bluuebunny/crossref_metadata_2025 huggingface dataset:
Urinary tract infection in patients with hip fracture: An underestimated event?
Authors: Bliemel Christopher , Buecking Benjamin , Hack Juliana , Aigner Rene , Eschbach Daphne‐Asimenia , Ruchholtz Steffen , Oberkircher Ludwig
Published: June 2017

Aim

Urinary tract infections (UTI) represent a common perioperative complication among elderly patients with hip fracture. To determine the impact of UTI on the perioperative course of elderly patients with hip fractures, a prospective study was carried out.

Methods

A total of 402 surgically‐treated geriatric hip fracture patients were consecutively enrolled at a level 1 trauma center. On admission, all patients received an indwelling urinary catheter. Clinically symptomatic patients were screened more closely for UTI. Patients diagnosed with UTI were compared with asymptomatic patients. Outcomes in both patient groups were measured using in‐hospital mortality, overall length of hospital stay, wound infection, functional results and mobility at discharge. Multivariate regression analysis was carried out to control for influencing factors.

Results

A total of 97 patients (24%) sustained a UTI during in‐hospital treatment. UTI were independently associated with inferior functional outcomes as assessed by the Barthel Index (β = −0.091; P = 0.031), Timed Up and Go test (β = 0.364; P = 0.001) and Tinetti test (β = −0.169; P = 0.001) at discharge. Additionally, length of hospital stay was significantly longer for patients with a UTI diagnosis (β = 0.123; P = 0.029) after controlling for all other variables. No differences were observed in the rate of wound infection (odds ratio 1.185; P = 0.898) or in‐hospital mortality (P < 0.997).

Conclusions

Patients with UTI seem to be at risk of inferior functional outcomes. In addition to an early detection of symptomatic UTI and a targeted antibiotic therapy, perioperative care should focus on preserving functional ability to protect these patients from further loss of independence and prolonged clinical courses. Geriatr Gerontol Int 2017; 17: 2369–2376.
Validity of the National Center for Geriatrics and Gerontology‐Functional Assessment Tool and Mini‐Mental State Examination for detecting the incidence of dementia in older Japanese adults
Authors: Shimada Hiroyuki , Makizako Hyuma , Park Hyuntae , Doi Takehiko , Lee Sangyoon
Published: June 2017

Aim

Numerous neuropsychological tests are implemented in the clinical setting. However, a readily available cognitive test is required to detect the risk of dementia in the community setting.

Methods

A total of 4151 persons aged ≥65 years participated in the present prospective cohort study. We assessed cognitive performance using the Mini‐Mental State Examination and the National Center for Geriatrics and Gerontology‐Functional Assessment Tool. The National Center for Geriatrics and Gerontology‐Functional Assessment Tool includes tests of story and word list memory, attention and executive function, processing speed, and visuospatial skill to screen for cognitive impairment. All measurements were transformed to Z‐scores to compare among the cognitive tests. The incidence of dementia was determined using data collected by the Japanese Health Insurance System over 36 months.

Results

After an average of 43 months, 180 (4.3%) participants were diagnosed with dementia. Survival analyses showed that the probability of dementia was significantly associated with all cognitive tests, except for visuospatial skill. The processing speed test showed the highest hazard ratios for the incidence of dementia (Z‐score: hazard ratio 0.61, 95% confidence interval 0.50–0.75, P < 0.01). In subgroup analysis, there were no significant relationships between cognitive tests and the incidence of dementia in participants without global cognitive impairment.

Conclusions

We conclude that the National Center for Geriatrics and Gerontology‐Functional Assessment Tool, as well as the Mini‐Mental State Examination, play an important role in detecting the risk of dementia in the community setting. Further analysis is required to identify the risk of dementia in older people without global cognitive impairment. Geriatr Gerontol Int 2017; 17: 2383–2388.
Comparison of healthcare utilization and life‐sustaining interventions between elderly patients with dementia and those with cancer near the end of life: A nationwide, population‐based study in Taiwan
Authors: Chen Yu‐Han , Ho Chung‐Han , Huang Chien‐Cheng , Hsu Ya‐Wen , Chen Yueh‐Chun , Chen Ping‐Jen , Chen Guan‐Ting , Wang Jhi‐Joung
Published: June 2017

Aim

Little is known about the pattern of healthcare services for end‐of‐life patients with dementia (PwD) in East Asia. We compared this pattern between PwD and cancer patients in their last year of life in Taiwan.

Methods

Taiwan's National Health Insurance Research Database was applied for this case–control analysis. The records of patients who had dementia and died between 2002 and 2011 were reviewed. The control group was decedents with cancer. The utilization of hospitalization, emergency department visits and life‐sustaining interventions during the last year of life between the two groups were compared.

Results

Of the 2724 patients enrolled, 908 had dementia and 1816 had cancer. PwD were more likely to have a higher frequency of admission to hospital and intensive care unit, and longer stays compared with cancer patients. PwD had a higher risk of enteral tube insertion and feeding, endotracheal intubation and tracheostomy, mechanical ventilation, hemodialysis and cardiopulmonary resuscitation (OR 4.36, 95% CI 3.51–5.41), which was the highest among the selected procedures.

Conclusions

PwD in their last year of life in Taiwan underwent aggressive interventions significantly more frequently than did their counterparts in Western countries. Providing comfort‐centered care for better quality of life for end‐of‐life PwD is a priority of Taiwan's national health policy. Geriatr Gerontol Int 2017; 17: 2545–2551.
Prevalence of chronic obstructive pulmonary disease in independent community‐dwelling older adults: The Fujiwara‐kyo study
Authors: Yoshikawa Masanori , Yamamoto Yoshifumi , Tomoda Koichi , Fujita Yukio , Yamauchi Motoo , Osa Takao , Uyama Hiroki , Okamoto Nozomi , Kurumatani Norio , Kimura Hiroshi
Published: June 2017

Aim

As the Japanese population ages, the number of older patients with chronic obstructive pulmonary disease (COPD) is expected to increase, but the prevalence of COPD in patients aged ≥80 years remains unclear. The purpose of the present study was to determine the prevalence of COPD in independent community‐dwelling older adults aged ≥80 years.

Methods

We investigated the prevalence of COPD in 2862 independent community‐dwelling older adults (1504 men, 1358 women, mean age 77.7 ± 7.0 years) who underwent spirometry in the Fujiwara‐kyo study, a study of successful aging in older adults. Those participants with airflow limitation (forced expiratory volume in 1 s/forced vital capacity <0.7) who indicated on a self‐administered questionnaire that they had a history of smoking and did not have bronchial asthma were considered to have COPD.

Results

The prevalence of COPD was 16.9% among all participants and 37.4% among smokers. The prevalence among individuals aged ≥80 years (19.7%) was significantly higher than that among those aged <80 years (16.0%; P < 0.05). When forced expiratory volume in 1 s/forced vital capacity lower limit of normal was used as the criterion for airflow limitation, the prevalence fell to 11.0%. Patients with mild‐to‐moderate airflow limitation (stage I/stage II) accounted for the great majority (91.2%) of COPD patients aged ≥80 years.

Conclusions

A high prevalence of mild‐to‐moderate COPD was observed even in the independent community‐dwelling older adults aged ≥80 years. However, the benefits of the spirometric screening and treatment for these patients needs to be determined. Geriatr Gerontol Int 2017; 17: 2421–2426.
A matter of timing: The religious factor and morality policies
Authors: Budde Emma T. , Knill Christoph , Fernández‐i‐Marín Xavier , Preidel Caroline
Published: June 2017

The question of whether or not religion accounts for variance in the governance of moral issues, between and within countries over time, has long been debated but never conclusively answered. A novel data set encompassing innovative measurements of state regulation of “life‐and‐death” issues and of the religious stratification of society enables us to answer why previous studies reached contradictory results. The time‐series cross‐sectional analysis of 26 countries over 50 years reveals that dominant religious denominations in society indeed influence state governance approaches regarding the issues of abortion and euthanasia. This denominational effect is shown to be contingent on the religiosity of a country's population, but independent from the formal state–church relationship. Lastly, it is shown that the religious effect has an inverse U‐shaped relationship with time, exposing the timeframe of analysis as decisive for inferences drawn in the study of morality policy.
Adult males with haemophilia have a different macrovascular and microvascular endothelial function profile compared with healthy controls
Authors: Sun H. , Yang M. , Fung M. , Chan S. , Jawi M. , Anderson T. , Poon M.‐C. , Jackson S.
Published: June 2017

Introduction

Endothelial function has been identified as an independent predictor of cardiovascular risk in the general population. It is unclear if the haemophilia population has a different endothelial function profile compared to the healthy population.

Aim

This prospective study aims to assess if there is a difference in endothelial function between haemophilia patients and healthy controls, and the impact of endothelial function on vascular outcomes in the haemophilia population. Baseline cardiovascular risk factors and endothelial function were presented.

Methods

Adult males with haemophilia A or B recruited from the British Columbia and Southern Alberta haemophilia treatment centres were matched to healthy male controls by age and cardiovascular risk factors. Macrovascular endothelial function was assessed by brachial artery flow‐mediated dilation (FMD) and nitroglycerin‐mediated dilation (NMD), and microvascular endothelial function was assessed by hyperaemic velocity time integral (VTI). Multivariable linear regression was used to assess the association between haemophilia and endothelial function.

Results

A total of 81 patients with haemophilia and 243 controls were included. Patients with haemophilia had a similar FMD and NMD compared to controls, although haemophilia was associated with higher FMD on multivariable analysis. Haemophilia was associated with significantly lower VTI on univariate and multivariable analyses, regardless of haemophilia type and severity.

Conclusions

Adult males with haemophilia appear to have lower microvascular endothelial function compared to healthy controls. Future studies to assess the impact of endothelial dysfunction on cardiovascular events in the haemophilia population are needed.
The university's governance paradox
Authors: Maassen Peter
Published: June 2017

One can observe a growing external pressure on universities to become more responsive to society through proactively engaging in various types of competition—competing for students, staff, external funding, and for academic prestige and status. The ensuing reform agendas aim at changing the intra‐university governance structures for stimulating the intended university responsiveness. This article discusses how intra‐university governance has developed over time with a changing internal and external dynamics. It will be argued that in the university governance practice a paradox has emerged: the more university leaders take on and operate in line with the reform agenda's ideologies, the less effective they appear to be in realising some of the reform intentions. How can such a paradox be accounted for? Building on three general theories of governance, this paradox is analysed as arising from the neglect of the interplay of historical university traditions and formal organisational–structural features of the university. The importance of this interplay will be discussed from the perspective of the prestige economy.
Acute effects of phenylbutyrate on glutamine, branched‐chain amino acid and protein metabolism in skeletal muscles of rats
Authors: Holecek Milan , Vodenicarovova Melita , Siman Pavel
Published: June 2017

Phenylbutyrate (PB) acts as chemical chaperone and histone deacetylase inhibitor, which is used to decrease ammonia in urea cycle disorders and has been investigated for use in the treatment of a number of lethal illnesses. We performed in vivo and in vitro experiments to examine the effects of PB on glutamine (GLN), branched‐chain amino acid (BCAA; valine, leucine and isoleucine) and protein metabolism in rats. In the first study, animals were sacrificed one hour after three injections of PB (300mg/kg b.w.) or saline. In the second study, soleus (SOL, slow twitch) and extensor digitorum longus (EDL, fast twitch) muscles were incubated in a medium with or without PB (5 mM). L‐[1‐14C] leucine was used to estimate protein synthesis and leucine oxidation, and 3‐methylhistidine release was used to evaluate myofibrillar protein breakdown. PB treatment decreased GLN, BCAA and branched‐chain keto acids (BCKAs) in blood plasma, decreased BCAA and increased GLN concentrations in muscles, and increased GLN synthetase activities in muscles. Addition of PB to incubation medium increased leucine oxidation (55% in EDL, 29% in SOL), decreased BCKA and increased GLN in medium of both muscles, increased GLN in muscles, decreased protein synthesis in SOL and increased proteolysis in EDL. It is concluded that PB decreases BCAA, BCKA and GLN in blood plasma, activates BCAA catabolism and GLN synthesis in muscle and exerts adverse effects on protein metabolism. The results indicate that BCAA and GLN supplementation is needed when PB is used therapeutically and that PB may be a useful prospective agent which could be effective in management of maple syrup urine disease.
The effectiveness of strategies similar to the Magnet model to create positive work environments on nurse satisfaction
Authors: Kol Emine , İlaslan Emine , Turkay Mehtap
Published: June 2017

Aim

The objective of this study was to identify the satisfaction levels of nurses with positive environment initiatives and positive management strategies.

Method

In total, 235 and 259 nurses participated in the study before and after the application of the initiatives and strategies, respectively. Strategies adopted from the magnet model to create positive work environments and management styles were executed according to the forces of magnetism. Data related to satisfaction were collected twice, once before and once after the strategies to create positive working environments were implemented.

Results

The rates of working environment satisfaction in the nurses' department were 57.07% in 2011 and 69.01% in 2013. The rate of satisfaction with governance differed significantly between 2011 and 2013, especially in terms of the merit system, equity and equality, information flow between the administration and the employees, and the influence of the nursing managers on institutional decision making.

Conclusion

This study showed that 24 months after the implementation of these strategies, nurse satisfaction with their work environment and management style increased significantly.
Factors affecting aging cognitive function among community‐dwelling older adults
Authors: Kim Chun‐Ja , Park JeeWon , Kang Se‐Won , Schlenk Elizabeth A.
Published: June 2017

Aim

The study purpose was to determine factors affecting aging cognitive function of 3,645 community‐dwelling older adults in Korea.

Methods

The Hasegawa Dementia Scale assessed aging cognitive function, blood analyses and anthropometrics assessed cardio‐metabolic risk factors, and the Geriatric Depression Scale Short Form Korean Version assessed depressive symptoms.

Results

Participants with poor aging cognitive function were more likely to be in the late age group (≥75 y) and currently smoking and have a medical history of stroke, high body mass index, and high level of depressive symptoms; they were also less likely to engage in regular meals and physical activities.

Conclusion

Regular meals and physical activities may be primary factors for clinical assessment to identify older adults at risk for aging cognitive function. With aging, depressive symptoms and other unhealthy lifestyle behaviours should be managed to prevent cognitive function disorders.
Cloning and functional identification of moricins from the diamondback moth, Plutella xylostella (L.)
Authors: Xia X.‐F. , Li Y. , Yu X.‐Q. , Lin J.‐H. , Li S.‐Y. , Li Q. , You M.‐S.
Published: June 2017

Antimicrobial peptides (AMPs) are small‐molecule peptides that play crucial roles in insect innate immune responses. To better understand the function of AMPs in Plutella xylostella, one of the main pests of cruciferous vegetables, three full‐length cDNAs encoding moricins were cloned from Pl. xylostella. Two variants of the moricin named PxMor2 and PxMor3 were heterologously expressed and purified. A secondary structure analysis using circular dichroism demonstrated that the two peptides adopted an α‐helical structure in the membrane‐like environment, but in aqueous solution, they were present in random coiled conformation. Antimicrobial activity assays demonstrated that PxMor2 exhibited high activity against Gram‐positive Staphylococcus aureus and Gram‐negative Escherichia coli; however, PxMor3 only demonstrated high activity against E. coli. Scanning electron microscopy and confocal laser‐scanning microscopy analyses suggest that PxMors can lead to the disruption of bacterial membrane, which might be the mechanism by which PxMors inhibit bacterial growth. This study contributes to the understanding of Pl. xylostella AMPs and immune responses, and also enriches the knowledge of insect moricin.
Overview of systematic reviews: Effective home support in dementia care, components and impacts—Stage 1, psychosocial interventions for dementia
Authors: Clarkson Paul , Hughes Jane , Xie Chengqiu , Larbey Matthew , Roe Brenda , Giebel Clarissa M. , Jolley David , Challis David ,   Members of the HoSt‐D (Home Support in Dementia) Programme Management Group
Published: June 2017

Aim

To synthesize evidence to identify the components of effective psychosocial interventions in dementia care to inform clinical practice, policy and research.

Background

With population ageing, dementia represents a significant care challenge with 60% of people with dementia living at home.

Design

Overview of systematic reviews with narrative summary.

Data sources

Electronic searches of published systematic reviews in English using Cochrane Database of Systematic Reviews, DARE and EPPI‐Centre, between September 2013 ‐ April 2014.

Review methods

Systematic reviews were appraised against Cochrane Collaboration levels of effectiveness. Components of psychosocial interventions were identified with their theoretical rationale. Findings were explored with a Patient, Public and Carer Involvement group.

Results

Thirty‐six systematic reviews were included. From interventions, 14 components were identified, nine for people with dementia and five for carers, mostly undertaken in nursing/care homes. For people with dementia, there was evidence of effectiveness for cognitive stimulation and cognitive training, but less evidence for sensory stimulation, reminiscence, staff education, behavioural therapy and ADL training. For carers, there was evidence of effectiveness for education and training, psychotherapy and counselling.

Conclusion

There was a lack of definitive evidence of effectiveness for most psychosocial interventions. Further studies with stronger methodology or replication of existing studies would strengthen the evidence base. Few interventions were undertaken with people with dementia and their carers living at home. Further work will investigate the extent to which components identified here are present in models of home support for people with dementia and carers and their effectiveness.
Effect of periodontal therapy with systemic antimicrobials on parameters of metabolic syndrome: A randomized clinical trial
Authors: Bizzarro Sergio , van der Velden Ubele , Teeuw Wijnand J. , Gerdes Victor E. A. , Loos Bruno G.
Published: June 2017

Aim

To investigate the effect of basic periodontal therapy (BPT) with antimicrobials (AM) on the parameters of metabolic syndrome (MetS) (waist circumference, systolic/diastolic blood pressure [BP], HDL‐cholesterol, triglycerides, glucose).

Methods

One hundred and ten periodontitis patients without known comorbidities and unaware of possible MetS were randomly assigned to BPT (n = 56) or BPT+AM (n = 54) and followed for 12 months post‐therapy. Number of patients with undiagnosed MetS was also determined.

Results

In all patients, the periodontal condition improved; however, the BTP+AM group showed greater pocket depth reduction than the BPT group. Post‐therapy, systolic BP (p < .05) and triglycerides (p < .05) reduced significantly during the follow‐up period. No significant differences could be assessed between the BPT+AM and BPT group. Despite the absence of self‐reported comorbidities, 27.2% (n = 30) periodontitis patients fulfilled the criteria of MetS at baseline. After therapy, this proportion changed to 14.5% at 3 months (p = .007), to 17.3% at 6 months (p = .017) and to 21.8% at 12‐month follow‐up (p = .383).

Conclusion

Although a reduction in systolic BP and triglycerides and a temporarily improvement in the whole metabolic status were observed, the use of antimicrobials in conjunction with BTP does not yield any additional improvement in the parameters of MetS.
Oral nutritional supplement use in relation to length of stay in heart failure patients at a regional medical center
Authors: Babb Ellen B. , Rohrer James
Published: June 2017

Rationale, aims, and objectives

Improving the nutritional status of hospitalized patients has been shown to reduce length of stay (LOS), hospital costs, readmission rates, complication rates, and mortality. Provision of nutrient‐rich, liquid, oral nutrition supplements (ONS) is one approach to improve nutritional status. Little information is available on ONS use and LOS among heart failure patients.

Methods

This study used a retrospective design to examine whether routine ONS use was associated with hospital LOS among 570 heart failure inpatients (89 ONS = yes; 481 ONS = no) at a regional medical center, adjusting for significant personal, locational, and time variables using multiple logistic regression analysis.

Results

Oral nutrition supplement use was associated with high LOS in this sample (odds ratio = 2.43). High LOS was also associated with higher Charlson comorbidity index values, discharge destination, hospital room location, and dietitian consults.

Conclusions

These results show that ONS orders alone are not adequate to reduce LOS among heart failure patients. Continued research is needed on ways to improve care to reduce LOS among hospitalized patients.
Determination of retinal surface area
Authors: Nagra Manbir , Gilmartin Bernard , Thai Ngoc Jade , Logan Nicola S.
Published: June 2017

Previous attempts at determining retinal surface area and surface area of the whole eye have been based upon mathematical calculations derived from retinal photographs, schematic eyes and retinal biopsies of donor eyes. 3‐dimensional (3‐D) ocular magnetic resonance imaging (MRI) allows a more direct measurement, it can be used to image the eye in vivo, and there is no risk of tissue shrinkage. The primary purpose of this study is to compare, using T2‐weighted 3D MRI, retinal surface areas for superior‐temporal (ST), inferior‐temporal (IT), superior‐nasal (SN) and inferior‐nasal (IN) retinal quadrants. An ancillary aim is to examine whether inter‐quadrant variations in area are concordant with reported inter‐quadrant patterns of susceptibility to retinal breaks associated with posterior vitreous detachment (PVD). Seventy‐three adult participants presenting without retinal pathology (mean age 26.25 ± 6.06 years) were scanned using a Siemens 3‐Tesla MRI scanner to provide T2‐weighted MR images that demarcate fluid‐filled internal structures for the whole eye and provide high‐contrast delineation of the vitreous‐retina interface. Integrated MRI software generated total internal ocular surface area (TSA). The second nodal point was used to demarcate the origin of the peripheral retina in order to calculate total retinal surface area (RSA) and quadrant retinal surface areas (QRSA) for ST, IT, SN, and IN quadrants. Mean spherical error (MSE) was −2.50 ± 4.03D and mean axial length (AL) 24.51 ± 1.57 mm. Mean TSA and RSA for the RE were 2058 ± 189 and 1363 ± 160 mm2, respectively. Repeated measures anova for QRSA data indicated a significant difference within‐quadrants (P < 0.01) which, contrasted with ST (365 ± 43 mm2), was significant for IT (340 ± 40 mm2 P < 0.01), SN (337 ± 40 mm2 P < 0.01) and IN (321 ± 39 mm2 P < 0.01) quadrants. For all quadrants, QRSA was significantly correlated with AL (P < 0.01) and exhibited equivalent increases in retinal area/mm increase in AL. Although the differences between QRSAs are relatively small, there was evidence of concordance with reported inter‐quadrant patterns of susceptibility to retinal breaks associated with PVD. The data allow AL to be converted to QRSAs, which will assist further work on inter‐quadrant structural variation.
Fiber type composition of the palmaris brevis muscle: implications for palmar function
Authors: Moore Colin W. , Beveridge Tyler S. , Rice Charles L.
Published: June 2017

The palmaris brevis (PB) is a small muscle of variant morphology located on the ulnar aspect of the palm, superficial to the hypothenar eminence. Functionally, the PB has been proposed to protect the neurovasculature of the ulnar canal from compressive forces during repetitive or intermittent trauma associated with grasping. Although PB function has been inferred from cadaveric observations, it is unknown whether it has the contractile capacity and fatigue‐resistance necessary to withstand these functional demands. Insight into the functional specialization of the PB can be provided through investigating the proportions of type I and type II muscle fibers by staining for myosin heavy chain (MHC) isoforms using immunohistochemical methods. Therefore, the purpose of this study was to quantify the proportion of type I and type II muscle fibers to provide insight into the role of the PB in palmar function based on its gross histological structure. Sixteen PB specimens were harvested from the hands (eight right, eight left) of eight formalin‐embalmed cadavers (mean age: 75 ± 14 years; three males, five females). PB muscle composition was determined by labeling serial cross‐sections with MHC type I and type II monoclonal antibodies. The results indicate that the PB is primarily composed of type I muscle fibers (72.2 ± 13.7%), with no significant differences between left and right hands. Given the predominance of type I muscle fibers, our findings indicate the PB may be fatigue‐resistant and thus, capable of contracting for prolonged durations. This supports cadaveric observations indicating that the PB functions to protect the ulnar neurovasculature of the palm by providing a muscular barrier in addition to serving as a functional anchor to the hypothenar fat pad when objects are firmly compressed into the palm.
IDENTIFYING VULNERABILITY TO POVERTY: A CRITICAL SURVEY
Authors: Gallardo Mauricio
Published: June 2017

In the economic literature on poverty, various methods have been proposed for measuring a phenomenon known as ‘vulnerability’. However, after more than a quarter century of research, no consensus has been reached on how to identify such vulnerable individuals within a given population. Some misunderstandings have also arisen from the overlapping of other closely related concepts, such as the expectation of being poor, expected poverty, multi‐period poverty and risk exposure. This paper offers a detailed conceptual discussion on vulnerability to poverty and its related elements, reviewing a wide range of identifying criteria provided in the literature. It is found that according to the state of the art in this field of research, two key elements stand out in identifying vulnerable individuals: an expected well‐being below the poverty line and a relevant risk of falling into poverty due to downside deviation from a reference level of well‐being. The traditional classification of vulnerability approaches has been updated into four groups: (i) those that stress the element of exposure to risk; (ii) those that emphasize the element of expected poverty; (iii) those that define vulnerability through a utility gap and (iv) those that are supported by a mean‐risk dominance criterion.
Impact of borderline–subclinical hypothyroidism on subsequent pregnancy outcome in women with unexplained recurrent pregnancy loss
Authors: Uchida Sayaka , Maruyama Tetsuo , Kagami Maki , Miki Fumie , Hihara Hanako , Katakura Satomi , Yoshimasa Yushi , Masuda Hirotaka , Uchida Hiroshi , Tanaka Mamoru
Published: June 2017

Aim

Because subclinical hypothyroidism (thyroid‐stimulating hormone [TSH] > 4.5 IU/mL) is associated with adverse pregnancy outcome, including early pregnancy loss, TSH is recommended to be titrated to ≤2.5 mIU/L in levothyroxine‐treated women before pregnancy. The purpose of this study was to determine whether borderline–subclinical hypothyroidism (borderline‐SCH; 2.5 < TSH ≤ 4.5 IU/mL) affects the outcome of subsequent pregnancies in women with unexplained recurrent pregnancy loss (uRPL).

Methods

After workup for antinuclear antibody (ANA), anti‐phospholipid syndrome, thrombophilia, uterine abnormalities, hormone disorders, and/or chromosomal abnormalities, 317 women with a history of uRPL were enrolled. The women were classified into two groups: borderline‐SCH, and euthyroidism (0.3 ≤ TSH ≤ 2.5 IU/mL). All women had normal serum free thyroxine (T4) and did not receive levothyroxine before or during the subsequent pregnancy.

Results

There were no significant differences in age, number of previous pregnancy losses, number of live births, or body mass index between the borderline‐SCH (n = 56) and the euthyroid (n = 261) groups, but the rate of ANA positivity differed significantly (53.6% vs 33.7%, respectively; P = 0.005). The subsequent pregnancy rate did not differ between the two groups (55.4%, 31/56 vs 51.3%, 134/261, respectively). The pregnancy loss rate (<22 weeks of gestation) tended to be higher in the borderline‐SCH than the euthyroid group (29.0%, 9/31 vs 17.9%, 24/134), although not significantly so (P = 0.16).

Conclusions

Although some subset of uRPL is though to be due to as‐yet‐unidentified cause(s), borderline‐SCH is unlikely to be involved in uRPL.
Clinical value of polymerase chain reaction in detecting group B streptococcus during labor
Authors: Koppes Dorothea Maria , Vriends Antonius Arnoldus Cornelis Maria , van Rijn Michiel , van Heesewijk Antonine Dimphne
Published: June 2017

Aim

To reduce the intrapartum use of antibiotics in women with prolonged rupture of the membranes (PROM) by restriction of antibiotics to women who are colonized with group B streptococci (GBS), as identified with the Cepheid Gene Xpert polymerase chain reaction (PCR) for detecting GBS.

Methods

We conducted a randomized controlled trial among full‐term delivering women with PROM. Fifty‐four women were enrolled, based on a power calculation with a significance level of 5% and a power of 95%. Twenty‐seven women received the standard treatment (rectovaginal swab [RVS] for bacterial culture and antibiotics). For another 27 women PCR was performed on the RVS and antibiotics were used only when the PCR was positive. The primary outcome was reduction in antibiotic use, defined as the percentage of women who received antibiotics during labor.

Results

54 Women were enrolled in the study between 1 May and 18 November 2014. There were no significant differences in baseline characteristics. In total, 10 of the 54 women were GBS positive (18.5%). Of those 10 women, three were identified on bacterial culture and seven on PCR. In the bacterial culture group all the women received antibiotics. In the PCR group 10 women (37%) received antibiotics (P = 0.002). Two false‐positive PCR tests were identified. There were no false‐negative PCR tests.

Conclusion

Real‐time identification of GBS on PCR reduces the intrapartum use of antibiotics in women with PROM.
Exploring the impact of endometriosis on partners
Authors: Ameratunga Devini , Flemming Tina , Angstetra Donald , Ng Shu‐Kay , Sneddon Anne
Published: June 2017

Aim

This study aimed to determine how endometriosis affects the quality of life of partners of women who suffer from this disease and how it impacts their relationships, finances, mental states, and daily living.

Methods

This was a questionnaire‐based cohort study that took place at a large tertiary hospital gynecology unit, which covered two sites. Fifty‐one partners of women who had surgically diagnosed endometriosis agreed to participate in the study and returned completed surveys.

Results

Ninety‐two percent (n = 46) of partners reported negative feelings about the diagnosis of endometriosis. Seventy percent (n = 35) reported that endometriosis affected their day‐to‐day life either moderately or severely. Over half (52%) also felt that their finances were affected. Only 34% (n = 17) of partners felt that health professionals had engaged them in decision‐making processes and had been supportive of them. Eighty percent (n = 40) of partners reported that they had received no information about the impact of endometriosis on couples. Partners reported a significant affect on their sex life (74%) and their relationship as a whole (56%). Participants whose relationships had been affected by endometriosis had also more likely had their day‐to‐day life (P = 0.027), sex life (P = 0.001), and finances (P = 0.002) affected.

Conclusion

Overall, our findings suggest that endometriosis can have a significant impact on partners with respect to day‐to‐day living, finances, sex lives, and relationships. Improvements can be made to engage partners in the treatment process, and to provide better education, support, and holistic management to women and families who suffer with endometriosis.
Bioelectronic medicine: technology targeting molecular mechanisms for therapy
Authors: Olofsson P. S. , Tracey K. J.
Published: June 2017

Content List – Read more articles from the symposium: 13th Key Symposium – Bioelectronic Medicine: Technology Targeting Molecular Mechanisms.
A model of leadership motivations, error management culture, leadership capacity, and career success
Authors: Maurer Todd J. , Hartnell Chad A. , Lippstreu Michael
Published: June 2017

We integrated ideas from literature on error management culture, leadership motivation, and career development to create several contributions for the research literature. First, we examined two situational factors – error management/aversion culture perceptions – that affect employees’ leadership‐relevant motivations. Second, we distinguish between two types of leader motivations, motivation to lead (MTL) and motivation to develop leadership skills (MTDL). We offer evidence of discriminant and predictive validity of the two leadership motivations on key leadership processes and outcomes. Third, we tested a linkage model in which error management/aversion perceptions influenced leadership motivations (MTL and MTDL) and these motivations predicted leadership capacity and leader career success (i.e., promotions, increased leadership responsibility, and pay increases). Based upon multisource data collected from 151 employees and their supervisors from diverse occupations and organizations over a period of 1 year, we found that error management perceptions were positively associated with social‐normative MTL (the motive to lead out of a sense of duty and obligation) and with MTDL whereas perceptions of error aversion were negatively related with affective‐identity and non‐calculative MTL. MTDL was distinguishable from MTL and demonstrated better predictive validity on leadership capacity and career success than MTL. We discuss a number of implications for both theory and practice.

Practitioner Points

Creating a culture in which errors are constructively managed enhances leadership motivations, leadership capacity (leader behaviour, development, and potential), and career success.

In managing leadership development and performance, distinguishing between motivation to be a leader and motivation to develop leadership skills is important, both in terms of how these motivations are influenced by error management and aversion and in terms of the how the motivations influence leadership capacity and success. Motive to lead out of a sense of duty is key.
Patient‐reported outcome measures in oral lichen planus: A comprehensive review of the literature with focus on psychometric properties and interpretability
Authors: Wiriyakijja Paswach , Fedele Stefano , Porter Stephen R , Mercadante Valeria , Ni Riordain Richeal
Published: June 2017

Objective

To review the range of patient‐reported outcome measures (PROMs) used in clinical studies of patients with oral lichen planus (OLP) and to assess their psychometric properties and interpretability.

Methods

Literature searches were performed on MEDLINE, EMBASE and Web of Science databases (1990–September 2016) to retrieve relevant studies related to the development, psychometric testing and/or use of PROMs assessing oral symptoms, psychosocial status and quality of life in individuals with OLP. The identified PROMs were then categorised by concept measured and assessed for instrument characteristics and evidence for psychometric properties and interpretability.

Results

We identified a total of 41 PROMs used in clinical studies for the assessment of patient‐reported outcomes in patients with OLP. There were three PROMs of oral symptoms, 30 PROMs of psychosocial status and eight PROMs of quality of life. Six instruments (Visual Analog Scale, Numerical Rating Scale, Change in Symptom Scale, Oral Health Impact Profile‐14, Oral Health‐related Quality of Life‐UK and Chronic Oral Mucosal Disease Questionnaire) demonstrated some evidence of psychometric properties but no evidence for interpretability of their results in the OLP population.

Conclusion

The range of PROMs used in clinical studies of patients with OLP is wide and include instruments for oral symptoms, psychosocial status and quality of life. The vast majority of these instruments have no evidence of psychometric properties and interpretability for patients with OLP. Further qualitative and validation studies are required to investigate whether these instruments are appropriate for use in this patient population.
Mass Production of Doubled Haploids in Japanese Flounder, Paralichthys olivaceus
Authors: Zhang Xiaoyan , Wang Guixing , Sun Zhaohui , Wang Yufen , Hou Jilun
Published: June 2017

Doubled haploid (DH) individuals have many applications in fish genetic and genomic research, as well as in fish breeding programs. Mass production of DHs is difficult because of an extremely low induction rate. Here, we report the mass production of mitotic gynogenetic DHs in Japanese flounder, Paralichthys olivaceus, an economically important marine‐culture fish species. Four groups of mitotic gynogenetic DHs were induced from four females of different genetic backgrounds. The heterozygous clonal female group had the highest hatching rate, lowest abnormality rate, and highest homozygosity rate. Early growth comparisons showed that the body weight and total length of the heterozygous clonal female group were the largest among the three DH groups (P < 0.05). At 6 mo postinduction, an estimated 10,766 DHs survived, and a notable percentage of male DHs (3.34–23.33%) were detected. This successful mass production of DHs lays the foundation for extensive use of DHs in Japanese flounder breeding and research.
Nitrogen, Phosphorus, and Carbon Concentrations in Some Common Aquaculture Feeds
Authors: Chatvijitkul Sirirat , Boyd Claude E. , Davis D. Allen
Published: June 2017

Nitrogen, phosphorus, and carbon concentrations were measured from 203 samples of starter, fingerling, and grower aquaculture feeds from several countries and for several common species. The feed protein concentrations reported by manufacturers often were slightly greater than the measured crude protein concentrations. The correlation coefficients (R2) between feed nitrogen and carbon concentrations were less than 0.50, and nitrogen and phosphorus concentrations in feed were not correlated. There were considerable differences in elemental concentrations among feeds, but the overall averages for carbon, nitrogen, and phosphorus concentrations, respectively, were as follows: starter feed 41.36, 7.78, and 1.57%; fingerling feed 39.75, 5.95, and 1.36%; grower feed 39.97, 5.36, and 1.22%. Concentrations of carbon, nitrogen, and phosphorus in feeds are required in estimating the pollution potential of aquaculture facilities. The crude protein concentration – if provided by the manufacturer – can be used to estimate nitrogen concentration in feed, but carbon and phosphorus concentrations should be measured.
Diversity of renal phenotypes in patients with WDR19 mutations: Two case reports
Authors: Yoshikawa Takahisa , Kamei Koichi , Nagata Hiroko , Saida Ken , Sato Mai , Ogura Masao , Ito Shuichi , Miyazaki Osamu , Urushihara Maki , Kondo Shuji , Sugawara Noriko , Ishizuka Kiyonobu , Hamasaki Yuko , Shishido Seiichiro , Morisada Naoya , Iijima Kazumoto , Nagata Michio , Yoshioka Takako , Ogata Kentaro , Ishikura Kenji
Published: June 2017

WDR19 has been reported as a causative gene of nephronophthisis‐related ciliopathies. Patients with WDR19 mutations can show various extrarenal manifestations such as skeletal disorders, Caroli disease, and retinal dystrophy, and typically display nephronophthisis as a renal phenotype. However, there is limited information on the renal phenotypes of patients with WDR19 mutations. We report two Japanese infants with Sensenbrenner syndrome caused by WDR19 mutations who demonstrated different features in renal ultrasound and histopathological results, despite several common extrarenal manifestations. Patient 1 had normal sized and hyperechogenic kidneys with several small cysts and histopathological findings compatible with infantile nephronophthisis. Renal ultrasound of Patient 2 showed enlarged kidneys with diffuse microcysts resembling those of autosomal recessive polycystic kidney disease. Her renal histopathology revealed dysplastic kidney with diffuse glomerular cysts. Genetic testing identified compound heterozygous mutations in WDR19 in both patients (Patient 1: c.953delA, c.3533G > A, Patient 2: c.2645 + 1G > T, c.3533G > A). Our patients suggest that WDR19 mutations can cause dysplastic kidney in addition to nephronophthisis pathologically. In addition, differences in pathology of the kidneys from WDR19 mutations may result in heterogeneous features in renal ultrasound findings. Renal phenotypes from WDR19 mutations may thus be more diverse than previously reported. Extrarenal manifestations and genetic testing can therefore help to diagnosis this disease more precisely.
Two Silene vulgaris copper transporters residing in different cellular compartments confer copper hypertolerance by distinct mechanisms when expressed in Arabidopsis thaliana
Authors: Li Yanbang , Iqbal Mazhar , Zhang Qianqian , Spelt Cornelis , Bliek Mattijs , Hakvoort Henk W. J. , Quattrocchio Francesca M. , Koes Ronald , Schat Henk
Published: June 2017

Silene vulgaris is a metallophyte of calamine, cupriferous and serpentine soils all over Europe. Its metallicolous populations are hypertolerant to zinc (Zn), cadmium (Cd), copper (Cu) or nickel (Ni), compared with conspecific nonmetallicolous populations. These hypertolerances are metal‐specific, but the underlying mechanisms are poorly understood.

We investigated the role of HMA5 copper transporters in Cu‐hypertolerance of a S. vulgaris copper mine population.

Cu‐hypertolerance in Silene is correlated and genetically linked with enhanced expression of two HMA5 paralogs, SvHMA5I and SvHMA5II, each of which increases Cu tolerance when expressed in Arabidopsis thaliana. Most Spermatophytes, except Brassicaceae, possess homologs of SvHMA5I and SvHMA5II, which originate from an ancient duplication predating the appearance of spermatophytes. SvHMA5II and the A. thaliana homolog AtHMA5 localize in the endoplasmic reticulum and upon Cu exposure move to the plasma membrane, from where they are internalized and degraded in the vacuole. This resembles trafficking of mammalian homologs and is apparently an extremely ancient mechanism. SvHMA5I, instead, neofunctionalized and always resides on the tonoplast, likely sequestering Cu in the vacuole.

Adaption of Silene to a Cu‐polluted soil is at least in part due to upregulation of two distinct HMA5 transporters, which contribute to Cu hypertolerance by distinct mechanisms.
Gas exchange recovery following natural drought is rapid unless limited by loss of leaf hydraulic conductance: evidence from an evergreen woodland
Authors: Skelton Robert P. , Brodribb Timothy J. , McAdam Scott A. M. , Mitchell Patrick J.
Published: June 2017

Drought can cause major damage to plant communities, but species damage thresholds and postdrought recovery of forest productivity are not yet predictable. We used an El Niño drought event as a natural experiment to test whether postdrought recovery of gas exchange could be predicted by properties of the water transport system, or if metabolism, primarily high abscisic acid concentration, might delay recovery.

We monitored detailed physiological responses, including shoot sapflow, leaf gas exchange, leaf water potential and foliar abscisic acid (ABA), during drought and through the subsequent rehydration period for a sample of eight canopy and understory species.

Severe drought caused major declines in leaf water potential, elevated foliar ABA concentrations and reduced stomatal conductance and assimilation rates in our eight sample species. Leaf water potential surpassed levels associated with incipient loss of leaf hydraulic conductance in four species. Following heavy rainfall gas exchange in all species, except those trees predicted to have suffered hydraulic impairment, recovered to prestressed rates within 1 d.

Recovery of plant gas exchange was rapid and could be predicted by the hydraulic safety margin, providing strong support for leaf vulnerability to water deficit as an index of damage under natural drought conditions.
Detection of halitosis in breath: Between the past, present, and future
Authors: Nakhleh MK , Quatredeniers M , Haick H
Published: June 2017

To develop a new generation of diagnostics for halitosis, replacing the subjective organoleptic assessment, a series of exhaled breath analyzers has been developed and assessed. All three devices rely on the assessment of exhaled volatile sulfuric compounds (VSCs), which are mainly generated in and emitted from the oral cavity, contributing to the malodor. Portable, on‐site and easy to use, these devices have potential for non‐invasive diagnosis of halitosis. However, global assessment of exhaled VSCs alone has two main drawbacks: (i) the absence of VSCs does not rule out halitosis; (ii) non‐sulfuric volatile compounds that could be biomarkers of systemic diseases, found in up to 15% of halitosis cases, are neglected. In this article, we review and discuss progress to date in the field of oral/exhaled volatile compounds as potential non‐invasive diagnostics for halitosis. We will briefly describe the generation of these compounds both from local (oral) and distal (extra‐oral) sources. In addition, we debate the different analytical approaches in use and discuss the potential value of bio‐inspired artificially intelligent olfaction in diagnosing and classifying oral and systemic diseases by analyzing exhaled breath.