bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of approaches in improving male partner involvement in the prevention of mother-to-child transmission of HIV on the uptake of maternal antiretroviral therapy among HIV-seropositive pregnant women in sub-Saharan Africa: a systematic review and meta-analysis
Authors: Takah Noah F , Kennedy Iain T R , Johnman Cathy
Published: November 2017

Objectives

To identify the approaches that are used in improving on male partner involvement in the prevention of mother-to-child transmission (PMTCT) of HIV and their impact on the uptake maternal antiretroviral therapy (ART) in sub-Saharan Africa (SSA).

Setting

This was a systematic review and meta-analysis of published studies carried out in SSA at all levels of healthcare (primary, secondary, tertiary and community).

Participants

The participants of the studies included were HIV-positive pregnant women and breastfeeding mothers with their male partners. Studies were included if they were conducted in SSA and mentioned an approach used in improving male partner involvement with data on the impact on the uptake of maternal ART uptake.

Outcomes

In the protocol, maternal ART uptake, infant prophylaxis, safe infant feeding options, condom use and family planning were envisaged. However, only maternal ART has been reported here due to limitations on the word count.

Results

From an initial 2316 non-duplicate articles, 17 articles were included in the systematic review and meta-analysis. In the combined model, the ORs for complex community interventions, enhanced psychosocial interventions, verbal encouragement and invitation letters were 4.22 (95% CI 2.27 to 7.77), 2.29 (95% CI 1.42 to 7.69), 2.39 (95% CI 1.26 to 4.53) and 1.21 (95% CI 0.89 to 1.63), respectively, whereas in the model using adjusted ORs, enhanced psychosocial interventions had a higher effect than any other intervention. The heterogeneity was moderate using adjusted ORs.

Conclusion

Enhanced psychosocial interventions and complex community interventions increase male partner involvement and the uptake of PMTCT services more than any other intervention. Invitation letters had no effect. More randomised trials and observational studies (that have adjusted for potential confounders) are needed in the future.

PROSPERO registration number

42016032673.
Is there an association between vitamin D status and risk of chronic low back pain? A nested case–control analysis in the Nord-Trøndelag Health Study
Authors: Heuch Ingrid , Heuch Ivar , Hagen Knut , Mai Xiao-Mei , Langhammer Arnulf , Zwart John-Anker
Published: November 2017

Objectives

To explore potential associations between vitamin D status and risk of chronic low back pain (LBP) in a Norwegian cohort, and to investigate whether relationships depend on the season of blood sample collection.

Design

A nested case–control study in a prospective data set.

Setting

The Norwegian community-based Nord-Trøndelag Health Study (HUNT). Data were collected in the HUNT2 (1995–1997) and HUNT3 (2006–2008) surveys.

Main outcome measure

Chronic LBP, defined as LBP persisting at least 3 months continuously during the past year.

Participants

Among individuals aged 19–55 years without LBP in HUNT2, a data set was generated including 1685 cases with LBP in HUNT3 and 3137 controls without LBP.

Methods

Blood samples from the participants collected in HUNT2 were analysed for serum 25-hydroxyvitamin D (25(OH)D) level. Associations with LBP in HUNT3 were evaluated by unconditional logistic regression analysis with adjustment for age, sex, work status, physical activity at work and in leisure time, education, smoking, and body mass index.

Results

No association between vitamin D status and risk of chronic LBP was found in the total data set (OR per 10 nmol/L 25(OH)D=1.01, 95% CI 0.97 to 1.06) or in individuals with blood samples collected in summer/autumn (OR per 10 nmol/L 25(OH)D=0.99, 95% CI 0.93 to 1.06). For blood samples drawn in winter/spring, associations differed significantly between women and men (p=0.004). Among women a positive association was seen (OR per 10 nmol/L 25(OH)D=1.11, 95% CI 1.02 to 1.20), but among men no significant association was observed (OR per 10 nmol/L 25(OH)D=0.90, 95% CI 0.81 to 1.01).

Conclusions

Overall, no association between vitamin D status and risk of LBP was demonstrated. The association suggested in women for the winter/spring season cannot be regarded as established.
Self-management of cardiac pain in women: an evidence map
Authors: Parry Monica , Bjørnnes Ann Kristin , Clarke Hance , Cooper Lynn , Gordon Allan , Harvey Paula , Lalloo Chitra , Leegaard Marit , LeFort Sandra , McFetridge-Durdle Judith , McGillion Michael , O’Keefe-McCarthy Sheila , Price Jennifer , Stinson Jennifer , Victor J Charles , Watt-Watson Judy
Published: November 2017

Objective

To describe the current evidence related to the self-management of cardiac pain in women using the process and methodology of evidence mapping.

Design and setting

Literature search for studies that describe the self-management of cardiac pain in women greater than 18 years of age, managed in community, primary care or outpatient settings, published in English or a Scandinavian language between 1 January 1990 and 24 June 2016 using AMED, CINAHL, ERIC, EMBASE, MEDLINE, Proquest, PsychInfo, the Cochrane Library, Scopus, Swemed+, Web of Science, the Clinical Trials Registry, International Register of Controlled Trials, MetaRegister of Controlled Trials, theses and dissertations, published conference abstracts and relevant websites using GreyNet International, ISI proceedings, BIOSIS and Conference papers index. Two independent reviewers screened using predefined eligibility criteria. Included articles were classified according to study design, pain category, publication year, sample size, per cent women and mean age.

Interventions

Self-management interventions for cardiac pain or non-intervention studies that described views and perspectives of women who self-managed cardiac pain.

Primary and secondary outcomes measures

Outcomes included those related to knowledge, self-efficacy, function and health-related quality of life.

Results

The literature search identified 5940 unique articles, of which 220 were included in the evidence map. Only 22% (n=49) were intervention studies. Sixty-nine per cent (n=151) of the studies described cardiac pain related to obstructive coronary artery disease (CAD), 2% (n=5) non-obstructive CAD and 15% (n=34) postpercutaneous coronary intervention/cardiac surgery. Most were published after 2000, the median sample size was 90 with 25%–100% women and the mean age was 63 years.

Conclusions

Our evidence map suggests that while much is known about the differing presentations of obstructive cardiac pain in middle-aged women, little research focused on young and old women, non-obstructive cardiac pain or self-management interventions to assist women to manage cardiac pain.

PROSPERO registration number

CRD42016042806.
Takayasu arteritis: challenges in diagnosis and management
Authors: Kim Esther S H , Beckman Joshua
Published: November 2017

Takayasu arteritis (TA) is a rare disease affecting chiefly young women, although it can affect both men and women and persons of many different ethnicities. TA carries a high morbidity rate, but importantly, overall mortality has declined over time such that the 15-year survival rate has increased from 82.9% for patients diagnosed between 1957 and 1975 to 96.5% for those diagnosed from 1976 to 1990. Severity of presenting arterial complications and delay to diagnosis have also decreased over the past decade owing to advances in non-invasive diagnostic imaging and the development of medical therapies. Despite these advances, there still remain significant gaps in the diagnosis and management of these complex patients. These gaps encompass the basic, yet extremely complex, tasks of defining a universally accepted diagnostic criterion, accurate assessment of disease activity and development of clinically meaningful and accurate outcome measures to guide necessary clinical trials for the management of these complex patients.
Lamin and the heart
Authors: Captur Gabriella , Arbustini Eloisa , Bonne Gisèle , Syrris Petros , Mills Kevin , Wahbi Karim , Mohiddin Saidi A , McKenna William J , Pettit Stephen , Ho Carolyn Y , Muchir Antoine , Gissen Paul , Elliott Perry M , Moon James C
Published: November 2017

Lamins A and C are intermediate filament nuclear envelope proteins encoded by theLMNAgene. Mutations inLMNAcause autosomal dominant severe heart disease, accounting for 10% of dilated cardiomyopathy (DCM). Characterised by progressive conduction system disease, arrhythmia and systolic impairment, lamin A/C heart disease is more malignant than other common DCMs due to high event rates even when the left ventricular impairment is mild. It has several phenotypic mimics, but overall it is likely to be an under-recognised cause of DCM. In certain clinical scenarios, particularly familial DCM with early conduction disease, the pretest probability of finding anLMNAmutation may be quite high.

Recognising lamin A/C heart disease is important because implantable cardioverter defibrillators need to be implanted early. Promising oral drug therapies are within reach thanks to research into the mitogen-activated protein kinase (MAPK) and affiliated pathways. Personalised heart failure therapy may soon become feasible forLMNA, alongside personalised risk stratification, as variant-related differences in phenotype severity and clinical course are being steadily elucidated.

Genotyping and family screening are clinically important both to confirm and to excludeLMNAmutations, but it is the three-pronged integration of such genetic information with functional data from in vivo cardiomyocyte mechanics, and pathological data from microscopy of the nuclear envelope, that is properly reshaping ourLMNAknowledge base, one variant at a time. This review explains the biology of lamin A/C heart disease (genetics, structure and function of lamins), clinical presentation (diagnostic pointers, electrocardiographic and imaging features), aspects of screening and management, including current uncertainties, and future directions.
Heart rate at first postdischarge visit and outcomes in patients with heart failure
Authors: Kim Tae-Hun , Kim Hyungseop , Kim In-Cheol , Yoon Hyuck-Jun , Park Hyoung-Seob , Cho Yun-Kyeong , Nam Chang-Wook , Han Seongwook , Hur Seung-Ho , Kim Yoon-Nyun
Published: November 2017

Objective

Heart rate control is important to prevent adverse outcomes in patients with heart failure (HF). However, postdischarge activity may worsen heart rate control, resulting in readmission. This study aimed to explore the implications of the heart rate differences between discharge and the first outpatient visit (D-O diff).

Methods

We retrospectively identified 458 patients (male: 46%; mean age: 72 years) discharged after HF. The heart rates at admission, discharge and first outpatient visit were analysed. The primary outcome was a composite of cardiovascular (CV) death and readmission of non-fatal myocardial infarction (MI), non-fatal stroke or non-fatal HF over a mean follow-up of 16 months.

Results

During follow-up, the clinical outcomes were noted in 223 patients (49%): HF, 199; stroke, 9; MI, 6; CV death, 9. The heart rate at the first outpatient visit (r=−0.311, P<0.001) and D-O diff (r=0.416, P<0.001) showed a better correlation with the time-to-clinical event than the heart rate at admission or discharge. The events group displayed a pronounced heart rate increase (13 beats/min) from discharge to the first outpatient visit compared with the event-free group (a decrease of 2 beats/min). A decrease less than −15 in the D-O diff showed a 4.5-fold risk of clinical outcomes during follow-up (P<0.001).

Conclusions

A decreased D-O diff was related to the adverse outcomes of HF. The failure of heart rate control within more than 15 beats/min at the first outpatient visit was an independent factor for CV events.
Impact of Weight Loss on Inflammation and Red Blood Cell Biomarkers after Laparoscopic Gastric Banding Surgery
Authors: Coimbra Susana , Ferreira Cátia , Belo Luís , Rocha-Pereira Petronila , Catarino Alice , Monteiro Luís , Catarino Cristina , Santos-Silva Alice
Published: November 2017

Adipose tissue produces several adipokines that are enrolled in different metabolic and inflammatory pathways that may disturb iron metabolism and erythropoiesis. Considering that laparoscopic adjustable gastric banding (LAGB) has not been associated with a long-term risk of malabsorption, we performed a 13-month follow-up study in severe obese patients submitted to LAGB in order to clarify its impact on inflammation, iron metabolism and on red blood cell (RBC) biomarkers. Twenty obese patients were enrolled in the study, being clinical and analytically assessed before (T0) and 13 months after LAGB intervention (T1). Inflammation, iron bioavailability and RBC biomarkers were evaluated at T0 and T1. At T1, weight and anthropometric indices decreased significantly; patients showed a significant increase in mean corpuscular volume, mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration (MCHC), and a reduction in red cell distribution width, ferritin, hepcidin, tumor necrosis factor-α, interleukin-6 (IL-6) and C-reactive protein. Before LAGB, IL-6 correlated negatively with iron, hemoglobin concentration and MCHC; hepcidin correlated inversely with transferrin. Our data show that 13 months after LAGB, the weight loss is associated with an improvement in inflammation, namely a reduction in IL-6 that may reduce hepcidin production, improving iron availability for erythropoiesis, as shown by more adequate erythrocyte hemoglobinization.
Predicting how health behaviours contribute to the development of diseases within a military population in the Hungarian Defence Forces
Authors: Novák Attila , Hornyák B , Rázsó Zs , Szalánczi Sz , Juhász Zs , Sótér A , Nyakas Cs
Published: November 2017

Introduction

Recent legislative amendments in Hungary have resulted in the possibility for early retirement being abolished in the Hungarian Defence Forces. The retirement age for professional soldiers has also increased to 65 years, thereby greatly increasing the average length of military service. This necessitates greater attention to the health and care of service personnel due to the increase of chronic non-communicable diseases with age. The aim of this research was to identify how health behaviours might potentially contribute to diseases in the Hungarian Defence Forces.

Methods

All members of the Hungarian Defence Forces undergoing health screenings between 2011 and 2015 were assessed. Health variables analysed were derived from the health screening data sheet which is collected from every member of the Hungarian Defence Forces undergoing a health screening since 2009. Items recorded were connected to health behaviour (physical activity, nutrition, smoking), subjective well-being (psychosomatic backache, fatigue and quality of waking up to describe the quality of sleep), sociodemographic data (age, gender) and the mental toughness quotient (MTQ). A logistic regression model was utilised to predict how health behaviour may affect the development of disease.

Results

Factors most associated with the development of disease included psychosomatic backache (P<0.000), age (P<0.001), frequency of undertaking sports (P<0.05), quality of sleeping and waking up (P<0.05) and the assessment of gender differences (P<0.05).

Conclusions

Extension of the length of active service will result in an increased burden of disease for members of the Hungarian Defence Forces. This includes both physical and psychological morbidity that could potentially be obstacles for service personnel to perform their military duties. Health behaviours such as psychosomatic backache, the frequency of performing sports and sleep quality may predict the development of disease and should be explored in health screening consultations.
Could routine spirometry suggest sensitisation in the military medicine setting?
Authors: Cirillo Ignazio , Gallo F , Ciprandi G
Published: November 2017

Introduction

Providing evidence of sensitisation is the formal requirement for allergy diagnosis. The aim of this study was to evaluate whether spirometry may be able to predict sensitisation in a representative cohort of Italian Navy military personnel.

Methods

2043 (1875 men, 168 women, mean age 28.35±11.6 years) Italian Navy military personnel were enrolled into this study. Spirometry and skin prick testing were performed to predict sensitisation.

Results

Sensitisation, assessed by skin prick test, was documented in 658 (32.2%) subjects. Impaired forced expiratory flow at the 25% and 75% of the pulmonary volume (FEF25–75) as demonstrated on spirometry was detected in 82 subjects, of whom 69 were sensitised (P<0.0001). Impaired FEF25–75 was significantly associated with sensitisation (OR 7.43; 95% CI 4.04 to 14.66; P<0.0001).

Discussion

The findings of this study suggest that impaired FEF25–75 may predict sensitisation in this cohort of Italian Navy personnel. This outcome is relevant in the military medical setting, as it could allow early identification of subjects with subclinical asthma.
Physiological monitoring for healthy military personnel
Authors: Stacey Michael John , Hill N , Woods D
Published: November 2017

Military employment commonly exposes personnel to strenuous physical exertion. The resulting interaction between occupational stress and individual susceptibility to illness demands careful management. This could extend to prospective identification of high physiological strain in healthy personnel, in addition to recognition and protection of vulnerable individuals. The emergence and ubiquitous uptake of ‘wearable’ physiological and medical monitoring devices might help to address this challenge, but requires that the right questions are asked in sourcing, developing, validating and applying such technologies. Issues that must be addressed include system requirements, such as the likelihood of end users deploying and using technology as intended; interpretation of data in relation to pretest probability, including the potential for false-positive results; differentiation of pathological states from normal physiology; responsibility for and consequences of acting on abnormal or unexpected results and cost-effectiveness. Ultimately, the performance of a single monitoring system, in isolation or alongside other measures, should be judged by whether any improvement is offered versus existing capabilities and at what cost to mission effectiveness.
Dangers of neglecting non-financial conflicts of interest in health and medicine
Authors: Wiersma Miriam , Kerridge Ian , Lipworth Wendy
Published: November 2017

Non-financial interests, and the conflicts of interest that may result from them, are frequently overlooked in biomedicine. This is partly due to the complex and varied nature of these interests, and the limited evidence available regarding their prevalence and impact on biomedical research and clinical practice. We suggest that there are no meaningful conceptual distinctions, and few practical differences, between financial and non-financial conflicts of interest, and accordingly, that both require careful consideration. Further, a better understanding of the complexities of non-financial conflicts of interest, and their entanglement with financial conflicts of interest, may assist in the development of a more sophisticated approach to all forms of conflicts of interest.
Learning health systems, clinical equipoise and the ethics of response adaptive randomisation
Authors: London Alex John
Published: November 2017

To give substance to the rhetoric of ‘learning health systems’, a variety of novel trial designs are being explored to more seamlessly integrate research with medical practice, reduce study duration and reduce the number of participants allocated to ineffective interventions. Many of these designs rely on response adaptive randomisation (RAR). However, critics charge that RAR is unethical on the grounds that it violates the principle of equipoise. In this paper, I reconstruct critiques of RAR as holding that it is inconsistent with five important ethical principles. I then argue that these criticisms rest on a faulty view of equipoise encouraged by the idea that a RAR study models the beliefs of a single rational agent about the relative merits of the interventions being studied. I outline a view in which RAR models an idealised health system in which diverse communities of fully informed experts shrink or grow as their constituent members update their expert opinions in light of reliable medical evidence. I show how a proper understanding of clinical equipoise can reconcile this conception of RAR with these five ethical principles. This analysis removes an in-principle objection to RAR and sheds important light on the relationship between clinical equipoise and transient diversity in the scientific community.
Safety and effectiveness of the Low Profile Visualized Intraluminal Support (LVIS and LVIS Jr) devices in the endovascular treatment of intracranial aneurysms: results of the TRAIL multicenter observational study
Authors: Iosif Christina , Piotin Michel , Saleme Suzana , Barreau Xavier , Sedat Jacques , Chau Yves , Sourour Nader , Aggour Mohamed , Brunel Herve , Bonafe Alain , Machi Paolo , Riquelme Carlos , Costalat Vincent , Pierot Laurent , Blanc Raphael , Mounayer Charbel
Published: November 2017

Background and purpose

To evaluate the safety and effectiveness of the low-profile braided intracranial stents called the Low Profile Visualized Intraluminal Support (LVIS) devices for stent-assisted coil embolization of wide-necked intracranial aneurysms.

Materials and methods

This was a prospective, multicenter, observational study of unruptured and ruptured intracranial aneurysms treated with the LVIS devices. Imaging and clinical data were independently analyzed respectively by CoreLab and Clinical Event Committee. Primary endpoints were clinical safety, effectiveness, and angiographic stability of the results at 6 and 18 months.

Results

Ten centers participated in the study; 102 patients were included and 90 patients (42.2% men, 57.8% women) were eventually analyzed, among which 27 (30.0%) had multiple aneurysms. Twenty-three (25.6%) were ruptured aneurysms, four of which (4.4%) were treated in the acute phase. One aneurysm was treated per patient; 92 LVIS and LVIS Jr devices were placed overall. The total aneurysm occlusion rate was 91.0% on immediate post-procedure angiograms, which remained unchanged at 6-month follow-up and was 92.4% at 18-month follow-up. One patient (1.1%) underwent retreatment between 6 and 18 months of follow-up. A modified Rankin score of 0 was documented for most cases immediately after the procedure (86.7%) and at 6-month (86.8%) and 18-month (83.3%) follow-up. The overall permanent morbidity rate at 18 months was 5.6% and the overall rate of events with sequelae related to the stent was 2.2%. The 18-month procedure-related mortality rate was 3.3%. No patient was deemed to require retreatment at 18-month follow-up.

Conclusion

The LVIS/LVIS Jr endovascular devices are safe and effective in the treatment of ruptured and unruptured intracranial aneurysms, with acceptable complication rates, very high immediate total occlusion rates, and stable angiographic results.
Retrograde 3D rotational venography (3DRV) for venous sinus stent placement in idiopathic intracranial hypertension
Authors: Young Christopher C , Morton Ryan P , Ghodke Basavaraj V , Levitt Michael R
Published: November 2017

Background

Dural venous sinus stenting has emerged as an effective and durable treatment for idiopathic intracranial hypertension (IIH). Improved visualization of the venous sinuses can improve stent placement.

Methods

We present two cases of IIH treated with venous sinus stenting in which retrograde three-dimensional rotational venography (3DRV) provided superior anatomical details of the venous sinuses for optimal sizing and positioning of stent.

Results

Comparison of pre-stent 3DRV with post-stent contrast-enhanced flat panel detector CT allowed confirmation of stent placement and the result of stenosis dilation.

Conclusion

This 3DRV technique provides precise visualization of venous sinus stenosis prior to stenting without the need for arterial cerebral angiography during the treatment course.
Psychiatric disease in an adolescent as a harbinger of cerebral X-linked adrenoleukodystrophy
Authors: Smith Jessica , Williams Mitchel T , Misra Vinod K
Published: November 2017

X-linked adrenoleukodystrophy (XALD) typically presents as a childhood cerebral demyelinating form, as an adult-onset adrenomyeloneuropathy or as adrenocortical insufficiency. Cerebral demyelination presenting in adolescence is unusual. We present an 17-year-old boy with adolescent-onset XALD initially manifesting with slowly progressive psychiatric symptoms. He was initially diagnosed with attention-deficit hyperactivity disorder and an acute psychosis. However, he was ultimately diagnosed with XALD based on his clinical course, neuroimaging findings and biochemical abnormalities. This case reiterates the atypical presentations of adolescent-onset cerebral XALD that may go unrecognised and misdiagnosed as a neurodevelopmental or psychiatric disease. Treatments for cerebral ALD are potentially life-saving, particularly when given early in the disease course.
Crowned dens syndrome
Authors: Ledingham David , Cappelen-Smith Cecilia , Cordato Dennis
Published: November 2017

Crowned dens syndrome is a rare presentation of calcium pyrophosphate deposition disease. It is characterised by severe occipital pain and neck stiffness. Acute presentations are typically accompanied by fever and an inflammatory response and hence can be misdiagnosed as polymyalgia rheumatica or meningitis. Chronic relapsing presentations may be misdiagnosed as cervicogenic neck pain or occipital neuralgia. We present a patient who presented with a chronic relapsing form of crowned dens syndrome and discuss the epidemiology, typical presentation and management of this eminently treatable condition.
Prospective cohort study showing persistent HSV-2 shedding in women with genital herpes 2 years after acquisition
Authors: Ramchandani Meena , Selke Stacy , Magaret Amalia , Barnum Gail , Huang Meei-Li Wu , Corey Lawrence , Wald Anna
Published: November 2017

Objectives

Herpes simplex virus type 2 (HSV-2) is a prevalent infection with great variability in clinical and virological manifestations among individuals. This prospective cohort study aims to evaluate the natural history of HSV-2 reactivation in the genital area in the same group of women over time.

Methods

Eighteen immunocompetent HSV-2 seropositive women were evaluated for viral shedding for 70 consecutive days within a median of 8 months (range 1–24 months) of HSV-2 acquisition and again approximately 2.5 years later from the original study. Participants obtained daily swabs of genital secretions for HSV PCR and recorded genital symptoms.

Results

The viral shedding rate was 29% during the initial study and 19% in the follow-up study (32% reduction, P=0.019). Subclinical shedding rate also decreased from 24% to 13% (37% reduction, P=0.032), as did the rate of days with genital lesions from 22% to 15% (33% reduction, P=0.24). The mean copy number during viral shedding remained unchanged over time at 4.8 log10 c/mL (SD=2.0 and 1.6 during each study, respectively, P=0.33). Women with high viral shedding rates in the past were likely to continue to have high shedding rates (r=0.63, P=0.005).

Conclusions

Despite some reduction, high viral shedding rates persist in women with genital HSV-2 greater than 2 years after acquisition.
Prospective cohort study to assess rates of contagious disease in pre‐weaned UK dairy heifers: management practices, passive transfer of immunity and associated calf health
Authors: Johnson Kate F , Chancellor Natalie , Burn Charlotte C , Wathes D Claire
Published: November 2017

Dairy calves are vulnerable to infectious diseases, particularly diarrhoea and bovine respiratory disease (BRD), causing mortality and reducing welfare and growth. A prospective cohort study was performed on 11 UK dairy farms to determine the underlying causes for calf disease. This first paper describes the incidence, timing and duration of infectious disease, mortality rates, passive transfer of immunity and key management practices that may contribute to disease incidence. Heifer calves were recruited in the first week of life (n=492) and a blood sample taken to measure IgG and total protein (TP). Each animal was examined weekly for nine weeks using a standardised health scoring system. Recruitment of calves occurred between August and February. Four farms provided supplementary colostrum to more than 75 per cent of calves born, whereas on the remainder only 0 to 19 per cent were supplemented. Mean serum IgG and TP were 19.0±10 and 56.7±10.3 mg/ml respectively, with 20.7 per cent (95CI: 17.2 to 24.7 per cent) of all calves classified as having failure of passive transfer (IgG <10 mg/ml). The overall preweaning mortality rate was 4.5 per cent. (95 per cent CI: 2.9 to 6.8 per cent). During this period,48.2 per cent of all calves (range 24.1 to 74.4 per cent between farms) were diagnosed with diarrhoea and 45.9 per cent (range 20.4 to 77.8 per cent) with BRD. The incidence rates were 7.8 cases of diarrhoea and 10.1 cases of BRD per 100 calf weeks at risk, respectively. Rates of infectious disease were therefore high despite relatively good passive transfer.
Three-dimensional hydrostratigraphy of the Orangeville Moraine area, southwestern Ontario, Canada
Authors: Burt Abigail
Published: November 2017

Regional-scale three-dimensional modelling of Quaternary sediments in the Orangeville Moraine area of southwestern Ontario has been completed as part of the Ontario Geological Survey groundwater initiative and provides an improved understanding of the glacial history and conceptual hydrostratigraphic framework for that region. Older (Marine Isotope Stage (MIS) 3–5) diamicton, glaciolacustrine, glaciofluvial, and rare nonglacial deposits forming regional aquitards and local aquifers are found in the northwestern part of the area. Catfish Creek Till, deposited during the Last Glacial Maximum (LGM) (MIS 2), forms a key aquitard and stratigraphic marker at depth. Diamicton, fine-textured glaciolacustrine sediments, and the gravel, sand, and silt conduit and subaqueous fan sediments that constitute the overlying Orangeville Moraine were deposited in an ice-walled lake formed between ice lobes during retreat from the LGM. Diamicton deposited during late-glacial ice margin fluctuations forms the upper aquitard unit and buries the edges of the moraine. The Orangeville Moraine is the largest aquifer in the area, and is partially confined by the upper tills. Thick fine-textured glaciolacustrine deposits, Catfish Creek Till, and older aquitards separate the moraine from bedrock aquifers across most of the area. Depending on hydraulic gradients, buried bedrock valleys with gravel and sand fills have the potential to recharge the bedrock aquifer.
Effects of periconceptional maternal alcohol intake and a postnatal high-fat diet on obesity and liver disease in male and female rat offspring
Authors: Gårdebjer Emelie M. , Cuffe James S. M. , Ward Leigh C. , Steane Sarah , Anderson Stephen T. , Dorey Emily S. , Kalisch-Smith Jacinta I. , Pantaleon Marie , Chong Suyinn , Yamada Lisa , Wlodek Mary E. , Bielefeldt-Ohmann Helle , Moritz Karen M.
Published: November 2017

The effects of maternal alcohol consumption around the time of conception on offspring are largely unknown and difficult to determine in a human population. This study utilized a rodent model to examine if periconceptional alcohol (PC:EtOH) consumption, alone or in combination with a postnatal high-fat diet (HFD), resulted in obesity and liver dysfunction. Sprague-Dawley rats were fed a control or an ethanol-containing [12.5% (vol/vol) EtOH] liquid diet from 4 days before mating until 4 days of gestation ( n = 12/group). A subset of offspring was fed a HFD between 3 and 8 mo of age. In males, PC:EtOH and HFD increased total body fat mass ( PPC:EtOH < 0.05, PHFD < 0.0001); in females, only HFD increased fat mass ( PHFD < 0.0001). PC:EtOH increased microvesicular liver steatosis in male, but not female, offspring. Plasma triglycerides, HDL, and cholesterol were increased in PC:EtOH-exposed males ( PPC:EtOH < 0.05), and LDL, cholesterol, and leptin (Lep) were increased in PC:EtOH-exposed females ( PPC:EtOH < 0.05). mRNA levels of Tnf-α and Lep in visceral adipose tissue were increased by PC:EtOH in both sexes ( PPC:EtOH < 0.05), and Il-6 mRNA was increased in males ( PPC:EtOH < 0.05). These findings were associated with reduced expression of microRNA-26a, a known regulator of IL-6 and TNF-α. Alcohol exposure around conception increases obesity risk, alters plasma lipid and leptin profiles, and induces liver steatosis in a sex-specific manner. These programmed phenotypes were similar to those caused by a postnatal HFD, particularly in male offspring. These results have implications for the health of offspring whose mothers consumed alcohol around the time of conception.
Curcumin and other dietary polyphenols: potential mechanisms of metabolic actions and therapy for diabetes and obesity
Authors: Jin Tianru , Song Zhuolun , Weng Jianping , Fantus I. George
Published: November 2017

Recent controversy regarding the therapeutic potential of curcumin indicates the challenges to research in this field. Here, we highlight the investigations of curcumin and other plant-derived polyphenols that demonstrate their application to metabolic diseases, in particular, obesity and diabetes. Thus, a number of preclinical and clinical investigations have shown the beneficial effect of curcumin (and other dietary polyphenols) in attenuating body weight gain, improving insulin sensitivity, and preventing diabetes development in rodent models and prediabetic subjects. Other intervention studies with dietary polyphenols have also found improvements in insulin resistance. Recent studies suggest that the metabolic effects of curcumin/polyphenols are linked to changes in the gut microbiota. Thus, research into curcumin continues to provide novel insights into metabolic regulation that may ultimately translate into effective therapy.
Pharmacological and genetic inhibition of downstream targets of p38 MAPK in experimental nephrotic syndrome
Authors: Nie Xiaojing , Chanley Melinda A. , Pengal Ruma , Thomas David B. , Agrawal Shipra , Smoyer William E.
Published: November 2017

The p38 MAPK pathway plays a crucial role in various glomerulopathies, with activation being associated with disease and inhibition being associated with disease amelioration. We hypothesized that the downstream targets of p38 MAPK, MAPK-activated protein kinase 2 and/or 3 (MK2 and/or MK3), play an important role in mediating injury in experimental nephrotic syndrome via their actions on their downstream substrates heat shock protein B1 (HSPB1) and cyclooxygenase-2 (COX-2). To test this hypothesis, the effects of both pharmacological and genetic inhibition of MK2 and MK3 were examined in mouse adriamycin (ADR) and rat puromycin aminonucleoside (PAN) nephropathy models. MK2−/−, MK3−/−, and MK2−/−MK3−/−mice were generated in the Sv129 background and subjected to ADR-induced nephropathy. MK2 and MK3 protein expression was completely abrogated in the respective knockout genotypes, and massive proteinuria and renal histopathological changes developed after ADR treatment. Furthermore, renal cortical HSPB1 was induced in all four genotypes by day 21, but HSPB1 was activated only in the wild-type and MK3−/−mice. Expression of the stress proteins HSPB8 and glucose-regulated protein 78 (GRP78) remained unaltered across all genotypes. Finally, while MK2 and/or MK3-knockout downregulated the proinflammatory enzyme COX-2, ADR significantly induced renal cortical COX-2 only in MK2−/−mice. Additionally, pharmacological MK2 inhibition with PF-318 during PAN-induced nephropathy did not result in significant proteinuria reduction in rats. Together, these data suggest that while the inhibition of MK2 and/or MK3 regulates the renal stress response, our currently available approaches are not yet able to safely and effectively reduce proteinuria in experimental nephrotic syndrome and that other p38MAPK downstream targets should also be considered to improve the future treatment of glomerular disease.
Model of a bilateral Brown-type central pattern generator for symmetric and asymmetric locomotion
Authors: Sobinov Anton , Yakovenko Sergiy
Published: November 2017

The coordinated activity of muscles is produced in part by spinal rhythmogenic neural circuits, termed central pattern generators (CPGs). A classical CPG model is a system of coupled oscillators that transform locomotor drive into coordinated and gait-specific patterns of muscle recruitment. The network properties of this conceptual model can be simulated by a system of ordinary differential equations with a physiologically inspired coupling locus of interactions capturing the timing relationship for bilateral coordination of limbs in locomotion. Whereas most similar models are solved numerically, it is intriguing to have a full analytical description of this plausible CPG architecture to illuminate the functionality within this structure and to expand it to include steering control. Here, we provided a closed-form analytical solution contrasted against the previous numerical method. The evaluation time of the analytical solution was decreased by an order of magnitude when compared with the numerical approach (relative errors, <0.01%). The analytical solution tested and supported the previous finding that the input to the model can be expressed in units of the desired limb locomotor speed. Furthermore, we performed parametric sensitivity analysis in the context of controlling steering and documented two possible mechanisms associated with either an external drive or intrinsic CPG parameters. The results identify specific propriospinal pathways that may be associated with adaptations within the CPG structure. The model offered several network configurations that may generate the same behavioral outcomes.

NEW & NOTEWORTHY Using a simple process of leaky integration, we developed an analytical solution to a robust model of spinal pattern generation. We analyzed the ability of this neural element to exert locomotor control of the signal associated with limb speeds and tested the ability of this simple structure to embed steering control using the velocity signal in the model’s inputs or within the internal connectivity of its elements.
Complementary metrics of human auditory nerve function derived from compound action potentials
Authors: Harris Kelly C. , Vaden Kenneth I. , McClaskey Carolyn M. , Dias James W. , Dubno Judy R.
Published: November 2017

Declines in auditory nerve (AN) function contribute to suprathreshold auditory processing and communication deficits in individuals with normal hearing, hearing loss, hyperacusis, and tinnitus. Procedures to characterize AN loss or dysfunction in humans are limited. We report several novel complementary metrics using the compound action potential (CAP), a direct measure of summated AN activity. Together, these metrics may be used to characterize AN function noninvasively in humans. We examined how these metrics change with stimulus intensity and interpreted these changes within a framework of known physiological properties of the basilar membrane and AN. Our results reveal how neural synchrony and the recruitment of AN fibers with longer first-spike latencies likely contribute to the CAP, affect auditory processing, and differ with noise exposure history in younger adults with normal pure-tone thresholds. Moving forward, this new battery of metrics provides a crucial step toward new diagnostics of AN function in humans.

NEW & NOTEWORTHY Loss or inactivity of auditory nerve (AN) fibers is thought to contribute to suprathreshold auditory processing deficits, but evidence-based methods to assess these effects are not available. We describe several novel metrics that together may be used to quantify neural synchrony and characterize AN function in humans.
Prevalence and risk factors of inadequate medicine home storage: a community-based study
Authors: Martins Rand Randall , Farias Andreza Duarte , Oliveira Yonara Monique da Costa , Diniz Rodrigo dos Santos , Oliveira Antonio Gouveia
Published: November 2017

OBJECTIVE: Assess the extent of inadequate home storage of medicines andidentify important risk factors. METHODS: A cross-sectional survey based on a probability sample in the community, conducted in 267 households in Cuité, State of Paraíba, Northeast Brazil, in 2014. Logistic regression was used to study the risk factors. RESULTS: The prevalence of households with inadequate storage was 76.0%. Problems with storage include direct exposure to sunlight in 10.9% of households, the presence of dust in 23.6%, and storage within reach of children in 76.0%. Medications no longer used are usually disposed of into the environment in 92.1% of households. Inadequate storage is more likely when home organization of medications is the responsibility of a male subject (OR = 1.729) or an older person (OR = 1.029), when out of date medicines are found (OR = 2.963), and in households with no children (OR = 2.088). CONCLUSIONS: Physicians and pharmacists should advise patients on how to adequately store medicines at home, especially when the person in charge of medications is a male or an older adult, and if there are no children in the household.
Epidemiological, clinical and laboratory profile of scrub typhus cases detected by serology and RT-PCR in Kumaon, Uttarakhand: a hospital-based study
Authors: Rawat Vinita , Singh Rajesh Kumar , Kumar Ashok , Saxena Sandip R , Varshney Umesh , Kumar Mukesh
Published: November 2017

We analysed the epidemiology, clinical and laboratory data of the 168 scrub typhus cases confirmed by a combination of any one of the following: real time polymerase chain reaction (RT-PCR) and/or immunofluorescence assay (IFA) (IgM and/or IgG). The peak season for scrub typhus was from July to October. By multivariate binary logistic regression analysis, the risk of scrub typhus was about four times in those working in occupation related to forest work. Major clinical manifestations were fever (100%), myalgia (65%), cough (51%) and vomiting (46%); major complications were meningitis/meningoencephatilitis (12.5%) and multi-organ failure (MOF) and pneumonia (5.3% each). Laboratory investigations revealed raised aminotranferase levels and thrombocytopenia in most confirmed cases. We conclude that scrub typhus is an important cause of febrile illness in the Kumaon hills of Uttarakhand where this disease had not previously been considered to exist.
Further Analysis of the Predictive Effects of a Free-Operant Competing Stimulus Assessment on Stereotypy
Authors: Brogan Kristen M. , Rapp John T. , Sennott Lisa A. , Cook Jennifer L. , Swinkels Erin
Published: November 2017

We conducted five experiments to evaluate the predictive validity of a free-operant competing stimulus assessment (FOCSA). In Experiment 1, we showed that each participant’s repetitive behavior persisted without social consequences. In Experiment 2, we used the FOCSA to identify high-preference, low-stereotypy (HP-LS) items for 11 participants and high-preference, high-stereotypy (HP-HS) items for nine participants. To validate the results of the FOCSAs (Experiment 3), we used a three-component multiple schedule to evaluate the immediate and subsequent effects of an HP-LS stimulus, an HP-HS stimulus, or both (in separate test sequences) on each participant’s stereotypy. Results of Experiment 3 showed that the FOCSA correctly predicted the immediate effect of the HP-LS stimulus for 10 of 11 participants; however, the FOCSA predictions were less accurate for the HP-HS stimulus. Results of Experiment 4 showed that a differential reinforcement of other behavior procedure in which participants earned access to the HP-LS for omitting vocal stereotypy increased all five participants’ latency to engaging in stereotypy; however, clinically significant omission durations were only achieved for one participant. Experiment 5 showed that differential reinforcement of alternative behavior in which participants earned access to the HP-LS stimulus contingent upon correct responses during discrete-trial training reduced targeted and nontargeted stereotypy and increased correct academic responding for all four participants. The potential utility of the FOCSA is discussed.
Managerial Ability and the Quality of Firms’ Information Environment
Authors: Baik Bok , Brockman Paul A. , Farber David B. , Lee Sam (Sunghan)
Published: November 2017

In this study, we examine the relation between managerial ability and the quality of a firm’s information environment. An emerging stream of research has identified managerial ability as an important determinant of accruals quality and management forecast quality. However, our understanding of the impact of managerial ability on a firm’s broader information environment is incomplete because it captures more than these specific financial reporting disclosures. Using a composite index based on various proxies for a firm’s information environment, we find a positive relation between managerial ability and a firm’s information environment. Consistent with our argument that managers’ equity incentives improve disclosure quality, we find that the quality of a firm’s information environment improves when managers have higher levels of equity incentives. We contribute to the literature by providing more complete and conclusive evidence about the impact of managerial ability on a firm’s broader information environment.
Left ventricular thrombus formation in patients undergoing femoral veno-arterial extracorporeal membrane oxygenation
Authors: Weber Carolyn , Deppe Antje-Christin , Sabashnikov Anton , Slottosch Ingo , Kuhn Elmar , Eghbalzadeh Kaveh , Scherner Maximilian , Choi Yeong-Hoon , Madershahian Navid , Wahlers Thorsten
Published: November 2017

Introduction:

Profoundly impaired left ventricular (LV) function in patients undergoing femoral veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) can result in intra-cardiac stasis and thrombus formation. There have been several attempts to improve LV unloading in patients with peripheral VA-ECMO, either by improving contractility or by venting the LV.

Methods:

Data from all patients who underwent femoral VA-ECMO between 2007 and 2015 due to cardiogenic decompensation were retrospectively analysed regarding intra-cardiac thrombus formation.

Results:

In total, 11 of 281 patients (3.91%) with femoral VA-ECMO developed an intra- or extra-cardiac thrombus despite adequate anticoagulation therapy. None of the patients survived this serious complication.

Conclusion:

Management strategies for patients with femoral VA-ECMO support and severely impaired LV function must be reassessed to avoid insufficient LV unloading at an early stage of ECMO therapy. Early LV decompression should be considered in patients with insufficient unloading of the LV to prevent intra-cardiac thrombus formation.