bluuebunny/crossref_metadata_2025 huggingface dataset:
Three‐year experience with access to nationally funded growth hormone (GH) replacement for GH‐deficient adults
Authors: Holdaway I.M. , Hunt P. , Manning P. , Cutfield W. , Gamble G. , Ninow N. , Staples‐Moon D. , Moodie P. , Metcalfe S.
Published: December 2014

Objective

Treatment of growth hormone (GH)‐deficient adults with GH has been shown to improve a range of metabolic abnormalities and enhance quality of life. However, the results of access to nationally funded treatment have not been reported.

Design

Retrospective case series auditing nationally funded treatment of defined GH‐deficient adults in New Zealand, with carefully designed entry and exit criteria overseen by a panel of endocrinologists.

Patients

Applications for 201 patients were assessed and 191 approved for funded treatment over the initial 3 years since inception. The majority had GH deficiency following treatment of pituitary adenomas or tumours adjacent to the pituitary.

Results

After an initial 9‐month treatment period using serum IGF‐I measurements to adjust GH dosing, all patients reported a significant improvement in quality of life (QoL) score on the QoL‐AGHDA® instrument (baseline (95%CI) 19 (18–21), 9 months 6 (5–7·5)), and mean serum IGF‐I SD scores rose from ‐3 to zero. Mean waist circumference decreased significantly by 2·8 ± 0·6 cm. The mean maintenance GH dose after 9 months of treatment was 0·39 mg/day. After 3 years, 17% of patients had stopped treatment, and all of the remaining patients maintained the improvements seen at 9 months of treatment.

Conclusion

Carefully designed access to nationally funded GH replacement in GH‐deficient adults was associated with a significant improvement in quality of life over a 3‐year period with mean daily GH doses lower than in the majority of previously reported studies.
Cadmium delays puberty onset and testis growth in adolescents
Authors: Interdonato Monica , Pizzino Gabriele , Bitto Alessandra , Galfo Federica , Irrera Natasha , Mecchio Anna , Pallio Giovanni , Ramistella Vincenzo , Luca Filippo De , Santamaria Angelo , Minutoli Letteria , Marini Herbert , Squadrito Francesco , Altavilla Domenica
Published: December 2014

Objective

Cadmium (Cd) has been shown to impair pubertal development in experimental animals. However, no data are available for male adolescents with increased urinary cadmium levels.

Design

The aim of this cross‐sectional study was to evaluate pubertal onset and pituitary–gonadal axis hormones in male adolescents with increased urinary levels of Cd.

Subjects

We studied 111 males, aged 12–14 years living in the Milazzo‐Valle del Mela area. A control age‐matched population (n = 60) living 28–45 km far from the industrial site was also enrolled.

Measurements

Pubertal stages were assessed by clinical examination according to Tanner's score. Mean testicular volume was also investigated by ultrasound examination. Urinary Cd concentration and blood levels of FSH, LH, testosterone and inhibin B were also investigated.

Results

Cd levels were significantly higher in adolescents living in the Milazzo‐Valle del Mela area, compared to both age‐matched subjects living far from the industrial plants and the reference values. Our population showed also a delayed onset of puberty, a smaller testicular volume and lower testosterone levels. An inverse correlation was found between urinary Cd and testicular volume (r = −0·25; P = 0·0008), testosterone levels (Spearman's r = −0·0·37; two‐tailed P < 0·0001) and LH levels (Spearman's r = 0·048; P < 0·05). Testosterone levels were positively correlated with testicular volume (Spearman's r = 0·48; P < 0·0001).

Conclusions

This study, for the first time, suggests that increased Cd burden is associated with delayed onset of puberty in male adolescents and impaired testicular growth.
Defining the histopathological changes induced by nonablative radiofrequency treatment of faecal incontinence – a blinded assessment in an animal model
Authors: Herman R. M. , Berho M. , Murawski M. , Nowakowski M. , Ryś J. , Schwarz T. , Wojtysiak D. , Wexner S. D.
Published: December 2014

Aim

Nonablative radiofrequency (RF) sphincter remodelling has been used to treat gastro‐oesophageal reflux disease (GERD) and faecal incontinence (FI). Its mechanism of action is unclear. We aimed to investigate the histomorphological and pathophysiological changes to the internal and external anal sphincter (IAS and EAS) following RF remodelling.

Method

An experimental FI model was created in 12 female pigs: eight underwent RF 6 weeks following induction of FI (FI+RF) and four were untreated (UFI). Four animals served as controls (CG). Two blinded pathologists examined all haematoxylin and eosin and trichrome stained slides.

Results

Compared with the UFI group, histological examination of the IAS in the FI+RF group demonstrated an increased smooth muscle (SM)/connective tissue ratio (77.2 vs 68.1%, P < 0.05) and increased collagen I compared with collagen III content (67.2 vs 54.9%, P < 0.001). The RF+FI group exhibited greater SM bundle thickness compared with the UFI group (SM width 486.93 vs 338.59 μm, P < 0.01; height 4384.4 vs 3321.0 μm, P < 0.05). The EAS of the FI+RF animals showed a significantly higher type I/II fibre ratio (33.5 vs 25.2%, P = 0.023) and fibre type I diameter (67.2 vs 59.7 μm, P < 0.001) compared with the UFI group. Post‐RF manometry showed higher basal (18.8 vs 0 mmHg, P < 0.001) and squeeze (76.8 vs 12.4 mmHg, P < 0.05) anal pressures. After RF treatment, the number of interstitial cells of Cajal was significantly reduced compared with the UFI and CG groups [0.9 (FI+RF) vs 6.7 (UFI) vs 0.7 (CG) per mm2, P < 0.001].

Conclusion

In an animal model nonablative RF appeared to induce morphological changes in the IAS and EAS leading to an anatomical state reminiscent of normal sphincter structure.
Treatment of rectovaginal fistula after colorectal resection with endoscopic stenting: long‐term results
Authors: Lamazza A. , Fiori E. , Schillaci A. , Sterpetti A. V. , Lezoche E.
Published: December 2014

Aim

To treat patients with rectovaginal fistula after anterior resection for cancer using self‐expanding metal stents.

Method

Ten patients of mean age of 56.3 years with rectovaginal fistula after colorectal resection for cancer were treated with endoscopic placement of a self‐expanding metal stent. In three patients a diverting proximal stoma had been performed elsewhere. The rectal opening of the fistula was located from 3 to 10 cm from the anal verge (mean 6 cm). All patients had preoperative radiotherapy. In seven patients the stent was placed as the initial treatment while three referred patients had had multiple failed operations.

Results

There were no complications after the procedure. At a mean follow‐up of 24 months the rectovaginal fistula has healed without major faecal incontinence in eight patients. In the remaining two the fistula has reduced significantly in size to allow a successful flap transposition.

Conclusion

Endoscopic placement of a self‐expanding metal stent is a valid adjunct to treat patients with rectovaginal fistula after colorectal resection for cancer.
Acute eccentric resistance exercise decreases matrix metalloproteinase activity in obese elderly women
Authors: Nascimento Dahan da Cunha , Navalta James Wilfred , Durigan João Luiz Quagliotti , Marqueti Rita de Cassia , Tibana Ramires Alsamir , Luiz Franco Octavio , de Almeida Jesser Alves , Camarço Nathalia Ferreira , Neto Ivo Vieira de Sousa , Prestes Jonato
Published: December 2014

The association of ageing with obesity commits elderly women and has been correlated with multiple degenerative processes, which could be occasioned by an enhancing in levels of matrix metalloproteinase‐2 and metalloproteinase‐9 (MMPs) as well by an cytokine unbalance that included an enhancing on interleukin‐6 (IL‐6). Furthermore, other factors could be also related to degenerative process, as they could be reduced by eccentric resistance exercise (ERE), which seems particularly important to initiate resistance training in obese older adults. In this view, this study aims to determinate the effects of an acute ERE session on serum MMP‐2, MMP‐9 and IL‐6 in elderly obese women. Ten elderly obese women participated in this study and completed a 10 repetitions maximum test (10 RM) utilizing leg extension exercise. Subjects then completed an acute ERE session consisting of seven sets of 10 repetitions at 110% of 10 RM with a rest of 3 min between sets. Blood samples were collected before, immediately after, 3, 24 and 48 h following the ERE session. Zymograms were utilized to measure the MMP‐2 and MMP‐9 enzymes from all individuals. Moreover, IL‐6 concentration was also determinated. After ERE session, MMP‐2 and MMP‐9 decreased, remaining significantly below baseline values after 48 h (P<0·05). Although not statistically significant, there was a tendency for IL‐6 to decrease 48 h after the ERE when compared with 3 h (P = 0·06). An acute ERE session decreases MMP‐9, MMP‐2 and IL‐6 in elderly obese women, possibly indicating a transient protection against the low grade inflammation present in this specific population.
Acute blood pressure changes are related to chronic effects of resistance exercise in medicated hypertensives elderly women
Authors: Moreira Sérgio R. , Cucato Gabriel G. , Terra Denize F. , Ritti‐Dias Raphael M.
Published: December 2014

Background

A previous study observed that the chronic effects of aerobic training on blood pressure (BP) are related to acute BP responses after a single bout of aerobic exercise. However, whether similar responses are observed with resistance exercise (RE) remains obscure. Thus, this study analysed the relationship between the acute BP responses to a single bout of RE and chronic changes in resting BP after a RE training in medicated hypertensive elderly women.

Methods and results

Twenty medicated hypertensive women participated in the study. They underwent an acute RE bout where BP and heart rate (HR) were obtained at rest and for 60 min after the RE. Subsequently, the participants underwent a progressive RE training for 12 weeks at 60–80% of maximal strength test. Resting BP and HR were also obtained after the RE training. The chronic decreases in systolic and diastolic BP were significantly greater in the participants who experienced acutely decreased systolic and diastolic BP, respectively (P<0·05). The changes in systolic BP after acute RE were correlated with the chronic changes in resting systolic BP after RE training (r = 0·47; P = 0·03). Similar correlations between acute and chronic responses were also observed for diastolic BP (r = 0·70; P = 0·01), mean BP (r = 0·58; P = 0·01), HR (r = 0·73; P<0·01) and RPP (r = 0·52; P = 0·01).

Conclusion

Similar to previously work involving aerobic exercise, BP responses to a single bout of RE are strongly related to chronic effects of RE training on BP in medicated hypertensive elderly women.
Acute and training effects of resistance exercise on heart rate variability
Authors: Kingsley J. Derek , Figueroa Arturo
Published: December 2014

Heart rate variability (HRV) has been used as a non‐invasive method to evaluate heart rate (HR) regulation by the parasympathetic and sympathetic divisions of the autonomic nervous system. In this review, we discuss the effect of resistance exercise both acutely and after training on HRV in healthy individuals and in those with diseases characterized by autonomic dysfunction, such as hypertension and fibromyalgia. HR recovery after exercise is influenced by parasympathetic reactivation and sympathetic recovery to resting levels. Therefore, examination of HRV in response to acute exercise yields valuable insight into autonomic cardiovascular modulation and possible underlying risk for disease. Acute resistance exercise has shown to decrease cardiac parasympathetic modulation more than aerobic exercise in young healthy adults suggesting an increased risk for cardiovascular dysfunction after resistance exercise. Resistance exercise training appears to have no effect on resting HRV in healthy young adults, while it may improve parasympathetic modulation in middle‐aged adults with autonomic dysfunction. Acute resistance exercise appears to decrease parasympathetic activity regardless of age. This review examines the acute and chronic effects of resistance exercise on HRV in young and older adults.
From Hesitation to Appreciation: the transformation of a single, local donation‐nurse project into an established organ‐donation service
Authors: Gyllström Krekula Linda , Malenicka Silvia , Nydahl Anders , Tibell Annika
Published: December 2014

This study evaluates the transition from a local project to promote organ donation to a permanent county‐based donation service inspired by the Spanish model. To address the problem of declining donation rates, a project with one donation‐specialized nurse (DOSS) was initiated at a single neuro‐intensive care unit. This project was later expanded into a permanent on‐call service consisting of seven DOSSes, covering a large urban county. During the different periods (before, during project and during permanent service), the DOSS function's effect on donation rates was significant, and the number of eligible donors that became actual donors increased from 37% to 73% and 74%, respectively. The effect on family vetoes was as prominent with a decrease from 34% to 8% and 14%. The staff appreciation of the DOSS function was also evident during the periods; all areas included in the questionnaire (family care, donor care and staff support) have improved greatly owing to the DOSS. The transition from a single, local donation‐nurse project, to an on‐call service with several DOSSes covering a large urban county was a success considering the donation rates as well as the staff's appreciation. Hence, organizational models from abroad can be adjusted and successfully adopted.
Autoimmunity after liver transplantation: a frequent event but a rare clinical problem
Authors: Foschi Antonella , Zavaglia Claudio Antonio , Fanti Diana , Mazzarelli Chiara , Perricone Giovanni , Vangeli Marcello , Viganò Raffaella , Belli Luca Saverio
Published: December 2014

Autoantibodies are frequently detected after liver transplantation (LT), but their role is unclear. This study was designed to address three points: autoantibody prevalence pre‐LT and over time up to five yr after LT, identification of possible predictors of autoantibody formation, and correlation between autoantibodies and graft dysfunction. To these aims, we retrospectively evaluated 92 consecutive LT recipients for whom prospectively stored frozen sera were available for autoantibodies assessment by immunofluorescence. The overall autoantibody prevalence resulted significantly higher after LT than before LT (64% vs. 27%, p < 0.001 and 35.9% vs. 8.7%, p < 0.001 considering cutoff titer of ≥1:80 and ≥1:160, respectively). Recipient gender, donor age and gender, and indication for LT and main immunosuppressant (cyclosporine vs. tacrolimus) were not associated with the presence of autoantibodies. Patients with graft dysfunction had a significantly higher autoantibody prevalence irrespective of the etiology of liver injury as compared to those patients with persistently normal liver biochemistry, but only for cutoff titers ≥1:160 (p = 0.004). No cases of de novo autoimmune hepatitis were observed. In conclusion, autoantibodies are very frequently detected after LT also at high titers and their association with graft dysfunction likely represents an aspecific indicator of liver injury.
Harnessing the biodiversity value of Central and Eastern European farmland
Authors: Sutcliffe Laura M. E. , Batáry Péter , Kormann Urs , Báldi András , Dicks Lynn V. , Herzon Irina , Kleijn David , Tryjanowski Piotr , Apostolova Iva , Arlettaz Raphaël , Aunins Ainars , Aviron Stéphanie , Baležentienė Ligita , Fischer Christina , Halada Lubos , Hartel Tibor , Helm Aveliina , Hristov Iordan , Jelaska Sven D. , Kaligarič Mitja , Kamp Johannes , Klimek Sebastian , Koorberg Pille , Kostiuková Jarmila , Kovács‐Hostyánszki Anikó , Kuemmerle Tobias , Leuschner Christoph , Lindborg Regina , Loos Jacqueline , Maccherini Simona , Marja Riho , Máthé Orsolya , Paulini Inge , Proença Vânia , Rey‐Benayas José , Sans F. Xavier , Seifert Charlotte , Stalenga Jarosław , Timaeus Johannes , Török Péter , van Swaay Chris , Viik Eneli , Tscharntke Teja
Published: December 2014

A large proportion of European biodiversity today depends on habitat provided by low‐intensity farming practices, yet this resource is declining as European agriculture intensifies. Within the European Union, particularly the central and eastern new member states have retained relatively large areas of species‐rich farmland, but despite increased investment in nature conservation here in recent years, farmland biodiversity trends appear to be worsening. Although the high biodiversity value of Central and Eastern European farmland has long been reported, the amount of research in the international literature focused on farmland biodiversity in this region remains comparatively tiny, and measures within the EU Common Agricultural Policy are relatively poorly adapted to support it. In this opinion study, we argue that, 10 years after the accession of the first eastern EU new member states, the continued under‐representation of the low‐intensity farmland in Central and Eastern Europe in the international literature and EU policy is impeding the development of sound, evidence‐based conservation interventions. The biodiversity benefits for Europe of existing low‐intensity farmland, particularly in the central and eastern states, should be harnessed before they are lost. Instead of waiting for species‐rich farmland to further decline, targeted research and monitoring to create locally appropriate conservation strategies for these habitats is needed now.
Autoantibody‐defined risk for Type 1 diabetes mellitus in a general population of schoolchildren: results of the Karlsburg Type 1 Diabetes Risk Study after 18 years
Authors: Till A.‐M. , Kenk H. , Rjasanowski I. , Wassmuth R. , Walschus U. , Kerner W. , Schlosser M.
Published: December 2014

Aims

To investigate the occurrence of diabetes‐associated autoantibodies and cumulative Type 1 diabetes risk over 18 years in a general population of schoolchildren.

Methods

In the Karlsburg Type 1 Diabetes Risk Study, 11 986 schoolchildren from north‐eastern Germany without a family history of diabetes were screened for glutamic acid decarboxylase antibodies, insulinoma‐associated antigen‐2 antibodies and insulin autoantibodies by radioligand binding assay. Those children found to be autoantibody‐positive were invited to follow‐up examinations and HLA‐DQB1 genotyping, and were followed for progression to Type 1 diabetes.

Results

At first follow‐up, 119 children had single and 36 children had multiple autoantibodies. Of the multiple autoantibody‐positive children, 33 had at least one diabetes‐associated HLA‐DQB1 allele (*02 and/or *0302). A total of 26 children progressed to Type 1 diabetes, of whom 22 had multiple autoantibodies. The male‐to‐female ratio of those who progressed to Type 1 diabetes was 1.6. The positive predictive value of multiple autoantibodies was 61.1% compared with only 23.7% for diabetes‐associated HLA‐DQB1 genotypes among all those who were autoantibody‐positive. The cumulative risk was 59.7% after 10 years and 75.1% after 18 years for children with multiple autoantibodies compared with 1.2 and 22.6%, respectively, for children with single autoantibodies (P<0.001). Among the three examined autoantibodies, insulinoma‐associated antigen‐2 antibodies conferred the highest risk.

Conclusions

The diabetes risk in schoolchildren with multiple autoantibodies was similar to the risk reported in other studies for genetically preselected probands; thus, a combined autoantibody‐based screening could effectively identify at‐risk individuals from the general population for future intervention trials.
Effectiveness of lifestyle‐based weight loss interventions for adults with type 2 diabetes: a systematic review and meta‐analysis
Authors: Terranova C. O. , Brakenridge C. L. , Lawler S. P. , Eakin E. G. , Reeves M. M.
Published: December 2014

Aims

To provide a systematic review and meta‐analysis of recent evidence on the effectiveness of lifestyle‐based weight loss interventions for adults with type 2 diabetes.

Methods

A search of the literature from January 2003 to July 2013 was conducted (PubMed, Embase, CINAHL and Web of Science). The studies considered eligible were randomized controlled trials evaluating weight loss interventions (diet and physical activity, with or without behavioural strategies) of ≥12 weeks duration, compared with usual care or another comparison intervention. Ten studies were included for review. Some heterogeneity was present in the sample, therefore, random‐effects models were used to calculate pooled effects.

Results

Intervention duration ranged from 16 weeks to 9 years, with all but one delivered via individual or group face‐to‐face sessions. From six studies comparing lifestyle intervention with usual care the pooled effect on weight (n = 5795) was −3.33 kg [95% confidence interval (CI) −5.06, −1.60 kg], and on glycated haemoglobin (HbA1c; n = 5784) was −0.29% (95% CI −0.61, 0.03%), with both attenuated in sensitivity analyses. The pooled within‐group effect on weight (n = 3063) from all 10 lifestyle intervention groups was −5.33 kg (95% CI −7.33, −3.34 kg), also attenuated in sensitivity analyses. None of the participant or intervention characteristics examined explained the heterogeneity. Only one study assessed whether intervention effects were maintained after the end of the intervention.

Conclusions

Lifestyle‐based weight loss intervention trials in type 2 diabetes achieve, on average, modest reductions in weight and HbA1c levels, but results were heavily influenced by one trial. Evidence‐based approaches for improving the effectiveness of lifestyle‐based interventions in type 2 diabetes are needed, along with future studies reporting on maintenance and cost‐effectiveness.
INTERNATIONAL NARCOTICS TRADE, FOREIGN AID, AND ENFORCEMENT
Authors: Oladi Reza , Gilbert John
Published: December 2014

Using a general equilibrium model of a developing narcotics‐producing and ‐exporting economy, we analyze the economic effects of policies designed to restrict the production and trade of narcotics: foreign aid tied to anti‐narcotics law enforcement activities, demand reduction policies, and alternative development policies. We characterize the problem as one of serious factor market distortions introduced by illicit production and enforcement. While aid to enforcement generally reduces the production and export of narcotics, it is less effective for economies with market power, and under plausible conditions may raise narcotics output and have negative welfare implications for the recipient. (JEL F1)
Predicting ecosystem functions from biodiversity and mutualistic networks: an extension of trait‐based concepts to plant–animal interactions
Authors: Schleuning Matthias , Fründ Jochen , García Daniel
Published: December 2014

Research linking biodiversity and ecosystem functioning (BEF) has been mostly centred on the influence of species richness on ecosystem functions in small‐scale experiments with single trophic levels. In natural ecosystems, many ecosystem functions are mediated by interactions between plants and animals, such as pollination and seed dispersal by animals, for which BEF relationships are little understood. Largely disconnected from BEF research, network ecology has examined the structural diversity of complex ecological networks of interacting species. Here, we provide an overview of the most important concepts in BEF and ecological network research and exemplify their applicability to natural ecosystems with examples from pollination and seed‐dispersal studies. In a synthesis, we connect the structural approaches of network analysis with the trait‐based approaches of BEF research and propose a conceptual trait‐based model for understanding BEF relationships of plant–animal interactions in natural ecosystems. The model describes the sequential processes that determine the BEF relationship, i.e. the responses of species to environmental filters, the matching of species in ecological networks and the functionality of species in terms of their quantitative and qualitative contributions to plant demography and ecosystem functioning. We illustrate this conceptual integration with examples from mutualistic interactions and highlight its value for predicting the consequences of biodiversity loss for multispecies interactions and ecosystem functions. We foresee that a better integration between BEF and network research will improve our mechanistic understanding of how biodiversity relates to the functioning of natural ecosystems. Our conceptual model is a step towards this integration between structural and functional biodiversity research.
Intracortical modulation, and not spinal inhibition, mediates placebo analgesia
Authors: Martini M. , Lee M. C. H. , Valentini E. , Iannetti G. D.
Published: December 2014

Suppression of spinal responses to noxious stimulation has been detected using spinal fMRI during placebo analgesia, which is therefore increasingly considered a phenomenon caused by descending inhibition of spinal activity. However, spinal fMRI is technically challenging and prone to false‐positive results. Here we recorded laser‐evoked potentials (LEPs) during placebo analgesia in humans. LEPs allow neural activity to be measured directly and with high enough temporal resolution to capture the sequence of cortical areas activated by nociceptive stimuli. If placebo analgesia is mediated by inhibition at spinal level, this would result in a general suppression of LEPs rather than in a selective reduction of their late components. LEPs and subjective pain ratings were obtained in two groups of healthy volunteers – one was conditioned for placebo analgesia while the other served as unconditioned control. Laser stimuli at three suprathreshold energies were delivered to the right hand dorsum. Placebo analgesia was associated with a significant reduction of the amplitude of the late P2 component. In contrast, the early N1 component, reflecting the arrival of the nociceptive input to the primary somatosensory cortex (SI), was only affected by stimulus energy. This selective suppression of late LEPs indicates that placebo analgesia is mediated by direct intracortical modulation rather than inhibition of the nociceptive input at spinal level. The observed cortical modulation occurs after the responses elicited by the nociceptive stimulus in the SI, suggesting that higher order sensory processes are modulated during placebo analgesia.
Depression and anxiety in women with epilepsy during pregnancy and after delivery: A prospective population‐based cohort study on frequency, risk factors, medication, and prognosis
Authors: Bjørk Marte Helene , Veiby Gyri , Reiter Simone C. , Berle Jan Øystein , Daltveit Anne Kjersti , Spigset Olav , Engelsen Bernt A. , Gilhus Nils Erik
Published: December 2014

Objective

To assess incidence, prevalence, risk factors, and prognosis of peripartum depression and anxiety in a prospective study of women with epilepsy.

Method

Pregnancies in women with epilepsy (n = 706) were compared to pregnancies in all women without epilepsy (n = 106 511) including women with specified nonepileptic chronic diseases (n = 8,372) in the Norwegian Mother and Child Cohort Study. The database was linked to the Medical Birth Registry of Norway. Depression and anxiety were assessed with validated questionnaires five times from the second trimester to 36 months after delivery. Blood was drawn for analysis of antiepileptic drug (AED) concentrations.

Results

Women with epilepsy more often had peripartum depression (26.7%) or anxiety (22.4%) than women without epilepsy (18.9% and 14.8%, respectively, p < 0.001 for both comparisons) and women with other chronic diseases (23.1% and 18.4%, respectively, p = 0.03 and 0.01). Women using AEDs during pregnancy were especially at risk regardless of AED type. The risk further increased with the use of multiple AEDs and with high doses and/or plasma levels. Risk factors associated with peripartum depression and/or anxiety in the epilepsy cohort were high seizure frequency, a history of physical and/or sexual abuse, adverse socioeconomic factors, previous loss of a child, AED use, unplanned pregnancy, and prepregnancy depression and/or anxiety. The recovery rate 3 years after delivery was lower for women with epilepsy with a history of depression/anxiety or physical/sexual abuse than for women without epilepsy. Depressed women with epilepsy were less frequently treated with antidepressive drugs during pregnancy than women without epilepsy.

Significance

Women with epilepsy frequently have depression and anxiety during and after pregnancy. Patients at risk should be identified before delivery as depressive symptoms could be undertreated in this group.
Fatigue behaviour of clinched joints in a steel sheet
Authors: Kim J‐B. , Kim H‐K.
Published: December 2014

Clinch joining has been used in sheet metal work owing to its simplicity and because it facilitates the joining dissimilar metal sheets. In this study, monotonic and fatigue tests were conducted using coach‐peel and cross‐tension type specimens to evaluate the fatigue strength of clinch joints in a cold‐rolled mild steel sheet. The monotonic experimental results reveal that the coach‐peel specimen exhibits the lowest monotonic strength among the three specimen configurations. The coach‐peel and cross‐tension specimen geometries exhibit very low fatigue ratios, compared with the tensile‐shear specimen. The maximum von Mises and principal stresses at the fatigue endurance limit are much higher than the engineering tensile strengths of the steel sheet used to determine the three specimen geometries. Compared with the effective stress and maximum principal stress, the Smith–Watson–Topper fatigue parameter can be used for an appropriate prediction of the current experimental fatigue life. With regard to the coach‐peel specimen geometry, all samples exhibit pull‐out failure mode in the fatigue testing range. However, for the cross‐tension specimen geometry, mixed (pull‐out and interface) and interface failure modes occurred, depending on the number of cycles to failure.
Seasonal weather patterns drive population vital rates and persistence in a stream fish
Authors: Kanno Yoichiro , Letcher Benjamin H. , Hitt Nathaniel P. , Boughton David A. , Wofford John E. B. , Zipkin Elise F.
Published: December 2014

Climate change affects seasonal weather patterns, but little is known about the relative importance of seasonal weather patterns on animal population vital rates. Even when such information exists, data are typically only available from intensive fieldwork (e.g., mark–recapture studies) at a limited spatial extent. Here, we investigated effects of seasonal air temperature and precipitation (fall, winter, and spring) on survival and recruitment of brook trout (Salvelinus fontinalis) at a broad spatial scale using a novel stage‐structured population model. The data were a 15‐year record of brook trout abundance from 72 sites distributed across a 170‐km‐long mountain range in Shenandoah National Park, Virginia, USA. Population vital rates responded differently to weather and site‐specific conditions. Specifically, young‐of‐year survival was most strongly affected by spring temperature, adult survival by elevation and per‐capita recruitment by winter precipitation. Low fall precipitation and high winter precipitation, the latter of which is predicted to increase under climate change for the study region, had the strongest negative effects on trout populations. Simulations show that trout abundance could be greatly reduced under constant high winter precipitation, consistent with the expected effects of gravel‐scouring flows on eggs and newly hatched individuals. However, high‐elevation sites would be less vulnerable to local extinction because they supported higher adult survival. Furthermore, the majority of brook trout populations are projected to persist if high winter precipitation occurs only intermittently (≤3 of 5 years) due to density‐dependent recruitment. Variable drivers of vital rates should be commonly found in animal populations characterized by ontogenetic changes in habitat, and such stage‐structured effects may increase population persistence to changing climate by not affecting all life stages simultaneously. Yet, our results also demonstrate that weather patterns during seemingly less consequential seasons (e.g., winter precipitation) can have major impacts on animal population dynamics.
Evaluating the efficiency of humic acid to remove micro‐organisms from denture base material
Authors: Meriç Gökçe , Güvenir Meryem , Süer Kaya
Published: December 2014

Objective

To evaluate the efficiency of humic acid substances on removing micro‐organisms from denture base materials.

Background

Old denture wearer needs effective, easy‐use and safe denture‐cleaning material.

Material and methods

Square‐shaped, heat‐polymerised acrylic resin specimens (n = 550) were prepared and divided into five groups (n = 110 for each) corresponding to the microbial contamination (Candida albicans, Staphylococcus aureus, Bacillus cereus, Enterococcus faecalis, Pseudomonas aeruginosa). Contaminated specimens were randomly assigned to the application of five different denture‐cleaning agents as follows (n = 20 for each): Kloroben, Corsodyl, Steradent, Corega, experimental solution with humic acid. Ten specimens were assessed as an experimental control carried out simultaneously for the treatment groups for each micro‐organism. It was divided into two groups: negative control and positive control (n = 5 for each). All acrylic specimens were incubated 37°C for 24 h (for bacterial strains) and 37°C for 48 h (for yeast strains). After incubation period, all brain–heart infusion broths (BHI) which contain disinfectant acrylic specimens were cultured on 5% sheep blood agar (for bacteria) and Sabouraud dextrose agar (SDA) for yeast using loop. The numbers of colony‐forming units per millilitre (CFU/ml) were calculated. The results were analysed by Mann–Whitney U‐test and Kruskal–Wallis tests (p = 0.05).

Results

Corsodyl and Kloroben completely eliminated the adherence of all investigated micro‐organisms (100%) and showed the highest removal activity compared with other cleaning agents (p < 0.05). There was no statistically significant difference between Corsodyl and Kloroben (p ≥ 0.05), and there was no statistically significant difference between Corega, Steradent and experimental solution (p ≥ 0.05).

Conclusion

Humic acid could be used as an alternative ‘natural’ solution for denture‐cleaning agent.
Relationships among structural empowerment, psychological empowerment, intent to stay and burnout in nursing field in mainland China—based on a cross‐sectional questionnaire research
Authors: Meng Lina , Liu Yanhui , Liu Hongwei , Hu Yu , Yang Jipeng , Liu Jingying
Published: December 2014

The aim of the study was to explore the relationship among perceived structural empowerment, psychological empowerment, burnout and intent to stay by nurses in mainland China.With the shortage of nurses in many countries, including China, intent to stay is a dominant factor to influence the quality of care. Also, burnout is identified to negatively affect the quality of care. Empowered clinical nurse practical environment is related to intent to stay and burnout. In the current literature, there is a lack of data based on empowering environment discussing the relationship between burnout and intent to stay. The study used an anonymous questionnaire, filled voluntarily by 219 nurses from different sections in a city in mainland China, 2012.Structural equation modelling (SEM) was used to test the proposed hypotheses. Based on the SEM model, structural empowerment and psychological empowerment had significant positive effects on intent to stay of nurses and negative effects on burnout. Burnout had a significant negative effect on intent to stay. The final modified models yielded χ2 = 58.580, P > 0.05, χ2/df = 1.046, root mean square error of approximation = 0.015, Tucker–Lewis Index = 0.996, comparative fit index = 0.998,which indicated good fit indices. Creating a positive empowering workplace can encourage nurses to stay long and prevent burnout. Therefore, higher level of empowering environment is required.
We can't all be supermodels: the value of comparative transcriptomics to the study of non‐model insects
Authors: Oppenheim Sara J. , Baker Richard H. , Simon Sabrina , DeSalle Rob
Published: December 2014

Insects are the most diverse group of organisms on the planet. Variation in gene expression lies at the heart of this biodiversity and recent advances in sequencing technology have spawned a revolution in researchers' ability to survey tissue‐specific transcriptional complexity across a wide range of insect taxa. Increasingly, studies are using a comparative approach (across species, sexes and life stages) that examines the transcriptional basis of phenotypic diversity within an evolutionary context. In the present review, we summarize much of this research, focusing in particular on three critical aspects of insect biology: morphological development and plasticity; physiological response to the environment; and sexual dimorphism. A common feature that is emerging from these investigations concerns the dynamic nature of transcriptome evolution as indicated by rapid changes in the overall pattern of gene expression, the differential expression of numerous genes with unknown function, and the incorporation of novel, lineage‐specific genes into the transcriptional profile.
Transforming growth factor‐β‐activated kinase 1 resistance limits glucocorticoid responsiveness to Toll‐like receptor 4‐mediated inflammation
Authors: Kong Fansheng , Laryea Gloria , Liu Zhiwei , Bhattacharyya Sandip
Published: December 2014

Glucocorticoids (GC) are among the most effective anti‐inflammatory drugs, but are often associated with serious adverse effects or inadequate therapeutic responses. Here, we use activation of different Toll‐like receptors (TLRs) by their respective ligands to evaluate context‐specific GC sensitivity in the macrophage. Recruitment and activation of transforming growth factor‐β‐activated kinase 1 (TAK1), downstream of TLR engagement, is crucial in activating multiple inflammatory pathways, and contributes to inflammatory disorders. We hypothesize that GC exert anti‐inflammatory effects through regulation of TAK1. Both in vivo and in vitro, in comparison to other TLRs, there was limited GC potency in restricting TLR4 ligand‐mediated secretion of interleukin‐6, tumour necrosis factor‐α and interleukin‐12. Also, we found that inactivation of TAK1 both in vivo and in vitro strongly inhibits TLR4‐induced inflammation‐associated genes beyond the suppressive effects from GC treatment. However, there was no effect of TAK1 inactivation on GC inhibition of TLR3‐ or TLR9‐initiated inflammatory actions. Together, our findings demonstrate that GC resistance for TAK1 activation associated with TLR4 engagement may be an important contributor to GC resistance in inflammatory disorders.
Engaging women at risk for poor perinatal mental health outcomes: A mixed‐methods study
Authors: Myors Karen A. , Johnson Maree , Cleary Michelle , Schmied Virginia
Published: December 2014

Risk factors for poor perinatal mental health are well known. Psychosocial assessment and depression screening during the perinatal period aim to identify women at risk for poor perinatal outcomes. Early intervention programmes are known to improve the mental health outcomes of women and infants. Key to any intervention is initial and ongoing engagement in the therapeutic process. This mixed‐methods study reports the proportion of women who engage/do not engage with services and their characteristics, as well as the strategies clinicians use to engage women. Data were collected by reviewing medical records, interviewing perinatal and infant mental health (PIMH) clinicians, their managers, key stakeholders, and women service users. Analyses identified that most (71.3%) women referred engaged with the PIMH service. Themes related to non‐engagement are ‘time to rethink’ and ‘stigma’. Themes reflecting the engagement strategies used by PIMH clinicians are initial engagement: ‘back to basics’ and ‘building trust’, therapeutic engagement: ‘making myself useful’, engagement at discharge: ‘woman or clinician led’, and models that facilitate engagement.
Microstructure, Thermal Conductivity, and Electrical Properties of In Situ Pressureless Densified SiC–BN Composites
Authors: Li Yinsheng , Yin Jie , Wu Haibo , Zhang Jingxian , Chen Jian , Yan Yongjie , Liu Xuejian , Huang Zhengren , Jiang Dongliang
Published: December 2014

The microstructure, thermal conductivity, and electrical properties of pressureless densified SiC–BN composites prepared from in situ reaction of Si3N4, B4C, and C were systematically investigated, to achieve outstanding performance as substrate materials in electronic devices. The increasing BN content (0.25–8 wt%) in the composites resulted in finer microstructure, higher electrical resistivity, and lower dielectric constant and loss, at the expense of only slight degradation of thermal conductivity. The subsequently annealed composites showed more homogeneous microstructures with less crystal defects, further enhanced thermal conductivities and electrical resistivities, and reduced dielectric constants and losses, compared with the unannealed ones. The enhanced insulating performance, the weakened interface polarization, and the reduced current conduction loss were explained by the gradual equalization of dissolved B and N contents in SiC crystals and the consequent impurity compensation effect. The schottky contact between graphite and p‐type SiC grains presumably played a critical role in the formation of grain‐boundary barriers. The annealed composites doped with 8 wt% BN exhibited considerably high electrical resistivity (4.11 × 1011 Ω·cm) at 100 V/cm, low dielectric constant (16.50), and dielectric loss (0.127) at 1 MHz, good thermal conductivity [66.06 W·(m·K)−1] and relatively high strength (343 MPa) at room temperature.
Infusion of DDAVP does not improve primary hemostasis in patients with cirrhosis
Authors: Arshad Freeha , Stoof Sara C.M. , Leebeek Frank W.G. , Ruitenbeek Karin , Adelmeijer Jelle , Blokzijl Hans , van den Berg Arie P. , Porte Robert J. , Kruip Marieke J.H.A. , Lisman Ton
Published: December 2014

Background & Aims

Cirrhosis frequently affects multiple components of hemostasis. Reversal of the coagulopathy of these patients is frequently required in case of bleeding episodes, or as prophylaxis before invasive procedures. Although 1‐deamino‐8‐D‐arginine vasopressin (DDAVP) is widely used as a pro‐hemostatic agent in patients with cirrhosis, it is unclear whether DDAVP truly enhances hemostasis in these patients. Here we investigated the hemostatic effects of a single bolus of DDAVP in patients with cirrhosis.

Methods

Ten patients with cirrhosis (child B or C) and ten patients with mild haemophilia A received an intravenous single bolus of 0.3 microgram/kg DDAVP. Plasma was collected prior to and at 1, 3, 6, and 24 h after DDAVP administration. Levels of Von Willebrand factor (VWF), VWF propeptide, factor VIII (FVIII), and ADAMTS13 were measured in all plasma samples, whereas VWF multimers and functional VWF‐dependent platelet adhesion were determined in the samples pre‐ and 1 h after DDAVP administration.

Results

Following DDAVP administration, VWF, FVIII, and VWF propeptide levels increased in patients with haemophilia, while patients with cirrhosis only showed an increase in VWF propeptide and FVIII levels. High molecular weight VWF multimers and VWF‐dependent platelet adhesion increased in patients with haemophilia one hour after DDAVP administration, but did not change in the patients with cirrhosis. Levels of ADAMTS13 were unaffected in both patient groups after DDAVP.

Conclusion

The lack of relevant effects of DDAVP on laboratory indices of primary hemostasis in patients with cirrhosis is in line with previous clinical study results in these patients.
Monitoring the Mechanical and Structural Behavior of the Pavement Structure Using Electronic Sensors
Authors: Čygas* Donatas , Laurinavičius Alfredas , Paliukaitė Miglė , Motiejūnas Algirdas , Žiliūtė Laura , Vaitkus Audrius
Published: December 2014

Over the last decade, pavement instrumentation has become an important tool for monitoring the performance of pavement structures and materials under real climatic and traffic conditions. Stress, strain transducers, loop profilers, temperature, and moisture sensors could be reasonably used for sophisticated analysis of pavement performance. Commonly, such research projects involve only few pavement structures under accelerated loading tests. The unique experimental road section was constructed in 2007 in Lithuania. It consists of 27 different flexible pavement structures and all necessary electronic sensors. This road is affected by real climatic conditions and high‐intensity heavy vehicle traffic. The aim of such research is to continuously monitor performance of different pavement structures and to elaborate on the most suitable and economically effective pavement structures.
Post‐transcriptional regulation of transcript abundance by a conserved member of the tristetraprolin family in Candida albicans
Authors: Wells Melissa L. , Washington Onica L. , Hicks Stephanie N. , Nobile Clarissa J. , Hartooni Nairi , Wilson Gerald M. , Zucconi Beth E. , Huang Weichun , Li Leping , Fargo David C. , Blackshear Perry J.
Published: December 2014

Members of the tristetraprolin (TTP) family of CCCH tandem zinc finger proteins bind to AU‐rich regions in target mRNAs, leading to their deadenylation and decay. Family members in Saccharomyces cerevisiae influence iron metabolism, whereas the single protein expressed in Schizosaccharomyces pombe, Zfs1, regulates cell–cell interactions. In the human pathogen Candida albicans, deep sequencing of mutants lacking the orthologous protein, Zfs1, revealed significant increases (> 1.5‐fold) in 156 transcripts. Of these, 113 (72%) contained at least one predicted TTP family member binding site in their 3′UTR, compared with only 3 of 56 (5%) down‐regulated transcripts. The zfs1Δ/Δ mutant was resistant to 3‐amino‐1,2,4‐triazole, perhaps because of increased expression of the potential target transcript encoded by HIS3. Sequences of the proteins encoded by the putative Zfs1 targets were highly conserved among other species within the fungal CTG clade, while the predicted Zfs1 binding sites in these mRNAs often ‘disappeared’ with increasing evolutionary distance from the parental species. C. albicans Zfs1 bound to the ideal mammalian TTP binding site with high affinity, and Zfs1 was associated with target transcripts after co‐immunoprecipitation. Thus, the biochemical activities of these proteins in fungi are highly conserved, but Zfs1‐like proteins may target different transcripts in each species.
Single bouts of exercise selectively sustain attentional processes
Authors: Pontifex Matthew B. , Parks Andrew C. , Henning David A. , Kamijo Keita
Published: December 2014

This study examined how single bouts of exercise may differentially modulate neuroelectric correlates of attentional orienting and processing. Using a within‐participants design, ERPs and task performance were assessed in response to a perceptually challenging three‐stimulus oddball task prior to and following a bout of exercise or seated rest during two separate, counterbalanced sessions. Findings revealed that, following a single bout of exercise, attentional processing was sustained relative to pretest whereas prolonged sitting resulted in attentional decrements. Focal attention resulting from attentional orienting, in contrast, does not appear to be sensitive to the influences of single bouts of physical activity. These findings suggest that acute exercise‐induced changes in cognition do not originate from an overall modulation of attention but instead are specific to aspects of attentional processing.