bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychometric evaluation of the Korean version of the Suicidal Ideation Scale in mentally ill patients living in the community
Authors: Han Jin Sil , Lee Eun‐Hyun , Suh Tongwoo , Hong Chang Hyung
Published: May 2016

Objective

The purpose of this study was to translate the Suicidal Ideation Scale (SIS) into Korean (SIS‐K) and then evaluate its psychometric properties in mentally ill Korean patients living in the community.

Methods

The SIS‐K was translated into Korean using a translation and back‐translation technique. A sample of 396 patients with mental disorders was recruited from regional mental health centres in Korea. Factorial‐construct validity was tested using both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The data were randomly split into two subsamples: one used for EFA to identify the underlying structure of the items, and the other used for CFA to test whether the underlying structure was supported by actual data. Convergent validity, known‐groups validity and internal‐consistency reliability were tested.

Results

Exploratory factor analysis extracted nine items clustered into two subscales that accounted for 68.59% of the variance. One item (‘I feel there is no solution to my problems other than taking my own life’) was deleted. The structure of the two subscales was supported by CFA. The SIS‐K score was moderately correlated with depression, and the scale demonstrated convergent validity. The SIS‐K scores were significantly higher in patients who had attempted suicide, implying the presence of satisfactory known‐groups validity. Cronbach's alpha of the total SIS‐K was 0.91.

Conclusions

The study has demonstrated the excellent psychometric properties of the SIS‐K. The SIS‐K is brief and easy to complete, and so it can be applied in both practice and research to patients with mental disorders. This cultural validation of the SIS‐K will promote both domestic and international studies of suicidal ideation.
American Identity, Congress, and the Puerto Rico Statehood Debate
Authors: Barreto Amílcar Antonio
Published: May 2016

Is the essence of American identity civic, ethnic, or a combination of the two? The 2010 debate in the U.S. House of Representatives on a bill to hold a referendum on the Puerto Rico status question provided a unique opportunity to shed light on these approaches. House Resolution 2499 would have asked the island's electorate whether they preferred remaining a Commonwealth, become an independent country, or the fifty‐first state. Despite three choices, House members overwhelming focused on one: statehood. Effectively this bill asked lawmakers, in keeping with the civic identity thesis, whether they were willing to accept a culturally and linguistically distinct territory as an equal partner in the federation. These deliberations divulge much about congressional views on the official, civic, American identity and its alternatives. At another level this debate questions the assumption that the stability and consolidation of national identities cannot proceed with clearly and consistently defined boundary markers. That clarity, some contend, is imperative on the part of government leaders. This article argues that significant differences in how the nation is objectified may be overlooked in the short run, but may incur significant long‐term instability.
Role of Temperament, Parenting Behaviors, and Stress on Turkish Preschoolers’ Internalizing Symptoms
Authors: Melis Yavuz H. , Selcuk Bilge , Corapci Feyza , Aksan Nazan
Published: May 2016

Child‐ and family‐related factors that predict internalizing symptoms are understudied in preschool years and have a negative influence on children's functioning. We examined observational assessments of preschoolers' temperamental fearfulness and exuberance, mother reports of negative control, warmth, and parenting stress in a sample of 109 Turkish preschoolers. High temperamental fearfulness and low joyful/exuberant positive affectivity in addition to low warmth and high parenting stress had significant effects on internalizing symptoms. Parenting stress had both direct and indirect relations to internalizing symptoms via lower maternal warmth. When comorbid elevations in externalizing symptoms were controlled, the results were consistent with the interpretation that poor parenting practices and stress associated with the parenting role predict maladaptation in general but that the specific form of maladaptation may be best predicted by individual differences in children's temperamental characteristics. This study contributes to our understanding of risk and protective factors that predict preschoolers' internalizing symptoms with a sample from a non‐Western population. These findings can guide early prevention and intervention programs to address internalizing problems in a culturally‐sensitive way.
Affective Social Competence in Adolescence: Current Findings and Future Directions
Authors: Booker Jordan A. , Dunsmore Julie C.
Published: May 2016

Affective Social Competence (ASC) is a conceptual framework describing complementary processes of sending, receiving, and experiencing emotions in dynamic interactions. This framework may be applied across the lifespan. To date, however, empirical studies addressing ASC have focused predominantly on childhood samples. In this review, we examine empirical evidence relevant to ASC in adolescence in comparison with childhood. We then discuss future directions that may promote understanding of Affective Social Competence among adolescent samples: the use of person‐oriented analyses to integrate all three components of ASC; consideration of understudied social contexts that may influence and be influenced by ASC; and use of microgenetic designs to examine growth across transitions during early, middle, and late adolescence.
HIV‐1 Nef: Taking Control of Protein Trafficking
Authors: Pereira Estela A. , daSilva Luis L. P.
Published: May 2016

The Nef protein of the human immunodeficiency virus is a crucial determinant of viral pathogenesis and disease progression. Nef is abundantly expressed early in infection and is thought to optimize the cellular environment for viral replication. Nef controls expression levels of various cell surface molecules that play important roles in immunity and virus life cycle, by directly interfering with the itinerary of these proteins within the endocytic and late secretory pathways. To exert these functions, Nef physically interacts with host proteins that regulate protein trafficking. In recent years, considerable progress was made in identifying host‐cell‐interacting partners for Nef, and the molecular machinery used by Nef to interfere with protein trafficking has started to be unraveled. Here, we briefly review the knowledge gained and discuss new findings regarding the mechanisms by which Nef modifies the intracellular trafficking pathways to prevent antigen presentation, facilitate viral particle release and enhance the infectivity of HIV‐1 virions.
Characterization of compressed earth blocks using low frequency guided acoustic waves
Authors: Ben Mansour Mohamed , Ogam Erick , Fellah Z. E. A. , Soukaina Cherif Amel , Jelidi Ahmed , Ben Jabrallah Sadok
Published: May 2016

The objective of this work was to analyze the influence of compaction pressure on the intrinsic acoustic parameters (porosity, tortuosity, air-flow resistivity, viscous, and thermal characteristic lengths) of compressed earth blocks through their identification by solving an inverse acoustic wave transmission problem. A low frequency acoustic pipe (60–6000 Hz of length 22 m, internal diameter 3.4 cm) was used for the experimental characterization of the samples. The parameters were identified by the minimization of the difference between the transmissions coefficients data obtained in the pipe with that from an analytical interaction model in which the compressed earth blocks were considered as having rigid frames. The viscous and thermal effects in the pores were accounted for by employing the Johnson-Champoux-Allard-Lafarge model. The results obtained by inversion for high-density compressed earth blocks showed some discordance between the model and experiment especially for the high frequency limit of the acoustic characteristics studied. This was as a consequence of applying high compaction pressure rendering them very highly resistive therefore degrading the signal-to-noise ratios of the transmitted waves. The results showed that the airflow resistivity was very sensitive to the degree of the applied compaction pressure used to form the blocks.
The Numbers Will Love You Back in Return—I Promise
Authors: Buchheit Martin
Published: May 2016

The first sport-science-oriented and comprehensive paper on magnitude-based inferences (MBI) was published 10 y ago in the first issue of this journal. While debate continues, MBI is today well established in sport science and in other fields, particularly clinical medicine, where practical/clinical significance often takes priority over statistical significance. In this commentary, some reasons why both academics and sport scientists should abandon null-hypothesis significance testing and embrace MBI are reviewed. Apparent limitations and future areas of research are also discussed. The following arguments are presented: P values and, in turn, study conclusions are sample-size dependent, irrespective of the size of the effect; significance does not inform on magnitude of effects, yet magnitude is what matters the most; MBI allows authors to be honest with their sample size and better acknowledge trivial effects; the examination of magnitudes per se helps provide better research questions; MBI can be applied to assess changes in individuals; MBI improves data visualization; and MBI is supported by spreadsheets freely available on the Internet. Finally, recommendations to define the smallest important effect and improve the presentation of standardized effects are presented.
How much of the human protein interactome remains to be mapped?
Authors: Vidal Marc
Published: May 2016

A high-quality reference map of the human protein-protein interactome is within reach.
Preventing infant blindness
Authors: Gough Nancy R.
Published: May 2016

Two HIF-1α–stabilizing drugs protect against retinopathy of prematurity by exerting tissue-specific effects.
The Disulfide Bond of the Peptide Thanatin Is Dispensible for Its Antimicrobial Activity
In Vivo
and
In Vitro
Authors: Ma Bo , Niu Chao , Zhou Ying , Xue Xiaoyan , Meng Jingru , Luo Xiaoxing , Hou Zheng
Published: May 2016

Thanatin (THA) displays potent antibiotic activity, especially against extended-spectrum-β-lactamase (ESBL)-producing
Escherichia coli
both
in vitro
and
in vivo
, with minimal hemolytic toxicity and satisfactory stability in plasma. However, the high cost of thanatin significantly limits its development and clinical application. To reduce the cost of peptide synthesis, a formulation of cyclic thanatin (C-thanatin) called linear thanatin (L-thanatin) was synthesized and its activity was evaluated
in vivo
and
in vitro
. Results showed that C-thanatin and L-thanatin MICs did not differ against eight Gram-negative and two Gram-positive bacterial strains. Furthermore, the survival rates of ESBL-producing-
E. coli
-infected mice were consistent after C-thanatin or L-thanatin treatment at 5 or 10 mg/kg of body weight. Neither C-thanatin nor L-thanatin showed toxicity for human red blood cells (hRBCs) and human umbilical vein endothelial cells (HUVECs) at a concentration as high as 256 μg/ml. Results of circular dichroism spectroscopy indicated that the secondary structure of L-thanatin is extremely similar to that of C-thanatin. Membrane permeabilization and depolarization assays showed that C-thanatin and L-thanatin have similar abilities to permeabilize the outer and inner membranes and to induce membrane depolarization in ESBL-producing
E. coli
. However, neither of them caused significant HUVEC membrane permeability. These findings indicate that the two peptides have similar effects on bacterial cell membranes and that the disulfide bond in thanatin is not essential for its antimicrobial activities
in vivo
and
in vitro
. L-thanatin is thus a promising low-cost peptide candidate for treating ESBL-producing
E. coli
infections.
Global Dissemination of
bla
KPC
into Bacterial Species beyond Klebsiella pneumoniae and
In Vitro
Susceptibility to Ceftazidime-Avibactam and Aztreonam-Avibactam
Authors: Kazmierczak Krystyna M. , Biedenbach Douglas J. , Hackel Meredith , Rabine Sharon , de Jonge Boudewijn L. M. , Bouchillon Samuel K. , Sahm Daniel F. , Bradford Patricia A.
Published: May 2016

The
Klebsiella pneumoniae
carbapenemase (KPC), first described in the United States in 1996, is now a widespread global problem in several Gram-negative species. A worldwide surveillance study collected Gram-negative pathogens from 202 global sites in 40 countries during 2012 to 2014 and determined susceptibility to β-lactams and other class agents by broth microdilution testing. Molecular mechanisms of β-lactam resistance among carbapenem-nonsusceptible
Enterobacteriaceae
and
Pseudomonas aeruginosa
were determined using PCR and sequencing. Genes encoding KPC enzymes were found in 586 isolates from 22 countries (76 medical centers), including countries in the Asia-Pacific region (32 isolates), Europe (264 isolates), Latin America (210 isolates), and the Middle East (19 isolates, Israel only) and the United States (61 isolates). The majority of isolates were
K. pneumoniae
(83.4%); however, KPC was detected in 13 additional species. KPC-2 (69.6%) was more common than KPC-3 (29.5%), with regional variation observed. A novel KPC variant, KPC-18 (KPC-3[V8I]), was identified during the study. Few antimicrobial agents tested remained effective
in vitro
against KPC-producing isolates, with ceftazidime-avibactam (MIC
90
, 4 μg/ml), aztreonam-avibactam (MIC
90
, 0.5 μg/ml), and tigecycline (MIC
90
, 2 μg/ml) retaining the greatest activity against
Enterobacteriaceae
cocarrying KPC and other β-lactamases, whereas colistin (MIC
90
, 2 μg/ml) demonstrated the greatest
in vitro
activity against KPC-positive
P. aeruginosa
. This analysis of surveillance data demonstrated that KPC is widely disseminated. KPC was found in multiple species of
Enterobacteriaceae
and
P. aeruginosa
and has now become a global problem.
Combining the FtsZ-Targeting Prodrug TXA709 and the Cephalosporin Cefdinir Confers Synergy and Reduces the Frequency of Resistance in Methicillin-Resistant Staphylococcus aureus
Authors: Kaul Malvika , Mark Lilly , Parhi Ajit K. , LaVoie Edmond J. , Pilch Daniel S.
Published: May 2016

Combination therapy of bacterial infections with synergistic drug partners offers distinct advantages over monotherapy. Among these advantages are (i) a reduction of the drug dose required for efficacy, (ii) a reduced potential for drug-induced toxicity, and (iii) a reduced potential for the emergence of resistance. Here, we describe the synergistic actions of the third-generation oral cephalosporin cefdinir and TXA709, a new, FtsZ-targeting prodrug that we have developed with improved pharmacokinetics and enhanced
in vivo
efficacy against methicillin-resistant
Staphylococcus aureus
(MRSA) relative to earlier agents. We show that the active product of TXA709 (TXA707) acts synergistically with cefdinir
in vitro
against clinical isolates of MRSA, vancomycin-intermediate
S. aureus
(VISA), vancomycin-resistant
S. aureus
(VRSA), and linezolid-resistant
S. aureus
(LRSA). In addition, relative to TXA707 alone, the combination of TXA707 and cefdinir significantly reduces or eliminates the detectable emergence of resistance. We also demonstrate synergy
in vivo
with oral administration of the prodrug TXA709 and cefdinir in mouse models of both systemic and tissue (thigh) infections with MRSA. This synergy reduces the dose of TXA709 required for efficacy 3-fold. Viewed as a whole, our results highlight the potential of TXA709 and cefdinir as a promising combination for the treatment of drug-resistant staphylococcal infections.
In Vitro
Activity of Lefamulin Tested against Streptococcus pneumoniae with Defined Serotypes, Including Multidrug-Resistant Isolates Causing Lower Respiratory Tract Infections in the United States
Authors: Mendes Rodrigo E. , Farrell David J. , Flamm Robert K. , Talbot George H. , Ivezic-Schoenfeld Zrinka , Paukner Susanne , Sader Helio S.
Published: May 2016

Lefamulin was evaluated against various
Streptococcus pneumoniae
serotypes that were collected from adults with lower respiratory tract infections. Lefamulin exhibited MIC
50
and MIC
90
values of 0.12 and 0.25 μg/ml, respectively, against the entire collection (
n
= 822). Similar results were obtained for lefamulin against each of the most common serotypes as well as against multidrug-resistant isolates and strains that are nonsusceptible to ceftriaxone or erythromycin. These data support the clinical development of lefamulin for the treatment of community-acquired respiratory tract infections.
Efficacy of Lysophosphatidylcholine in Combination with Antimicrobial Agents against Acinetobacter baumannii in Experimental Murine Peritoneal Sepsis and Pneumonia Models
Authors: Parra Millán R. , Jiménez Mejías M. E. , Sánchez Encinales V. , Ayerbe Algaba R. , Gutiérrez Valencia A. , Pachón Ibáñez M. E. , Díaz C. , Pérez del Palacio J. , López Cortés L. F. , Pachón J. , Smani Y.
Published: May 2016

Immune response stimulation to prevent infection progression may be an adjuvant to antimicrobial treatment. Lysophosphatidylcholine (LPC) is an immunomodulator involved in immune cell recruitment and activation. In this study, we aimed to evaluate the efficacy of LPC in combination with colistin, tigecycline, or imipenem in experimental murine models of peritoneal sepsis and pneumonia. We used
Acinetobacter baumannii
strain Ab9, which is susceptible to colistin, tigecycline, and imipenem, and multidrug-resistant strain Ab186, which is susceptible to colistin and resistant to tigecycline and imipenem. Pharmacokinetic and pharmacodynamic parameters for colistin, tigecycline, and imipenem and the 100% minimal lethal dose (MLD
100
) were determined for both strains. The therapeutic efficacies of LPC, colistin (60 mg/kg of body weight/day), tigecycline (10 mg/kg/day), and imipenem (180 mg/kg/day), alone or in combination, were assessed against Ab9 and Ab186 at the MLD
100
in murine peritoneal sepsis and pneumonia models. The levels of pro- and anti-inflammatory cytokines, i.e., tumor necrosis factor alpha (TNF-α) and interleukin-10 (IL-10), were determined by enzyme-linked immunosorbent assay (ELISA) for the same experimental models after inoculating mice with the MLD of both strains. LPC in combination with colistin, tigecycline, or imipenem markedly enhanced the bacterial clearance of Ab9 and Ab186 from the spleen and lungs and reduced bacteremia and mouse mortality rates (
P
< 0.05) compared with those for colistin, tigecycline, and imipenem monotherapies. Moreover, at 4 h post-bacterial infection, Ab9 induced higher TNF-α and lower IL-10 levels than those with Ab186 (4 μg/ml versus 3 μg/ml [
P
< 0.05] and 2 μg/ml versus 3.4 μg/ml [
P
< 0.05], respectively). LPC treatment combined with colistin, tigecycline, or imipenem modestly reduced the severity of infection by
A. baumannii
strains with different resistance phenotypes compared to LPC monotherapy in both experimental models.
Mouse Model of Coxiella burnetii Aerosolization
Authors: Melenotte Cléa , Lepidi Hubert , Nappez Claude , Bechah Yassina , Audoly Gilles , Terras Jérôme , Raoult Didier , Brégeon Fabienne
Published: May 2016

Coxiella burnetiiis mainly transmitted by aerosols and is responsible for multiple-organ lesions. Animal models have shownC. burnetiipathogenicity, but long-term outcomes still need to be clarified. We used a whole-body aerosol inhalation exposure system to mimic the natural route of infection in immunocompetent (BALB/c) and severe combined immunodeficient (SCID) mice. After an initial lung inoculum of 104C. burnetiicells/lung, the outcome, serological response, hematological disorders, and deep organ lesions were described up to 3 months postinfection.C. burnetii-specific PCR, anti-C. burnetiiimmunohistochemistry, and fluorescentin situhybridization (FISH) targetingC. burnetii-specific 16S rRNA completed the detection of the bacterium in the tissues. In BALB/c mice, a thrombocytopenia and lymphopenia were first observed, prior to evidence ofC. burnetiireplication. In all SCID mouse organs, DNA copies increased to higher levels over time than in BALB/c ones. Clinical signs of discomfort appeared in SCID mice, so follow-up had to be shortened to 2 months in this group. At this stage, all animals presented bone, cervical, and heart lesions. The presence ofC. burnetiicould be attestedin situfor all organs sampled using immunohistochemistry and FISH. This mouse model describedC. burnetiiNine Mile strain spread using aerosolization in a way that corroborates the pathogenicity of Q fever described in humans and completes previously published data in mouse models.C. burnetiiinfection occurring after aerosolization in mice thus seems to be a useful tool to compare the pathogenicity of different strains ofC. burnetii.
Ecological Opportunity, Evolution, and the Emergence of Flea-Borne Plague
Authors: Hinnebusch B. Joseph , Chouikha Iman , Sun Yi-Cheng
Published: May 2016

The plague bacillusYersinia pestisis unique among the pathogenicEnterobacteriaceaein utilizing an arthropod-borne transmission route. Transmission by fleabite is a recent evolutionary adaptation that followed the divergence ofY. pestisfrom the closely related food- and waterborne enteric pathogenYersinia pseudotuberculosis. A combination of population genetics, comparative genomics, and investigations ofYersinia-flea interactions have disclosed the important steps in the evolution and emergence ofY. pestisas a flea-borne pathogen. Only a few genetic changes, representing both gene gain by lateral transfer and gene loss by loss-of-function mutation (pseudogenization), were fundamental to this process. The emergence ofY. pestisfits evolutionary theories that emphasize ecological opportunity in adaptive diversification and rapid emergence of new species.
Cytomegalovirus colitis mimicking rectal carcinoma in an immunocompetent elderly woman
Authors: Chidlovskii Elena , Deroux Alban , Bernard Sylvain , Couturier Pascal
Published: May 2016

Cytomegalovirus (CMV) colitis is uncommon in immunocompetent patients, despite a high seroprevalence rate of CMV in the general population. CMV infection has been described in individuals with compromised immune systems: in AIDS, under corticosteroid and immune modulating treatment, with cancer or haematological malignancies. Its most frequent clinical presentation is a necrotising ulcerative form; pseudotumoural CMV colitis has been described as highly exceptional. We report a case of CMV colitis mimicking rectal carcinoma in an immunocompetent elderly woman. The immunosenescence and protein-energy malnutrition increase incidence and severity of infectious diseases in elderly individuals. Immunosenescence may affect all aspects of immunity; severe protein malnutrition modifies mostly cellular immunity, growing susceptibility to infections.
Unusual presentation of phaeochromocytoma
Authors: Hope D C D , Palan J M
Published: May 2016

A 44-year-old woman, with a background of heart, lung and renal transplantation secondary to cystic fibrosis and type 1 diabetes, presented with tachycardia, hyperglycaemia, nausea and vomiting. She was initially managed for diabetic ketoacidosis with severe dehydration. However, persistent episodic hypertension and tachycardia led the investigating team to identify significantly raised urinary metanephrines and a left-sided adrenal mass; Iodine-123-meta-iodobenzylguanidine single photon emission computer tomography scan (MIBG SPECT/CT) showed avid uptake of tracer, confirming a left-sided phaeochromocytoma. She was started on medical management and is awaiting an elective laparoscopic procedure. This case describes the presentation of a unilateral phaeochromocytoma as ketoacidosis in a patient with type 1 diabetes with no other apparent precipitant. This highlights the metabolic counter-regulatory effect of excess catecholamines in addition to the inotropic/chronotropic effects that are associated with this adrenal tumour. Recognition of atypical signs and symptoms may point towards an atypical precipitant of diabetic ketoacidosis—a medical emergency presenting to front-line clinicians.
Xeroderma pigmentosum with bilateral ocular surface squamous neoplasia and review of the literature
Authors: Kalamkar Charudutt , Radke Nishant , Mukherjee Amrita , Radke Snehal
Published: May 2016

Xeroderma pigmentosum is a rare genetic disorder associated with various ocular malignancies. Here we report a single paediatric case of xeroderma pigmentosum with bilateral ocular surface squamous neoplasia (OSSN) presenting with diffuse lesion in one eye and a large mass in the other eye. Diffuse OSSN in one eye was treated with topical chemotherapy using mitomycin-C (0.04%) and the large OSSN in the other eye was treated with a combination of surgery and topical chemotherapy. Long-term follow-up and a multimodality treatment approach are necessary to identify and manage recurrences of OSSN in XP.
Spontaneous idiopathic bilateral adrenal haemorrhage: a rare cause of abdominal pain
Authors: Nazir Salik , Sivarajah Surendra , Fiscus Valena , York Eugene
Published: May 2016

We describe a case of a 62-year-old woman with a history of chronic obstructive pulmonary disease and gastro-oesophageal reflux disease who presented to the emergency department with left lower quadrant abdominal pain, flank pain with nausea and no history of preceding trauma. The patient had finished a course of azithromycin and oral methylprednisolone 1 day prior to presentation. Abdominal and pelvic CT scan identified changes suggestive of bilateral adrenal haemorrhage. The patient did not show signs of acute adrenal insufficiency but was started on steroid replacement therapy because of concerns about possible disease progression. All recognised causes of adrenal haemorrhage were excluded suggesting this was a case of spontaneous idiopathic bilateral adrenal haemorrhage, a rarely reported phenomenon in the literature. The patient was discharged after clinical improvement following 6 days in hospital, taking oral steroid replacement.
Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction: the Delaware-Oslo ACL cohort study
Authors: Grindem Hege , Snyder-Mackler Lynn , Moksnes Håvard , Engebretsen Lars , Risberg May Arna
Published: May 2016

Background

Knee reinjury after ACL reconstruction is common and increases the risk of osteoarthritis. There is sparse evidence to guide return to sport (RTS) decisions in this population.

Objectives

To assess the relationship between knee reinjury after ACL reconstruction and (1) return to level I sports, (2) timing of RTS and (3) knee function prior to return.

Methods

106 patients who participated in pivoting sports participated in this prospective 2-year cohort study. Sports participation and knee reinjury were recorded monthly. Knee function was assessed with the Knee Outcome Survey—Activities of Daily Living Scale, global rating scale of function, and quadriceps strength and hop test symmetry. Pass RTS criteria were defined as scores >90 on all tests, failure as failing any.

Results

Patients who returned to level I sports had a 4.32 (p=0.048) times higher reinjury rate than those who did not. The reinjury rate was significantly reduced by 51% for each month RTS was delayed until 9 months after surgery, after which no further risk reduction was observed. 38.2% of those who failed RTS criteria suffered reinjuries versus 5.6% of those who passed (HR 0.16, p=0.075). More symmetrical quadriceps strength prior to return significantly reduced the knee reinjury rate.

Conclusions

Returning to level I sports after ACL reconstruction leads to a more than 4-fold increase in reinjury rates over 2 years. RTS 9 months or later after surgery and more symmetrical quadriceps strength prior to return substantially reduce the reinjury rate.
The incidence and patterns of illness at the Sochi 2014 Winter Paralympic Games: a prospective cohort study of 6564 athlete days
Authors: Derman W , Schwellnus M P , Jordaan E , Runciman P , Van de Vliet P , Blauwet C , Webborn N , Willick S , Stomphorst J
Published: May 2016

Objective

To describe the epidemiology of illness at the Sochi 2014 Winter Paralympic Games.

Methods

A total of 547 athletes from 45 countries were monitored daily for 12 days over the Sochi 2014 Winter Paralympic Games (6564 athlete days). Illness data were obtained daily from teams without their own medical support (13 teams, 37 athletes) and teams with their own medical support (32 teams, 510 athletes) through electronic data capturing systems.

Results

The total number of illnesses reported was 123, with an illness incidence rate (IR) of 18.7 per 1000 athlete days (95% CI 15.1% to 23.2%). The highest IR was reported for wheelchair curling (IR of 20.0 (95% CI 10.1% to 39.6%)). Illnesses in the respiratory system (IR of 5.6 (95% CI 3.8% to 8.0%)), eye and adnexa (IR of 2.7 (95% CI 1.7% to 4.4%)) and digestive system (IR of 2.4 (95% CI 1.4% to 4.2%)) were the most common. Older athletes (35–63 years) had a significantly higher IR than younger athletes (14–25 years, p=0.049).

Conclusions

The results of this study indicate that Paralympic athletes report higher illness incidence rates compared to Olympic athletes at similar competitions. The highest rates of illness were reported for the respiratory and digestive systems, eye and adnexa, respectively. Thus, the results of this study form a basis for the identification of physiological systems at higher risk of illness, which can in turn inform illness prevention and management programmes with eventual policy change to promote athlete safety in future editions of the Winter Paralympic Games.
Integrative health coaching: a behavior skills approach that improves HbA1c and pharmacy claims-derived medication adherence
Authors: Wolever Ruth Q , Dreusicke Mark H
Published: May 2016

Objective

Medication adherence requires underlying behavior skills and a supporting mindset that may not be addressed with education or reminders. Founded in the study of internal motivation and health psychology, integrative health coaching (IHC) helps patients gain insight into their behaviors and make long-term, sustainable lifestyle changes. The purpose of the study is to determine whether IHC improves oral medication adherence, glycated hemoglobin (HbA1c), and psychosocial measures, and to assess whether adherence changes are sustained after the intervention.

Methods

Using a prospective observational design, participants (n=56) received 14 coaching calls by telephone over 6 months. Medication possession ratio (MPR) was calculated for time intervals before, during, and after the intervention. HbA1c and patient-reported psychosocial outcomes were obtained to test interactions with MPR.

Results

Medication adherence (MPR) increased from 0.74±0.197 to 0.85±0.155 during coaching, and was sustained at 0.82±0.175 during a 6-month period after the study. Better adherence correlated with a greater decrease in HbA1c. HbA1c decreased from 8.0±1.92% to 7.7±1.70% over the 6-month intervention. All psychosocial measures showed significant improvement. In addition to discussing medication adherence strategies with their coach, patients discussed nutrition and exercise (86.9% of calls), stress management (39.8%), and social support and relationships (15.4%).

Conclusions

IHC targets internal motivation and supports behavior change by facilitating patients’ insight into their own behaviors, and it uses this insight to foster self-efficacy. This approach may yield sustainable results for medication adherence and warrants further exploration for health-related behavior change.
Protocol for a population-based molecular epidemiology study of tuberculosis transmission in a high HIV-burden setting: the Botswana Kopanyo study
Authors: Zetola N M , Modongo C , Moonan P K , Click E , Oeltmann J E , Shepherd J , Finlay A
Published: May 2016

Introduction

Mycobacterium tuberculosis(Mtb) is transmitted from person to person via airborne droplet nuclei. At the community level, Mtb transmission depends on the exposure venue, infectiousness of the tuberculosis (TB) index case and the susceptibility of the index case's social network. People living with HIV infection are at high risk of TB, yet the factors associated with TB transmission within communities with high rates of TB and HIV are largely undocumented. The primary aim of the Kopanyo study is to better understand the demographic, clinical, social and geospatial factors associated with TB and multidrug-resistant TB transmission in 2 communities in Botswana, a country where 60% of all patients with TB are also infected with HIV. This manuscript describes the methods used in the Kopanyo study.

Methods and analysis

The study will be conducted in greater Gaborone, which has high rates of HIV and a mobile population; and in Ghanzi, a rural community with lower prevalence of HIV infection and home to the native San population. Kopanyo aims to enrol all persons diagnosed with TB during a 4-year study period. From each participant, sputum will be cultured, and for all Mtb isolates, molecular genotyping (24-locus mycobacterial interspersed repetitive units-variable number of tandem repeats) will be performed. Patients with matching genotype results will be considered members of a genotype cluster, a proxy for recent transmission. Demographic, behavioural, clinical and social information will be collected by interview. Participant residence, work place, healthcare facilities visited and social gathering venues will be geocoded. We will assess relationships between these factors and cluster involvement to better plan interventions for reducing TB transmission.

Ethics

Ethical approval from the Independent Review Boards at the University of Pennsylvania, US Centers for Disease Control and Prevention, Botswana Ministry of Health and University of Botswana has been obtained.
Use of the ICU Nurse–Physician Questionnaire (ICU N-P-Q): testing reliability and validity in neonatal intensive care units in Japan
Authors: Sasaki Hatoko , Yonemoto Naohiro , Mori Rintaro , Nishida Toshihiko , Kusuda Satoshi , Nakayama Takeo
Published: May 2016

Objective

Although communication among health providers has become a critical part of improving quality of care, few studies on this topic have been conducted in Japan. This study aimed to examine the reliability and validity of the Intensive Care Unit Nurse–Physician Questionnaire (ICU N-P-Q) for use among nurses and physicians in neonatal ICUs (NICUs) in Japan.

Methods

A Japanese translation of the ICU N-P-Q was administered to physicians and nurses working at 40 NICUs across Japan, which were participating in the Improvement of NICU Practice and Team Approach Cluster randomized controlled trial (INTACT). We used the principal components analysis to evaluate the factor structure of the instruments. Convergent validity was assessed by examining correlations between the subscales of Communication and Conflict Management of the ICU N-P-Q and the subscales and total score of the Nurse–Physician Collaboration Scale (NPCS). Correlations between the subscales of Communication and Conflict Management by correlation with scales that refer to performance, including Job Satisfaction and Unit Effectiveness, were calculated to test the criterion validity.

Results

In total, 2006 questionnaires were completed by 316 physicians and 1690 nurses. The exploratory factor analysis revealed 15 factors in the physicians' questionnaire and 12 in the nurses' questionnaire. Convergent validity was confirmed, except for ‘Between-group Accuracy’ and ‘Cooperativeness’ in the physicians' scale, and for ‘Between-group Accuracy’ and ‘Sharing of Patient Information’ in the nurses' scale. Correlations between the subscales of communication and outcomes were confirmed in the nurses' questionnaire but were not fully supported in the physicians' questionnaire.

Conclusions

Although the psychometric property behaved somewhat differently by occupation, the present findings provide preliminary support for the utility of the common item structure with the original scale, to measure the degree and quality of communication and collaboration among staff at NICUs and similar healthcare settings in Japan.

Trial registration number

UMIN000007064; Pre-results.
Protocol of a cluster randomised stepped-wedge trial of behavioural interventions targeting amphetamine-type stimulant use and sexual risk among female entertainment and sex workers in Cambodia
Authors: Page Kimberly , Stein Ellen S , Carrico Adam W , Evans Jennifer L , Sokunny Muth , Nil Ean , Ngak Song , Sophal Chhit , McCulloch Charles , Maher Lisa
Published: May 2016

Introduction

HIV risk among female entertainment and sex workers (FESW) remains high and use of amphetamine-type stimulants (ATS) significantly increases this risk. We designed a cluster randomised stepped wedge trial (TheCambodiaIntegrated HIV and DrugPreventionImplementation (CIPI) study) to test sequentially delivered behavioural interventions targeting ATS use.

Methods and analysis

The trial combines a 12-week Conditional Cash Transfer (CCT) intervention with 4 weeks of cognitive-behavioural group aftercare (AC) among FESW who use ATS. The primary goal is to reduce ATS use and unprotected sex among FESW. The CCT+AC intervention is being implemented in 10 provinces where order of delivery was randomised. Outcome assessments (OEs) including biomarkers and self-reported measures of recent sexual and drug use behaviours are conducted prior to implementation, and at three 6-month intervals after completion. Consultation with multiple groups and stakeholders on implementation factors facilitated acceptance and operationalisation of the trial. Statistical power and sample size calculations were based on expected changes in ATS use and unprotected sex at the population level as well as within subjects.

Ethics and dissemination

Ethical approvals were granted by the Cambodia National Ethics Committee; University of New Mexico; University of California, San Francisco; and FHI360. The trial is registered with ClinicalTrials.gov. Dissemination of process indicators during the multiyear trial is carried out through annual in-country Stakeholder Meetings. Provincial ‘Close-Out’ forums are held at the conclusion of data collection in each province. When analysis is completed, dissemination meetings will be held in Cambodia with stakeholders, including community-based discussion sessions, policy briefs and results published and presented in the HIV prevention scientific journals and conferences.

Conclusions

CIPI is the first trial of an intervention to reduce ATS use and HIV risk among FESW in Cambodia.

Results

Will inform both CCT+AC implementation in low and middle-income countries and programmes designed to reach FESW.

Trial registration number

NCT01835574; Pre-results.
High-intensity interval training to improve fitness in children with cerebral palsy
Authors: Lauglo Reidun , Vik Torstein , Lamvik Torarin , Stensvold Dorthe , Finbråten Ane-Kristine , Moholdt Trine
Published: May 2016

Aim

To evaluate effects of high-intensity interval training (HIT) on aerobic exercise capacity, quality of life, and body composition in children with cerebral palsy (CP).

Methods

This was a baseline control trial. Children with CP, Gross Motor Function Classification System (GMFCS) levels I–IV, and age 10–17 years were included. The primary outcome, peak, and submaximum oxygen uptake (VO2peak, VO2submax) were measured at enrolment to the study (T0), after a pretraining period (T1), and after HIT (T2). Secondary outcomes were quality of life assessed with the KINDL questionnaire, and body composition measured using whole body dual-energy X-ray absorptiometry scanning. The exercise was performed on treadmills and consisted of 24 sessions, each with a total of 16 min of exercise at >85% of maximal heart rate.

Results

20 children were included and 6 children dropped out. VO2peakincreased by 10%, from a median of 37.3 (31.0–40.1) to 41.0 (36.6–48.5) mL/kg/min from T1 to T2 (p<0.01). VO2submaxdid not change; thereby, the percentage oxygen utilisation was reduced. Body composition was unchanged. Parent-reported quality of life improved, whereas quality of life reported by the children did not improve.

Conclusions

Aerobic exercise capacity improved and per cent utilisation of VO2maxdeclined after HIT in children with CP. Therefore, HIT can be a time efficient way to improve maximal capacity, and increase energy reserve in this patient group.

Trial registration number

NCT00965133.
Good Diagnostic Accuracy of a Chemiluminescent Immunoassay in Stool Samples for Diagnosis of Helicobacter Pylori Infection in Patients with Dyspepsia
Authors: Ramírez-Lázaro María José , Lite Josep , Lario Sergio , Pérez-Jové Pepa , Montserrat Antònia , Quílez María Elisa , Martínez-Bauer Eva , Calvet Xavier
Published: May 2016

Laboratory-based chemiluminescence immunoassays (CLIA) are widely used in clinical laboratories. Some years ago, a CLIA test was developed for the detection of Helicobacter pylori in stool samples, known as LIAISON H. pylori SA, but little information on its use has been reported. To evaluate the accuracy of the LIAISON H. pylori SA assay for diagnosing H. pylori infection prior to eradication treatment. Diagnostic reliability was evaluated in 252 untreated consecutive patients with dyspepsia. The gold standard for diagnosing H. pylori infection was defined as the concordance of the rapid urease test (RUT), histopathology and urea breath test (UBT). The CLIA assay was performed according to the manufacturer's instructions. Sensitivity, specificity, positive and negative predictive values, and 95% CIs were calculated. According to the gold standard selected, 121 patients were positive for H. pylori infection and 131 negative. LIAISON H. pylori SA had a sensitivity of 90.1% and a specificity of 92.4%, with positive and negative predictive values of 91.6% and 90.1%, respectively. The accuracy of the LIAISON H. pylori SA chemiluminescent diagnostic assay seems comparable to that of ELISA or the best-performing LFIAs. Its sensitivity and specificity, however, seem slightly lower than those of histology, RUT or UBT. The advantages of the assay are that it is cheap, automated, and minimally labor-intensive.
Velocity and Doubling Time of Prostate-Specific Antigen: Mathematics Can Matter
Authors: Uchio Edward , Aslan Mihaela , Ko John , Wells Carolyn K , Radhakrishnan Krishnan , Concato John
Published: May 2016

Changes in prostate-specific antigen (PSA) values are often reported as velocity or doubling time. We compared the association of these two calculations—at the time of PSA failure after primary treatment for prostate cancer—with prostate cancer mortality. From a source population of 1313 US Veterans with prostate cancer, including 623 treated with curative intent, the study population included 242 men experiencing biochemical failure, 81 after surgery and 161 after radiation therapy. Clinically relevant calculations of PSA velocity (linear slope) and PSA doubling time (logarithmic slope) were assessed for their association with 11–16 years of mortality from prostate cancer. Death due to prostate cancer occurred in 52/242 (21.5%) men. Among men receiving surgery, PSA velocity ≥1.0 ng/mL/year was associated with increased prostate cancer mortality (HR=4.2, p value=0.037), whereas doubling time ≤12 months did not confer risk (HR=1.0, p value=0.95). Conversely, among patients receiving radiation therapy, doubling time ≤12 months was associated with increased prostate cancer mortality (HR=2.4, p value=0.049), but velocity did not confer a statistically significant risk (HR=3.8, p value=0.19). When assessing risk of prostate cancer mortality, PSA velocity can be more predictive after surgery and PSA doubling time can be more predictive after radiation therapy.
Plasma Thyroid Hormone Concentration is Associated with Hepatic Triglyceride Content in Patients with Type 2 Diabetes
Authors: Bril Fernando , Kadiyala Sushma , Portillo Sanchez Paola , Sunny Nishanth E , Biernacki Diane , Maximos Maryann , Kalavalapalli Srilaxmi , Lomonaco Romina , Suman Amitabh , Cusi Kenneth
Published: May 2016

The underlying mechanisms responsible for the development and progression of non-alcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes mellitus (T2DM) are unclear. Since the thyroid hormone regulates mitochondrial function in the liver, we designed this study in order to establish the association between plasma free T4 levels and hepatic triglyceride accumulation and histological severity of liver disease in patients with T2DM and NAFLD. This is a cross-sectional study including a total of 232 patients with T2DM. All patients underwent a liver MR spectroscopy (1H-MRS) to quantify hepatic triglyceride content, and an oral glucose tolerance test to estimate insulin resistance. A liver biopsy was performed in patients with a diagnosis of NAFLD. Patients were divided into 5 groups according to plasma free T4 quintiles. We observed that decreasing free T4 levels were associated with an increasing prevalence of NAFLD (from 55% if free T4≥1.18 ng/dL to 80% if free T4<0.80 ng/dL, p=0.016), and higher hepatic triglyceride accumulation by 1H-MRS (p<0.001). However, lower plasma free T4 levels were not significantly associated with more insulin resistance or more severe liver histology (ie, inflammation, ballooning, or fibrosis). Decreasing levels of plasma free T4 are associated with a higher prevalence of NAFLD and increasing levels of hepatic triglyceride content in patients with T2DM. These results suggest that thyroid hormone may play a role in the regulation of hepatic steatosis and support the notion that hypothyroidism may be associated with NAFLD. No NCT number required.
Studysearch: A Web-Based Application for Posting and Searching Clinical Research Studies
Authors: Gonsenhauser Blair , Hallarn Rose , Carpenter Daniel , Para Michael F , Reider Carson R
Published: May 2016

Participant accrual into research studies is critical to advancing clinical and translational research to clinical care. Without sufficient recruitment, the purpose of any research study cannot be realized; yet, low recruitment and enrollment of participants persist. StudySearch is a web-based application designed to provide an easily readable, publicly accessible, and searchable listing of IRB-approved protocols that are accruing study participants. The Regulatory, Recruitment and Biomedical Informatics Cores of the Center for Clinical and Translational Science (CCTS) at The Ohio State University developed this research study posting platform. Postings include basic descriptive information: study title, purpose of the study, eligibility criteria and study personnel contact information. Language concerning benefits and/or inducements is not included; therefore, while IRB approval for a study to be listed on StudySearch is required, IRB approval of the posted language is not. Studies are listed by one of two methods; one automated and one manual: (1). Studies registered on ClinicalTrials.gov are automatically downloaded once a month; or (2). Studies are submitted directly by researchers to the CCTS Regulatory Core staff. In either case, final language is a result of an iterative process between researchers and CCTS staff. Deployed in January 2011 at OSU, this application has grown to approximately 200 studies currently posted and 1500 unique visitors per month. Locally, StudySearch is part of the CCTS recruitment toolkit. Features continue to be modified to better accommodate user behaviors. Nationally, this open source application is available for use.