bluuebunny/crossref_metadata_2025 huggingface dataset:
2016 European guideline for the management of vulval conditions
Authors: van der Meijden W.I. , Boffa M.J. , ter Harmsel W.A. , Kirtschig G. , Lewis F.M. , Moyal‐Barracco M. , Tiplica G.S. , Sherrard J.
Published: February 2017

Vulval conditions may present to a variety of clinicians, such as dermatologists, gynaecologists and general practitioners. Women with these conditions are best managed by a multidisciplinary approach, which includes clear referral pathways between disciplines or access to a specialist multidisciplinary vulval service. Informed consent is a prerequisite for all examinations, investigations and treatments. Consent is particularly important for intimate examinations of the anogenital area, and a chaperone should be offered in all cases. All efforts should be made to maintain a patient's dignity. Depending on symptoms and risk factors, screening for sexually transmitted infections (STI) should be considered. If the patient presents with vulval itch, particularly if also complaining of increased vaginal discharge, vulvaginal candidiasis should be excluded. Sexual dysfunction should be considered in all patients with vulval complaints, either as the cause of the symptoms or secondary to symptoms, and assessed if appropriate. This guideline covers several aspects, such as diagnosis and treatment, of the more common vulval conditions (relatively) often encountered at vulval clinics, i.e. vulval dermatitis (eczema), psoriasis, lichen simplex chronicus, lichen sclerosus, lichen planus, vulvodynia and vulval intraepithelial neoplasia (VIN).
Occurrence and Genetic Characteristics of Cryptosporidium hominis and Cryptosporidium andersoni in Horses from Southwestern China
Authors: Deng Lei , Li Wei , Zhong Zhijun , Gong Chao , Cao Xuefeng , Song Yuan , Wang Wuyou , Huang Xiangming , Liu Xuehan , Hu Yanchun , Fu Hualin , He Min , Wang Ya , Zhang Yue , Wu Kongju , Peng Guangneng
Published: February 2017

A total of 333 fecal specimens from horses in southwestern China were genotyped based on analysis of the small subunit rRNA (SSU rRNA) gene. Cryptosporidium hominis and Cryptosporidium andersoni were identified in 2 and 4 stool specimens, respectively. The identification of C. hominis was confirmed by sequence analysis of the 70‐kDa heat shock protein (HSP70) and oocyst wall protein (COWP) genes. Subtyping analysis of the 60‐kDa glycoprotein (GP60) gene sequence of C. hominis revealed a new rare subtype Id, named IdA15; only three Id isolates have been reported in humans to date. Multilocus sequence typing (MLST) analysis indicated that the C. andersoni subtype was A6, A5, A2, and A1 at the four minisatellite loci (MS1, MS2, MS3, and MS16, respectively). This is the first report to identify the presence of C. andersoni and C. hominis in horses in southwestern China and the first to identify a rare zoonotic subtype Id of C. hominis in horses. These findings suggest that infected horses may act as potential reservoirs of Cryptosporidium to transmit infections to humans.
Physicians’ Responsibilities for Deaths Occurring at Home
Authors: Yang Mia , McNabney Matthew K.
Published: February 2017

Deaths occurring at home are increasing in the United States. Primary care physicians and trainees may not be explicitly taught about management of deaths in the home. Physician responsibilities for expected and unexpected deaths at home are summarized. The medical examiner should be contacted if death was due to natural disease processes but occurred suddenly or when a physician was not treating the decedent. Police and emergency personnel are often called after terminally ill individuals have died at home, which may cause significant family distress and is typically not necessary if the death was expected. Clinicians should counsel patients and families on managing expected deaths without involving emergency personnel. There is also the question of autopsy, which has become less common throughout the country. Although there are no requirements for physicians to ask families whether they want an autopsy if the death occurred at home, unexpected deaths should be referred to the medical examiner for possible forensic or medicolegal autopsy. If the medical examiner declines the case, the family can be offered private‐pay autopsy; costs can exceed $3000. Regarding the completion of death certificates, it is appropriate for the physician to write “probable’’ or “presumed” for diagnoses when the precise cause of death at home is uncertain. After a person has died, clinicians can still offer significant postmortem guidance and closure to the family.
Relationship Between Midlife Cardiovascular Health and Late‐Life Physical Performance: The ARIC Study
Authors: Windham B. Gwen , Harrison Kimystian L. , Lirette Seth T. , Lutsey Pamela L. , Pompeii Lisa A. , Gabriel Kelley P. , Koton Silvia , Steffen Lyn M. , Griswold Michael E. , Mosley Thomas H.
Published: February 2017

Objectives

To examine the association between midlife cardiovascular health and physical performance 25 years later.

Design

Cohort study (Atherosclerosis Risk in Communities Study); multinomial logistic and logistic regression adjusted for demographic characteristics and clinical measures.

Setting

Four U.S. communities: Forsyth County, North Carolina; Washington County, Maryland; Minneapolis, Minnesota; and Jackson, Mississippi.

Participants: Individuals aged 54.2 ± 5.8 at baseline (N = 15,744; 55% female, 27% black).

Measurements

Cardiovascular health was measured at baseline using the American Heart Association's Life's Simple 7 (LS7) score (0–14) and LS7 component categories (poor, intermediate, ideal) for each risk factor. The Short Physical Performance Battery (SPPB) was used to quantify physical function as ordinal (0–12) and categorical (low (0–6), fair (7–9), good (10–12) outcomes.

Results

Mean baseline LS7 score was 7.9 ± 2.4; 6,144 (39%) individuals returned 25 years later for the fifth ARIC examination, at which point the SPPB was administered. Of 5,916 individuals who completed the SPPB, 3,288 (50%) had good physical performance. Each 1‐unit increase in LS7 score was associated with a 17% higher SPPB score (rate ratio (RR) = 1.17, 95% confidence interval (CI) = 1.15–1.19) and a 29% greater chance of having a late‐life SPPB score of 10 or greater compared to SPPB score of less than 10 (RR = 1.29, 95% CI = 1.25–1.34). Ideal baseline glucose (RR = 2.53, 95% CI = 2.24–2.87), smoking (RR = 1.97, 95% CI = 1.81–2.15), blood pressure (RR = 1.70, 95% CI = 1.54–1.88), body mass index (RR = 1.51, 95% CI = 1.37–1.66), and physical activity (RR = 1.31, 95% CI = 1.20–1.43) had the strongest associations with late‐life SPPB score, adjusting for other LS7 components.

Conclusion

Better cardiovascular health during midlife may lead better physical functioning in older age.
Advancing the Neurophysiological Understanding of Delirium
Authors: Shafi Mouhsin M. , Santarnecchi Emiliano , Fong Tamara G. , Jones Richard N. , Marcantonio Edward R. , Pascual‐Leone Alvaro , Inouye Sharon K.
Published: February 2017

Delirium is a common problem associated with substantial morbidity and increased mortality. However, the brain dysfunction that leads some individuals to develop delirium in response to stressors is unclear. In this article, we briefly review the neurophysiologic literature characterizing the changes in brain function that occur in delirium, and in other cognitive disorders such as Alzheimer's disease. Based on this literature, we propose a conceptual model for delirium. We propose that delirium results from a breakdown of brain function in individuals with impairments in brain connectivity and brain plasticity exposed to a stressor. The validity of this conceptual model can be tested using Transcranial Magnetic Stimulation in combination with Electroencephalography, and, if accurate, could lead to the development of biomarkers for delirium risk in individual patients. This model could also be used to guide interventions to decrease the risk of cerebral dysfunction in patients preoperatively, and facilitate recovery in patients during or after an episode of delirium.
Brain MRI‐markers Associate Differentially with Cognitive Versus Functional Decline Leading to Dementia
Authors: Verlinden Vincentius J. A. , van der Geest Jos N. , Hofman Albert , Niessen Wiro J. , van der Lugt Aad , Vernooij Meike W. , Ikram M. Arfan
Published: February 2017

Background

Brain MRI‐markers are risk factors of dementia and decline in cognition and daily functioning. It is unknown to what extent the associations of brain MRI‐markers with cognition and daily functioning are part of the pathway leading to dementia. We aimed to investigate associations of brain MRI‐markers with change in cognition and daily functioning during 15 years of follow‐up, including their relation to dementia.

Design, Setting, and Participants

Four hundred and sixty three stroke‐free and non‐demented participants from the population‐based Rotterdam Study that underwent brain‐MRI, yielding brain volumetrics, between 1995 and 1996.

Measurements

We assessed cognition using the Mini‐Mental State Examination (MMSE) and daily functioning using instrumental and basic activities of daily living (IADL and BADL) up to seven times between 1990 and 2011. Analyses were performed both including and excluding incident demented participants.

Results

Smaller brain volume associated with larger decline in MMSE, IADL, and BADL. Larger white matter lesion volume associated with larger decline in MMSE. Frontal lobe volume associated strongest with decline in IADL and BADL, and temporal lobe volume with decline in MMSE. After excluding incident demented participants (n = 63), associations with IADL and BADL remained, while associations with MMSE disappeared.

Conclusions

Smaller brain volumes and larger white matter volume associate with larger decline in cognition and daily functioning, during 15 years of follow‐up. Importantly, the relation of brain volume with cognition, but not daily functioning, was driven by those individuals that ultimately developed dementia.
An Integrative Review of Biological Variants and Chronic Stress in Emerging Adults With Chronic Conditions
Authors: Ersig Anne L. , Starkweather Angela R.
Published: February 2017

Purpose

The purpose of this integrative review was to evaluate and synthesize studies that incorporated biological measures and examined their associations with chronic stress and anxiety in adolescents and emerging adults with chronic health conditions.

Design

An integrative literature review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses statement to identify studies published between 2005 and 2015.

Methods

Using key terms, three databases (PubMed/Medline, PsycInfo and the Cumulative Index to Nursing and Allied Health Literature) were searched by a research librarian. Additional publications with relevance to the topic were identified from citing and cited literature. The full text of 61 publications was reviewed. The final group of articles analyzed for this review included 36 peer‐reviewed publications and meeting abstracts.

Findings

Studies varied considerably in characteristics, theoretical frameworks, phenotypes of interest, and study measures. Few studies evaluated genomic variants; those that did often examined small samples and a limited number of biological factors.

Conclusions

Studies of chronic stress and anxiety in adolescents and emerging adults with chronic health conditions are currently limited in scope and impact. A more comprehensive approach will facilitate translation into practice to improve short‐ and long‐term health outcomes.

Clinical Relevance

Precision and genomic healthcare initiatives support the relevance of this work for nurses in all areas of clinical practice. Genomic testing is expanding to include individuals in all age groups, with and without diagnosed conditions. As psychological and behavioral phenotypes may influence self‐management outcomes of adolescents and emerging adults with chronic health conditions, further research in this area is warranted.
The cosmetic and dermatological potential of keratin hydrolysate
Authors: Mokrejs Pavel , Hutta Matous , Pavlackova Jana , Egner Pavlina , Benicek Lubomir
Published: February 2017

Background

Although keratin hydrolysates have become established as standard components in hair and nail cosmetics, studies on the moisturizing effects of keratin hydrolysates do not appear among contemporary literature.

Objectives

To test if adding keratin hydrolysate into an ointment base increases hydration of the skin and improves skin barrier function, or diminishes trans‐epidermal water loss.

Methods

Formulations were prepared containing 2%, 4%, and 6% keratin hydrolysates (based on weight of the ointment base). The moisturizing properties of keratin hydrolysates were tested by measuring skin hydration, trans‐epidermal water loss and skin pH; measurements were carried out at intervals of 1, 2, 3, 4, 24, and 48 h. Testing was conducted on 10 women.

Results

As regards hydration, adding 2% keratin hydrolysate to the ointment base is optimal, as an increase of 14%‐23% occurs in hydration of the stratum corneum. For trans‐epidermal water loss, adding 4% KH to the ointment base is preferential, as this triggers a 26%‐46% decrease in trans‐epidermal water loss.

Conclusions

Keratin hydrolysate acts as a humectant (it binds water from lower layers of the epidermis to the stratum corneum) as well as an occlusive (it reduces trans‐epidermal water loss). The highly favorable properties of keratin hydrolysates are attributed to the wide distribution of keratin hydrolysates molecular weights; low‐molecular weight fractions easily penetrate the SC, while high‐molecular weight fractions form a protective film on the epidermis. Adding keratin hydrolysates to the ointment base did not cause phase separation even after 6 mo storage.
Prevalence of difficult venous access and associated risk factors in highly complex hospitalised patients
Authors: Armenteros‐Yeguas Victoria , Gárate‐Echenique Lucía , Tomás‐López Maria Aranzazu , Cristóbal‐Domínguez Estíbaliz , Moreno‐de Gusmão Breno , Miranda‐Serrano Erika , Moraza‐Dulanto Maria Inmaculada
Published: February 2017

Aims and objectives

To estimate the prevalence of difficult venous access in complex patients with multimorbidity and to identify associated risk factors.

Background

In highly complex patients, factors like ageing, the need for frequent use of irritant medication and multiple venous catheterisations to complete treatment could contribute to exhaustion of venous access.

Design

A cross‐sectional study was conducted.

Methods

‘Highly complex’ patients (n = 135) were recruited from March 2013–November 2013. The main study variable was the prevalence of difficult venous access, assessed using one of the following criteria: (1) a history of difficulties obtaining venous access based on more than two attempts to insert an intravenous line and (2) no visible or palpable veins. Other factors potentially associated with the risk of difficult access were also measured (age, gender and chronic illnesses). Univariate analysis was performed for each potential risk factor. Factors with p < 0·2 were then included in multivariable logistic regression analysis. Odds ratios were also calculated.

Results

The prevalence of difficult venous access was 59·3%. The univariate logistic regression analysis indicated that gender, a history of vascular access complications and osteoarticular disease were significantly associated with difficult venous access. The multivariable logistic regression showed that only gender was an independent risk factor and the odds ratios was 2·85.

Conclusions

The prevalence of difficult venous access is high in this population. Gender (female) is the only independent risk factor associated with this. Previous history of several attempts at catheter insertion is an important criterion in the assessment of difficult venous access.

Relevance to clinical practice

The prevalence of difficult venous access in complex patients is 59·3%. Significant risk factors include being female and a history of complications related to vascular access.
Possible non‐sexual modes of transmission of human papilloma virus
Authors: Sabeena Sasidharanpillai , Bhat Parvati , Kamath Veena , Arunkumar Govindakarnavar
Published: February 2017

Aim

There is strong evidence to suggest vertical and horizontal modes of transmission of human papilloma virus (HPV), an established etiologic agent of cervical cancer. Infants, children, and adults can acquire both high‐risk and low‐risk infections by birth or by close contact even though HPV is mainly transmitted sexually. A thorough review of the literature was performed to assess the possible non‐sexual modes of transmission of HPV.

Methods

An electronic search of databases for review articles, cross‐sectional studies, cohort studies, and case reports on non‐sexual modes of transmission among sexually unexposed women and children was carried out using search terms such as “human papilloma virus, HPV, transmission, horizontal transmission, vertical transmission, and fomites”. Articles published between 1983 and 2015 were retrieved.

Results

Epidemiological and clinical data support various non‐sexual modes of transmission especially at the time of birth and by close contact. Even though the role of fomites in the transmission of HPV is not well established, HPV‐DNA positivity has been reported in transvaginal ultrasound probes and colposcopes after routine disinfection.

Conclusion

Awareness needs to be spread among the public about alternate modes of transmission. For a proper understanding of the exact natural history of HPV infection acquired via the non‐sexual route, long‐term prospective studies need to be undertaken.
Smokeless tobacco (snus) is associated with an increased risk of type 2 diabetes: results from five pooled cohorts
Authors: Carlsson S. , Andersson T. , Araghi M. , Galanti R. , Lager A. , Lundberg M. , Nilsson P. , Norberg M. , Pedersen N. L. , Trolle‐Lagerros Y. , Magnusson C.
Published: February 2017

Background

Smoking and nicotine exposure increase insulin resistance and the risk of type 2 diabetes. Swedish smokeless tobacco (snus) is high in nicotine, and its use is prevalent in Scandinavian countries, but few studies have investigated snus use in relation to diabetes risk.

Objective

To explore the association between snus use and risk of type 2 diabetes using pooled data from five cohorts.

Methods

Analyses were based on prospective studies conducted between 1990 and 2013 including 54 531 never‐smoking men and 2441 incident cases of type 2 diabetes identified through screening, self‐reporting and hospital and prescription registries. Hazard ratios (HRs) and 95% confidence intervals (CIs) were assessed and adjusted for age, body mass index, educational level, alcohol consumption and physical activity.

Results

Compared to never users, the HR of type 2 diabetes was 1.15 (95% CI: 1.00–1.32) in current users of snus. In individuals consuming 5–6 boxes per week, the HR was 1.42 (95% CI: 1.07–1.87); in those consuming ≥7 boxes per week, the HR was 1.68 (95% CI: 1.17–2.41). Each additional box of snus consumed per week yielded an HR of 1.08 (95% CI: 1.01–1.16).

Conclusion

Our findings indicate that high consumption of snus is a risk factor for type 2 diabetes. The risk was similar to that in smokers, implying that smokers will not reduce their risk of type 2 diabetes by changing to snus use. The results also support the notion that nicotine increases the risk of type 2 diabetes.
Tissue‐engineered 3D microvessel and capillary network models for the study of vascular phenomena
Authors: Bogorad Max I. , DeStefano Jackson , Wong Andrew D. , Searson Peter C.
Published: February 2017

Advances in tissue engineering, cell biology, microfabrication, and microfluidics have led to the development of a wide range of vascular models. Here, we review platforms based on templated microvessel fabrication to generate increasingly complex vascular models of (i) the tumor microenvironment, (ii) occluded microvessels, and (iii) perfused capillary networks. We outline fabrication guidelines and demonstrate a number of experimental methods for probing vascular function such as permeability measurements, tumor cell intravasation, flow characterization, and endothelial cell morphology and proliferation.
Microfluidic traction force microscopy to study mechanotransduction in angiogenesis
Authors: Boldock Luke , Wittkowske Claudia , Perrault Cecile M.
Published: February 2017

The formation of new blood vessels from existing vasculature, angiogenesis, is driven by coordinated endothelial cell migration and matrix remodeling in response to local signals. Recently, a growing body of evidence has shown that mechanotransduction, along with chemotransduction, is a major regulator of angiogenesis. Mechanical signals, such as fluid shear stress and substrate mechanics, influence sprouting and network formation, but the mechanisms behind this relationship are still unclear. Here, we present cellular traction forces as possible effectors activated by mechanosensing to mediate matrix remodeling, and encourage the use of TFM to study mechanotransduction in angiogenesis. We also suggest that deciphering the response of EC to mechanical signals could reveal an optimal angiogenic mechanical environment, and provide insight into development, wound healing, the initiation and growth of tumors, and new strategies for tissue engineering.
Peptide‐nucleotide antibiotic Microcin C is a potent inducer of stringent response and persistence in both sensitive and producing cells
Authors: Piskunova Julia , Maisonneuve Etienne , Germain Elsa , Gerdes Kenn , Severinov Konstantin
Published: February 2017

Microcin C (McC) is a peptide‐nucleotide antibiotic that inhibits aspartyl‐tRNA synthetase. Here, we show that McC is a strong inducer of persistence in Escherichia coli. Persistence induced by McC is mediated by (p)ppGpp and requires chromosomally encoded toxin‐antitoxin modules. McC‐producing cells have increased persistence levels due to a combined effect of McC imported from the cultured medium and intracellularly synthesized antibiotic. McC‐producing cells also induce persistence in sensitive cells during co‐cultivation, underscoring complex interactions in bacterial communities where an antagonistic compound produced by one community member can benefit other members by increasing their ability to withstand antibiotics.
Importance of the E. coli DinJ antitoxin carboxy terminus for toxin suppression and regulated proteolysis
Authors: Ruangprasert Ajchareeya , Maehigashi Tatsuya , Miles Stacey J. , Dunham Christine M.
Published: February 2017

Toxin–antitoxin genes play important roles in the regulation of bacterial growth during stress. One response to stress is selective proteolysis of antitoxin proteins which releases their cognate toxin partners causing rapid inhibition of growth. The features of toxin–antitoxin complexes that are important to inhibit toxin activity as well as to release the active toxin remain elusive. Furthermore, it is unclear how antitoxins are selected for proteolysis by cellular proteases. Here, we test the minimal structural requirements of the Escherichia coli DinJ antitoxin to suppress its toxin partner, YafQ. We find that DinJ–YafQ complex formation is critically dependent on the last ten C‐terminal residues of DinJ. However, deletion of these 10 DinJ residues has little effect on transcriptional autorepression suggesting that the YafQ toxin is not a critical component of the repression complex in contrast to other toxin–antitoxin systems. We further demonstrate that loop 5 preceding these ten C‐terminal residues is important for Lon‐mediated proteolysis. These results provide important insights into the critical interactions between toxin–antitoxin pairs necessary to inhibit toxin activity and the regulated proteolysis of antitoxins.
The Botrytis cinerea PAK kinase BcCla4 mediates morphogenesis, growth and cell cycle regulating processes downstream of BcRac
Authors: Minz‐Dub Anna , Sharon Amir
Published: February 2017

Rac proteins are involved in a variety of cellular processes. Effector proteins that interact with active Rac convey the GTPase‐generated signal to downstream developmental cascades and processes. Here we report on the analysis of the main effector and signal cascade downstream of BcRac, the Rac homolog of the grey mold fungus Botrytis cinerea. Several lines of evidence highlighted the p21‐activated kinase Cla4 as an important effector of Rac in fungi. Analysis of Δbccla4 strains revealed that the BcCla4 protein was sufficient to mediate all of the examined BcRac‐driven processes, including hyphal growth and morphogenesis, conidia production and pathogenicity. In addition, the Δbccla4 strains had altered nuclei content, a phenomenon that was previously observed in Δbcrac isolates, thus connecting the BcRac/BcCla4 module with cell cycle control. Further analyses revealed that BcRac/BcCla4 control mitotic entry through changes in phosphorylation status of the cyclin dependent kinase BcCdk1. The complete cascade includes the kinase BcWee1, which is downstream of BcCla4 and upstream of BcCdk1. These results provide a mechanistic insight on the connection of cell cycle, morphogenesis and pathogenicity in fungi, and position BcCla4 as the most essential effector and central regulator of all of these processes downstream of BcRac.
Jürgen Habermas and the dilemmas of experience of disability
Authors: Pezdek Krzysztof , Doliński Wojciech
Published: February 2017

The article addresses Jürgen Habermas’ theory of communicative action, which offers very productive tools for analysing disability. The Habermasian division of social reality helps examine positive and negative effects of tensions between the lifeworld of a person with disability and the system. By exploring such an individual's communicative action, one can obtain an insight into his/her validity claims and disruptions in the communication process and self‐understandings inscribed in group narratives. The study reported in the article used in‐depth interviews, which narratively reveal the experiences of a person with disability in family, education, sports and labour. The key findings are, first, that the rationalization of lifeworlds of people with disability increases while processes in which they are colonized by the system intensify; second, that education and family are significant factors in the raising of validity claims; and third, that validity claims as tools of verbal communication should be augmented with arguments from non‐verbal language (e.g. gesture, empathy).
Sleep–obesity relation: underlying mechanisms and consequences for treatment
Authors: St‐Onge M.‐P.
Published: February 2017

Short sleep duration has been associated with obesity in numerous epidemiological studies. However, such association studies cannot establish evidence of causality. Clinical intervention studies, on the other hand, can provide information on a causal effect of sleep duration on markers of weight gain: energy intake and energy expenditure. Herein is an overview of the science related to the impact of sleep restriction, in the context of clinical intervention studies, on energy intake, energy expenditure and body weight. Additionally, studies that evaluate the impact of sleep restriction on weight loss and the impact of sleep extension on appetite are discussed. Information to date suggests that weight management is hindered when attempted in the context of sleep restriction, and the public should be made aware of the negative consequences of sleep restriction for weight regulation.
Isometric thermogenesis at rest and during movement: a neglected variable in energy expenditure and obesity predisposition
Authors: Dulloo A. G. , Miles‐Chan J. L. , Montani J.‐P. , Schutz Y.
Published: February 2017

Isometric thermogenesis as applied to human energy expenditure refers to heat production resulting from increased muscle tension. While most physical activities consist of both dynamic and static (isometric) muscle actions, the isometric component is very often essential for the optimal performance of dynamic work given its role in coordinating posture during standing, walking and most physical activities of everyday life. Over the past 75 years, there has been sporadic interest into the relevance of isometric work to thermoregulatory thermogenesis and to adaptive thermogenesis pertaining to body‐weight regulation. This has been in relation to (i) a role for skeletal muscle minor tremor or microvibration – nowadays referred to as ‘resting muscle mechanical activity’ – in maintaining body temperature in response to mild cooling; (ii) a role for slowed skeletal muscle isometric contraction–relaxation cycle as a mechanism for energy conservation in response to caloric restriction and weight loss and (iii) a role for spontaneous physical activity (which is contributed importantly by isometric work for posture maintenance and fidgeting behaviours) in adaptive thermogenesis pertaining to weight regulation. This paper reviews the evidence underlying these proposed roles for isometric work in adaptive thermogenesis and highlights the contention that variability in this neglected component of energy expenditure could contribute to human predisposition to obesity.
The effect of exercise on non‐exercise physical activity and sedentary behavior in adults
Authors: Melanson E. L.
Published: February 2017

It is widely assumed that structured exercise causes an additive increase in physical activity energy expenditure (PAEE) and total daily energy expenditure (TDEE). However, the common observation that exercise often leads to a less than expected decrease in body weight, without changes in energy intake, suggests that some compensatory behavioral adaptations occur. A small number of human studies have shown that adoption of structured exercise can lead to decreases in PAEE, which is often interpreted as a decrease in physical activity (PA) behavior. An even smaller number of studies have objectively measured PA, and with inconsistent results. In animals, high levels of imposed PA induce compensatory changes in some components of TDEE. Recent human cohort studies also provide evidence that in those at the highest levels of PA, TDEE is similar when compared to less physically active groups. The objective of this review is to summarize the effects of structured exercise training on PA, sedentary behavior, PAEE and TDEE. Using models from ecological studies in animals and observational data in humans, an alternative model of TDEE in humans is proposed. This model may serve as a framework to investigate the complex and dynamic regulation of human energy budgets.
Applicability of a Novel Formula (Bogossian formula) for Evaluation of the QT‐Interval in Heart Failure and Left Bundle Branch Block Due to Right Ventricular Pacing
Authors: FROMMEYER GERRIT , BOGOSSIAN HARILAOS , PECHLIVANIDOU ELENI , CONZEN PHILIPP , GEMEIN CHRISTOPHER , WEIPERT KAY , HELMIG INGA , CHASAN RITVAN , JOHNSON VICTORIA , ECKARDT LARS , HAMM CHRISTIAN W , SEYFARTH MELCHIOR , LEMKE BERND , ZARSE MARKUS , SCHMITT JÖRN , ERKAPIC DAMIR
Published: February 2017

Background

The presence of left bundle branch block (LBBB) due to right ventricular pacing represents a particular challenge in properly measuring the QTc interval. In 2014, a new formula for the evaluation of QT interval in patients with LBBB was reported.

Methods

145 patients with implantable cardioverter defibrillator were included in this prospective multicenter observational study. Inclusion criteria were: no permanent right ventricular stimulation, an intrinsic QRS interval of <120 ms, and reduced left ventricular function. 12‐lead electrocardiogram recordings during intrinsic rhythm and during right ventricular threshold testing were performed. After LBBB correction using the reported Bogossian formula, the QTc interval was evaluated with Bazett's formula. The corrected QTc interval was compared in each patient with the QTc interval during intrinsic rhythm. All measurements were performed by an experienced electrophysiologist and a trainee who worked independently and in a blinded manner.

Results

74 patients (65 ± 13 years; male n = 42) with apical and 71 patients (68 ± 11 years; male n = 42) with nonapical right ventricular pacing were included in this study. The mean left ventricular ejection fraction was 40 ± 13%. The QTc interval was determined to be 461 ± 34 ms (modified by Bogossian's formula) in paced and 436 ± 34 ms in intrinsic rhythm. The QTc interval was overestimated by ΔQTc of 25 ± 21 ms (mean deviation 5.7%) when using the Bogossian formula.

Conclusion

The novel Bogossian formula seems to be a reliable tool for QTc interval evaluation in patients with heart failure and right ventricular pacing. However, a slight overestimation of the QT‐interval must be respected.
Left Ventricular Size does not Modify the Effect of QRS Duration in Predicting Response to Cardiac Resynchronization Therapy
Authors: RICKARD JOHN , BARANOWSKI BRYAN , GRIMM RICHARD A. , NIEBAUER MARK , VARMA NIRAJ , TANG W.H. WILSON , WILKOFF BRUCE L.
Published: February 2017

Background

QRS duration (QRSd) may be impacted by both left ventricular (LV) dilatation and conduction delay. It is possible therefore that the same QRSd may portend significantly different amounts of LV activation delay in patients with small versus large left ventricles. We hypothesized that LV size modifies the effect of QRSd on predicting outcomes in patients undergoing CRT implant.

Methods

We extracted data on consecutive patients presenting for initial CRT implant. In patients with a follow‐up echocardiogram, response was defined as an absolute improvement in LV ejection fraction ≥5%. Multivariate models were created to determine if left ventricular end‐diastolic diameter (LVEDD) modified the effect of QRSd on its association with both long‐term survival free of left ventricular assist device (LVAD) and heart transplant and echocardiographic response.

Results

464 patients met inclusion criteria. At a mean follow‐up of 4.9 ± 2.6 years, there were 210 deaths, 13 heart transplants, and 12 LVAD placements. There was a weak but significant correlation between baseline QRSd and LVEDD (Spearman's Rho 0.106, P < 0.001). In a multivariate analysis, there was no evidence of effect modification of LVEDD on QRSd (LVEDDi*QRS interaction term HR 1.0 [0.995–1.006], P = 0.94). Note that 305 patients had a follow‐up echocardiogram, of whom 193 met the criteria for response. In a multivariate analysis, there was no evidence of effect modification of LVEDD on QRSd (LVEDDi*QRS interaction term odds ratio 0.998 (0.988–1.008), P = 0.65).

Conclusion

LV size does not modify the effect of QRSd and its association with outcomes following CRT. The correlation between LV size and QRSd in patients with a QRSd ≥ 120 ms is weak.
Root cortical senescence decreases root respiration, nutrient content and radial water and nutrient transport in barley
Authors: Schneider Hannah M. , Wojciechowski Tobias , Postma Johannes A. , Brown Kathleen M. , Lücke Andreas , Zeisler Viktoria , Schreiber Lukas , Lynch Jonathan P.
Published: February 2017

The functional implications of root cortical senescence (RCS) are poorly understood. We tested the hypotheses that RCS in barley (1) reduces the respiration and nutrient content of root tissue; (2) decreases radial water and nutrient transport; and (3) is accompanied by increased suberization to protect the stele. Genetic variation for RCS exists between modern germplasm and landraces. Nitrogen and phosphorus deficiency increased the rate of RCS. Maximal RCS, defined as the disappearance of the entire root cortex, reduced root nitrogen content by 66%, phosphorus content by 63% and respiration by 87% compared with root segments with no RCS. Roots with maximal RCS had 90, 92 and 84% less radial water, nitrate and phosphorus transport, respectively, compared with segments with no RCS. The onset of RCS coincided with 30% greater aliphatic suberin in the endodermis. These results support the hypothesis that RCS reduces root carbon and nutrient costs and may therefore have adaptive significance for soil resource acquisition. By reducing root respiration and nutrient content, RCS could permit greater root growth, soil resource acquisition and resource allocation to other plant processes. RCS merits investigation as a trait for improving the performance of barley, wheat, triticale and rye under edaphic stress.
Prevention of DNA damage in human skin by topical sunscreens
Authors: Olsen Catherine M. , Wilson Louise F. , Green Adèle C. , Biswas Neela , Loyalka Juhi , Whiteman David C.
Published: February 2017

Background/purpose

There is strong evidence that topical sunscreens, designed to protect against ultraviolet radiation (UVR)‐induced erythema, decrease the amount of UVR to which the skin is exposed, but their effectiveness in reducing UVR‐induced DNA damage in vivo has not been well quantified.

Methods

We systematically reviewed the published literature (1990‐2015) to determine whether sunscreens prevent DNA damage in human skin when applied prior to UVR exposure. We included experimental studies measuring UVR‐induced DNA damage in human skin in vivo with and without sunscreens and excluded studies conducted in animal models and cell lines. Eligible studies were identified by computerized search of bibliographic databases, supplemented by hand‐searching the reference lists of retrieved articles.

Results

We identified ten eligible studies. Despite heterogeneity in methodological approaches, including the sun protection factors of the sunscreens assessed, range of skin types examined, the UVR exposure time and dose, the timing of post‐irradiation biopsies and in the markers of DNA damage examined, all studies reported markedly reduced (or nil) UVR‐induced DNA damage on sunscreen‐protected skin.

Conclusion

Our review of the experimental evidence supports a protective effect of topical sunscreens in preventing UVR‐induced DNA damage in human skin cells in vivo.
The Role of Implicit Attitudes in Populist Radical‐Right Support
Authors: Bos Linda , Sheets Penelope , Boomgaarden Hajo G.
Published: February 2017

Previous research on the populist radical right (PRR) has focused exclusively on explicit measures in explaining support for these contested political players. In this study, we explore the role of implicit attitudes in predicting vote likelihood for a PRR party. We use an online survey (n = 773) among Dutch respondents in which we measured implicit attitudes towards the Dutch PRRPartij voor de Vrijheid(PVV) with a Single‐Target Implicit Association Test (ST‐IAT). The results show that the implicit measure predicts vote likelihood in general, as well as in ways beyond that accounted for by traditional explanations of PRR party support. Importantly, the results also show that the impact of implicit attitudes on intended vote choice is greater for less extreme voters; in other words, those voters less likely to say they would vote for the PVV are more heavily influenced at an implicit level, beyond their awareness. This suggests that implicit attitudes of the PRR party may be quite useful for explaining support among voters who would not normally self‐report it.
Free Clinics as Safety Net Providers for Hispanic Immigrants
Authors: Ameringer Carl F. , Liebert Saltanat
Published: February 2017

Related Content: Mathews (PAR March/April 2017)

Related Content: Liebert and Ameringer (PAR November/December 2013)
Responsibility and Global Justice
Authors: Risse Mathias
Published: February 2017

The two traditional ways of thinking about justice at the global level either limit the applicability of justice to states—the only distributions that can be just or unjust, strictly speaking, are within the state—or else extend it to all human beings. The view I defend in On Global Justice (Risse ) rejects both of these approaches. Instead, my view, and thus my attempt at meeting the aforementioned challenge, acknowledges the existence of multiple grounds of justice. My purpose here is to explain what my view has to say about responsibility. First of all, I explain what my view implies about the responsibilities of the state for the realization of justice. Then I explain that in addition to obligations of justice, my view also gives rise to obligations of account‐giving. I end by sketching what all this implies for institutional reform at the global level.
Forever transnational: The ambivalence of return and cross‐border activities of the Shan across the Thailand‐Myanmar border
Authors: Jirattikorn Amporn
Published: February 2017

Over the past two decades, northern Thailand has experienced a massive influx of Shan ethnic nationals from Myanmar migrating to escape economic hardship and political conflicts at home. Myanmar's recent reforms raise the question of whether these migrants will return. The paper brings together the context of current changes in Myanmar with migrants' prospects of return and the impact of large‐scale migration on homeland politics. On the one hand, the paper explores the possibility that Shan migrants could remain forever transnational, for many of them will most likely never return. On the other hand, it considers the perspective of Shan elites in Myanmar on the fact a large portion of young Shan now spend their adult lives living and working in Thailand. While out‐migration of young Shan threatens the social fabric of Shan community in Myanmar, Shan ethnonationalists strive across the Myanmar border to regain loyalty among the Shan migrant population in Thailand. By examining the two aspects, this paper attempts to shed light on the impact of transnational migration on both migrants and their home country.
Identification of a novel HLA‐B*13 allele, HLA‐B*13:99, by sequence‐based typing in German bone marrow donor
Authors: Valatkaite‐Rakstiene B. , Cekauskiene R. , Griskevicius L. , Jakubauskas A.
Published: February 2017

Amino acid substitution Glu277Lys of the
HLA‐B*13:02:09 results in a novel allele,
HLA‐B*13:99.
Escherichia coli contamination of child complementary foods and association with domestic hygiene in rural Bangladesh
Authors: Parvez Sarker Masud , Kwong Laura , Rahman Musarrat Jabeen , Ercumen Ayse , Pickering Amy J. , Ghosh Probir K , Rahman Md. Zahidur , Das Kishor Kumar , Luby Stephen P. , Unicomb Leanne
Published: February 2017

Objective

To determine the frequency and concentration of Escherichia coli in child complementary food and its association with domestic hygiene practices in rural Bangladesh.

Method

A total of 608 households with children <2 years were enrolled. We collected stored complementary food samples, performed spot checks on domestic hygiene and measured ambient temperature in the food storage area. Food samples were analysed using the IDEXX most probable number (MPN) method with Colilert‐18 media to enumerate E. coli. We calculated adjusted prevalence ratios (APR) to assess the relationship between E. coli and domestic hygiene practices using modified Poisson regression, adjusting for clustering and confounders.

Result

Fifty‐eight percentage of stored complementary food was contaminated with E. coli, and high levels of contamination (≥100 MPN/dry g food) were found in 12% of samples. High levels of food contamination were more prevalent in compounds where the food was stored uncovered (APR: 2.0, 95% CI: 1.2–3.2), transferred from the storage pot to the serving dish using hands (APR: 2.0, 95% CI: 1.3–3.2) or stored for >4 h (APR: 2.5, 95% CI: 1.5, 4.2), in compounds where water was unavailable in the food preparation area (APR: 2.6, 95% CI: 1.6, 4.2), where ≥1 fly was captured in the food preparation area (APR: 1.6, 95% CI: 1.0, 2.6), or where the ambient temperature was high (>25–40 °C) in the food storage area (APR: 2.7, 95% CI: 1.5, 4.4).

Conclusion

Interventions to keep stored food covered and ensure water availability in the food preparation area would be expected to reduce faecal contamination of complementary foods.
Blood Group Antigen Matching Influence on Gestational Outcomes (AMIGO) study
Authors: Delaney Meghan , Wikman Agneta , van de Watering Leo , Schonewille Henk , Verdoes Jennie P. , Emery Stephen P. , Murphy Michael F. , Staves Julie , Flach Susanne , Arnold Donald M. , Kaufman Richard M. , Ziman Alyssa , Harm Sarah K. , Fung Mark , Eppes Catherine S. , Dunbar Nancy M. , Buser Andreas , Meyer Erin , Savoia Helen , Abeysinghe Padmakumari , Heddle Nancy , Tinmouth Alan , Traore Aicha N. , Yazer Mark H. ,   for the BEST Collaborative
Published: February 2017

BACKGROUND

Red blood cell (RBC) antigen matching policies to prevent alloimmunization in females of childbearing potential (FCP) vary between centers. To inform transfusion centers responsible for making decisions about matching policies for FCPs, the causal stimulus of the antibodies implicated in severe hemolytic disease of the fetus and newborn (HDFN) must be determined.

STUDY DESIGN AND METHODS

We conducted a multinational retrospective study of women with offspring affected by severe HDFN requiring neonatal exchange transfusion and/or intrauterine transfusion. Mothers treated at centers that provide extended antigen‐negative RBCs (MATCH, five centers) and those that do not (NoMATCH, nine centers) were compared.

RESULTS

A total of 293 mothers had at least one affected pregnancy: 179 at MATCH centers and 114 at NoMATCH centers. Most alloimmunization (83%) was attributed to previous pregnancy: 3% to transfusion (two cases at MATCH, six at NoMATCH centers) and 14% undetermined (both antecedent transfusion and pregnancy). Only 50 mothers had received transfusions; 13 had HDFN due to anti‐K at MATCH and four at NoMATCH centers. Most (12/13, 92%) of the anti‐K HDFN cases at MATCH centers had K+ paternal antigen status. Mothers at the MATCH centers do not appear to be protected from HDFN due to K, C, c, and E antibodies, although the low number of FCPs who received transfusions precluded drawing firm conclusions.

CONCLUSION

The causal stimulus of antibodies that cause HDFN is predominantly from previous pregnancy. Although extended RBC matching for FCPs may impart some protection from allosensitization, we were unable to show a positive effect, possibly because matching policies are not uniform and there was a small number of mothers who previously received transfusions.
Qualitative assessment of pica experienced by frequent blood donors
Authors: Chansky Melanie C. , King Melissa R. , Bialkowski Walter , Bryant Barbara J. , Kiss Joseph E. , D'Andrea Pam , Cable Ritchard G. , Spencer Bryan R. , Mast Alan E.
Published: February 2017

BACKGROUND

Pica, the compulsive consumption of ice or other nonnutritious substances, is associated with iron deficiency, a common negative consequence of frequent blood donation. Because of this, blood donors, such as those participating in the Strategies to Reduce Iron Deficiency (STRIDE) study, are an ideal population to explore pica and iron deficiency.

STUDY DESIGN AND METHODS

STRIDE was a 2‐year intervention trial to assess the effectiveness of iron supplementation for mitigating iron deficiency in frequent blood donors. Subjects completed baseline and follow‐up questionnaires that included questions about pica symptoms. In‐depth telephone interviews were conducted with 14 of these subjects reporting pica symptoms and eight presumed controls (casual ice chewers) to gain a deeper understanding of pica symptoms and their impact on daily life and to make a final determination on the presence of pica.

RESULTS

Pica was confirmed in five of the 14 subjects reporting symptoms and in two of eight controls. Outcome misclassification based on the questionnaire was attributed to inadequate assessment of several pica symptoms identified during the interview. Comparison of subjects' repeated quantitative iron measurements taken throughout STRIDE with subjects' final adjudicated pica status revealed a positive relationship between development of pica and worsening iron status; the opposite was found in those whose pica symptoms resolved.

CONCLUSION

Continued refinement of pica symptom questions will allow for rapid and accurate detection of pica in frequent blood donors and confirmation of successful treatment with iron supplements.