bluuebunny/crossref_metadata_2025 huggingface dataset:
Appendiceal orifice inflammation is associated with proximal extension of disease in patients with ulcerative colitis
Authors: Anzai H. , Hata K. , Kishikawa J. , Ishii H. , Yasuda K. , Otani K. , Nishikawa T. , Tanaka T. , Kiyomatsu T. , Kawai K. , Nozawa H. , Kazama S. , Yamaguchi H. , Ishihara S. , Sunami E. , Watanabe T.
Published: June 2016

Aim

Ulcerative colitis (UC) is considered to be a disease of continuous mucosal inflammation extending proximally from the rectum. However, appendiceal orifice inflammation (AOI) is a skip lesion with segments of continuous involvement from the rectum. The aim of this study was to examine the clinical characteristics and clinical course, particularly focused on proximal extension, of UC in patients with AOI.

Method

A retrospective evaluation of patients with UC who underwent total colonoscopy at the Department of Surgical Oncology, The University of Tokyo, from 2004 to 2014. The degree of AOI was graded endoscopically as follows: 0 (no inflammation); 1 (slight oedema); 2 (moderate inflammation); and 3 (marked inflammation). A total of 189 patient records were reviewed retrospectively. The presence of AOI was analysed with regard to the clinical information of each patient, and its association with proximal extension of proctitis or left‐sided colitis was evaluated.

Results

Of 189 patients with UC who underwent total colonoscopy at our institution, 92 were diagnosed with pancolitis, 50 with left‐sided colitis and 47 with proctitis. Endoscopic findings of AOI were observed in 26 patients, including 11 (12.0%) with pancolitis, six (12.0%) with left‐sided colitis and nine (19.1%) with proctitis. During follow up, proximal extension of the disease occurred in all nine patients with proctitis AOI.

Conclusion

AOI is more frequently observed in patients with proctitis. Our results showed correlations between AOI and subsequent proximal extension of mucosal inflammation in patients with proctitis.
Hypoxia‐induced microRNA‐301b regulates apoptosis by targeting Bim in lung cancer
Authors: Wu Duoguang , Chen Baishen , Cui Fei , He Xiaotian , Wang Wenjian , Wang Minghui
Published: June 2016

Objectives

Worldwide, lung cancer accounts for the majority of cancer‐related deaths. Aberrant expression of miRNAs has increasingly been reported to be associated with tumour progression. This study aimed to explore the role of miR‐301b in regulating apoptosis in lung cancer.

Materials and methods

Expression of miR‐301b was assessed by real‐time PCR in cell lines, human patient tissues and cells treated under hypoxia and DMOG. Scramble siRNA, miR‐301b inhibitor and miR‐301b mimics were transfected into lung cancer cells to determine their effects on apoptosis. Additionally, a mouse xenograft model was used to explore functions of miR‐301b on apoptosis, in vivo. Finally, relationships between Bim and miR‐301b levels were explored by luciferase reporter assay and Western blotting.

Results

We found that miR‐301b was highly expressed in lung cancer tissues and cell lines. Expression of miR‐301b was induced by hypoxia, and miR‐301b suppressed expression of Bim by targeting its 3′UTR. Functionally, ectopic expression of miR‐301b enhanced cell population growth, reduced apoptosis and reduced sensitivity of cells to chemotherapy. In the xenograft model, overexpression of miR‐301b promoted tumour growth. Additionally, miR‐301b and Bim expression were inversely correlated in clinical lung cancer samples.

Conclusions

This study provides new insights into the function of miRNA‐301b in lung cancer and suggests that miRNA‐301b could be a potential molecular target for chemotherapy.
Microclimate predicts within‐season distribution dynamics of montane forest birds
Authors: Frey Sarah J. K. , Hadley Adam S. , Betts Matthew G.
Published: June 2016

Aim

Climate changes are anticipated to have pervasive negative effects on biodiversity and are expected to necessitate widespread range shifts or contractions. Such projections are based upon the assumptions that (1) species respond primarily to broad‐scale climatic regimes, or (2) that variation in climate at fine spatial scales is less relevant at coarse spatial scales. However, in montane forest landscapes, high degrees of microclimate variability could influence occupancy dynamics and distributions of forest species. Using high‐resolution bird survey and under‐canopy air temperature data, we tested the hypothesis that the high vagility of most forest bird species combined with the heterogeneous thermal regime of mountain landscapes would enable them to adjust initial settlement decisions to track their thermal niches.

Location

Western Cascade Mountains, Oregon, USA.

Methods

We used dynamic occupancy models to test the degree to which microclimate affects the distribution patterns of forest birds in a heterogeneous mountain environment. In all models we statistically accounted for vegetation structure, vegetation composition and potential biases due to imperfect detection of birds. We generated spatial predictions of forest bird distributions in relation to microclimate and vegetation structure.

Results

Fine‐scale temperature metrics were strong predictors of bird distributions; effects of temperature on within‐season occupancy dynamics were as large or larger (1–1.7 times) than vegetation effects. Most species (86.7%) exhibited apparent within‐season occupancy dynamics. However, species were almost as likely to be warm associated (i.e., apparent settlement at warmer sites and/or vacancy at cooler sites; 53.3% of species) as cool associated (i.e., apparent settlement at cooler sites and/or vacancy at warmer sites; 46.7% of species), suggesting that microclimate preferences are species specific.

Main conclusions

High‐resolution temperature data increase the quality of predictions about avian distribution dynamics and should be included in efforts to project future distributions. We hypothesize that microclimate‐associated distribution patterns may reflect species' potential for behavioural buffering from climate change in montane forest environments.
Variants associated with autoimmune Type 1 diabetes in Japanese children: implications for age‐specific effects of cis‐regulatory haplotypes at 17q12‐q21
Authors: Ayabe T. , Fukami M. , Ogata T. , Kawamura T. , Urakami T. , Kikuchi N. , Yokota I. , Ihara K. , Takemoto K. , Mukai T. , Nishii A. , Kikuchi T. , Mori T. , Shimura N. , Sasaki G. , Kizu R. , Takubo N. , Soneda S. , Fujisawa T. , Takaya R. , Kizaki Z. , Kanzaki S. , Hanaki K. , Matsuura N. , Kasahara Y. , Kosaka K. , Takahashi T. , Minamitani K. , Matsuo S. , Mochizuki H. , Kobayashi K. , Koike A. , Horikawa R. , Teno S. , Tsubouchi K. , Mochizuki T. , Igarashi Y. , Amemiya S. , Sugihara S. ,   the Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes (JSGIT)
Published: June 2016

Aims

The aim of this study was to clarify the significance of previously reported susceptibility variants in the development of autoimmune Type 1 diabetes in non‐white children. Tested variants included rs2290400, which has been linked to Type 1 diabetes only in one study on white people. Haplotypes at 17q12‐q21 encompassing rs2290400 are known to determine the susceptibility of early‐onset asthma by affecting the expression of flanking genes.

Methods

We genotyped 63 variants in 428 Japanese people with childhood‐onset autoimmune Type 1 diabetes and 457 individuals without diabetes. Possible association between variants and age at diabetes onset was examined using age‐specific quantitative trait locus analysis and ordered‐subset regression analysis.

Results

Ten variants, including rs2290400 in GSDMB, were more frequent among the people with Type 1 diabetes than those without diabetes. Of these, rs689 in INS and rs231775 in CTLA4 yielded particularly high odds ratios of 5.58 (corrected P value 0.001; 95% CI 2.15–14.47) and 1.64 (corrected P value 5.3 × 10‐5; 95% CI 1.34–2.01), respectively. Age‐specific effects on diabetes susceptibility were suggested for rs2290400; heterozygosity of the risk alleles was associated with relatively early onset of diabetes, and the allele was linked to the phenotype exclusively in the subgroup of age at onset ≤ 5.0 years.

Conclusions

The results indicate that rs2290400 in GSDMB and polymorphisms in INS and CTLA4 are associated with the risk of Type 1 diabetes in Japanese children. Importantly, cis‐regulatory haplotypes at 17q12‐q21 encompassing rs2290400 probably determine the risk of autoimmune Type 1 diabetes predominantly in early childhood.
Left Ventricular Mechanics in Functional Ischemic Mitral Regurgitation in Acute Inferoposterior Myocardial Infarction
Authors: Valuckiene Zivile , Ovsianas Justas , Ablonskyte‐Dudoniene Ruta , Mizariene Vaida , Melinyte Karolina , Jurkevicius Renaldas
Published: June 2016

Ischemic mitral regurgitation (MR) is an established adverse prognostic factor after myocardial infarction (MI). Functional ischemic mitral regurgitation in acute phase of MI remains under‐investigated due to its often transient and dynamic nature. We aimed to assess left ventricular (LV) mechanics by speckle‐tracking echocardiography in acute inferoposterior MI and ischemic mitral regurgitation (MR).

Methods

Sixty‐nine patients with no structural cardiac valve abnormalities and first acute inferoposterior MI were prospectively enrolled into the study. Two‐dimensional transthoracic echocardiography for regional myocardial function and valve assessment was performed within 48 hours of presentation after reperfusion therapy (percutaneous coronary intervention). Based on degree of MR, patients were divided into no significant MR (NMR) group (N = 34, with no or mild (grade 0–I) MR) and ischemic MR (IMR) group (N = 35, with grade ≥2 MR). Thirty‐five age‐ and gender‐matched healthy individuals served as a normal reference group. Offline 2D speckle tracking analysis was performed with GE EchoPAC software.

Results

LV ejection fraction and longitudinal myocardial deformation parameters were significantly better in healthy subjects, but did not differ between both study groups. All circumferential myocardial deformation parameters were significantly worse in IMR group compared to healthy subjects and NMR group. Global, basal, and mid‐ventricular radial strain was significantly lower in IMR group compared to both—healthy subjects and NMR group.

Conclusion

Ischemic mitral regurgitation in acute inferoposterior MI is associated with worse radial and circumferential LV deformation parameters assessed by 2D speckle tracking echocardiography.
Three‐dimensional transesophageal echocardiography incremental value in a rare case of a bileaflet tricuspid valve
Authors: Mahmoud Hani M. , Walley Hossam , Hosny Hatem , Yacoub Magdi
Published: June 2016

Detailed assessment of the tricuspid valve using two‐dimensional echocardiography is always challenging, as only two of three leaflets can be seen at a time. Three‐dimensional echocardiography can provide the enface view of the tricuspid valve that allows simultaneous visualization of all of the three leaflets. In a 42‐year‐old male patient scheduled for pulmonary endarterectomy, 3DTEE showed that the tricuspid valve is bileaflet, with one septal and another lateral leaflet. There were two commissures, one of them is anteriorly positioned and the other one is posterior. Our findings were confirmed intra‐operatively by direct surgical visualization of the tricuspid valve.
Left atrial and ventricular systolic and diastolic myocardial mechanics in patients with end‐stage renal disease
Authors: Calleja Anna M. , Rakowski Harry , Williams Lynne K. , Jamorski Michal , Chan Christopher T. , Carasso Shemy
Published: June 2016

Background

Diastolic cardiac dysfunction is an important complication of end‐stage renal disease (ESRD), but quantification remains a challenge. Given that diastolic dysfunction is reflected in both left atrial (LA) and ventricular (LV) function, we aimed to identify abnormalities in LV and LA volume and function using measures of myocardial mechanics.

Methods

We retrospectively studied 53 incident ESRD patients (46±16 y/o 44% male) and compared them to 85 normal controls. LA phasic volumes and functional parameters were obtained from the apical 4CH view. Global ventricular peak longitudinal and circumferential strain, strain rate (GLS, GL‐SR, CS), and rotation were obtained from apical and short‐axis views. LA and LV measurements were taken off line using dedicated software (eSie VVI).

Results

ESRD patients had abnormal systolic function with lower LV ejection fraction and peak endocardial strain parameters (mean: GLS −16.6% vs −19.9%, GL‐SR −0.91 vs −1.04, and CS −25.6% vs 27.9%, P≤.01 for all). Traditional Doppler parameters remained similar between groups, while diastolic mechanics were abnormal in ESRD. Reduced LV‐derived diastolic parameters, fractional early reverse rotation, a marker of ventricular relaxation (P<.006), and ratio of early diastolic SR to systolic SR (P<.04) denote significant diastolic dysfunction. Increased LA volumes (P<.001), decreased LA reservoir (P<.001), conduit (P<.0004), and contractile (P<.02) function reflect diastolic dysfunction.

Conclusion

Myocardial strain measurements quantitated the abnormalities in both LV diastolic and LA function associated with the uremic state. The distinct abnormal diastolic parameters were suggestive of abnormal relaxation and increased filling pressures. Early and accurate assessment of diastolic function may help tailor patient management ESRD.
Conditional crisis? Ecological challenges and conditions of growth during the agricultural revolution in southern Sweden, c. 1700–1900†
Authors: Bohman Magnus
Published: June 2016

Was there an agro‐ecological crisis in Europe which preceded and contributed to pushing forward the agricultural revolution? This article presents a new theoretical and empirical approach to this controversial perspective on agricultural transformation and relates to an ongoing debate on conditions of growth in pre‐industrial societies. The results demonstrate that there were indeed indicators of a crisis, which grew stronger during the eighteenth century and culminated in the early nineteenth century. The crisis was, however, not general, but was rather restricted to areas that stand out due to poor natural conditions for agriculture. In other words, the crisis was conditional. Furthermore, the findings show that the crisis could push forward changes that were important for enabling agricultural transformation and growth. However, both the emergence and reversal of the crisis were connected to new opportunities opened up by market development. Enough differences were found between different types of regions to suggest that there were many development paths within the agricultural transformation process, and that they were not necessarily linear.
The antibacterial activity of chlorhexidine digluconate against Streptococcus mutans biofilms follows sigmoidal patterns
Authors: Lee Dae‐Woo , Jung Ji‐Eun , Yang Yeon‐Mi , Kim Jae‐Gon , Yi Ho‐Keun , Jeon Jae‐Gyu
Published: June 2016

The aim of this study was to determine the pattern of the antibacterial activity of chlorhexidine digluconate (CHX) against mature Streptococcus mutans biofilms. Streptococcus mutans biofilms were formed on saliva‐coated hydroxyapatite discs and then treated with 0–20% CHX, once, three times, or five times (1 min per treatment) during the period of mature biofilm formation (beyond 46 h). After the treatments, the colony‐forming unit (CFU) counts of the treated biofilms were determined. The pH values of the spent culture medium were also determined to investigate the change in pH resulting from the antibacterial activity of CHX. The relationships between the concentration of CHX and the CFU counts and the concentration of CHX and culture medium pH, relative to the number of treatments performed, were evaluated using a sigmoidal curve‐fitting procedure. The changes in CFU counts and culture medium pH followed sigmoidal curves and were dependent on the concentration of CHX (R2 = 0.99). The sigmoidal curves were left‐shifted with increasing number of treatments. Furthermore, the culture‐medium pH of the treated biofilms increased as their CFU counts decreased. The lowest CHX concentration to increase culture‐medium pH above the critical pH also decreased as the number of treatments increased. These results may provide fundamental information for selecting the appropriate CHX concentrations to treat S. mutans biofilms.
Patient safety events in hospital care of individuals with epilepsy
Authors: Mendizabal Adys , Thibault Dylan P. , Willis Allison W.
Published: June 2016

Objectives

(1) To describe patient adverse events (PAEs) experienced by hospitalized individuals with epilepsy and examine the association of an epilepsy diagnosis on risk of specific PAEs; (2) to examine the impact of a PAE on (a) length of stay (LOS), (b) inpatient death, and (c) use of institutional post‐acute care.

Methods

We applied the Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicator (PSI) software to the National Inpatient Sample database to identify potential medical and postoperative PAEs among >72 million hospitalizations of adults in the United States from 2000 to 2010. Logistic regression models compared the odds of experiencing each PAE between hospitalizations of persons with epilepsy (PWE) and the general inpatient population. We also examined the impact of experiencing a PAE on LOS, inpatient death, and discharge disposition.

Results

Hospitalized PWEs were at increased risk for specific postoperative PAEs: fall with hip fracture (Adjusted Odds Ratio, AOR 1.90, 1.21–2.99), respiratory failure (AOR 2.64, 2.43–2.87), sepsis (AOR 1.41, 1.21–1.63), and preventable postoperative death (AOR 1.25, 1.15–1.36). The odds of perioperative pulmonary embolism/deep vein thrombosis (AOR 1.65, 1.57–1.73), skin pressure ulcer (AOR 1.25, 1.22–1.29), and central venous catheter‐related bloodstream infections (AOR 1.24, 1.17–1.32) were also greater among hospitalizations of PWEs. Experiencing a PAE was associated with a prolonged mean length of stay (15 days vs. 5 days, t‐test p < 0.001), a 416% increase in the odds of inpatient death (AOR 4.16, 3.95–4.38), and a 282% increase in use of high‐level post‐acute care (AOR 2.82, 2.72–2.93).

Significance

Hospitalized adults with epilepsy are vulnerable to specific safety‐related adverse events, and these potential patient safety failures substantially impact outcomes and resource use. Efforts to reduce long‐term disability and improve the value of care delivered to PWEs may need to consider provider‐level interventions to reduce adverse events.
Seed growth of three perennial ryegrass cultivars sown on two dates and treated with trinexapac ethyl straw shortener
Authors: Chynoweth R. J. , Moot D. J.
Published: June 2016

First‐year crops of diploid perennial ryegrass (cvs. Meridian, Bronsyn and Grasslands Impact) were sown on 1 April and 14 May 2008. Applications of trinexapac ethyl (TE) plant growth regulator at 0, 200 and 400 g a.i. ha−1 were used to shorten stems to examine the impact of seed growth. Seed filling followed a consistent sigmoidal growth pattern with a lag phase of 127°C days, and linear duration of 390°C days. Time to 95% of final seed weight was 517°C days. Seed yield increases from TE were from higher numbers of first‐grade seeds m−2, achieved by a higher rate of seed filling during the linear phase of 0·115 mg per °C day per spike. For all cultivars, the maximum stem dry weight occurred at 310–400°C days post‐anthesis, which suggest the stem was a strong sink. As seeds developed, their demand for assimilate increased and they drew more from the stem. At harvest, stem weights from TE treatments were 25% heavier than at anthesis, while untreated ‘Bronsyn’ and ‘Grasslands Impact’ stems were similar to those at anthesis. Thus, stems treated with TE contributed assimilates to increase seed yield but were still a net sink with assimilates in the stem at harvest. Trinexapac ethyl rate induced an inverse relationship between seed yield and stem height. This showed that competition for assimilate between stems and growing seeds limited the seed yield. Management or genetic factors that reduce stem height are likely to increase seed yields of perennial ryegrass.
Improvement in health‐related quality of life in patients with haemophilia B treated with nonacog beta pegol, a new extended half‐life recombinant FIX product
Authors: Chowdary P. , Kearney S. , Regnault A. , Hoxer C. S. , Yee D. L.
Published: June 2016

Introduction

Health‐related quality of life (HRQoL) of individuals with haemophilia has greatly improved with the use of factor replacement and routine prophylaxis.

Aim

To explore the HRQoL of individuals with haemophilia B treated with nonacog beta pegol, an extended half‐life recombinant factor IX, in a single‐blind, randomized multinational phase III pivotal trial (paradigm™2) and its open‐label extension (paradigm™4).

Methods

In the pivotal trial, adolescents and adults with haemophilia B were allocated to 28‐week on‐demand treatment or randomized to 52 weeks of prophylaxis with 10 or 40 IU kg−1 nonacog beta pegol administered every seven days. In the extension trial, patients could continue on the same treatment or switch to the alternate dosing regimen at any time. HRQoL was assessed with the HAEMO‐QOL/HAEM‐A‐QOL age‐specific questionnaires and the EQ‐5D.

Results

In the pivotal trial, adults receiving 40 IU kg−1 prophylaxis reported significant improvements in the ‘HAEM‐A‐QOL Total’ score (−6.4 ± 8.5, P = 0.017) and in ‘Sport’ (−15.3 ± 8.5, P = 0.020), ‘Feeling’ (−15.2 ± 18.3, P = 0.010) and ‘Partnership’ (−9.6 ± 15.5, P = 0.046) domain scores; no significant improvements were seen in the other arms. At the pivotal trial end, fewer patients reported problems in the EQ‐5D ‘Mobility’ and ‘Pain/Discomfort’ dimensions, in particular those receiving prophylaxis. In the extension trial, adult patients switching from 10 to 40 IU kg−1 prophylaxis showed significant improvements in ‘HAEM‐A‐QOL Total’ score (−12.5 ± 8.7, P = 0.016) and ‘Physical health’ domain (−23.1 ± 14.4, P = 0.016).

Conclusion

Prophylactic treatment with nonacog beta pegol 40 IU kg−1 once weekly leads to HRQoL benefits in individuals with haemophilia B; this might be related to fewer bleeding episodes and higher FIX activity levels.
Cerebral Sinus Thrombosis
Authors: Agrawal Kunal , Burger Kathy , Rothrock John F.
Published: June 2016

Background

Although cerebral venous thrombosis/cerebral sinus thrombosis (CVT/CST) remains a relatively uncommon cause of stroke and other neurologic complications, the widespread availability of noninvasive brain imaging has led to an increase in its diagnosis.

Purpose

Through a review and description of its epidemiology, clinical features and treatment, to heighten awareness of CVT/CST.

Methodology

Via a systematic review of the more recently published medical literature relevant to the topic and focusing in particular on primary sources, we compiled data related to the incidence of CVT/CST and its diagnosis, treatment and prognosis.

Results

Thrombosis of a cerebral vein or sinus may occur in individuals of any age and may be caused by a myriad of prothrombotic conditions, both primary and acquired. The clinical presentation of CVT/CST is widely variable, but headache is present in the great majority of cases, and the predominant symptom in many. The headache associated with CVT/CST may be acute, severe, and even “thunderclap” in character, or it may be chronic, pervasive, and of lower intensity.

Conclusions

Given its eclectic epidemiology, its potential to produce a highly unfavorable clinical outcome, and evidence suggesting that specific treatment improves outcome, CVT/CST is a disorder whose salient features should be familiar to virtually all clinicians.
Three‐dimensional microscopic analysis of clinical prostate specimens
Authors: van Royen Martin E , Verhoef Esther I , Kweldam Charlotte F , van Cappellen Wiggert A , Kremers Gert‐Jan , Houtsmuller Adriaan B , van Leenders Geert J L H
Published: June 2016

Aims

Microscopic evaluation of prostate specimens for both clinical and research purposes is generally performed on 5‐μm‐thick tissue sections. Because cross‐sections give a two‐dimensional (2D) representation, little is known about the actual underlying three‐dimensional (3D) architectural features of benign prostate tissue and prostate cancer (PCa). The aim of this study was to show that a combination of tissue‐clearing protocols and confocal microscopy can successfully be applied to investigate the 3D architecture of human prostate tissue.

Methods and results

Optical clearing of intact fresh and formalin‐fixed paraffin‐embedded (FFPE) clinical prostate specimens allowed us to visualize tissue structures up to a depth of 800 μm, whereas, in uncleared tissue, detection of fluorescence was only possible up to 70 μm. Fluorescent labelling with a general nuclear dye and antibodies against cytokeratin (CK) 5 and CK8‐18 resulted in comprehensive 3D imaging of benign peripheral and transition prostate zones, as well as individual PCa growth patterns. After staining, clearing, and imaging, samples could still be processed for 2D (immuno)histochemical staining and DNA analysis, enabling additional molecular and diagnostic characterization of small tissue specimens.

Conclusions

In conclusion, the applicability of 3D imaging to archival FFPE and fresh clinical specimens offers unlimited opportunities to study clinical and biological topics of interest in their actual 3D context.
HIV viraemia and mother‐to‐child transmission risk after antiretroviral therapy initiation in pregnancy in Cape Town, South Africa
Authors: Myer L , Phillips TK , McIntyre JA , Hsiao N‐Y , Petro G , Zerbe A , Ramjith J , Bekker L‐G , Abrams EJ
Published: June 2016

Objectives

Maternal HIV viral load (VL) drives mother‐to‐child HIV transmission (MTCT) risk but there are few data from sub‐Saharan Africa, where most MTCT occurs. We investigated VL changes during pregnancy and MTCT following antiretroviral therapy (ART) initiation in Cape Town, South Africa.

Methods

We conducted a prospective study of HIV‐infected women initiating ART within routine antenatal services in a primary care setting. VL measurements were taken before ART initiation and up to three more times within 7 days postpartum. Analyses examined VL changes over time, viral suppression (VS) at delivery, and early MTCT based on polymerase chain reaction (PCR) testing up to 8 weeks of age.

Results

A total of 620 ART‐eligible HIV‐infected pregnant women initiated ART, with 2425 VL measurements by delivery (median gestation at initiation, 20 weeks; median pre‐ART VL, 4.0 log10 HIV‐1 RNA copies/mL; median time on ART before delivery, 118 days). At delivery, 91% and 73% of women had VL ≤ 1000 and ≤ 50 copies/mL, respectively. VS was strongly predicted by time on therapy and pre‐ART VL. The risk of early MTCT was strongly associated with delivery VL, with risks of 0.25, 2.0 and 8.5% among women with VL < 50, 50–1000 and > 1000 copies/mL at delivery, respectively (P < 0.001).

Conclusions

High rates of VS at delivery and low rates of MTCT can be achieved in a routine care setting in sub‐Saharan Africa, indicating the effectiveness of currently recommended ART regimens. Women initiating ART late in pregnancy and with high VL appear substantially less likely to achieve VS and require targeted research and programmatic attention.
Childhood adiposity and fertility difficulties: the Bogalusa Heart Study
Authors: Jacobs M. B. , Bazzano L. A. , Pridjian G. , Harville E. W.
Published: June 2016

Background

Adult obesity is associated with infertility; however, childhood obesity has received little consideration.

Objectives

The present study sought to evaluate the impact of childhood adiposity on fertility.

Methods

Associations between childhood adiposity and self‐reported fertility difficulties were estimated among women participating in a long‐term study of cardiovascular risks and reproductive health (n = 1061).

Results

Participants with obesity between ages 9 and 12 were more likely to report fertility difficulties (adjusted relative risk [aRR], 1.82, 95% CI 1.17–2.82) and inability to become pregnant when trying (aRR = 1.94, 95% CI 1.22–3.08) as were those with obesity prior to age 9 (aRR = 1.76, 95% CI 1.04–2.97). Similar associations were seen among those ever overweight or obese in childhood. High subscapular skinfold thickness (age < 12) increased risk of receiving help becoming pregnant (aRR = 2.16, 95% CI 1.15–4.06), inability to become pregnant (aRR = 1.46, 95% CI 1.05–2.04) and any fertility difficulties (aRR = 1.56, 95% CI 1.13–2.14); associations for triceps skinfold were attenuated. Participants with increased adiposity also had fewer pregnancies and live births. Effects persisted, excluding women with polycystic ovarian syndrome.

Conclusions

This study supports an association between childhood adiposity and infertility, not solely driven by polycystic ovarian syndrome.
Challenges facing foster parent resource workers in Canada
Authors: Brown Jason , Gerrits Julie , Anderson Landy
Published: June 2016

Many different professional staff members in children's services systems interact with foster parents. In Canada, the title “resource worker” is used in many jurisdictions for those who work most directly and closely with licensed foster parents. There is, however, limited research on the experiences of resource workers. In the study, 68 resource workers from 14 agencies within a large metropolitan area in Canada were asked: “What challenges do you face as a foster parent resource worker?” The results were analyzed using concept mapping methodology and resulted in nine concepts: balance diverse stakeholder needs, motivate foster parents, manage dual roles, respond to foster parent misconduct, deal with disagreements, maintain credibility, meet demands of organization, stay up to date on changes, and lack of support. The results were compared and contrasted with the available literature.
Collaborative contribution of six cytochrome P450 monooxygenase genes to fenpropathrin resistance in Tetranychus cinnabarinus (Boisduval)
Authors: Shi L. , Zhang J. , Shen G. , Xu Z. , Xu Q. , He L.
Published: June 2016

Cytochrome P450 monooxygenases (P450s), as an important family of detoxification enzymes, participate in the metabolism of agrochemicals in almost all agricultural pests and play important roles in the development of insecticide resistance. Two P450 genes (CYP389B1 and CYP392A26) were identified and their expression patterns were investigated in our previous study. In this study, four more P450 gene sequences (CYP391A1, CYP384A1, CYP392D11 and CYP392A28) from the Clan 2, Clan 3 and Clan 4 families were identified and characterized. Quantitative PCR analysis showed that these four P450 genes were highly expressed in a fenpropathrin‐resistant (FeR) strain of Tetranychus cinnabarinus. In addition, their expressions were much more sensitive to fenpropathrin induction in the FeR strain than the susceptible strain. Gene‐silencing experiments via double‐stranded RNA feeding were carried out. The results showed that mRNA levels of these six P450 genes were reduced in the FeR strain and the activities of P450s were decreased. Consequently mite susceptibilities to fenpropathrin were increased. Interestingly, silencing all six P450 genes simultaneously had an even greater effect on resistance than silencing them individually. This study increases our understanding of the molecular mechanisms of insecticide detoxification, suggesting that the overexpression of these six P450 genes might play important roles in fenpropathrin resistance in T. cinnabarinus collaboratively.
Structural and Piezoelectric Properties of (Na1−xKx)NbO3 Platelets and Their Application for Piezoelectric Nanogenerator
Authors: Xu HaiBo , Ko Young‐Jin , Lee Tae‐Gon , Park Su‐Jin , Noh Myoung‐Sub , Kim Bo‐Yun , Kim Jeong Seog , Nahm Sahn
Published: June 2016

(Na1−xKx)NbO3 (NKN) platelets synthesized at 600°C for 12 h have an Amm2 orthorhombic structure. However, the structure of NKN platelets synthesized at 500°C is a mixture of R3m rhombohedral and Amm2 orthorhombic structures. The formation of a rhombohedral structure is attributed to the presence of OH− and H2O defects in the NKN platelets. The piezoelectric strain constant (d33) of NKN platelets synthesized at 600°C for 12 h is 100 pmV−1, whereas that of NKN platelets synthesized at 500°C is lesser (50 pmV−1) due to the presence of these defects. Piezoelectric nanogenerators (PNGs) are fabricated using composites consisting of NKN platelets and polydimethylsiloxane. A large output voltage of 25 V and output current of 2.7 μA were obtained for the PNG with NKN platelets synthesized at 600°C for 6 h. This PNG shows a high output electrical energy of 3.0 μW at an external load of 5.1 MΩ.
Local adaptation to developmental density does not lead to higher mating success in Drosophila melanogaster
Authors: Shenoi V. N. , Prasad N. G.
Published: June 2016

In this study, we investigate the effect of local adaptation to developmental density on male mating success in laboratory populations of Drosophila melanogaster. Mating success is known to be influenced by body condition which can in turn be influenced by local adaptation. We test the hypothesis that males adapted to a given environment have higher mating success when assayed in that environment. We used males selected for adaptation to high larval density and their controls which are reared at low larval density. We grew assay males in low and high densities whereas the focal females (raised at low larval density) used for the experiment belonged to the common ancestor of selected and control populations. We considered selected males grown at high density and control males grown at low density as ‘adapted’. Similarly, we considered selected males grown at low density and control males grown at high density as ‘nonadapted’. Selected male belonging to a given treatment (larval density) was made to compete with control male of the same treatment for mating with ancestral female. We quantified components of reproductive fitness: mating latency, copulation duration, mating success and number of progeny sired by the ‘adapted’ and ‘nonadapted’ males. The results show that local adaptation does not lead to higher mating success in populations adapted to their own larval rearing environment.
Does size matter? A test of size‐specific mortality in Atlantic salmon Salmo salar smolts tagged with acoustic transmitters
Authors: Newton M. , Barry J. , Dodd J. A. , Lucas M. C. , Boylan P. , Adams C. E.
Published: June 2016

Mortality rates of wild Atlantic salmon Salmo salar smolts implanted with acoustic transmitters were assessed to determine if mortality was size dependent. The routinely accepted, but widely debated, ‘2% transmitter mass: body mass’ rule in biotelemetry was tested by extending the transmitter burden up to 12·7% of body mass in small [mean fork length (LF) 138·3 mm, range 115–168 mm] downstream migrating S. salar smolts. Over the short timescale of emigration (range 11·9–44·5 days) through the lower river and estuary, mortality was not related to S. salar size, nor was a relationship found between mortality probability and transmitter mass: body mass or transmitter length: LF ratios. This study provides further evidence that smolt migration studies can deviate from the ‘2% rule’ of thumb, to more appropriate study‐specific measures, which enables the use of fishes representative of the body size in natural populations without undue effects.
Risk factors for metachronous colorectal cancer or polyp: A systematic review and meta‐analysis
Authors: Jayasekara Harindra , Reece Jeanette C , Buchanan Daniel D , Ahnen Dennis J , Parry Susan , Jenkins Mark A , Win Aung Ko
Published: June 2016

Background and Aim

We conducted a systematic review and meta‐analysis to identify personal, lifestyle, and tumor‐related risk factors for metachronous colorectal cancer (CRC) and polyp.

Methods

Relevant studies were identified by searching MEDLINE, Web of Science and Cochrane Central Register through 15 May 2016. Estimates for associations were summarized using random effects models.

Results

Fifty‐five studies were included in the review. For individuals who had a CRC resection, having a synchronous polyp was a risk factor for metachronous CRC or polyp (relative risk [RR], 2.04; 95% confidence interval [CI], 1.48–2.82) and having a synchronous CRC (RR, 1.90; 95% CI, 1.25–2.91) and proximally located CRC (RR, 2.12; 95% CI, 1.24–3.64) were risk factors for metachronous CRC. For individuals who had a polypectomy, larger size (RR, 4.26; 95% CI, 2.11–8.57) or severe dysplasia of the initial polyp (RR, 5.15; 95% CI, 2.02–13.14), and having a synchronous polyp (RR, 2.52; 95% CI, 1.35–4.73) were risk factors for metachronous CRC; and a family history of CRC (RR, 1.90; 95% CI, 1.26–2.87), having a synchronous polyp (RR, 2.47; 95% CI, 1.74–3.50) and a larger size (RR, 1.49; 95% CI, 1.03–2.15) and proximal location of the initial polyp (RR, 1.20; 95% CI, 1.02–1.40) were risk factors for metachronous polyp. Meta‐regression showed duration of follow‐up was not a source of heterogeneity for most associations. There was no evidence that lifestyle factors were associated with metachronous CRC or polyp risk.

Conclusion

A comprehensive list of risk factors identified for metachronous CRC or polyp may have important clinical implications.
Quality of Care Provided by a Comprehensive Dementia Care Comanagement Program
Authors: Jennings Lee A. , Tan Zaldy , Wenger Neil S. , Cook Erin A. , Han Weijuan , McCreath Heather E. , Serrano Katherine S. , Roth Carol P. , Reuben David B.
Published: June 2016

Multiple studies have shown that quality of care for dementia in primary care is poor, with physician adherence to dementia quality indicators (QIs) ranging from 18% to 42%. In response, the University of California at Los Angeles (UCLA) Health System created the UCLA Alzheimer's and Dementia Care (ADC) Program, a quality improvement program that uses a comanagement model with nurse practitioner dementia care managers (DCM) working with primary care physicians and community‐based organizations to provide comprehensive dementia care. The objective was to measure the quality of dementia care that nurse practitioner DCMs provide using the Assessing Care of Vulnerable Elders (ACOVE‐3) and Physician Consortium for Performance Improvement QIs. Participants included 797 community‐dwelling adults with dementia referred to the UCLA ADC program over a 2‐year period. UCLA is an urban academic medical center with primarily fee‐for‐service reimbursement. The percentage of recommended care received for 17 dementia QIs was measured. The primary outcome was aggregate quality of care for the UCLA ADC cohort, calculated as the total number of recommended care processes received divided by the total number of eligible quality indicators. Secondary outcomes included aggregate quality of care in three domains of dementia care: assessment and screening (7 QIs), treatment (6 QIs), and counseling (4 QIs). QIs were abstracted from DCM notes over a 3‐month period from date of initial assessment. Individuals were eligible for 9,895 QIs, of which 92% were passed. Overall pass rates of DCMs were similar (90–96%). All counseling and assessment QIs had pass rates greater than 80%, with most exceeding 90%. Wider variation in adherence was found among QIs addressing treatments for dementia, which patient‐specific criteria triggered, ranging from 27% for discontinuation of medications associated with mental status changes to 86% for discussion about acetylcholinesterase inhibitors. Comprehensive dementia care comanagement with a nurse practitioner can result in high quality of care for dementia, especially for assessment, screening, and counseling. The effect on treatment QIs is more variable but higher than previous reports of physician‐provided dementia care.
Self‐Reported Sleep Duration, Napping, and Incident Heart Failure: Prospective Associations in the British Regional Heart Study
Authors: Wannamethee S. Goya , Papacosta Olia , Lennon Lucy , Whincup Peter H.
Published: June 2016

Objectives

To examine the associations between self‐reported nighttime sleep duration and daytime sleep and incident heart failure (HF) in men with and without preexisting cardiovascular disease (CVD).

Design

Population‐based prospective study.

Setting

General practices in 24 British towns.

Participants

Men aged 60–79 without prevalent HF followed for 9 years (N = 3,723).

Measurements

Information on incident HF cases was obtained from primary care records. Assessment of sleep was based on self‐reported sleep duration at night and daytime napping.

Results

Self‐reported short nighttime sleep duration and daytime sleep of longer than 1 hour were associated with preexisting CVD, breathlessness, depression, poor health, physical inactivity, and manual social class. In all men, self‐reported daytime sleep of longer than 1 hour duration was associated with significantly greater risk of HF after adjustment for potential confounders (adjusted hazard ratio (aHR) = 1.69, 95% CI = 1.06–2.71) than in those who reported no daytime napping. Self‐reported nighttime sleep duration was not associated with HF risk except in men with preexisting CVD (<6 hours: aHR = 2.91, 95% CI = 1.31–6.45; 6 hours: aHR = 1.89, 95% CI = 0.89–4.03; 8 hours: aHR = 1.29, 95% CI = 0.61–2.71; ≥9 hours: aHR = 1.80, 905% CI = 0.71–4.61 vs nighttime sleep of 7 hours). Snoring was not associated with HF risk.

Conclusion

Self‐reported daytime napping of longer than 1 hour is associated with greater risk of HF in older men. Self‐reported short sleep (<6 hours) in men with CVD is associated with particularly high risk of developing HF.
The Lived Experiences of People With Chronic Obstructive Pulmonary Disease: A Phenomenological Study
Authors: Chang Yi‐Ya , Dai Yu‐Tzu , Chien Nai‐Hui , Chan Hui‐Ya
Published: June 2016

Purpose

This study explored the lived experiences of people with chronic obstructive pulmonary disease (COPD) following hospitalization for acute exacerbation or pneumonia.

Design and Method

A phenomenological approach was adopted to collect data through semistructured interviews. Fourteen participants were recruited from a medical center in northern Taiwan. Data were collected from January 2013 to January 2014. Giorgi's phenomenological methodology was adopted to analyze the interview content.

Findings

Three phenomenological themes emerged: trapped in an invisible cage, torments in the winter, and striving for wellness.

Conclusions

This study sought to elucidate the lived experiences of people with COPD, who perceived themselves as feeling an overwhelming sense of confinement. The interviewees displayed positive attitudes, indicating that people with COPD are willing to cope with their disease. Health practitioners should focus on educating people with COPD about their needs, encouraging them to be more positive, and assisting them in engaging in self‐management.

Clinical Relevance

People with COPD can cope with the disease and seek alternative methods to improve their health. These positive attitudes could be used to encourage self‐management in the future.
New graduate registered nurse transition into primary health care roles: an integrative literature review
Authors: Murray‐Parahi Pauline , DiGiacomo Michelle , Jackson Debra , Davidson Patricia M
Published: June 2016

Aims and objectives

To summarise the literature describing new graduate nurse transition to professional practice within the primary health care (PHC) setting.

Background

There is a plethora of research literature spanning several decades about new graduate nurse transition in the acute care setting. Yet, the experiences of new graduate nurse in the PHC setting is unremarkable particularly considering the increasing demand for skilled health care workers and focus of health reform to provide care where people work and live.

Design

Electronic data bases, Academic Search Complete, EBSCO, Medline, PsycINFO, CINHAL, and ERIC were searched using a combination of terms and synonyms arising from three key concepts which identify the phenomenon; ‘transition’, ‘new graduate registered nurse’ and ‘primary health care. An inclusive search strategy placed no limits on language or publication date.

Results

Of the 50 articles located and examined for relevance; 40 were sourced through databases and 10 from Google Scholar/Alerts and hand‐searching references. None of the 19 articles retained for analysis addressed all key concepts.

Conclusions

Some challenges of researching the professional transition of graduate nurses in PHC settings included, an absence of definitive transition models, a dearth of literature and deference to acute care research.

Relevance to clinical practice

Nursing in PHC settings, particularly the client's home is notably different to hospital settings because of higher levels of isolation and autonomy. Societal changes, health reform and subsequent demand for skilled workers in PHC settings has caused health care providers to question the logic that such roles are only for experienced nurses. Implications arise for education and health service providers who desire to close the theory practice gap and mitigate risk for all stakeholders when next generation nurses have limited opportunities to experience PHC roles as undergraduates and newly graduated registered nurses are already transitioning in this setting.
Patients' experience of mood while waiting for day surgery
Authors: Svensson Margita , Nilsson Ulrica , Svantesson Mia
Published: June 2016

Aims and objectives

The aim was to describe the moods experienced by people waiting for day surgery.

Background

Except for anxiety, there is a lack of knowledge about the moods experienced by patients while waiting for day surgery, as well as the impact of mood during the perioperative period. Preoperative anxiety is common and has multiple negative effects. A deeper knowledge of preoperative moods and how they are experienced is needed and may be useful for improving perioperative care.

Design

Qualitative descriptive design.

Methods

Qualitative semi‐structured interviews (n = 20) with adults waiting for day surgery in a Swedish university hospital. Data were analysed with inductive content analysis.

Results

The informants described a variety of moods and mood‐influencing reasons. The main category that emerged was, ‘feeling hope about regaining health as a help to balance mood’ regardless of mood. This category was abstracted from the generic categories ‘experiencing a harmonious mood’ and ‘experiencing a shifting mood’. The subcategories were ‘feeling calm and at ease despite concerns and fear,’ ‘experiencing expectation,’ ‘feeling trust and confidence,’ ‘shifting between expectancy and anxiety,’ ‘feeling vulnerable and exposed, and ‘feeling uncertainty’.

Conclusions

The findings contribute to the knowledge about that regardless of mood, feeling hope about regaining health may help patients to balance their mood during the waiting period.

Relevance to clinical practice

The results can have implications with respect to developing and improving preoperative care, such as having clinicians extend offers of individual assistance and information during the waiting period to patients experiencing shifting mood. Instilling hopefulness in patients who are waiting for day surgery by means of clinical staff attitudes and interactions may help patients to develop healthy coping strategies and thereby improve their physical and emotional well‐being.