B mutation-associated aHUS and myocardial infarction
Authors: Noronha Natália , Costa Filipa Dias , Dias Andrea , Dinis Alexandra
Published: July 2017

A 6-month-old female infant was referred with a 3-day history of low-grade fever, slight nasal congestion and rhinorrhoea. On admission, the clinical findings were unremarkable and she was discharged home. However, she became progressively more listless with a decreased urine output and was once again seen in the emergency department. Analytically she was found to have metabolic acidosis, hyperkalaemia, thrombocytopaenia, anaemia and schistocytes in the peripheral blood smear. Based on these findings, the diagnosis of haemolyticâ-uremic syndrome was made. A few hours postadmission, there was an abrupt clinical deterioration. She went into cardiorespiratory arrest and she was successfully resuscitated. An ST-segment elevation was noted on the ECG monitor and the troponin I levels were raised, suggesting myocardial infarction. Despite intensive supportive therapy, she went into refractory shock and died within 30 hours.
Ciliated foregut cyst of the gall bladder: the largest ever described
Authors: Farrugia Alexia , Blazic Ivan , Andrejevic Predrag
Published: July 2017

A 78-year-old man presented to the accident and emergency department with acute abdominal pain. A CT scan done to investigate the pain showed an intra-abdominal abscess medial to the caecum and an incidental exophytic lesion in the gall bladder. This was excised during surgery and sent for histological examination. Histology showed a ciliated foregut cyst of the gall bladder. A literature review revealed that this was the 13th case worldwide, as ciliated foregut cysts are usually found either above the diaphragm or in the liver. It was also the largest cyst described, with 45â€‰mm diameter. So far none of these cysts found in the gall bladder have shown malignant transformation, though those found in the liver have been known to become malignant. Due to histological similarity, excision of ciliated foregut cysts of the gall bladder should be considered as there is still a risk of malignant transformation.
Is it safe to acutely discontinue insulin therapy in patients with chronic hyperglycaemia starting GLP-1R agonists?
Authors: Okiro Julie Omolola , Mc Hugh Catherine , Abdalla Abuelmagd
Published: July 2017

We report two patients with chronic hyperglycaemia secondary to type 2 diabetes who developed severe vomiting on d. The first patient was diagnosed with a mixed picture of diabetic ketoacidosis (DKA) and hyperosmolar hyperglycaemic state (HHS) and the second, with DKA. They were on insulin therapy which was discontinued on commencing d because of inefficacy and weight gain. The HHS patient developed dehydration secondary to vomiting and had lactic acidosis but no other precipitant could be found in either case. It appears that the abrupt insulin discontinuation coupled with vomiting and dehydration led to the metabolic derangements. Subsequent C-peptide levels were found to be low in both patients. In view of the predisposition of patients with chronic hyperglycaemia to glucagon-like peptide 1 receptor (GLP-1R) downregulation and the lag time to optimal efficacy of GLP-1R agonists, we propose that patients should have C-peptide levels measured to determine the risk of ketosis and whether insulin should be continued with dose adjustments when starting a GLP-1R agonist.
Postural sway, working years and BMI in healthy truck drivers: an observational study
Authors: Ohlendorf Daniela , Troebs Paul , Lenk Andreas , Wanke Eileen , Natrup Jörg , Groneberg David
Published: July 2017

Objectives

The following study analyses the influence of risk factors among the occupational group of truck drivers on postural control and body mass index (BMI).

Design

Observational study.

Setting

One motorway station close to several highways in Germany.

Participants

180 truck drivers (177 male/3 female), aged 21–65 years old, took part in this study.

Outcome measures

Postural control was examined using a pressure plate. In order to examine the influence of body weight (BMI) and working years on postural control, subjects were divided into samples of five and three groups, respectively. Furthermore, it was evaluated whether the subjects suffered from back pain. For data analysis, the Kruskal-Wallis test was used as the data were not normally distributed. Once the p value of the Kruskal-Wallis test was p≤0.05, the Conover-Iman comparison and afterwards the Bonferroni-Holm correction were used. The significance level was set at α ≤0.05.

Results

Regarding the number of working years, a significant increase of frontal (p≤0.04) and sagittal (p≤0.001) sway were observed. The correlation of the five BMI groups with the number of working years demonstrates that an increase of the working years leads to an increase of BMI (p≤0.03). Furthermore, the majority of truck drivers participating in this study suffered from back pain (61.7%).

Conclusions

BMI and musculoskeletal impairment are indicators of health risk factors. In this study, it is shown that an increasing number of working years and an increasing BMI lead to a decrease in frontal and sagittal postural sway. In addition, the number of working years correlates with body weight and back pain.
Wealth-related inequality in early uptake of HIV testing among pregnant women: an analysis of data from a national cross-sectional survey, South Africa
Authors: Ngandu Nobubelo Kwanele , Van Malderen Carine , Goga Ameena , Speybroeck Niko
Published: July 2017

Objectives

Wealth-related inequality across the South African antenatal HIV care cascade has not been considered in detail as a potential hindrance to eliminating mother-to-child HIV transmission (EMTCT). We aimed to measure wealth-related inequality in early (before enrolling into antenatal care) uptake of HIV testing and identify the contributing determinants.

Design

Cross-sectional survey.

Settings

South African primary public health facilities in 2012.

Participants

A national-level sample of 8618 pregnant women.

Outcome measures

Wealth-related inequality in early uptake of HIV testing was measured using the Erreygers concentration index (CI) further adjusted for inequality introduced by predicted healthcare need (ie, need-standardised). Determinants contributing to the observed inequality were identified using the Erreygers and Wagstaff decomposition methods.

Results

Participants were aged 13 to 49 years. Antenatal HIV prevalence was 33.2%, of which 43.7% came from the lowest 40% wealth group. A pro-poor wealth-related inequality in early HIV testing was observed. The need-standardised concentration index was −0.030 (95% confidence interval −0.038 to −0.022). The proportion of early HIV testing was significantly better in the lower 40% wealth group compared with the higher 40% wealth group (p value=0.040). The largest contributions to the observed inequality were from underlying inequalities in province (contribution, 65.27%), age (−44.38%), wealth group (24.73%) and transport means (21.61%).

Conclusions

Our results on better early uptake of HIV testing among the poorer subpopulation compared with the richer highlights inequity in uptake of HIV testing in South Africa. This socioeconomic difference could contribute to fast-tracking EMTCT given the high HIV prevalence among the lower wealth group. The high contribution of provinces and age to inequality highlights the need to shift from reliance on national-level estimates alone but identify subregional-specific and age-specific bottlenecks. Future interventions need to be context specific and tailored for specific subpopulations and subregional settings.
How people with dementia and carers understand and react to social functioning changes in mild dementia: a UK-based qualitative study
Authors: Singleton David , Mukadam Naaheed , Livingston Gill , Sommerlad Andrew
Published: July 2017

Objectives

To analyse people with dementia and their family carers’ attribution of social changes in dementia and the consequences of these attributions.

Design

Qualitative study, using a semi-structured interview guide. Individual interviews continued to theoretical saturation. Two researchers independently analysed interview transcripts.

Setting and participants

People with mild dementia and family carers purposively selected from London-based memory services for diverse demographic characteristics to encompass a range of experiences.

Primary and secondary outcomes

Attribution of social changes experienced by the person with dementia and the consequences of these attributions.

Results

We interviewed nine people with dementia and nine carers, encompassing a range of age, ethnicity and educational backgrounds.

Both groups reported that the person with dementia had changed socially. People with dementia tended to give one or two explanations for social change, but carers usually suggested several. People with dementia were often socially embarrassed or less interested in going out, and they or their relatives’ physical illness or fear of falls led to reduced social activity. Carers often attributed not going out to a choice or premorbid personality. Carers found that their relative needed more support to go out than they could give and carers needed time to themselves because of carer stress or other problems from which they shielded the person with dementia. Additionally, there was decreased opportunity to socialise, as people were bereaved of friends and family. Participants acknowledged the direct impact of dementia symptoms on their ability to socially engage but sometimes decided to give up socialising when they knew they had dementia. There were negative consequences from social changes being attributed to factors such as choice, rather than dementia.

Conclusion

Clinicians should ask about social changes in people with dementia. Explaining that these may be due to dementia and considering strategies to overcome them may be beneficial.
Management of hiccups in palliative care patients
Authors: Jeon Yong Suk , Kearney Alison Mary , Baker Peter Graham
Published: July 2017

Persistent hiccups are a frustrating experience for palliative care patients, and can have a profound impact on their quality of life. This article provides an evidence-based approach overview of the causes and treatment of this not infrequently debilitating condition for such patients, with a management algorithm. In situations where no readily reversible cause is identified, or where simple physical manoeuvres, such as breath holding have failed, a systematic approach is required. Hiccups can be broadly divided into central and peripheral types. These respond differently to pharmacological intervention. The drug of choice for central causes of persistent hiccups is baclofen, with metoclopramide recommended as the first choice for peripheral causes. Midazolam may be useful in cases of terminal illness. Interventional procedures such as vagal or phrenic nerve block or stimulation should be considered in patients who are refractory to medications. The management of persistent hiccups still presents an ongoing clinical challenge however, requiring further research on pathophysiology and treatment strategies. Multinational randomised controlled trials to evaluate and compare both current and new medications or procedures to better manage this difficult condition are suggested as a means of reaching this goal.
Peptide dendrimers: drug/gene delivery and other approaches
Authors: Santos S.S. , Gonzaga R.V. , Silva J.V. , Savino D.F. , Prieto D. , Shikay J.M. , Silva R.S. , Paulo L.H.A. , Ferreira E.I. , Giarolla J.
Published: July 2017

Dendrimers are versatile hyperbranched molecules, which have deserved attention especially for their potential in many applications, including biological. Peptide dendrimers comprise interesting classes of dendrimers, and their use has been emphasized as a drug/bioactive compound delivery system, mostly in the antineoplastic area. The bioactive molecules can be covalently linked or entrapped inside the peptide derivative. Self-assembled nanocarriers are a recent trend in the design of potential delivery systems, and pH-sensitive carriers, one of their methods, have been designed to control their systems. In addition, the use of targeting peptides or other specific groups that direct the drug/bioactive compounds to specific organs is an important trend in the search for better drug delivery systems. Recent examples have been given in the literature, showing that gene delivery as another important peptide dendrimer application. It is worth emphasizing that some peptide dendrimers show activity per se, without bioactive compounds. Immune compounds and vaccines are presented herein, as well as uses of other peptide dendrimers are briefly discussed in this review, which encompasses around 10 years of work.
Laser cleaning of the contaminations on the surface of tire mould
Authors: Ye Yayun , Jia Baoshen , Chen Jing , Jiang Yilan , Tang Hongping , Wang Haijun , Luan Xiaoyu , Liao Wei , Zhang Chuanchao , Yao Caizhen
Published: July 2017

During the manufacturing of tires, surface pollutants on tire mould will lead to the production of unqualified tires. Tire moulds need to be regularly cleaned. Laser cleaning is recognized as a non-destructive, effective, precise and environmental friendly method. In this paper, laser cleaning was used to remove contaminants on tire mould surface. First, laser induced damage experiments were performed. The results showed that the roughness and hardness of the cast steel sample surface seldom changed under the energy range of 140.1–580.2 mJ laser irradiation 1 pulse and the energy range of 44.7–168.9 mJ laser irradiation 100 pulses. In the laser cleaning experiments, the cleaning thresholds and the optimal cleaning parameters were obtained. Results indicated that laser cleaning was safe and effective for tire mould contamination removal.
Influence of adhesive non-uniformity on zero offset of micro accelerometer
Authors: Zhou Wu , Li Fei , Yu Huijun , Qu Hao , Hao Rui , Wang Dong , Sun Sheng , Peng Bei
Published: July 2017

Adhesive attaching is a common method used in the packaging of high accurate MEMS devices. A full understanding of the effects of adhesive on device performance, therefore, plays a significant role in MEMS design because the thermal stress formed in packaging process highly depends on the shape, size, amount, properties and layout of the die attach adhesive. This paper investigates intensively the influence of adhesive nonuniformity in the sensitive direction of microaccelerometers on the distribution of thermal stress during the variation of environment temperature. The thermal stress will induce a movement of anchors and lead to nonzero voltage output of microaccelerometer. The influence of the adhesive with different levels of nonuniformity [Formula: see text] on zero voltage output is investigated and the results show that the adhesive nonuniformity significantly influences the zero offset of the sensors, and the maximum one can reach 8.6 mV when nonuniformity factor is 0.975.
A New Model for Integrating Phases of Decision-Making and Knowledge Base for Improving Customer Satisfaction
Authors: Hadi Wa'el
Published: July 2017

Knowledge base is becoming a key factor within organisations, since it can maximise the probability and impact of customer satisfaction in, for example, an airline company. Therefore, phases of decision-making and knowledge base are widely used in airline companies to improve the degree of customer satisfaction. The objective of this paper is to develop a customer satisfaction model by integrating the phases of decision-making and knowledge base of Royal Jordanian Airlines. The data collection for this study is achieved quantitatively through a survey based on a sample set of 130. All individuals in the sample are employed by Royal Jordanian Airlines and are targeted with questionnaires, while the smart partial least squares (PLSs) technique is employed to analytically test each hypothesis. The results of the study find a positive interaction between the decision-making phases of intelligence and design in enhancing customer satisfaction, which is fully mediated by knowledge base. In addition, the results find a positive interaction between the decision-making phases of choice and implementation in enhancing customer satisfaction, which is partially mediated by knowledge base.
Would Functional Specialization of Space Narrow Down Regional Disparities? — An Empirical Analysis Based on Panel Data of Chinese Urban Agglomerations 2003–2011
Authors: ZHAO Yong , QI Ouge
Published: July 2017

Strengthening regional cooperation and promoting functional specialization of space are significant orientations of current regional development strategies, but whether the functional specialization of space based on the co-agglomeration of manufacturing industry and service industry narrows regional disparities is yet to be verified. The authors utilize the panel data of 16 Chinese urban agglomerations from 2003 to 2011 and verify that functional specialization of space and regional disparities present an inverted U-curve relationship, that is, as functional specialization of space develops, regional disparities get larger and vice versa. By comparing indexes of functional specialization of space of major urban agglomerations in China, the authors find that by 2011 only the Yangtze River Delta, Pearl River Delta, and Beijing-Tianjin-Hebei urban agglomerations enter the second half of the inverted U-curve. Some other urban agglomerations are at or reaching the inflection point. However, half of Chinese urban agglomerations are still at the first half of the inverted U-curve, and it is expected to take a long time for some of them to reach the inflection point. In addition, this paper provides circumstantial evidence for the existence of an S-curve relationship for three times between the labor productivity of a city’s service industry and the distance from the city to large ports, meaning that the agglomerating efficiency of the service industry is relatively high in the eastern and western regions of China and low in the central region. The above conclusions indicate that different types of urban agglomerations should adopt different coping strategies in promoting coordinated regional development by strengthening regional cooperation and boosting functional specialization of space.
Beyond just hemoglobin: Red blood cell potentiation of hemoglobin-oxygen unloading in fish
Authors: Brauner Colin J. , Harter Till S.
Published: July 2017

Teleosts comprise 95% of fish species, almost one-half of all vertebrate species, and represent one of the most successful adaptive radiation events among vertebrates. This is thought to be in part because of their unique oxygen (O2) transport system. In salmonids, recent in vitro and in vivo studies indicate that hemoglobin-oxygen (Hb-O2) unloading to tissues may be doubled or even tripled under some conditions without changes in perfusion. This is accomplished through the short circuiting of red blood cell (RBC) pH regulation, resulting in a large arterial-venous pH difference within the RBC and induced reduction in Hb-O2affinity. This system has three prerequisites: 1) highly pH-sensitive hemoglobin, 2) rapid RBC pH regulation, and 3) a heterogeneous distribution of plasma-accessible CA in the cardiovascular system (presence in the tissues and absence at the gills). Although data are limited, these attributes may be general characteristics of teleosts. Although this system is not likely operational to the same degree in other vertebrates, some of these prerequisites do exist, and the generation and elimination of pH disequilibrium states at the RBC will likely enhance Hb-O2unloading to some degree. In human disease states, there are conditions that may partly satisfy those for enhanced Hb-O2unloading, tentatively an avenue for future work that may improve treatment efficacy.
КЛІНІЧНІ ОСОБЛИВОСТІ НЕЕФЕКТИВНО ЛІКОВАНОГО ВПЕРШЕ ДІАГНОСТОВАНОГО ТУБЕРКУЛЬОЗУ ЛЕГЕНЬ ІЗ НАЯВНІСТЮ СТІЙКОСТІ ДО ПРОТИТУБЕРКУЛЬОЗНИХ ПРЕПАРАТІВ
Authors: Yasinskyi R. M. , Krasnevich A. M.
Published: July 2017

Метою дослідження стало встановлення клінічних особливостей неефективно лікованого вперше діагностованого туберкульозу легень при наявності стійкості до протитуберкульозних засобів.Матеріали і методи. Для досягнення мети проаналізовано 60 історій хвороб пацієнтів. Хворих було поділено на 2 групи: до 1 групи увійшли 25 осіб, у яких була встановлена резистентність до протитуберкульозних препаратів, та які не належали до 4 категорії хворих, до 2 групи увійшли 35 осіб, у яких зберігалася чутливість до всіх протитуберкульозних препаратів. Визначали статистичну значимість відмінностей між групами за допомогою критерію «χ-квадратів», при кількості випадків менше 20 додатково користувалися правкою Єтса.Результати. Тривалість захворювання до встановлення діагнозу туберкульозу становила 18,7 % у хворих 1 групи та 7,4 % – у 2 групи понад 3 місяці, р˂0,05. Визначалася тенденція до більш поширених форм туберкульозу у пацієнтів 1 групи: інфільтративний туберкульоз без засіву визначався лише у 2 групі: 11,4 % проти 0 у 1, р˂0,1; дисемінований туберкульоз легень порівняно частіше діагностували у 1 групі: 48,0 % проти 25,7 %, р˂0,1.Висновки. У хворих на неефективно лікований вперше діагностований туберкульоз легень із наявністю стійкості до протитуберкульозних засобів, яких не включено до 4 категорії, порівняно із пацієнтами зі збереженою чутливістю до протитуберкульозних препаратів, відзначається більша тривалість інтоксикаційно-респіраторного синдрому в анамнезі до встановлення діагнозу. У таких хворих виявлено тенденцію до більш поширених уражень легень. За іншими клініко-рентгенологічними та бактеріологічними показниками статистично значимих відмінностей не виявлено.
ЗАСТОСУВАННЯ МЕЛЬДОНІЮ В РЕАБІЛІТАЦІЇ ХВОРИХ НА ХРОНІЧНИЙ ПАНКРЕАТИТ У ПОЄДНАННІ ІЗ СТАБІЛЬНОЮ ІШЕМІЧНОЮ ХВОРОБОЮ СЕРЦЯ
Authors: Babinets L. S. , Melnyk N. A. , Gnizdyuh I. O. , Dobrorodnya L. V.
Published: July 2017

Один із небагатьох способів відновлення нормальної роботи всіх життєво важливих органів і систем – це застосування метаболічної терапії.Метою роботи було дослідити ефективність курсового лікування метаболічним препаратом Мельдоній для корекції прооксидатно-антиоксидантних і трофологічних порушень у хворих з коморбідним перебігом хронічного панкреатиту (ХП) та стабільної ішемічної хвороби серця (СІХС).Матеріал і методи. У дослідження включено 90 пацієнтів із ХП в поєднанні із СІХС, яких було поділено на дві групи (залежно від програм лікування): І група (45 хворих) отримувала загальноприйняте лікування (ЗПЛ); ІІ група (45 хворих) – окрім ЗПЛ додатково отримувала ступінчастий курс препарату мельдонію (Вазонат) за наступною схемою: перший ступінь – по 5 мл в/в струминно 1 раз на день протягом 10 днів; другий ступінь – введення мельдонію електрофорезом на ділянку лівого підребер’я через день впродовж 15 днів; третій ступінь – подальший прийомом препарату по 2 капсули 1 раз на день впродовж місяця.Результати. Було доведено, що додавання до комплексної терапії хворих із коморбідністю ХП та СІХС препарату Мельдонію більшою мірою сприяє поліпшенню показників трофологічного і прооксидатно-антиоксидантного статусу, ніж при стандартній базисній терапії.