bluuebunny/crossref_metadata_2025 huggingface dataset:
Depression, Vascular Factors, and Risk of Dementia in Primary Care: A Retrospective Cohort Study
Authors: Köhler Sebastian , Buntinx Frank , Palmer Katie , van den Akker Marjan
Published: April 2015

Objectives

To study the interaction between and timing effects of depression and vascular disorders on dementia risk.

Design

Retrospective cohort study.

Setting

Primary care practices in the south of the Netherlands.

Participants

Individuals in primary care aged 50 to 100 followed for 13 years (N = 35,791).

Measurements

Medical diagnoses of incident depression, hypertension, obesity, type 2 diabetes mellitus, stroke, and dementia were extracted from a research database. Cox proportional hazards regression was used to test whether incident depression predicted dementia and its putative interactions with vascular factors.

Results

In total, 1,680 participants developed dementia. Individuals with depression (n = 978) had a higher risk of dementia (adjusted hazard ratio (HR) = 2.03, 95% confidence interval (CI) = 1.56–2.64). Depression exerted most effect in participants with incident stroke (HR = 5.29, 95% CI = 2.52–11.14) or newly diagnosed hypertension (HR = 3.09, 95% CI = 1.54–6.20).

Conclusion

Depression in later life increases the risk of dementia. The effect is particularly high in individuals with depression and vascular disorders. Targeting late‐onset depression in individuals with vascular disorders might lower dementia risk by preventing cerebrovascular changes.
Barriers to food intake in acute care hospitals: a report of the Canadian Malnutrition Task Force
Authors: Keller H. , Allard J. , Vesnaver E. , Laporte M. , Gramlich L. , Bernier P. , Davidson B. , Duerksen D. , Jeejeebhoy K. , Payette H.
Published: April 2015

Background

Poor food intake is common in acute care patients and can exacerbate or develop into malnutrition, influencing both recovery and outcome. Yet, research on barriers and how they can be alleviated is lacking. The present study aimed to (i) describe the prevalence of food intake barriers in diverse hospitals and (ii) determine whether patient, care or hospital characteristics are associated with the experience of these barriers.

Methods

Patients (n = 890; 87%) completed a validated questionnaire on barriers to food intake, including perceptions of food quality, just before their discharge from a medical or surgical unit in each of 18 hospitals across Canada. Scores were created for barrier domains. Associations between these barriers and selected patient characteristics collected at admission or throughout the hospital stay and site characteristics were determined using bivariate analyses.

Results

Common barriers were being interrupted at meals (41.8%), not being given food when a meal was missed (69.2%), not wanting ordered food (58%), loss of appetite (63.9%) and feeling too sick (42.7%) or tired (41.1%) to eat. Younger patients were more likely (P < 0.0001) to report being disturbed at meals (44.6%) than older patients (33.9%) and missing a meal for tests (39.0% versus 31.0%, P < 0.05). Patients who were malnourished, women, those with more comorbidity, and those who ate <50% of the meal reported several barriers across domains.

Conclusions

The present study confirms that barriers to food intake are common in acute care hospitals. This analysis also identifies that specific patient subgroups are more likely to experience food intake barriers. Because self‐reported low food intake in hospital was associated with several barriers, it is relevant to consider assessing, intervening and monitoring barriers to food intake during the hospital stay.
Cholesterol regulates multiple forms of vesicle endocytosis at a mammalian central synapse
Authors: Yue Hai‐Yuan , Xu Jianhua
Published: April 2015

Endocytosis in synapses sustains neurotransmission by recycling vesicle membrane and maintaining the homeostasis of synaptic membrane. A role of membrane cholesterol in synaptic endocytosis remains controversial because of conflicting observations, technical limitations in previous studies, and potential interference from non‐specific effects after cholesterol manipulation. Furthermore, it remains unclear whether cholesterol participates in distinct forms of endocytosis that function under different activity levels. In this study, applying the whole‐cell membrane capacitance measurement to monitor endocytosis in real time at the rat calyx of Held terminals, we found that disrupting cholesterol with dialysis of cholesterol oxidase or methyl‐β‐cyclodextrin impaired three different forms of endocytosis, including slow endocytosis, rapid endocytosis, and endocytosis of the retrievable membrane that exists at the surface before stimulation. The effects were observed when disruption of cholesterol was mild enough not to change Ca2+ channel current or vesicle exocytosis, indicative of stringent cholesterol requirement in synaptic endocytosis. Extracting cholesterol with high concentrations of methyl‐β‐cyclodextrin reduced exocytosis, mainly by decreasing the readily releasable pool and the vesicle replenishment after readily releasable pool depletion. Our study suggests that cholesterol is an important, universal regulator in multiple forms of vesicle endocytosis at mammalian central synapses.

image

By monitoring endocytosis with whole‐cell membrane capacitance measurement, this study demonstrated that acute disruption of cholesterol with cholesterol oxidase or methyl‐β‐cyclodextrin impaired slow clathrin‐mediated endocytosis, rapid endocytosis, and endocytosis of pre‐existing retrievable membrane at a large mammalian nerve terminal, the calyx of Held. This data suggest a universal cholesterol requirement in distinct pathways of synaptic vesicle endocytosis.
Health needs of older Aboriginal people in Taiwan: a community‐based assessment using a multidimensional instrument
Authors: Lee Ling‐Ling , Lin Shu‐Huan , Philp Ian
Published: April 2015

Aims and objectives

To explore the health needs of older Aboriginal people, using a multidimensional instrument. The gender differences related to their health needs were also addressed.

Background

Health status and life expectancy between Aborigines and non‐Aborigines have been shown to differ. The investigation of the health needs of Aboriginal people is however scarce, particularly among the older adult population. There is a need to address unmet health needs and improve information on the health needs assessment of the older Aboriginal population.

Design

A cross‐sectional design was used.

Methods

Aboriginal people aged 65 and over were randomly sampled to take part in the present study. A multidimensional instrument consisting of eight domains and three cross‐domain categories was used to assess their health needs.

Results

A group of older Aboriginal people was recruited (n = 90, mean age = 73·5). The top three identified needs were ‘mental health and well‐being’, ‘staying healthy’ and ‘social participation’. The female participants had statistically significant higher scores for the ‘mental health and well‐being’, ‘getting around’ domains and in the ‘risk of falls’ than the male ones. A regression model demonstrated that the health need of ‘looking after oneself’ was associated with all cross‐domain categories of health need, which are ‘independence’, ‘risk of breakdown in care’ and ‘risk of falls’.

Conclusions

The present study has revealed major health needs among older Aboriginal people and found that older female Aborigines have more health needs than older male Aborigines. Further study to identify effective approaches to address these needs among this group is warranted.

Relevance to clinical practice

The findings can be used to identify effective approaches to addressing health needs among older Aboriginal people with a consideration of gender. Only then can resources be allocated and prioritised in a culturally sensitive and gender‐specific manner nationally and globally.
Predictors of levels of functioning among Chinese people with severe mental illness: a 12‐month prospective cohort study
Authors: Chien Wai‐Tong , Lam Claire K K , Ng Bacon F L
Published: April 2015

Aim and objectives

The aim of the study was to identify the predictors of functioning in Chinese people with serious mental illness.

Background

Mental healthcare services for people suffering from serious mental illness are delivered to not only minimise their psychiatric symptoms but also enhance their levels of functioning in the community. Yet, there is insufficient research directed towards the associated or predictive factors that may influence different aspects of functioning, particularly in terms of patients' psychosocial variables.

Design

A longitudinal, prospective cohort study design was adopted.

Methods

A clustered random sample of 395 of 611 outpatients with serious mental illness completed the same set of questionnaires at baseline and at 12 months. Changes in patients' functioning as measured by self‐maintenance, social functioning and community living skills were recorded over 12 months. Potential relationships between their level of functioning and symptom severity, self‐esteem, self‐efficacy, perceived negative familial response, negative self‐stigma towards mental illness, re‐hospitalisation rate and socio‐demographic characteristics were investigated.

Results

Most participants reported moderate to moderately high levels of overall functioning, self‐efficacy, self‐stigma and perceived negative familial response at baseline and there were significant observed correlations between these variables. Results of multiple regression models indicated that while symptom severity predicted functioning in patients with psychotic and affective disorders, a negatively perceived familial response only predicted negative changes in social functioning of the patients with psychotic disorders (β = −0·25). In addition, improvements in self‐efficacy (β = 0·23) and reduction in self‐stigma (β = −0·15) positively predicted changes in the community living skills of patients with affective disorders.

Conclusion

The findings indicate the significance of psychiatric patients' symptom management and factors such as self‐efficacy and self‐stigma to predict their functioning over a 12‐month follow‐up.

Relevance to clinical practice

Mental healthcare services should consider giving priority to self‐stigma reduction and empowerment to manage illness especially in this population of patients and their families, thus effectively enhancing their self‐care ability to cope with their illness and/or difficult life situations.
MACRO‐FINANCE LINKAGES
Authors: Morley James
Published: April 2015

In this survey, I review the academic and policy‐oriented literature on the linkages between financial markets and the rest of the economy. First, I summarize the leading economic theories for why the financial sector can influence the macroeconomy. Second, I consider empirical research on spillovers from the financial sector to the rest of the economy, as well as across financial markets in different countries. Third, I discuss key monetary policy debates regarding the appropriate response of central banks to financial conditions. Finally, I conclude with an overview of the major gaps in the existing literature.
Reflections on applications of naturalistic decision making
Authors: Klein Gary
Published: April 2015

This article is a commentary, reflecting on the special section ‘Applications for naturalistic decision‐making’ (Gore, Flin, Stanton, Wong, 2015, J. Occup. Organ. Psychol., doi:10.1111/joop.12121).
Transcranial direct current stimulation and exercises for treatment of chronic temporomandibular disorders: a blind randomised‐controlled trial
Authors: Oliveira L. B. , Lopes T. S. , Soares C. , Maluf R. , Goes B. T. , Sá K. N. , Baptista A. F.
Published: April 2015

To evaluate the effect of adding transcranial direct current stimulation (tDCS) to exercises for chronic pain, dysfunction and quality of life in subjects with temporomandibular disorders (TMD). Participants were selected based on the RDC/TMD criteria and assessed for pain intensity, pressure pain threshold over temporomandibular joint and cervical muscles and quality of life. After initial assessment, all individuals underwent a 4‐week protocol of exercises and manual therapy, together with active or sham primary motor cortex tDCS. Stimulation was delivered through sponge electrodes, with 2 mA amplitude, for 20 min daily, over the first 5 days of the trial. A total of 32 subjects (mean age 24·7 ± 6·8 years) participated in the evaluations and treatment protocol. Mean pain intensity pre‐treatment was 5·5 ± 1·4 for active tDCS group, and 6·3 ± 1·2 for sham tDCS. Both groups showed a decrease in pain intensity scores during the trial period (time factor – F4·5,137·5 = 28·7, P < 0·001; group factor – F1·0,30·0 = 7·7, P < 0·05). However, there were no differences between the groups regarding change in pain intensity (time*group interaction – F4·5,137·5 = 1·5, P = 0·137). This result remained the same after 5 months (t‐test t = 0·29, P > 0·05). Pressure pain thresholds decrease and improvement in quality of life were also noticeable in both groups, but again without significant differences between them. Absolute benefit increase was 37·5% (CI 95%: −15·9% to 90·9%), and number needed to treat was 2·66. This study suggests that there is no additional benefit in adding tDCS to exercises for the treatment of chronic TMD in young adults.
An inverse association of Helicobacter pylori infection with oral squamous cell carcinoma
Authors: Meng Xue , Wang Qiuxu , He Caiyun , Chen Moye , Liu Jingwei , Liu Weixian , Yuan Yuan
Published: April 2015

Background

Few studies have focused on the relationship between Helicobacter pylori (H. pylori) infection and oral diseases. In this study, we explored the correlation between H. pylori infection and oral squamous cell carcinoma (OSCC).

Methods

A total of 68 patients with OSCC and 104 age‐ and sex‐ matched healthy control subjects were retrospectively enrolled in this study. The H. pylori immunoglobin (Ig) G antibodies in serum were detected by enzyme‐linked immunosorbent assay (ELISA) method to assess the status of H. pylori infection of our study sample. Polymerase chain reaction (PCR) was also employed using H. pylori genus‐specific 16S rRNA primers in fasting blood, and OSCC specimens were analyzed by histochemical stain of each enrolled subject. The strength of correlation between H. pylori and the development of OSCC was estimated by Spearman's correlation coefficient.

Results

According to the three methods for detecting prevalence of H. pylori infection in the patients with OSCC, it was statistically lower than that in the healthy controls (35.3% vs. 54.8%, P = 0.012). An inverse correlation was observed between H. pylori infection and OSCC development (Spearman's correlation coefficient = −0.191, P = 0.012). In stratification analysis, we also found a statistical association between H. pylori infection and OSCC in the subpopulation with age ≥60 years (P = 0.037).

Conclusion

Our findings suggested that H. pylori infection may be negatively related to OSCC. A reverse association of H. pylori infection with OSCC risk in the subpopulation with age ≥60 years was also found.
The positive correlation of the CCL2‐CCR2 axis with the disease activity may indicate the fundamental role in the pathogenesis of oral lichen planus
Authors: Yin Jingfang , Yang Xi , Zeng Qi , Yang Linglan , Cheng Bin , Tao Xiaoan
Published: April 2015

Background

The important roles of CCL2 and its receptor CCR2 had been reported in a series of inflammatory disorders. However, few studies investigated the potential role of CCL2/CCR2 axis in oral lichen planus (OLP). Therefore, this study aimed to detect the expression of CCL2 and CCR2 in OLP lesions and compare their changes before and after treatment.

Methods

CCL2 and CCR2 expression was investigated using immunohistochemical staining and real‐time RT‐PCR in 32 patients with OLP and eight controls. Moreover, changes in their expression after treatment with triamcinolone acetonide were assessed in lesions from three patients.

Results

CCL2+ and CCR2+ cells were few in the controls and remarkably increased in the epithelial and subepithelial layers of lesions (n = 32, all P < 0.001). However, the densities of CCL2+ and CCR2+ cells were not significantly different between reticular (n = 12) and erythematous⁄erosive lesions (n = 20), although they significantly decreased after treatment (627.7 ± 108.2 vs. 258.3 ± 148.3, P = 0.017; 1034.7 ± 74.6 vs. 648 ± 77.6, P = 0.003, respectively). CCL2+/CCR2+ cell numbers were positively correlated with disease activity (correlation coefficient, 0.588; P < 0.001; correlation coefficient, 0.409; P = 0.02, respectively).

Conclusions

The results of this study indicated that the CCL2‐CCR2 axis was involved in the pathogenesis of OLP and was positively correlated with disease activity.
Aflatoxin levels in chronic hepatitis B patients with cirrhosis or hepatocellular carcinoma in Balıkesir, Turkey
Authors: Aydın M. , Aydın S. , Bacanlı M. , Başaran N.
Published: April 2015

Aflatoxins, the secondary metabolites produced by species of naturally occurring Aspergilli, are commonly found in food such as cereals, dried fruits and juice, wine, beer and spices. They are hepatotoxic and are well known human carcinogens based on evidence from human studies. Aflatoxins are an environmental risk factor for the development of hepatocellular carcinoma (HCC). Chronic hepatitis B‐infected patients are at increased risk of cirrhosis, hepatic failure and liver cancer. This study was designed to determine the serum aflatoxin B1 (AFB1), aflatoxin B2 (AFB2), aflatoxin G1 (AFG1) and aflatoxin G2 (AFG2) concentrations using high‐pressure liquid chromatography (HPLC) in hepatitis B‐infected patients with or without cirrhosis and liver cancer, alongside healthy controls in Balıkesir, Turkey. The mean AFB1 and total AF levels in patients without liver cancer and cirrhosis were significantly higher than healthy controls. The mean AFB1 and total AF levels in patients with chronic hepatitis B and HCC were significantly higher than infected patients with or without cirrhosis. These results suggest that patients with chronic hepatitis B who are exposed to AFs are at increased risk for developing HCC, which might be prevented by reducing consumption of contaminated foods.
From olivine to ringwoodite: a TEM study of a complex process
Authors: Pittarello Lidia , Ji Gang , Yamaguchi Akira , Schryvers Dominique , Debaille Vinciane , Claeys Philippe
Published: April 2015

The study of shock metamorphism of olivine might help to constrain impact events in the history of meteorites. Although shock features in olivine are well known, so far, there are processes that are not yet completely understood. In shock veins, olivine clasts with a complex structure, with a ringwoodite rim and a dense network of lamellae of unidentified nature in the core, have been reported in the literature. A highly shocked (S5‐6), L6 meteorite, Asuka 09584, which was recently collected in Antarctica by a Belgian–Japanese joint expedition, contains this type of shocked olivine clasts and has been, therefore, selected for detailed investigations of these features by transmission electron microscopy (TEM). Petrographic, geochemical, and crystallographic studies showed that the rim of these shocked clasts consists of an aggregate of nanocrystals of ringwoodite, with lower Mg/Fe ratio than the unshocked olivine. The clast's core consists of an aggregate of iso‐oriented grains of olivine and wadsleyite, with higher Mg/Fe ratio than the unshocked olivine. This aggregate is crosscut by veinlets of nanocrystals of olivine, with extremely low Mg/Fe ratio. The formation of the ringwoodite rim is likely due to solid‐state, diffusion‐controlled, transformation from olivine under high‐temperature conditions. The aggregate of iso‐oriented olivine and wadsleyite crystals is interpreted to have formed also by a solid‐state process, likely by coherent intracrystalline nucleation. Following the compression, shock release is believed to have caused opening of cracks and fractures in olivine and formation of olivine melt, which has lately crystallized under postshock equilibrium pressure conditions as olivine.
Systematic review of randomised controlled trials of interventions that aim to reduce the risk, either directly or indirectly, of overweight and obesity in infancy and early childhood
Authors: Redsell Sarah A. , Edmonds Barrie , Swift Judy Anne , Siriwardena Aloysius Niroshan , Weng Stephen , Nathan Dilip , Glazebrook Cris
Published: April 2015

The risk factors for childhood overweight and obesity are known and can be identified antenatally or during infancy, however, the majority of effective interventions are designed for older children. This review identified interventions designed to reduce the risk of overweight/obesity that were delivered antenatally or during the first 2 years of life, with outcomes reported from birth to 7 years of age. Six electronic databases were searched for papers reporting randomised controlled trials of interventions published from January 1990 to September 2013. A total of 35 eligible studies were identified, describing 27 unique trials of which 24 were behavioural and three were non‐behavioural. The 24 behavioural trials were categorised by type of intervention: (1) nutritional and/or responsive feeding interventions targeted at parents of infants, which improved feeding practices and had some impact on child weight (n = 12); (2) breastfeeding promotion and lactation support for mothers, which had a positive effect on breastfeeding but not child weight (n = 5); (3) parenting and family lifestyle (n = 4); and (4) maternal health (n = 3) interventions that had some impact on feeding practices but not child weight. The non‐behavioural trials comprised interventions manipulating formula milk composition (n = 3). Of these, lower/hydrolysed protein formula milk had a positive effect on weight outcomes. Interventions that aim to improve diet and parental responsiveness to infant cues showed most promise in terms of self‐reported behavioural change. Despite the known risk factors, there were very few intervention studies for pregnant women that continue during infancy which should be a priority for future research.
Contemporary evolution during invasion: evidence for differentiation, natural selection, and local adaptation
Authors: Colautti Robert I. , Lau Jennifer A.
Published: April 2015

Biological invasions are ‘natural’ experiments that can improve our understanding of contemporary evolution. We evaluate evidence for population differentiation, natural selection and adaptive evolution of invading plants and animals at two nested spatial scales: (i) among introduced populations (ii) between native and introduced genotypes. Evolution during invasion is frequently inferred, but rarely confirmed as adaptive. In common garden studies, quantitative trait differentiation is only marginally lower (~3.5%) among introduced relative to native populations, despite genetic bottlenecks and shorter timescales (i.e. millennia vs. decades). However, differentiation between genotypes from the native vs. introduced range is less clear and confounded by nonrandom geographic sampling; simulations suggest this causes a high false‐positive discovery rate (>50%) in geographically structured populations. Selection differentials (¦s¦) are stronger in introduced than in native species, although selection gradients (¦β¦) are not, consistent with introduced species experiencing weaker genetic constraints. This could facilitate rapid adaptation, but evidence is limited. For example, rapid phenotypic evolution often manifests as geographical clines, but simulations demonstrate that nonadaptive trait clines can evolve frequently during colonization (~two‐thirds of simulations). Additionally, QST‐FST studies may often misrepresent the strength and form of natural selection acting during invasion. Instead, classic approaches in evolutionary ecology (e.g. selection analysis, reciprocal transplant, artificial selection) are necessary to determine the frequency of adaptive evolution during invasion and its influence on establishment, spread and impact of invasive species. These studies are rare but crucial for managing biological invasions in the context of global change.
Scab resistance in ‘Geneva’ apple is conditioned by a resistance gene cluster with complex genetic control
Authors: Bastiaanse Héloïse , Bassett Heather C. M. , Kirk Christopher , Gardiner Susan E. , Deng Cecilia , Groenworld Remmelt , Chagné David , Bus Vincent G. M.
Published: April 2015

Apple scab, caused by the fungal pathogen Venturia inaequalis, is one of the most severe diseases of apple worldwide. It is the most studied plant–pathogen interaction involving a woody species using modern genetic, genomic, proteomic and bioinformatic approaches in both species. Although ‘Geneva’ apple was recognized long ago as a potential source of resistance to scab, this resistance has not been characterized previously. Differential interactions between various monoconidial isolates of V. inaequalis and six segregating F1 and F2 populations indicate the presence of at least five loci governing the resistance in ‘Geneva’. The 17 chromosomes of apple were screened using genotyping‐by‐sequencing, as well as single marker mapping, to position loci controlling the V. inaequalis resistance on linkage group 4. Next, we fine mapped a 5‐cM region containing five loci conferring both dominant and recessive scab resistance to the distal end of the linkage group. This region corresponds to 2.2 Mbp (from 20.3 to 22.5 Mbp) on the physical map of ‘Golden Delicious’ containing nine candidate nucleotide‐binding site leucine‐rich repeat (NBS‐LRR) resistance genes. This study increases our understanding of the complex genetic basis of apple scab resistance conferred by ‘Geneva’, as well as the gene‐for‐gene (GfG) relationships between the effector genes in the pathogen and resistance genes in the host.
A barley SKP1‐like protein controls abundance of the susceptibility factor RACB and influences the interaction of barley with the barley powdery mildew fungus
Authors: Reiner Tina , Hoefle Caroline , Hückelhoven Ralph
Published: April 2015

In an increasing number of plant–microbe interactions, it has become evident that the abundance of immunity‐related proteins is controlled by the ubiquitin–26S proteasome system. In the interaction of barley with the biotrophic barley powdery mildew fungus Blumeria graminis f.sp. hordei (Bgh), the RAC/ROP [RAT SARCOMA‐related C3 botulinum toxin substrate/RAT SARCOMA HOMOLOGUE (RHO) of plants] guanosine triphosphatase (GTPase) HvRACB supports the fungus in a compatible interaction. By contrast, barley HvRBK1, a ROP‐binding receptor‐like cytoplasmic kinase that interacts with and can be activated by constitutively activated HvRACB, limits fungal infection success. We have identified a barley type II S‐phase kinase 1‐associated (SKP1)‐like protein (HvSKP1‐like) as a molecular interactor of HvRBK1. SKP1 proteins are subunits of the SKP1‐cullin 1‐F‐box (SCF)–E3 ubiquitin ligase complex that acts in the specific recognition and ubiquitination of protein substrates for subsequent proteasomal degradation. Transient induced gene silencing of either HvSKP1‐like or HvRBK1 increased protein abundance of constitutively activated HvRACB in barley epidermal cells, whereas abundance of dominant negative RACB only weakly increased. In addition, silencing of HvSKP1‐like enhanced the susceptibility of barley to haustorium establishment by Bgh. In summary, our results suggest that HvSKP1‐like, together with HvRBK1, controls the abundance of HvRACB and, at the same time, modulates the outcome of the barley–Bgh interaction. A possible feedback mechanism from RAC/ROP‐activated HvRBK1 on the susceptibility factor HvRACB is discussed.
Health‐related quality of life in survivors of acute kidney injury: The Prolonged Outcomes Study of the Randomized Evaluation of Normal versus Augmented Level Replacement Therapy study outcomes
Authors: Wang Amanda Y , Bellomo Rinaldo , Cass Alan , Finfer Simon , Gattas David , Myburgh John , Chadban Steve , Hirakawa Yoichiro , Ninomiya Toshiharu , Li Qiang , Lo Serigne , Barzi Federica , Sukkar Louisa , Jardine Meg , Gallagher Martin P ,   POST‐RENAL Study Investigators and the ANZICS Clinical Trials Group
Published: April 2015

Aim

While patients with chronic kidney disease have reduced health‐related quality of life (HRQOL), long‐term HRQOL of survivors of severe acute kidney injury (AKI) remains unclear.

Methods

We analysed HRQOL from the Prolonged Outcomes Study of the Randomized Evaluation of Normal versus Augmented Level Replacement Therapy (POST‐RENAL) study and compared findings with those from a general Australian adult population enrolled in the Australian Diabetes, Obesity and Lifestyle (AusDiab) study. We used a multivariate analysis adjusted for baseline characteristics along with sensitivity analysis using age and sex‐matched case controls.

Results

In the POST‐RENAL study, 282 participants had HRQOL data collected using the SF‐12 questionnaire. This was compared with 6330 participants from the AusDiab study. Unadjusted analyses showed that POST‐RENAL participants had lower physical component scores (PCS, mean score 40.0 vs 49.8, P < 0.0001) and lower mental component scores (MCS, mean score 49.8 vs 53.9, P < 0.0001) than the AusDiab group. After age and sex matching, the difference in PCS and MCS remained statistically significant (P < 0.0001). Advanced age, reduced renal function and albuminuria (all P ≤ 0.01) were all strongly associated with lower PCS values but not MCS values. After matching subsets of the cohorts on the basis of age, sex and renal function, PCS and MCS were lower in the POST‐RENAL group (P < 0.0001).

Conclusion

Survivors of severe AKI in the POST‐RENAL study had lower physical and mental components of HRQOL compared with general population, even after adjustment for their reduced renal function. Increasing age and reduced renal function were associated with poorer physical QOL.
Minimizing Concentration of Sodium Hypochlorite in Root Canal Irrigation by Combination of Ultrasonic Irrigation with Photodynamic Treatment
Authors: Wang Yanhuang , Xiao Suli , Ma Dianfu , Huang Xiaojing , Cai Zhiyu
Published: April 2015

Concentration of sodium hypochlorite (NaOCl) is positively correlated with its effectiveness in root canal disinfection but negatively correlated with its biocompatibility. The objective of this in vitro study was to compare the bactericidal effects among ultrasonic irrigation with different concentration of NaOCl alone or together with photodynamic treatment (PDT) against Enterococcus faecalis (E. faecalis) in infected root canals. One hundred and twenty bovine root canals contaminated with E. faecalis were randomly distributed into 12 groups treated with different disinfection methods: PDT, ultrasonic irrigation with NaOCl at different concentrations (0.5%, 1.0%, 2.0%, 2.5% and 5.25%), and ultrasonic irrigation with NaOCl at different concentrations plus PDT. Data of microorganism load were collected before and after disinfection and analyzed by one‐way ANOVA and LSD tests. Significantly enhanced antibacterial effects were noticed in groups treated by PDT plus 2.0% or 2.5% NaOCl irrigation (P < 0.05). No statistical differences existed in bactericidal efficacy among groups of PDT plus ultrasonic irrigation with 2.0%, 2.5% or 5.25% NaOCl, and ultrasonic irrigation with 5.25% NaOCl alone (P > 0.05). Our study confirmed the feasibility to reduce the concentration of NaOCl to a safer level while maintaining its antibacterial efficiency through synergistic effect of PDT with NaOCl ultrasonic irrigation.
Understanding Suicide in Socially Vulnerable Contexts: Psychological Autopsy in a Small Town in Mexico
Authors: Chávez‐Hernández Ana‐María , Macías‐García Luis‐Fernando
Published: April 2015

In Mexico, suicides are increasing in certain latitudes where local rates have grown to levels of alert; suicide is also the second most common cause of death for the group aged 15 to 19. The psychological autopsy method was utilized to uncover and analyze common factors in all of the registered suicides within 2011 and 2012 in a small town of the state of Guanajuato, located in the center of Mexico. A total of nine decedents were analyzed, and 22 interviews were conducted. The most salient factors were as follows: poverty, financial stress, substance abuse, low levels of education, conflictive relationships, and a poor handling of emotions. The concepts of social exclusion and vulnerability were employed to analyze suicides as symptoms of a much deeper problem of this country, suggesting that anomie and social malady are nowadays important suicidal factors, mostly for children and young people.
Reinforcement Learning and Counterfactual Reasoning Explain Adaptive Behavior in a Changing Environment
Authors: Zhang Yunfeng , Paik Jaehyon , Pirolli Peter
Published: April 2015

Animals routinely adapt to changes in the environment in order to survive. Though reinforcement learning may play a role in such adaptation, it is not clear that it is the only mechanism involved, as it is not well suited to producing rapid, relatively immediate changes in strategies in response to environmental changes. This research proposes that counterfactual reasoning might be an additional mechanism that facilitates change detection. An experiment is conducted in which a task state changes over time and the participants had to detect the changes in order to perform well and gain monetary rewards. A cognitive model is constructed that incorporates reinforcement learning with counterfactual reasoning to help quickly adjust the utility of task strategies in response to changes. The results show that the model can accurately explain human data and that counterfactual reasoning is key to reproducing the various effects observed in this change detection paradigm.
Challenge study of the pathogen reduction capacity of the THERAFLEX MB‐Plasma technology
Authors: Reichenberg S. , Gravemann U. , Sumian C. , Seltsam A.
Published: April 2015

Background and Objectives

Although most pathogen reduction systems for plasma primarily target viruses, bacterial contamination may also occur. This study aimed to investigate the bacterial reduction capacity of a methylene blue (MB) treatment process and its virus inactivation capacity in lipaemic plasma.

Materials and Methods

Bacterial concentrations in plasma units spiked with different bacterial strains were measured before and after the following steps of the THERAFLEX MB‐Plasma procedure: leucocyte filtration, MB/light treatment and MB filtration. Virus inactivation was investigated for three virus types in non‐lipaemic, borderline lipaemic and highly lipaemic plasma.

Results

Leucocyte filtration alone efficiently eliminated most of the tested bacteria by more than 4 logs (Staphylococcus epidermidis and Staphylococcus aureus) or to the limit of detection (LOD) (≥ 4·8 logs; Escherichia coli, Bacillus cereus and Klebsiella pneumoniae). MB/light and MB filtration further reduced Staphylococcus epidermidis and Staphylococcus aureus to below the LOD. The small bacterium Brevundimonas diminuta was reduced by 1·7 logs by leucocyte filtration alone, and to below the LOD by additional MB/light treatment and MB filtration (≥ 3·7 logs). Suid herpesvirus 1, bovine viral diarrhoea virus and human immunodeficiency virus 1 were efficiently inactivated by THERAFLEX MB‐Plasma, independent of the degree of lipaemia.

Conclusion

THERAFLEX MB‐Plasma efficiently reduces bacteria, mainly via the integrated filtration system. Its virus inactivation capacity is sufficient to compensate for reduced light transparency due to lipaemia.
Correlation of the hypotonic shock response and extent of shape change with the new ThromboLUX™
Authors: Kraemer L. , Raczat T. , Weiss D.R. , Strobel J. , Eckstein R. , Ringwald J.
Published: April 2015

ThromboLUX (TLX)‐Score was compared with hypotonic shock response (HSR) and extent of shape change (ESC) in 99 samples from 42 platelet concentrates. Tests were performed in parallel and duplicate. Mean values for TLX Score, HSR and ESC were 30·3 ± 3·8%, 69·0 ± 12·2% and 23·2 ± 4·9%, respectively. We found no significant correlation between TLX Score and HSR or ESC (r = −0·158, P = 0·118 and r = −115, P = 0·255, respectively), whereas HSR and ESC correlated significantly (r = 0·351, P < 0·001). As TLX Score did not show significant correlation with HSR and ESC, the value of TLX for platelet quality testing remains unclear. Studies comparing these parameters with transfusion outcome are needed.
Blood donor to inactive donor transition in the Basel region between 1996 and 2011: a retrospective cohort study
Authors: Volken T. , Buser A. , Holbro A. , Bart T. , Infanti L.
Published: April 2015

Background and Objectives

For the prevention of blood shortages, it is essential for blood banks to design and implement donor recruitment and donor retention strategies that take into account the determinants of donor return.

Material and Methods

We studied the behaviour of first‐time blood donors in the region of Basel, Switzerland, between 1996 and 2011 and described factors associated with transition from active to inactive donor in two successive first‐time donor cohorts (1996–2002, 2003–2008).

Results

The risk of becoming an inactive donor was associated with being younger and female, not being a 0‐negative donor and living in an urban area. Over time, hazards of becoming an inactive donor were converging for individuals living in non‐urban and urban areas as were those of younger and older donors. After their first donation, 73·6% and 67·5% of males in the 1996–2002 and 2003–2008 cohorts, respectively, donated at least once in the following 24 months. The proportion of returning female donors was 71·8% and 65·4%, respectively.

Conclusions

The increased volatility of first‐time blood donors suggests that marketing actions and strategies aimed at increasing return rates should be reinforced, especially for younger and female blood donors.
Intravenous iron isomaltoside 1000 (Monofer®) reduces postoperative anaemia in preoperatively non‐anaemic patients undergoing elective or subacute coronary artery bypass graft, valve replacement or a combination thereof: a randomized double‐blind placebo‐controlled clinical trial (the PROTECT trial)
Authors: Johansson P. I. , Rasmussen A. S. , Thomsen L. L.
Published: April 2015

Background and Objectives

This trial explores whether intravenous iron isomaltoside 1000 (Monofer®) results in a better regeneration of haemoglobin levels and prevents anaemia compared to placebo in preoperative non‐anaemic patients undergoing cardiac surgery.

Study Design and Methods

The trial is a prospective, double‐blind, comparative, placebo‐controlled trial of 60 non‐anaemic patients undergoing cardiac surgery. The patients were randomized 1:1 to either 1000 mg intravenous iron isomaltoside 1000 administered perioperatively by infusion or placebo.

Results

Mean preoperative haemoglobin in the active treatment group was 14·3 g/dl vs. 14·0 g/dl in the placebo group. At discharge 5 days after surgery, haemoglobin levels were reduced to 10·7 and 10·5 g/dl, respectively. One month after surgery, haemoglobin concentration had increased to an average of 12·6 g/dl vs. 11·8 g/dl (p = 0·012) and significantly more patients were non‐anaemic in the intravenous iron isomaltoside 1000‐treated group compared to the placebo group (38·5% vs. 8·0%; p = 0·019). There were no differences in side‐effects between the groups.

Conclusion

A single perioperative 1000 mg dose of intravenous iron isomaltoside 1000 significantly increased the haemoglobin level and prevented anaemia 4 weeks after surgery, with a short‐term safety profile similar to placebo. Future trials on potential clinical benefits of preoperative treatment with intravenous iron in non‐anaemic patients are needed.
Quality indicators for the hospital transfusion chain: a national survey conducted in 100 dutch hospitals
Authors: Zijlker‐Jansen P. Y. , Janssen M. P. , van Tilborgh‐de Jong A. J. W. , Schipperus M. R. , Wiersum‐Osselton J. C.
Published: April 2015

Background

The 2011 Dutch Blood Transfusion Guideline for hospitals incorporates seven internal quality indicators for evaluation of the hospital transfusion chain. The indicators aim to measure guideline compliance as shown by the instatement of a hospital transfusion committee and transfusion safety officer (structural indicators), observance of transfusion triggers and mandatory traceability of labile blood components (process indicators).

Study Design and Methods

Two voluntary online surveys were sent to all Dutch hospitals for operational years 2011 and 2012 to assess compliance with the guideline recommendations.

Results

Most hospitals had a hospital transfusion committee and had appointed a transfusion safety officer (TSO). In 2012, only 23% of hospitals complied with the recommended minimum of four annual transfusion committee meetings and 8 h/week for the TSO. Compliance with the recommended pretransfusion haemoglobin threshold for RBC transfusion was achieved by 90% of hospitals in over 80% of transfusions; 58% of hospitals measured the pretransfusion platelet count in over 80% of platelet transfusions and 87% of hospitals complied with the legally mandatory traceability of blood components in over 95% of transfusions.

Conclusion

With the current blood transfusion indicators, it is feasible to monitor aspects of the quality of the hospital transfusion chain and blood transfusion practice and to assess guideline compliance. The results from this study suggest that there are opportunities for significant improvement in blood transfusion practice in the Netherlands. These indicators could potentially be used for national and international benchmarking of blood transfusion practice.
Control of a Cable-Driven Platform in a Master–Slave Robotic System: Linear Parameter Varying Approach
Authors: Salimi Amirhossein , Ramezanifar Amin , Grigoriadis Karolos M.
Published: April 2015

Space restrictions prevent surgeons to directly interact with the patient during magnetic resonance imaging (MRI)-guided procedures. One practical solution would be to develop a robotic system that can act as an interface between surgeon and patient during those interventions. The proposed system consists of a commercial PHANTOM device (product of The Sensable Technologies) as the master robot and an MRI-compatible patient-mounted parallel platform (that we name ROBOCATHETER) designed to serve as the slave mechanism inside the scanner bore. As the main contribution of this paper, a linear parameter varying (LPV) gain-scheduling controller is designed and implemented to obtain the desired performance of the slave robot in tracking set points and reference trajectories. To do so, a reduced-order dynamic model of the robot based on the Lagrange method is derived to capture the nonlinear dynamics of the platform. The model is then used for the design of an output-feedback LPV controller to command the robot to position the catheter in any desired states. During the course of control, appropriate selection of scheduling parameters not only helps to compensate for the nonlinearities of the system dynamics but also leads to a set of decoupled models for the system, where each degree-of-freedom (DOF) could be treated separately. The performance of the controller is compared with a variable-gain proportional-derivative-integral (PID) controller. Experimental results show that the proposed control scheme has significant advantages in terms of set point tracking and actuator saturation over the baseline PID controller.
A Framework for Control of Robots With Energy Regeneration
Authors: Richter Hanz
Published: April 2015

This paper focuses on robot control problems where energy regeneration is an explicit consideration, and it proposes a methodology for modeling and control design of regenerative motion control systems. The generic model consists of a robotic manipulator where some joints are actively controlled and the remaining joints are energetically self-contained and semi-actively controlled. The model can capture various electromechanical and hydraulic actuator configurations for industrial robots and powered human-assist devices. The basic control approach consists of three steps. First, a virtual control design is conducted by any suitable means. Then, virtual control inputs are enacted by a matching law for the adjustable parameters of the semi-active joints. Finally, the energy storage dynamics are adjusted using design parameters and an optional outer supervisory loop. The method has several attractive features: design simplicity, amenability to simultaneous plant and control design optimization, explicit treatment of energy regeneration, and applicability to multiple domains. This paper emphasizes electromechanical robots whose semi-active joints use ultracapacitors as the single energy storage medium. An internal energy balance equation and associated ideal self-powered operation (ISPO) condition are given for the semi-active joints. This condition is a structural characteristic of the system and independent of the control law. Extensions to handle higher-order dynamics are presented. Also, it is shown that discrepancies between virtual and actual controls can be mapped to parametric uncertainty in the virtual design. Experimental results confirm the validity of the approach.
Influence of Glass Transition Temperature of Underfill on the Stress Behavior and Reliability of Microjoints Within a Chip Stacking Architecture
Authors: Chang Jing-Yao , Huang Shin-Yi , Lee Chang-Chun , Chuang Tung-Han , Chang Tao-Chih
Published: April 2015

In this study, the reliability performance of two capillary-type underfill materials with different glass transition temperatures (Tg) and coefficients of thermal expansion (CTE) were assessed for a chip stacking architecture. The microbumps for integrating four chips on a Si interposer were with a pitch size of 20 μm and composed of 5 μm Cu/3 μm Ni/5 μm Sn2.5Ag solder cap. A thermocompressive bonder was used to interconnect the microbumps at 280 °C for 15 s, and the microgaps between the chips and the interposer were then, respectively, sealed by the mentioned underfill materials to form a chip stacking architecture. Then, the reliability characteristics of the test vehicles were evaluated following the preconditioning and temperature cycling test (TCT). Furthermore, a numerical analysis model was established by ansys software to study the stress and strain contours of the microjoints sealed by different underfill materials. It was found that the lifetime of microjoints was highly related to the Tg points of underfills, an interfacial fracture was observed within the microjoints sealed by a lower Tg underfill after temperature cycling because the tensile strength damaged the Sn depletion zone as heated.