bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient‐reported outcome results in patients with type 2 diabetes treated with once‐weekly dulaglutide: data from the AWARD phase III clinical trial programme
Authors: Yu M. , Van Brunt K. , Varnado O. J. , Boye K. S.
Published: December 2015

We evaluated patient‐reported outcome (PRO) measures from the Assessment of Weekly AdministRation of LY2189265 (dulaglutide) in Diabetes (AWARD) clinical trial programme for dulaglutide (1.5 mg and 0.75 mg) in patients with type 2 diabetes (T2D). The Impact of Weight on Self‐Perception (IW‐SP), Impact of Weight on Ability to Perform Physical Activities of Daily Living (APPADL), Impact of Weight on Quality of Life‐Lite, EQ‐5D, Diabetes Treatment Satisfaction Questionnaire (DTSQ), Diabetes Symptom Checklist‐Revised and Adult Low Blood Sugar Survey were administered and analysed for changes from baseline in one or more AWARD studies. Significant within‐group changes from baseline to the primary time point were observed for several PRO measures across all studies. Compared with insulin glargine, significantly greater improvements in the IW‐SP score were observed with dulaglutide 1.5 mg and with both dulaglutide doses in the APPADL score. Both dulaglutide doses resulted in significantly greater improvement in DTSQ scores (all subscales) compared with exenatide. Dulaglutide 1.5 mg also resulted in significantly greater improvement on the DTSQ hyperglycaemia subscale compared with metformin. Overall, these PRO results suggest that dulaglutide is beneficial in the treatment of T2D.
Active aggregation among sexes in bean flower thrips (Megalurothrips sjostedti) on cowpea (Vigna unguiculata)
Authors: Niassy Saliou , Ekesi Sunday , Maniania Nguya K. , Orindi Benedict , Moritz Gerald B. , de Kogel Willem J. , Subramanian Sevgan
Published: December 2015

Male sexual aggregations are a common territorial, mating‐related or resource‐based, behaviour observed in diverse organisms, including insects such as thrips. The influence of factors such as plant substrate, time of day, and geographic location on aggregation of thrips is uncertain, therefore we monitored the dispersion of male and female bean flower thrips (BFT), Megalurothrips sjostedti (Trybom) (Thysanoptera: Thripidae), on cowpea, Vigna unguiculata (L.) Walp. (Fabaceae), over three cowpea growth stages and across three cowpea‐growing areas of Kenya. Our results indicated that for all the crop growth stages, the density of BFTs varied over the time of day, with higher densities at 10:00, 13:00, and 16:00 hours than at 07:00 hours. Thrips densities did not differ among blocks at the budding stage, but they did at peak flowering and podding stages. Dispersion indices suggested that both male and female BFTs were aggregated. Active male aggregation occurred only on green plant parts and it varied across blocks, crop stages, and locations. Similarly, active female aggregation was observed in peak flowering and podding stages. Such active aggregation indicates a semiochemical or behaviour‐mediated aggregation. Identification of such a semiochemical may offer new opportunities for refining monitoring and management strategies for BFT on cowpea, the most important grain legume in sub‐Saharan Africa.
Low multifunctional redundancy of soil fungal diversity at multiple scales
Authors: Mori Akira S. , Isbell Forest , Fujii Saori , Makoto Kobayashi , Matsuoka Shunsuke , Osono Takashi
Published: December 2015

Theory suggests that biodiversity might help sustain multiple ecosystem functions. To evaluate possible biodiversity–multifunctionality relationships in a natural setting, we considered different spatial scales of diversity metrics for soil fungi in the northern forests of Japan. We found that multifunctionality increased with increasing local species richness, suggesting a limited degree of multifunctional redundancy. This diversity–multifunctionality relationship was independent of the compositional uniqueness of each community. However, we still found the importance of community composition, because there was a positive correlation between community dissimilarity and multifunctional dissimilarity across the landscape. This result suggests that functional redundancy can further decrease when spatial variations in identities of both species and functions are simultaneously considered at larger spatial scales. We speculate that different scales of diversity could provide multiple levels of insurance against the loss of functioning if high‐levels of local species diversity and compositional variation across locations are both maintained. Alternatively, making species assemblages depauperate may result in the loss of multifunctionality.
Blood–brain barrier leakage after status epilepticus in rapamycin‐treated rats II: Potential mechanisms
Authors: van Vliet Erwin A. , Otte Willem M. , Wadman Wytse J. , Aronica Eleonora , Kooij Gijs , de Vries Helga E. , Dijkhuizen Rick M. , Gorter Jan A.
Published: December 2015

Objective

Blood–brain barrier (BBB) leakage may play a pro‐epileptogenic role after status epilepticus. In the accompanying contrast‐enhanced magnetic resonance imaging (CE‐MRI) study we showed that the mammalian target of rapamycin (mTOR) inhibitor rapamycin reduced BBB leakage and seizure activity during the chronic epileptic phase. Given rapamycin's role in growth and immune response, the potential therapeutic effects of rapamycin after status epilepticus with emphasis on brain inflammation and brain vasculature were investigated.

Methods

Seven weeks after kainic acid–induced status epilepticus, rats were perfusion fixed and (immuno)histochemistry was performed using several glial and vascular markers. In addition, an in vitro model for the human BBB was used to determine the effects of rapamycin on transendothelial electrical resistance as a measure for BBB integrity.

Results

(Immuno)histochemistry showed that local blood vessel density, activated microglia, and astrogliosis were reduced in rapamycin‐treated rats compared to vehicle‐treated rats. In vitro studies showed that rapamycin could attenuate TNFα‐induced endothelial barrier breakdown.

Significance

These data suggest that rapamycin improves BBB function during the chronic epileptic phase by a reduction of local brain inflammation and blood vessel density that can contribute to a milder form of epilepsy.
Recent changes in the spawning grounds of Black Sea anchovy, Engraulis encrasicolus
Authors: Gucu Ali Cemal , Inanmaz Özgür Emek , Ok Meltem , Sakinan Serdar
Published: December 2015

Towards the end of the 1980s, when the spawning grounds in the northwestern shelf (NWS) of the Black Sea were lingering with the effects of eutrophication and of an exotic invasive ctenophore, a series of basin‐wide international ichthyoplankton surveys pointed out an increase in the anchovies spawning in the southern half of the Black Sea. Later, with the help of international conservation efforts, several key littoral ecosystem components within the anchovy's historical spawning grounds showed signs of recovery. However, the fate of the spawning stock anchovy in the south remained unanswered. In order to present the current situation in the southern Black Sea after two decades, an ichthyoplankton survey adopting the same methodology as previously used was undertaken during the peak spawning season of the Black Sea anchovy (BSa). The survey showed that the density of eggs was by far greater than for any of the surveys conducted previously. A wider geographical distribution of the eggs indicated an increase in the number of vagrants which had drifted away from the known spawning grounds. In contrast, the increased reproductive activity in the south signifies existence of a growing, non‐migrating southern BS stock. This stock seems to utilize the coastal hydrographic features associated with the rim current facilitating escape (loophole) from gelatinous predators such as Mnemiopsis leidyi and Aurelia aurata.
A novel method to assess effects of chemical stressors on natural biofilm structure and function
Authors: Costello David M. , Rosi‐Marshall Emma J. , Shaw Lawton E. , Grace Michael R. , Kelly John J.
Published: December 2015

The regulation and management of chemical contaminants rarely use community‐ and ecosystem‐level endpoints, partly due to a lack of suitable methods. To overcome this limitation, we propose contaminant exposure substrata (CES), an adaptation of the widely used nutrient‐diffusing substratum method, to assess responses of biofilm communities to chemical contaminants in situ.

We describe methods for using CES to assess effects on biofilm biomass, community structure, process rates, biofilm–consumer interactions and biofilm chemistry. We also provide equations to calculate the flux of soluble chemicals from CES and describe an approach to compare contaminant dose in CES assays to the contaminant dose encountered by biofilms in polluted surface waters.

Data from four case studies demonstrate that CES can detect impairment of biofilm structure and function.

The adaptability, simplicity and cost‐effectiveness of CES make them valuable tools to assess community‐ and ecosystem‐level responses to contaminants, suggesting potential for routine use and incorporation of data generated from such assays into contaminant regulation and management.
Biomarker assessment and molecular testing for prognostication in breast cancer
Authors: Kos Zuzana , Dabbs David J
Published: December 2015

Current treatment of breast cancer incorporates clinical, pathological and molecular data. Oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) define prognosis and identify tumours for targeted therapy, and remain the sole established single‐molecule biomarkers defining the minimum breast cancer pathology data set. Ki67 remains one of the most promising yet controversial biomarkers in breast cancer, implemented routinely in some, but not all, pathology departments. Beyond the single‐molecule biomarkers, a host of multigene expression tests have been developed to interrogate the driver pathways and biology of individual breast cancers to predict clinical outcome more accurately. A minority of these assays have entered into clinical practice. This review focuses on the established biomarkers of ER, PR and HER2, the controversial but clinically implemented biomarker Ki67 and the currently marketed gene expression signatures.
An approach to the diagnosis of spindle cell lesions of the breast
Authors: Rakha Emad A , Aleskandarany Mohammed A , Lee Andrew H S , Ellis Ian O
Published: December 2015

Although most breast spindle cell lesions (BSCLs) are rare, they constitute a wide spectrum of diseases, ranging from reactive processes to aggressive malignant tumours. Despite their varied histogenesis and behaviour, some lesions show an overlap of morphological features, making accurate diagnosis a challenging task, particularly in needle core biopsies. Clinical history and immunohistochemistry can help in making a correct diagnosis in morphologically challenging cases. To make an accurate diagnosis, it is important to maintain a wide differential diagnosis and be familiar with the diverse morphological appearances of these different entities. BSCLs can generally be classified into bland‐looking and malignant‐looking categories. In the former, the commonest diagnosis is scarring. However, it is important to distinguish low‐grade spindle cell metaplastic breast carcinoma from other benign entities, as the management is clearly different. In the malignant category, it is important to differentiate metaplastic carcinoma from other malignant primary and metastatic malignant spindle cell tumours of the breast, such as malignant phyllodes tumour, angiosarcoma, and melanoma. This review focuses on the classification and histological and molecular diagnosis of various BSCLs, with an emphasis on the diagnostic approach, including in core biopsies.
Immunohistochemical expression of cytokeratin 15, cytokeratin 19, follistatin, and Bmi‐1 in basal cell carcinoma
Authors: Kim Hyun Chull , Sohng Seung Hyun , Shin Dong Hoon , Choi Jong Soo , Bae Young Kyung
Published: December 2015

Backgrounds

Basal cell carcinoma (BCC) is the most common cutaneous neoplasm. Despite numerous previous studies, the origin of BCC is still controversial.

Objective

The aim of this study is to evaluate whether BCC arises from the hair follicle rather than the epidermal basal cell.

Methods

The labeling index and differences of expression of the immunohistochemical (IHC) stainings of CK15, CK19, follistatin, and Bmi‐1 were evaluated in 20 cases of BCC, 13 cases of trichoblastoma, 21 cases of actinic keratosis (AK), and 19 cases of squamous cell carcinoma (SCC) which were biopsied in the department of dermatology of the Yeungnam University Medical Center.

Results

For CK15, labeling indexes of BCC (83.0%) and trichoblastoma (84.4%) were significantly higher than those of AK (15.9%) and SCC (15.8%). For CK19, labeling indexes of BCC (8.1%), trichoblastoma (6.6%), AK (3.5%), and SCC (14.8%) revealed no difference. For follistatin, labeling indexes of BCC (51.1%) and trichoblastoma (70.1%) were significantly higher than those of AK (0.9%) and SCC (8.5%). For Bmi‐1, labeling indexes of BCC (74.4%) and trichoblastoma (84.7%) were significantly higher than those of AK (24.7%) and SCC (18.6%).

Conclusion

In this study, strong positivity of CK15, follistatin, and Bmi‐1 was more frequently observed in BCC and trichoblastoma than in SCC and AK. These findings suggest that BCC and trichoblastoma share the same differentiation toward the hair follicle. Furthermore, CK15, follistatin, and Bmi‐1 can be useful as markers to differentiate BCC from SCC.
Composition and functionality of wheat bran and its application in some cereal food products
Authors: Onipe Oluwatoyin O. , Jideani Afam I. O. , Beswa Daniso
Published: December 2015

Production of wheat bran (WB) for human consumption is estimated to be about 90 million tonnes per year. WB is a cheap and abundant source of dietary fibre which has been linked to improved bowel health and possible prevention of some diseases such as colon cancer. It also contains minerals, vitamins and bioactive compounds such as phenolic acids, arabinoxylans, alkylresorcinol and phytosterols. These compounds have been suggested as an aid in prevention of noncommunicable diseases such as cardiovascular disease. This article discusses WB extraction, its nutritional properties, potential health benefits, effects on quality and sensory properties of some cereal foods, and its application in some baked products as well as in fried cereal snacks, as an additive for oil reduction and fibre enrichment.
A tertiary hospital audit of opioids and sedatives administered in the last 24 h of life
Authors: Douglas C. , Clarke M. , Alexander S. , Khatun M.
Published: December 2015

Background/Aim

To audit the doses of opioids and sedatives administered to patients in the last 24 h of life in an Australian tertiary hospital and compare results with doses published in New Zealand (NZ) benchmarking studies and to examine the effect of caring for dying patients using a modified version of the Liverpool Care Pathway (mLCP) in respect to doses of opioids and sedatives.

Methods

A retrospective chart audit of 102 patients who died in a tertiary hospital was carried out over a 3‐month period in 2011. Diagnosis, demographic patient characteristics, use of themLCP, use of subcutaneous infusions and key symptoms were identified. Chi‐squared and the non‐parametric Mann–Whitney tests were applied to compare the group differences for categorical and continuous variables as appropriate. Parenteral morphine‐equivalent daily dose (pMEDD) was calculated. At‐test assessed the variable mean doses of medication and patient characteristics.

Results

Of the audited patients, 76.5% died of non‐malignant disease. The overall mean dose of midazolam was significantly lower compared with that of theNZstudypMEDD(6.0 vs 20.7 mg). The overall mean dose of morphine benchmarked closely with theNZstudy (56.5 mg Australian study vs 47.8 mgNZstudy). A total of 83% of patients with a malignant diagnosis was supported with themLCPcompared with 51% of patients with a non‐malignant diagnosis.

Conclusion

The significance of the lower midazolam doses was postulated, including the possibility of inadequate symptom control for patients with a non‐malignant diagnosis. The use of themLCPdid not lead to the provision of higher doses of medications.
Labour under the law: a new law of combination, and master and servant, in 21st‐century Britain?
Authors: Smith Paul
Published: December 2015

It is valuable to evaluate contemporary employment law on industrial action and trade unions, and employment protection, in relation to the 19th‐century law of combination, and master and servant. Such a historical comparison, despite differing language and legal sanctions, focuses attention on the goal of legal ‘reform’—the drive to control workers' collective organisations and enhance the managerial prerogative in order to consolidate employers' capacity to determine the terms of the contract of employment or for services, and the content of the pay–effort bargain, that is, the real subordination of labour. It is a form of class struggle from above.
The development and testing of a skin tear risk assessment tool
Authors: Newall Nelly , Lewin Gill F , Bulsara Max K , Carville Keryln J , Leslie Gavin D , Roberts Pam A
Published: December 2015

The aim of the present study is to develop a reliable and valid skin tear risk assessment tool. The six characteristics identified in a previous case control study as constituting the best risk model for skin tear development were used to construct a risk assessment tool. The ability of the tool to predict skin tear development was then tested in a prospective study. Between August 2012 and September 2013, 1466 tertiary hospital patients were assessed at admission and followed up for 10 days to see if they developed a skin tear. The predictive validity of the tool was assessed using receiver operating characteristic (ROC) analysis. When the tool was found not to have performed as well as hoped, secondary analyses were performed to determine whether a potentially better performing risk model could be identified. The tool was found to have high sensitivity but low specificity and therefore have inadequate predictive validity. Secondary analysis of the combined data from this and the previous case control study identified an alternative better performing risk model. The tool developed and tested in this study was found to have inadequate predictive validity. The predictive validity of an alternative, more parsimonious model now needs to be tested.
The Effect of Composition on the Optical Properties and Hardness of Transparent Al‐rich MgO·nAl2O3 Spinel Ceramics
Authors: Waetzig Katja , Krell Andreas
Published: December 2015

The study investigates the transmittance and hardness of Al‐rich spinel ceramics (MgO·nAl2O3, 1 ≤ n ≤ 2.5) prepared by reaction air sintering (up to closed porosity) of different ratios of fine and coarse‐grained commercial Al2O3 and MgO raw powders completed by subsequent hot isostatic pressing (HiP). Different compositions give rise to a wide range of presintering temperatures. With starting compositions 1 ≤ n ≤ 1.5, presintering results in a formation of single‐phase spinel, in which the excess of Al is solved. With higher Al contents (n > 1.5), however, a biphasic ceramic of stoichiometric MgAl2O4 and residual alumina is formed first. This excess alumina is incorporated into the spinel lattice during the final HiP at a temperature of 1750°C. Single‐phase, highly transparent spinel is obtained by increasing the Al‐content up to n = 2.5, which gives about 85% in‐line transmittance in the visible range of light and about 63% at a UV wavelength of 200 nm. Whereas the optical properties can be improved, the hardness (HV1) slightly decreases with increasing Al content. Depending on the raw powders, the hardness of samples prepared by finer powders tend to higher values enabled by the development of a bimodal microstructure with a finer grain fraction (≤2 μm) between coarser grains (≤156 μm). In contrast, samples made of coarser powders need higher sintering temperatures and exhibit, then, a monomodal microstructure of very large grains (≤622 μm) only.
Effect of Plasma Enthalpy on the Structure of La2Zr2O7 Coatings Prepared by Suspension Plasma Spraying
Authors: Zotov Nikolay , Guignard Alexandre , Mauer Georg , Vaßen Robert
Published: December 2015

La2Zr2O7 coatings, prepared by suspension plasma spraying, have been studied by X‐ray diffraction (XRD) as a function of torch power. Rietveld refinements of high‐resolution XRD data show that with increasing plasma temperature (as a result of the increasing torch power), the La2Zr2O7 coatings remain cation ordered but progressively anion disordered.
How to ask about patient satisfaction? The visual analogue scale is less vulnerable to confounding factors and ceiling effect than a symmetric Likert scale
Authors: Voutilainen Ari , Pitkäaho Taina , Kvist Tarja , Vehviläinen‐Julkunen Katri
Published: December 2015

Aims

To study the effects of scale type (visual analogue scale vs. Likert), item order (systematic vs. random), item non‐response and patient‐related characteristics (age, gender, subjective health, need for assistance with filling out the questionnaire and length of stay) on the results of patient satisfaction surveys.

Background

Although patient satisfaction is one of the most intensely studied issues in the health sciences, research information about the effects of possible instrument‐related confounding factors on patient satisfaction surveys is scant.

Design

A quasi‐experimental design was employed. A non‐randomized sample of 150 surgical patients was gathered to minimize possible alterations in care quality.

Methods

Data were collected in May–September 2014 from one tertiary hospital in Finland using the Revised Humane Caring Scale instrument. New versions of the instrument were created for the present purposes. In these versions, items were either in a visual analogue format or Likert‐scaled, in systematic or random order. The data were analysed using an analysis of covariance and a paired samples t‐test.

Results

The visual analogue scale items were less vulnerable to bias from confounding factors than were the Likert‐scaled items. The visual analogue scale also avoided the ceiling effect better than Likert and the time needed to complete the visual analogue scale questionnaire was 28% shorter than that needed to complete the Likert‐scaled questionnaire.

Conclusion

The present results supported the use of visual analogue scale rather than Likert scaling in patient satisfaction surveys and stressed the need to account for as many potential confounding factors as possible.
Disentangling the components of surface acting in emotion work: experiencing emotions may be as important as regulating them
Authors: Semmer Norbert K. , Messerli Laurence , Tschan Franziska
Published: December 2015

Measures of surface acting (SA) do not distinguish between feeling emotions and regulating emotions. SA typically involves negative emotions; these often persist and may, at least partly, be responsible for the effects of SA on well‐being. In two diary studies and one survey study, negative emotions felt predicted lower well‐being, and controlling for them rendered the effect of suppressing their display insignificant. Additionally, in Study 2, SA predicted higher interaction quality once emotions felt were controlled. Results indicate that the effects of SA are, at least partly, due to emotions felt when negative emotions are suppressed. Therefore, research should control for emotions felt and focus more strongly on the emotions themselves and their triggers.
Yogurt Enrichment with Grape Pomace: Effect of Grape Cultivar on Physicochemical, Microbiological and Sensory Properties
Authors: Marchiani Roberta , Bertolino Marta , Belviso Simona , Giordano Manuela , Ghirardello Daniela , Torri Luisa , Piochi Maria , Zeppa Giuseppe
Published: December 2015

Grape skin flours obtained from grape pomace of Chardonnay, Moscato and Pinot noir varieties were used as sources of polyphenolic compounds in yogurt formulation during 3 weeks of storage. Yogurt containing grape skin flour presented significantly higher total phenolic content (+55%), antioxidant activity (+80%) and acidity (+25%) whereas lower pH, syneresis (−10%) and fat (−20%) than control. Procyanidin B1 and vanillic acids were detected only in the yogurt added of Pinot noir flour while gallic acid, catechin and quercitrin were the major phenolic compounds found in the yogurts with Moscato or Chardonnay grape skins. Significant differences were highlighted for acidity and lactose content while total phenolic content, antioxidant activity and lactic acid bacteria trend were stable after production and storage. The liking test performed with consumers showed a loss of textural quality for yogurts fortified with grape skin flours.

Practical Applications

Grape skin is a nutritious, but underused, by‐product of winemaking containing fiber and antioxidants. Using a suitable production design, a new fortified yogurt formulation with grape by‐product could be optimized for enhance antioxidant consumers’ daily intake. The use of grape skin flour in the development of value‐added food products will be a step toward making new functional foods, and partially solving waste management problem from wine production. The results of this study would provide an opportunity of dairy producer to develop a novel product in agreement with consumers’ preferences. This research represents a new approach in the development of novel dairy foods with high nutritional quality and with great potential applications on food industry.
Far‐reaching geometrical artefacts due to thermal decomposition of polymeric coatings around focused ion beam milled pigment particles
Authors: RYKACZEWSKI K. , MIERITZ D.G. , LIU M. , MA Y. , IEZZI E.B. , SUN X. , WANG L.P. , SOLANKI K.N. , SEO D.‐K. , WANG R.Y.
Published: December 2015

Focused ion beam and scanning electron microscope (FIB‐SEM) instruments are extensively used to characterize nanoscale composition of composite materials, however, their application to analysis of organic corrosion barrier coatings has been limited. The primary concern that arises with use of FIB to mill organic materials is the possibility of severe thermal damage that occurs in close proximity to the ion beam impact. Recent research has shown that such localized artefacts can be mitigated for a number of polymers through cryogenic cooling of the sample as well as low current milling and intelligent ion beam control. Here we report unexpected nonlocalized artefacts that occur during FIB milling of composite organic coatings with pigment particles. Specifically, we show that FIB milling of pigmented polysiloxane coating can lead to formation of multiple microscopic voids within the substrate as far as 5 μm away from the ion beam impact. We use further experimentation and modelling to show that void formation occurs via ion beam heating of the pigment particles that leads to decomposition and vaporization of the surrounding polysiloxane. We also identify FIB milling conditions that mitigate this issue.
Extracorporeal membrane oxygenation: a breakthrough for respiratory failure
Authors: Frenckner B.
Published: December 2015

Extracorporeal membrane oxygenation (ECMO) is a method for providing long‐term treatment of a patient in a modified heart–lung machine. Desaturated blood is drained from the patient, oxygenated and pumped back to a major vein or artery. ECMO supports heart and lung function and may be used in severe heart and/or lung failure when conventional intensive care fails. The Stockholm programme started in 1987 with treatment of neonates. In 1995, the first adult patient was accepted onto the programme. Interhospital transportation during ECMO was started in 1996, which enabled retrieval of extremely unstable patients during ECMO. Today, the programme has an annual volume of about 80 patients. It has been characterized by, amongst other things, minimal patient sedation. By 31 December 2014, over 900 patients had been treated, the vast majority for respiratory failure, and over 650 patients had been transported during ECMO. The median ECMO duration was 5.3, 5.7 and 7.1 days for neonatal, paediatric and adult patients, respectively. The survival to hospital discharge rate for respiratory ECMO was 81%, 70% and 63% in the different age groups, respectively, which is significantly higher than the overall international experience as reported to the Extracorporeal Life Support Organization (ELSO) Registry (74%, 57% and 57%, respectively). The survival rate was significantly higher in the Stockholm programme compared to ELSO for meconium aspiration syndrome, congenital diaphragmatic hernia in neonates and pneumocystis pneumonia in paediatric patients
Gene variance in the nicotinic receptor cluster (CHRNA5‐CHRNA3‐CHRNB4) predicts death from cardiopulmonary disease and cancer in smokers
Authors: Halldén S. , Sjögren M. , Hedblad B. , Engström G. , Hamrefors V. , Manjer J. , Melander O.
Published: December 2015

Background

Genetic variation in the cluster on chromosome 15, encoding the nicotinic acetylcholine receptor subunits (CHRNA5‐CHRNA3‐CHRNB4), has shown strong associations with tobacco consumption and an additional risk increase in smoking‐related diseases such as chronic obstructive pulmonary disease (COPD), peripheral artery disease and lung cancer.

Objectives

To test whether rs1051730 (C/T), a tag for multiple variants in the CHRNA5‐CHRNA3‐CHRNB3 cluster, is associated with a change in risk of smoking‐related mortality and morbidity in the Malmö Diet and Cancer study, a population‐based prospective cohort study.

Methods

At baseline participants were classified as current (n = 6951), previous (n = 8426) or never (n = 9417) smokers. Cox‐proportional hazards models were used to determine the correlation between rs1051730 and incidence of first COPD, tobacco‐related cancer, other cancer and cardiovascular disease (CVD), and total mortality due to these causes, during approximately 14 years of follow‐up.

Results

Amongst current smokers there were 480 first incident COPD events, 852 tobacco‐related cancers, 810 other cancers and 1022 CVD events. A total of 1508 deaths occurred, including 500 due to CVD, 102 due to respiratory diseases and 677 due to cancer. In adjusted additive models, an increasing number of T alleles were associated with a gradual increase in total mortality, incident COPD and tobacco‐related cancer, even after adjustment for smoking quantity. No significant associations were observed amongst never smokers.

Conclusion

Our data suggest that gene variance in the CHRNA5‐CHRNA3‐CHRNB4 cluster is associated with an increased risk of death, incidence of COPD and tobacco‐related cancer in smokers. These findings indicate an individual susceptibility to tobacco use and its complications; this may be important when targeting and designing smoking cessation therapies.
Family Quality of Life for People With Intellectual Disabilities in Catalonia
Authors: Giné Climent , Gràcia Marta , Vilaseca Rosa , Salvador Beltran Francesc , Balcells‐Balcells Anna , Dalmau Montalà Mariona , Luisa Adam‐Alcocer Ana , Teresa Pro Maria , Simó‐Pinatella David , Maria Mas Mestre Joana
Published: December 2015

Researchers, professionals, and families have shown increasing concern about the quality of life of people with intellectual disabilities (ID) and their families. Due to the growing interest in family quality of life (FQoL) as a key issue for social policy in the ID field, the aim of this research was to explore FQoL in Catalonia (Spain). The Spanish Family Quality of Life Scales (CdVF‐E) were completed by 144 families using the version for households with children up to 18 years of age and by 122 families using the version for households with adult children over 18 years of age. The results show that FQoL is higher in families with adult children over 18 years of age than in families with children up to 18 years of age, and there are differences among domains in both groups. Likewise, there are relations between the scores in the scales and some demographic characteristics such as marital status, level of education, employment status, and family income, particularly in households with children under 18 years of age.
Adenovirus 2,Bordetella bronchiseptica, and Parainfluenza Molecular Diagnostic Assay Results in Puppies After vaccination with Modified Live Vaccines
Authors: Ruch‐Gallie R. , Moroff S. , Lappin M.R.
Published: December 2015

Background

Canine adenovirus 2, parainfluenza, andBordetella bronchisepticacause respiratory disease in dogs, and each has a modified live intranasal vaccine available. Molecular diagnostic assays to amplify specific nucleic acids are available for each of these agents. If positive molecular diagnostic assay results are common after vaccination, the positive predictive value of the diagnostic assays for disease would be decreased.

Objective

To determine the impact of administration of commercially available modified live topical adenovirus 2,B. bronchiseptica, and parainfluenza vaccine has on the results of a commercially availablePCRpanel.

Animals

Eight puppies from a research breeding facility negative for these pathogens.

Methods

Blinded prospective pilot study. Puppies were vaccinated with a single dose of modified live topical adenovirus 2,B. bronchiseptica, and parainfluenza and parenteral dose of adenovirus 2, canine distemper virus, and parvovirus. Nasal and pharyngeal swabs were collected on multiple days and submitted forPCRassay.

Results

Nucleic acids of all 3 organisms contained in the topical vaccine were detected from both samples multiple times through 28 days after vaccination with higher numbers of positive samples detected between days 3 and 10 after vaccination.

Conclusions and Clinical Importance

Vaccine status should be considered when interpreting respiratory agentPCRresults if modified live vaccines have been used. Development of quantitativePCRand wild‐type sequencing are necessary to improve positive predictive value of these assays by distinguishing vaccinate from natural infection.
Demographics of Adult Heritage Language Speakers in the United States: Differences by Region and Language and Their Implications
Authors: NAGANO TOMONORI
Published: December 2015

Heritage language (HL) speakers have received scholarly attention in recent years as an interdisciplinary research theme, but relatively less attention has been paid to their demographics. Existing studies of HL speakers’ demographics often focus on young children in areas of high immigrant concentration (i.e., California, Florida, and New York); no study has systematically investigated cross‐regional and chronological demographic patterns of adult HL speakers. From the perspective of HLs as a national resource, such demographic data on adult HL speakers are useful to gauge the availability of a bilingual workforce and determine structures needed to support and develop a bilingual U.S. population. Using the Integrated Public User Microdata Series (Ruggles & Sobek, ), which is based on data from the U.S. Census and the American Community Survey, this study makes geographical and chronological comparisons among groups of adult HL speakers from 1980 to 2010. The data show major differences in the demographics of adult HL speakers in different regions. The analyses also reveal differences by language, specifically between the adult HL speakers of Spanish and other languages. Implications of these patterns are discussed.
Promoting Task‐Based Pragmatics Instruction in EFL Classroom Contexts: The Role of Task Complexity
Authors: KIM YOUJIN , TAGUCHI NAOKO
Published: December 2015

Robinson's (2001) Cognition Hypothesis claims that more complex tasks promote interaction and language development. This study examined the effect of task complexity in the learning of request‐making expressions. Task complexity was operationalized as [+/− reasoning] following Robinson's framework. The study employed a pretest–posttest research design and was conducted over 6 weeks. Korean junior high school students from 3 classes (N = 73) were assigned to one of the following groups: simple, complex, or control. Both task groups performed a pretest, 2 collaborative tasks, and 2 posttests, whereas the control group performed the pre‐ and posttests only. Learners’ oral interaction during tasks was audiorecorded and analyzed by the number of pragmatic‐related episodes (PREs). Learners’ knowledge of request expressions was measured by a discourse completion test (DCT). The results indicated that task complexity levels influenced the occurrence of PREs, but no difference was found in the quality of task outcome between the simple and complex groups. In terms of learning outcomes, both task groups outperformed the control group, but no difference was found on the immediate posttest. However, the complex group maintained its gain on the delayed posttest.
Comparative effectiveness of fungicidal vs. fungistatic therapies for the treatment of paediatric candidaemia
Authors: Vendetti Neika , Bryan Matthew , Zaoutis Theoklis E. , Damianos Andreas , Fisher Brian T.
Published: December 2015

Adult data suggest that echinocandins for treatment of candidaemia are associated with decreased mortality, attributed to their fungicidal activity. There are limited data comparing antifungals in children. We compared 30‐day all‐cause mortality among paediatric candidaemia patients treated with fungicidal vs. fungistatic agents. All inpatients (>6 months and <19 years of age) with candidaemia between 2000 and 2012 at The Children's Hospital of Philadelphia were retrospectively identified. Definitive therapy with fungicidal (amphotericin B and caspofungin) agents was compared with fungistatic (fluconazole) agents. A propensity score model generated the inverse probability of receiving a fungicidal agent, which was included in a weighted logistic regression model. Among 203 children meeting inclusion criteria, 151 (74.4%) and 52 (25.6%) received a fungicidal and fungistatic agent, respectively. Overall, 18 (8.9%) patients died within 30 days. There was no statistically significant difference in mortality between patients started on a fungicidal or fungistatic agent (OR: 2.19, 95% CI: 0.42–11.48). In a propensity score–weighted model, definitive therapy with a fungicidal agent did not result in a significant decrease in mortality. These data suggest that both agents can be considered definitive therapy for paediatric candidaemia. The results should be interpreted with caution given the small sample size. Larger cohort studies are needed.
Australian nursing students' stories of end‐of‐life care simulation
Authors: Gillan Pauline Catherine , van der Riet Pamela , Jeong Sarah
Published: December 2015

Because nurses are at the forefront of end‐of‐life care, it is imperative that nursing students are prepared for this role upon graduation. Research suggests that many nursing students are unprepared to deliver compassionate and quality end‐of‐life care. There have been many attempts to address this need; one emerging method is end‐of‐life care simulation. This paper explores the experiences of 18 undergraduate nursing students of end‐of‐life care simulation. Participants' stories were obtained via observation during end‐of‐life care simulation, audio‐recorded post simulation debriefing, and semi‐structured interviews. Using Clandinin and Connolly's three dimensions of Narrative Inquiry (temporality, spatiality, and sociality) participants' stories reflected convergence of time, place, and person. Findings revealed three distinct plotlines along a time continuum, specifically surrounding time of death: (i) “The privilege of end‐of‐life care;” (ii) “Witnessing death as surreal;” and (iii) “The honor of providing after‐death care.” Participants' narratives suggest that end‐of‐life care simulation is an important means of preparing students for clinical end‐of‐life care experiences. This has implications for nursing educators wishing to consider simulation in end‐of‐life care education.
Stress and glucocorticoid receptor transcriptional programming in time and space: Implications for the brain–gut axis
Authors: Wiley J. W. , Higgins G. A. , Athey B. D.
Published: December 2015

Background

Chronic psychological stress is associated with enhanced abdominal pain and altered intestinal barrier function that may result from a perturbation in the hypothalamic–pituitary–adrenal (HPA) axis. The glucocorticoid receptor (GR) exploits diverse mechanisms to activate or suppress congeneric gene expression, with regulatory variation associated with stress‐related disorders in psychiatry and gastroenterology.

Purpose

During acute and chronic stress, corticotropin‐releasing hormone drives secretion of adrenocorticotropic hormone from the pituitary, ultimately leading to the release of cortisol (human) and corticosterone (rodent) from the adrenal glands. Cortisol binds with the GR in the cytosol, translocates to the nucleus, and activates the NR3C1 (nuclear receptor subfamily 3, group C, member 1 [GR]) gene. This review focuses on the rapidly developing observations that cortisol is responsible for driving circadian and ultradian bursts of transcriptional activity in the CLOCK (clock circadian regulator) and PER (period circadian clock 1) gene families, and this rhythm is disrupted in major depressive disorder, bipolar disorder, and stress‐related gastrointestinal and immune disorders. Glucocorticoid receptor regulates different sets of transcripts in a tissue‐specific manner, through pulsatile waves of gene expression that includes occupancy of glucocorticoid response elements located within constitutively open spatial domains in chromatin. Emerging evidence supports a potentially pivotal role for epigenetic regulation of how GR interacts with other chromatin regulators to control the expression of its target genes. Dysregulation of the central and peripheral GR regulome has potentially significant consequences for stress‐related disorders affecting the brain–gut axis.
Emerging treatments in neurogastroenterology: eluxadoline – a new therapeutic option for diarrhea‐predominant IBS
Authors: Lacy B. E.
Published: December 2015

Background

Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder worldwide. The global prevalence of IBS is estimated to be as high as 15%. For many patients, IBS is a chronic disorder which can significantly reduce quality of life. Just as important as the effects on any one individual, IBS also places a significant impact on the population as a whole with its negative effects on the health care system. Irritable bowel syndrome is categorized into one of three main categories: IBS with diarrhea, IBS with constipation, and IBS with mixed bowel habits. Patients with diarrhea‐predominant IBS (IBS‐D) comprise a substantial proportion of the overall IBS population. A number of therapeutic options exist to treat the symptoms of abdominal pain, bloating, diarrhea, and fecal urgency, including non‐pharmacologic therapies such as dietary changes and probiotics, or pharmacologic therapies such as loperamide and alosetron. However, many patients have persistent symptoms despite these therapies. This unmet need led to the development of eluxadoline, a mu‐opioid receptor agonist/delta‐opioid receptor antagonist/kappa‐receptor agonist. Approved by the FDA in May 2015, this medication shows promise in the treatment of diarrhea‐predominant IBS for both men and women.

Purpose

This monograph will briefly review the impact of IBS, discuss current treatments for IBS‐D, and then focus on the pharmacology, clinical efficacy and safety of eluxadoline. Potential mechanisms related to rare events of acute pancreatitis or elevated liver tests will be discussed.
Bristol Stool Form Scale reliability and agreement decreases when determining Rome III stool form designations
Authors: Chumpitazi B. P. , Self M. M. , Czyzewski D. I. , Cejka S. , Swank P. R. , Shulman R. J.
Published: December 2015

Background

Rater reproducibility of the Bristol Stool Form Scale (BSFS), which categorizes stools into one of seven types, is unknown. We sought to determine reliability and agreement by individual stool type and when responses are categorized by Rome III clinical designation as normal or abnormal (constipation or diarrhea).

Methods

Thirty‐four gastroenterology providers from three institutions rated 35 stool photographs using the BSFS. Twenty rerated the photographs.

Key Results

1190 individual stool type ratings were completed. Though only four photographs had absolute agreement (all Type 1 or Type 7), general agreement was high with 1132 (95.1%) of ratings being within one category type of the modal rating. Inter‐rater and intra‐rater reliability of the BSFS by individual stool type was excellent with intraclass correlations of 0.88 (95% CI: 0.86–0.90, p < 0.001) and 0.89 (95% CI: 0.86–0.91, p < 0.001), respectively. However, agreement decreased when using Rome III designations with 13 (37%) photographs having significantly diverging classifications (semi‐interquartile range = 0.5). These 13 photographs were rated by the majority of raters as either type 2 vs type 3 or type 5 vs type 6 stools, representing the boundaries of normal vs abnormal stools. Inter‐rater and intra‐rater reliability of the BSFS by Rome III clinical categorization decreased with intraclass correlations of 0.75 (95% CI: 0.69–0.81, p < 0.001) and 0.65 (95% CI: 0.49–0.81, p < 0.001), respectively.

Conclusions & Inferences

The Bristol Stool Form Scale has excellent reliability and agreement when used to rate individual stool type by raters. However, BSFS reliability and agreement decreases when determining Rome III stool form categories.
The development of lurasidone for bipolar depression
Authors: Loebel Antony , Xu Jane , Hsu Jay , Cucchiaro Josephine , Pikalov Andrei
Published: December 2015

Bipolar disorder is a chronic, recurrent illness that ranks among the top 10 causes of disability in the developed world. As the illness progresses, major depressive episodes increasingly predominate. However, few treatment options are available that have demonstrated efficacy in the treatment of bipolar depression, either as monotherapy or adjunctive therapy in combination with mood stabilizers. Lurasidone is an atypical antipsychotic drug that was initially developed for the treatment of schizophrenia. Since no previous atypical antipsychotic development program had proceeded directly from work on schizophrenia to bipolar depression, the decision to focus on this indication represented an innovation in central nervous system drug development and was designed to address a clinically significant unmet need. The current review summarizes key results of a clinical development program undertaken to characterize the efficacy and safety of lurasidone in patients diagnosed with bipolar depression. Lurasidone is currently the only treatment for bipolar depression approved in the United States as both a monotherapy and an adjunctive therapy with lithium or valproate. The approval of lurasidone expands available treatment options for patients with bipolar depression and provides a therapy with an overall favorable risk–benefit profile.