bluuebunny/crossref_metadata_2025 huggingface dataset:
Low education and lack of spousal relationship are associated with dementia in older adults with diabetes mellitus in Nigeria
Authors: Yusuf Abdulkareem J. , Baiyewu Olusegun , Bakari Adamu G. , Garko Sani B. , Jibril Mohammed E.‐B. , Suleiman Aishatu M. , Muktar Haruna M. , Amedu Micheal A.
Published: February 2018

Background

The relationship between dementia and type 2 diabetes mellitus (T2DM) in older adults is well established in the literature. However, there have been few studies on this relationship in older adults living in low‐ and middle‐income countries, and most demographic projections predict that older adult population will increase substantially in these regions by 2050.

Methods

In this study, older adults with T2DM attending a tertiary health facility were examined and compared with community‐dwelling older adults without T2DM. The participants were assessed using the Consortium to Establish Registry for Alzheimer's Disease, the Stick Design Test, the 30‐item Geriatric Depression Scale, and the Instrumental Activities of Daily Living Scale. Additionally, all the participants had a physical examination, including assessment of glycated haemoglobin, fasting blood glucose, lipid profile, and HIV status. A consensus diagnosis of dementia was made based on the criteria for dementia in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, and the International Classification for Diseases, 10th edition. The data were analyzed using SPSS version 20 for Windows.

Results

This study included 224 diabetic patients and 116 controls. A total of 27 diabetic patients (12.1%) had dementia, 19 of whom were women. Of the 27 diabetic patients with dementia, 25 patients (92.6%) had Alzheimer's disease and 2 patients (7.4%) had mixed dementia (vascular dementia and Alzheimer's disease). Only one person among the controls had Alzheimer's type dementia. Dementia in the diabetic patients was significantly associated with advancing age, female gender, education level, duration of diabetes, and absence of a spouse.

Conclusion

Dementia is common in older adults with T2DM in this low‐resource setting, and the risk factors for dementia were similar to those reported in earlier studies in Western societies.
Combined assessment of attentional reserve and cognitive‐motor effort under various levels of challenge with a dry EEG system
Authors: Gentili Rodolphe J. , Jaquess Kyle J. , Shuggi Isabelle M. , Shaw Emma P. , Oh Hyuk , Lo Li‐Chuan , Tan Ying Ying , Domingues Clayton A. , Blanco Justin A. , Rietschel Jeremy C. , Miller Matthew W. , Hatfield Bradley D.
Published: February 2018

A novel ERP approach was proposed to index variations in mental workload, particularly in attentional reserve, which is complementary to EEG spectral content thought to reflect mental effort. To our knowledge, no study has assessed mental effort and attentional reserve simultaneously in EEG gel‐based and, importantly, dry systems, which are particularly well suited for real‐world settings. Therefore, by systematically considering ERP, EEG spectral, and importantly the combination of both, this study examined if a small set of dry EEG electrodes could detect changes in both spectral and ERP metrics to assess the mental workload under various challenges with a similar fidelity to their gel‐based counterparts in a laboratory setting. By employing both EEG gel‐based and dry systems, the ERP and spectral markers were computed while participants executed a visuomotor task under three levels of challenge. For both EEG systems, more challenging levels of difficulty were associated with concomitant changes in ERP amplitude, and spectral power reflected a reduction of the attentional reserve and an increase in cognitive‐motor effort, respectively. Those variations in attentional reserve and cognitive‐motor effort collectively indexed mental workload with nearly identical fidelity for both gel‐based and dry EEG systems. These findings promise to assess the mental workload in situations where the use of dry EEG systems could be advantageously employed to examine human cognitive‐motor performance.
Lucky achievement: virtue epistemology on the value of knowledge
Authors: Ho Tsung‐Hsing
Published: February 2018

Virtue epistemology argues that knowledge is more valuable than Gettierized belief because knowledge is an achievement, but Gettierized belief is not. The key premise in the achievement argument is that achievement is apt (successful because competent) and Gettierized belief is inapt (successful because lucky). I first argue that the intuition behind the achievement argument is based wrongly on the fact that ‘being successful because lucky’ implicates ‘being not competent enough’. I then offer an argument from moral luck to argue that virtue epistemologists should maintain that knowledge is no more valuable than Gettierized belief.
Statistical Challenges of Administrative and Transaction Data
Authors: Hand David J.
Published: February 2018

Administrative data are becoming increasingly important. They are typically the side effect of some operational exercise and are often seen as having significant advantages over alternative sources of data. Although it is true that such data have merits, statisticians should approach the analysis of such data with the same cautious and critical eye as they approach the analysis of data from any other source. The paper identifies some statistical challenges, with the aim of stimulating debate about and improving the analysis of administrative data, and encouraging methodology researchers to explore some of the important statistical problems which arise with such data.
Changing the culture of social care in Scotland: Has a shift to personalization brought about transformative change?
Authors: Pearson Charlotte , Watson Nicholas , Manji Kainde
Published: February 2018

In April 2014, the Social Care (Self‐directed Support) (Scotland) Act 2013 (SDS Act) was implemented in Scotland. This marked a major shift in how social care is delivered and organized for both users and professionals across the country. Whilst it emerged through the personalization agenda—which has dominated international social care systems over recent years—self‐directed support (SDS) represented a significant shift in thinking for service provision in Scotland. In this article, we review the initial stages of policy implementation. Drawing on two Freedom of Information requests from 2015 and 2016 and a series of interviews with local authority practitioners, we argue that, to date, SDS has yet to produce radical transformative change. We explore the reasons behind this through four key themes. First, we highlight the challenges of promoting the principles of co‐production in policy and suggest that, in reality, this has been compromised through SDS implementation. Second, we suggest that SDS has been caught up in a policy overload and ultimately overshadowed by new legislation for health and social care integration. In looking at the impact of this relationship, our third theme questions the role of new partnership working. Lastly, we argue that the timing of SDS in a period of acute austerity in social care has resulted in disabled people being offered limited choice rather than increased opportunities for independent living.
Child Development Accounts and Saving for College: Mediated by Parental Educational Expectations?*
Authors: Kim Youngmi , Huang Jin , Sherraden Michael , Clancy Margaret
Published: February 2018

Objective

Child Development Accounts (CDAs) are universal and progressive savings accounts that facilitate saving for long‐term developmental goals, including postsecondary education. We examine whether parents’ educational expectations for their children motivate them to increase saving for children's education and whether parents’ expectations mediate the positive effect of CDAs on parental saving.

Methods

We use logistic regressions to analyze data from SEED for Oklahoma Kids (SEED OK), a randomized policy experiment implemented in Oklahoma (N = 2,161).

Results

Our study shows that the likelihood of holding a 529 college savings account is greater among treatment mothers than among control‐group counterparts and greater for mothers with higher expectations. Yet, we find no evidence that parents’ expectations play a mediating role in the SEED OK intervention's relationship with 529 account holding.

Conclusions

Institutional supports from CDAs and enabling parents to maintain positive parental expectations would make substantial differences in parents’ financial investment for their child's education.
Tellurium, selenium and cobalt enrichment in Neoproterozoic black shales, Gwna Group, UK: Deep marine trace element enrichment during the Second Great Oxygenation Event
Authors: Armstrong Joseph G. T. , Parnell John , Bullock Liam A. , Perez Magali , Boyce Adrian J. , Feldmann Jorg
Published: February 2018

Black shales of the late Neoproterozoic Gwna Group (570–580 Ma), UK, contain enrichments of tellurium (Te), selenium (Se) and cobalt (Co) relative to average shale compositions. The Te and Co enrichments bear comparison with those of ferromanganese crusts in the modern deep ocean. Gwna Group deposition coincides with the Second Great Oxidation Event, which had a significant effect on trace element fixation globally. Selenium and Te concentrations within these black shales indicate increased continental weathering rates, high biological productivity and corresponding increases in atmospheric O2 concentrations. Cobalt, nickel (Ni) and arsenic (As) enrichments in this succession are secondary mineralisation phases. Demand for many of the trace elements found enriched in the Gwna Group black shales make their mechanisms of accumulation, and variations through the geological record, important to understand, and suggests that new resources may be sought based on black shale protoliths from this period.
Stewardship opportunities in viral pneumonia: Why not the immunocompromised?
Authors: Mercuro Nicholas J. , Kenney Rachel M. , Samuel Linoj , Tibbetts Robert J. , Alangaden George J. , Davis Susan L.
Published: February 2018

Antimicrobial management of viral pneumonia has proven to be a challenge in hospitalized immunocompromised patients. A host of factors contribute to the dilemma, such as diagnostic uncertainty, lack of organism identification, and clinical status of the patient. Respiratory virus panel (RVP) use was compared between 131 immunocompromised patients who received send‐out (n = 56) vs in‐house (n = 75) testing. Antimicrobial optimization interventions consisted of antiviral addition/discontinuation, antibiotic discontinuation/de‐escalation, or modification of immunosuppressive regimen. After implementation of an in‐house test with audit and feedback, turnaround time of the RVP was reduced from 46.7 to 5.5 hours (P < .001) and time to intervention was reduced from 52.1 to 13.9 hours (P < .001), yet the frequency of antimicrobial optimization interventions was unchanged (30.7% vs 35.7%). Differences were not observed in duration of empiric antibiotic therapy or length of stay. The overall discontinuation rate for patients tested with a RVP was low (4.6%), and those with positive RVP (n = 43) had antibiotics stopped in 14% of cases. Bacterial pneumonia coinfection was confirmed in 2 patients. Further systematic efforts should be taken to reduce antibiotic use in viral pneumonia and identify the major barriers in the immunocompromised population.
Total andToxocara canislarval excretory/secretory antigen‐ and allergen‐specific IgE in atopic and non‐atopic dogs
Authors: Zwickl Lena L. M. N. , Joekel Deborah E. , Fischer Nina M. , Rostaher Ana , Thamsborg Kristian , Deplazes Peter , Favrot Claude
Published: February 2018

Background

Total IgE concentrations are higher in dogs than in humans. PersistentToxocara canislarval infection is prevalent in dogs and is associated with substantial specific antibody reactions. A correlation, however, between total IgE andT. canis‐specific antibody levels in dogs has not been evaluated.

Objectives

To determine the relationship between total IgE,T. canis‐specific IgG and IgE, and allergen‐specific IgE levels in atopic and non‐atopic dogs, and to evaluate possible confounding factors.

Animals

Sera of 30 atopic and 30 non‐atopic client‐owned dogs.

Methods

Total IgE,T. canis‐specific antibody and allergen‐specific IgE levels were evaluated byELISA.

Results

Total IgE,T. canis‐specific antibody and allergen‐specific IgE levels were significantly higher in non‐atopic compared to atopic dogs. A positive correlation was demonstrated betweenT. canis‐specific IgG andT. canis‐specific IgE;T. canis‐specific IgG and total IgE;T. canis‐specific IgE and total IgE; and allergen‐specific IgE and total IgE. No differences were detected on the basis of age, gender, vaccination status; deworming or season between atopic and non‐atopic dogs. Previous immunomodulatory treatment and cause of atopy did not influence antibody levels of atopic dogs.

Conclusions

Toxocara canis‐specific IgE appears to be a major component of total IgE in dogs. Total andT. canis‐specific IgE levels are higher in non‐atopic compared to atopic dogs. It is speculated thatT. canisinfection may have a protective effect against the development of canine atopic dermatitis and/or that elevations in total serum IgE level are often not associated with atopic dermatitis.
In vitro and in vivo investigation of a novel amniotic‐based chitosan dressing for wound healing
Authors: Momeni Maryam , Zarehaghighi Mohammad , Hajimiri Mirhamed , Khorasani Ghasemali , Dinarvand Rassoul , Nekookar Abdolhossein , Sodeifi Niloofar , Khosravani Pardis , Shayanasl Niloofar , Ebrahimi Marzieh
Published: February 2018

It is more than a decade that amniotic membrane has been used as a wound dressing because of its anti‐inflammatory, anti‐microbial, anti‐fibrotic, anti‐scarring properties, as well as its pain relieving and epithelialization promoting features. However, amniotic membrane had limited applications because it needs to suture in surgery, is highly fragile, firmly adhere to the wound and may cause bleeding and pain when changing the bandage. This study investigated the possibility of development of a novel amniotic‐based chitosan gel dressing as a potential wound repair substrate with marked efficacy. In this experiment, amniotic gel prepared based on chitosan/PVP gel containing human amniotic membrane extract (AME‐Gel) was investigated in terms of wound‐healing efficacy and scar preventive effects in a rat burn model. The levels of re‐epithelialization and dermal regeneration were examined by histological assessment using H&E and Masson's trichrome staining. Also, we clarified the mechanism of healing and cytokine‐releasing activities of AME as well as its effect on epithelization, angiogenesis, and fibroblast growth and migration. Our results revealed that AME‐Gel induces epidermal and dermal regeneration at a shorter time through formation of granulation tissue, enhancement of fibroblast proliferation, and improvement of blood capillary formation concomitant with developing collagen bundles. Therefore, AME‐Gel could be considered a simple and easy to be used as a biological dressing for any type of superficial burn wounds, without any adverse effects.
Presidential Election Results and Stock Market Performance: Evidence From Nigeria
Authors: Osuala A.E. , Onoh U.A. , Nwansi G.U.
Published: February 2018

The study investigates the effect of Presidential election results on the performance of an emerging stock market using the case of the 2011 and 2015 Presidential elections in Nigeria. Adopting Event Study methodology to analyse the secondary data obtained from the Nigerian Stock Exchange (NSE) and some national dailies, the results of the study suggest that the 2011 presidential election result had negative significant impact on the performance of the stock market. On the other hand, the 2015 Presidential election result had positive but insignificant impact on the stock market as evidenced by the average and cumulative abnormal returns on the event date and one day post-event date- an indication that the result of the 2015 Presidential election was a welcomed development as leadership changed from PDP to All Progressives Congress (APC).
Social work perceptions and identity: How social workers perceive public and professional attitudes towards their vocation and discipline
Authors: Hobbs Elizabeth Kathryn , Evans Nikki
Published: February 2018

INTRODUCTION: A century after Abraham Flexner’s (1915/2001) infamous speech conveyed his “dismissive attitude toward social work’s professionalism,” Gelman and González (2016) reflected that social work is again at a critical juncture. The fight for recognition of social work’s professional status has been influenced by multiple factors including negative public perceptions of the occupation. In Aotearoa New Zealand, professionalisation campaigns have been far from unifying, with diverse ideas about practice standards and accountability polarising opinions. At a time that the country is grappling with mandatory registration of social workers, this research considers the ways in which social workers perceive themselves, and the profession that they identify with.METHODS: Semi-structured interviews with 83 social workers in Aotearoa New Zealand were conducted. Participants were required to be eligible for social work registration. Interview transcripts were thematically analysed.FINDINGS: Several identity themes emerged during the analysis of the 83 interviews. The first theme relates to the ways in which statutory child protection social work has impacted on identity. The second, and perhaps predictable theme, is that many social workers in this study experienced significant professional marginalisation from their colleagues. The third theme emerged from participants’ views about the likelihood of mandatory registration of social workers impacting on their identity and the professional standing of social work.CONCLUSION:  Most participants in the current study believed that mandatory social worker registration may positively influence the public’s view of social workers, other professionals, and also social workers themselves. However, many participants seemed to experience levels of self-stigma – and potentially believe they are viewed more negatively by the public than they actually are. Social workers’ perceptions of their role and profession is an area that warrants further investigation.
Five years in the news: A media analysis of Child, Youth and Family in two daily newspapers (2008–2012)
Authors: Staniforth Barbara , Beddoe Elizabeth
Published: February 2018

INTRODUCTION: This article describes a subset of data relating to the term “Child Youth and Family” from a media analysis of two major Aotearoa New Zealand newspapers from 2008 to 2012 and reports on the major themes emerging from a qualitative analysis of these articles.METHODS: A search was conducted within the online versions of the New Zealand Herald and the Otago Daily Times for the years 2008 to 2012 on the search terms: “social work,” “social worker” and “child youth and family.” A qualitative thematic analysis of 1,512 articles within the data set “child youth and family” was conducted.FINDINGS: Child Youth and Family (CYF) content overwhelmingly made up the largest sub-set of the data and within that subset, the reporting was principally related to crime and abuse. Social workers were seen mainly as receivers of referrals and of removing children and placing them in “care.” There was little mention of intervention or treatment.  There were many reports of the ways things went badly in the process, and at those times social workers were reportedly at the forefront. CONCLUSION: The CYF content presents a limited view of social work, with potential implications for the scope of social work practice being limited to removal of children, and a reduction in the acknowledgement of the wider scope of treatment and intervention. There is also an emphasis on criticism of social workers when children are the victims of violence that occurs within a wider socio-political context.
New horizons and strong foundations
Authors: Hyslop Ian , Stanfield Deb
Published: February 2018

The editorial for issue 29(4).
Dependence of ferromagnetic properties on phosphorus concentration in Ga1-xMnxAs1-yPy
Authors: Li Xiang , Liu Xinyu , Dong Sining , Gorsak Cameron , Furdyna Jacek K. , Dobrowolska Margaret , Bac Seul-Ki , Lee Sanghoon , Rouvimov Sergei
Published: February 2018

A series of Ga1-xMnxAs1-yPy thin films grown on GaAs (100) substrates by molecular beam epitaxy were systematically investigated to establish the effect of phosphorous on structural and magnetic properties of the alloy. Detailed characterization of both as-grown and annealed samples by x-ray diffraction and magnetometry were carried out. Reciprocal space map scans confirmed that the quaternary alloy is fully strained by the substrate throughout its thickness. Magnetization measurements revealed a clear trend of decreasing Curie temperature with increasing P concentration, and revealed that the magnetic easy axis gradually turns from in-plane to out-to-plane orientation as P concentration increases.
Dispersion curves for Lamb wave propagation in prestressed plates using a semi-analytical finite element analysis
Authors: Peddeti Kranthi , Santhanam Sridhar
Published: February 2018

Acoustoelastic techniques have been recently used to characterize the state of prestress in structures such as plates. The velocity of guided wave modes propagating through plates is sensitive to the magnitude and orientation of the initial state of stress. Dispersion curves for phase velocities of plate guided waves can be computed using the superposition of partial bulk waves (SPBW) method. Here, a semi-analytical finite element (SAFE) method is formulated for the acoustoelastic problem of guided waves in weakly nonlinear elastic plates. The SAFE formulation is shown to provide phase velocity dispersion curve results identical with those provided by the SPBW method for the problem of a plate under a uniaxial and uniform tensile stress. Analytical phase and group velocity dispersion curves are also obtained for a plate with an initial prestress gradient through its thickness using the SAFE method. The magnitude of the prestress gradient is shown to have a significant effect on phase and group velocities of the fundamental and first order Lamb modes, only in certain frequency-thickness regimes.
Review on the conversion of thermoacoustic power into electricity
Authors: Timmer Michael A. G. , de Blok Kees , van der Meer Theo H.
Published: February 2018

Thermoacoustic engines convert heat energy into high amplitude acoustic waves and subsequently into electric power. This article provides a review of the four main methods to convert the (thermo)acoustic power into electricity. First, loudspeakers and linear alternators are discussed in a section on electromagnetic devices. This is followed by sections on piezoelectric transducers, magnetohydrodynamic generators, and bidirectional turbines. Each segment provides a literature review of the given technology for the field of thermoacoustics, focusing on possible configurations, operating characteristics, output performance, and analytical and numerical methods to study the devices. This information is used as an input to discuss the performance and feasibility of each method, and to identify challenges that should be overcome for a more successful implementation in thermoacoustic engines. The work is concluded by a comparison of the four technologies, concentrating on the possible areas of application, the conversion efficiency, maximum electrical power output and more generally the suggested focus for future work in the field.
Metabolism and Exercise During Youth—The Year That Was 2017
Authors: Tolfrey Keith , Zakrzewski-Fruer Julia Kirstey , Thackray Alice Emily
Published: February 2018

Two publications were selected because they are excellent representations of studies examining different ends of the exercise-sedentary behavior continuum in young people. The first study is an acute response study with 13 mixed-sex, mid to late adolescents presenting complete data from 4 different randomized experimental crossover conditions for analyses. Continuous glucose monitoring showed that interrupting prolonged continuous sitting with body-weight resistance exercises reduced the postprandial glucose concentration compared with a time-matched uninterrupted period of sitting. Furthermore, the effects of the breaks in sitting time were independent of the energy content of the standardized meals, but variations in the area under the glucose time curves expression were important. The second study adopted a chronic 12-week exercise training intervention design with a large sample of obese children and adolescents who were allocated randomly to high-intensity interval training (HIIT), moderate-intensity continuous training, or nutritional advice groups. HIIT was the most efficacious for improving cardiorespiratory fitness compared with the other interventions; however, cardiometabolic biomarkers and visceral/subcutaneous adipose tissue did not change meaningfully in any group over the 12 weeks. Attrition rates from both HIIT and moderate-intensity continuous training groups reduce the validity of the exercise training comparison, yet this still provides a solid platform for future research comparisons using HIIT in young people.
Pharmacodynamics of Voriconazole for Invasive Pulmonary Scedosporiosis
Authors: Box Helen , Negri Clara , Livermore Joanne , Whalley Sarah , Johnson Adam , McEntee Laura , Alastruey-Izquierdo Ana , Meis Jacques F. , Thornton Christopher , Hope William
Published: February 2018

Scedosporium apiospermum
is a medically important fungal pathogen that causes a wide range of infections in humans. There are relatively few antifungal agents that are active against
Scedosporium
spp. Little is known about the pharmacodynamics of voriconazole against
Scedosporium
. Both static and dynamic
in vitro
models of invasive scedosporiosis were developed. Monoclonal antibodies that target a soluble cell wall antigen secreted by
Scedosporium apiospermum
were used to describe the pharmacodynamics of voriconazole. Mathematical pharmacokinetic-pharmacodynamic models were fitted to the data to estimate the drug exposure required to suppress the release of fungal antigen. The experimental results were bridged to humans using Monte Carlo simulation. All 3 strains of
S. apiospermum
tested invaded through the cellular bilayer of the
in vitro
models and liberated antigen. There was a concentration-dependent decline in the amount of antigen, with near maximal antifungal activity against all 3 strains being achieved with voriconazole at 10 mg/liter. Similarly, there was a drug exposure-dependent decline in the amount of circulating antigen in the dynamic model and complete suppression of antigen, with an area under the concentration-time curve (AUC) of approximately 80 mg · h/liter. A regression of the AUC/MIC versus the area under the antigen-time curve showed that a near maximal effect was obtained with an AUC/MIC of approximately 100. Monte Carlo simulation suggested that only isolates with an MIC of 0.5 mg/liter enabled pharmacodynamic targets to be achieved with a standard regimen of voriconazole. Isolates with higher MICs may need drug exposure targets higher than those currently recommended for other fungi.
Display of Recombinant Proteins on Bacterial Outer Membrane Vesicles by Using Protein Ligation
Authors: van den Berg van Saparoea H. Bart , Houben Diane , de Jonge Marien I. , Jong Wouter S. P. , Luirink Joen
Published: February 2018

The
Escherichia coli
virulence factor hemoglobin protease (Hbp) has been engineered into a surface display system that can be expressed to high density on live
E. coli
and
Salmonella enterica
serovar Typhimurium cells or derived outer membrane vesicles (OMVs). Multiple antigenic sequences can be genetically fused into the Hbp core structure for optimal exposure to the immune system. Although the Hbp display platform is relatively tolerant, increasing the number, size, and complexity of integrated sequences generally lowers the expression of the fused constructs and limits the density of display. This is due to the intricate mechanism of Hbp secretion across the outer membrane and the efficient quality control of translocation-incompetent chimeric Hbp molecules in the periplasm. To address this shortcoming, we explored the coupling of purified proteins to the Hbp carrier after its translocation across the outer membrane using the recently developed SpyTag/SpyCatcher protein ligation system. As expected, fusion of the small SpyTag to Hbp did not hamper display on OMVs. Subsequent addition of purified proteins fused to the SpyCatcher domain resulted in efficient covalent coupling to Hbp-SpyTag. Using in addition the orthogonal SnoopTag/SnoopCatcher system, multiple antigen modules could be coupled to Hbp in a sequential ligation strategy. Not only antigens proved suitable for Spy-mediated ligation but also nanobodies. Addition of this functionality to the platform might allow the targeting of live bacterial or OMV vaccines to certain tissues or immune cells to tailor immune responses.

IMPORTANCE
Outer membrane vesicles (OMVs) derived from Gram-negative bacteria attract increasing interest in the development of vaccines and therapeutic agents. We aim to construct a semisynthetic OMV platform for recombinant antigen presentation on OMVs derived from attenuated
Salmonella enterica
serovar Typhimurium cells displaying an adapted
Escherichia coli
autotransporter, Hbp, at the surface. Although this autotransporter accepts substantial modifications, its capacity with respect to the number, size, and structural complexity of the antigens genetically fused to the Hbp carrier is restricted. Here we describe the application of SpyCatcher/SpyTag protein ligation technology to enzymatically link antigens to Hbp present at high density in OMVs. Protein ligation was apparently unobstructed by the membrane environment and allowed a high surface density of coupled antigens, a property we have shown to be important for vaccine efficacy. The OMV coupling procedure appears versatile and robust, allowing fast production of experimental vaccines and therapeutic agents through a modular plug-and-display procedure.
Pathogenesis of
Proteus mirabilis
Infection
Authors: Armbruster Chelsie E. , Mobley Harry L. T. , Pearson Melanie M.
Published: February 2018

Proteus mirabilis
, a Gram-negative rod-shaped bacterium most noted for its swarming motility and urease activity, frequently causes catheter-associated urinary tract infections (CAUTIs) that are often polymicrobial. These infections may be accompanied by urolithiasis, the development of bladder or kidney stones due to alkalinization of urine from urease-catalyzed urea hydrolysis. Adherence of the bacterium to epithelial and catheter surfaces is mediated by 17 different fimbriae, most notably MR/P fimbriae. Repressors of motility are often encoded by these fimbrial operons. Motility is mediated by flagella encoded on a single contiguous 54-kb chromosomal sequence. On agar plates,
P. mirabilis
undergoes a morphological conversion to a filamentous swarmer cell expressing hundreds of flagella. When swarms from different strains meet, a line of demarcation, a “Dienes line,” develops due to the killing action of each strain’s type VI secretion system. During infection, histological damage is caused by cytotoxins including hemolysin and a variety of proteases, some autotransported. The pathogenesis of infection, including assessment of individual genes or global screens for virulence or fitness factors has been assessed in murine models of ascending urinary tract infections or CAUTIs using both single-species and polymicrobial models. Global gene expression studies performed in culture and in the murine model have revealed the unique metabolism of this bacterium. Vaccines, using MR/P fimbria and its adhesin, MrpH, have been shown to be efficacious in the murine model. A comprehensive review of factors associated with urinary tract infection is presented, encompassing both historical perspectives and current advances.
The Transcriptional Regulator HlyU Positively Regulates Expression of
exsA
, Leading to Type III Secretion System 1 Activation in Vibrio parahaemolyticus
Authors: Getz Landon J. , Thomas Nikhil A.
Published: February 2018

Many
Vibrio
species are zoonotic pathogens, infecting both animals and humans, resulting in significant morbidity and, in extreme cases, mortality. While many
Vibrio
species virulence genes are known, their associated regulation is often modestly understood. We set out to identify genetic factors of
V. parahaemolyticus
that are involved in activating
exsA
gene expression, a process linked to a type III secretion system involved in host cytotoxicity. We discover that
V. parahaemolyticus
employs a genetic regulatory switch involving H-NS and HlyU to control
exsA
promoter activity. While HlyU is a well-known positive regulator of
Vibrio
species virulence genes, this is the first report linking it to a transcriptional master regulator and type III secretion system paradigm.
Cost analysis of the CTLB Study, a multitherapy antenatal education programme to reduce routine interventions in labour
Authors: Levett Kate M , Dahlen Hannah G , Smith Caroline A , Finlayson Kenneth William , Downe Soo , Girosi Federico
Published: February 2018

Objective

To assess whether the multitherapy antenatal education ‘CTLB’ (Complementary Therapies for Labour and Birth) Study programme leads to net cost savings.

Design

Cost analysis of the CTLB Study, using analysis of outcomes and hospital funding data.

Methods

We take a payer perspective and use Australian Refined Diagnosis-Related Group (AR-DRG) cost data to estimate the potential savings per woman to the payer (government or private insurer). We consider scenarios in which the intervention cost is either borne by the woman or by the payer. Savings are computed as the difference in total cost between the control group and the study group.

Results

If the cost of the intervention is not borne by the payer, the average saving to the payer was calculated to be $A808 per woman. If the payer covers the cost of the programme, this figure reduces to $A659 since the average cost of delivering the programme was $A149 per woman. All these findings are significant at the 95% confidence level. Significantly more women in the study group experienced a normal vaginal birth, and significantly fewer women in the study group experienced a caesarean section. The main cost saving resulted from the reduced rate of caesarean section in the study group.

Conclusion

The CTLB antenatal education programme leads to significant savings to payers that come from reduced use of hospital resources. Depending on which perspective is considered, and who is responsible for covering the cost of the programme, the net savings vary from $A659 to $A808 per woman. Compared with the average cost of birth in the control group, we conclude that the programme could lead to a reduction in birth-related healthcare costs of approximately 9%.

Trial registration number

ACTRN12611001126909.
Your health is your wealth: faith-based community action on the health of African migrant communities in Amsterdam
Authors: Agyemang Charles , Meeks Karlijn , Boateng Reynolds , Beune Erik
Published: February 2018

The African migrant communities in Europe face many challenges including poor health outcomes. Migrant community leaders can play a crucial role in addressing the health needs of their community members. In this paper, we described Sub-Saharan African migrant community leaders’ action to improve the health of their faith-based community members in Amsterdam, the Netherlands.
Community group membership and multidimensional subjective well-being in older age
Authors: Fancourt Daisy , Steptoe Andrew
Published: February 2018

Background

It has been highlighted as a public health priority to identify ways of supporting well-being in older age to allow people to lead healthy and integrated lifestyles. This study explored whether membership in eight different sorts of community groups was associated with enhanced experienced, evaluative and eudemonic well-being among older adults.

Methods

We analysed data from 2548 adults aged 55+ drawn from the English Longitudinal Study of Aging. We used multivariate logistic and linear regression models to compare change in well-being between baseline and follow-up 10 years later in relation to membership of different community groups while controlling for potential confounding variables.

Results

Membership in two types of community groups was associated with enhanced well-being: attending education, arts or music classes was longitudinally associated with lower negative affect (OR 0.73, CI 0.57 to 0.92) and life satisfaction (β 0.55, CI 0.02 to 1.08) while church or religious group membership was longitudinally associated with lower negative affect (OR 0.79, CI 0.65 to 0.98) and higher positive affect (OR 1.54, CI 1.25 to 1.90). There was no evidence of reverse causality through cross-lagged analyses. However, just 17.4% and 24.6% of older adults were found to engage in these two types of community groups, respectively, and several demographic factors were identified as barriers to participation.

Conclusions

Overall, this study suggests that education, arts or music classes and church or religious groups may support well-being in older age. Programmes to encourage engagement could be designed for older adults who may not normally access these community resources.
Incidence and disease burden of chemotherapy-induced peripheral neuropathy in a population-based cohort
Authors: Shah Arya , Hoffman E Matthew , Mauermann Michelle L , Loprinzi Charles L , Windebank Anthony J , Klein Christopher J , Staff Nathan P
Published: February 2018

Objective

To assess disease burden of chemotherapy-induced peripheral neuropathy (CIPN), which is a common dose-limiting side effect of neurotoxic chemotherapy. Late effects of CIPN may increase with improved cancer survival.

Methods

Olmsted County, Minnesota residents receiving neurotoxic chemotherapy were identified and CIPN was ascertained via text searches of polyneuropathy symptoms in the medical record. Clinical records were queried to collect data on baseline characteristics, risk factors, signs and symptoms of CIPN, medications, impairments and International Classification of Diseases, Ninth Revision (ICD-9) diagnostic codes for all subjects.

Results

A total of 509 individuals with incident exposure to an inclusive list of neurotoxic chemotherapy agents between 2006 and 2008 were identified. 268 (52.7%) of these individuals were determined to have CIPN. The median time from incident exposure to first documented symptoms was 71 days. Patients with CIPN received a neuropathy ICD-9 diagnosis in only 37 instances (13.8%). Pain symptoms and use of pain medications were observed more often in patients with CIPN. Five-year survival was greater in those with CIPN (55.2%) versus those without (36.1%). Those with CIPN surviving greater than 5 years (n=145) continued to have substantial impairments and were more likely to be prescribed opioids than those without CIPN (OR 2.0, 1.06–3.69).

Conclusions

Results from our population-based study are consistent with previous reports of high incidence of CIPN in the first 2 years following incident exposure to neurotoxic chemotherapeutic agents, and its association with significant pain symptomatology and accompanied long-term opioid use. Increased survival following exposure to neurotoxic chemotherapy and its long-term disease burden necessitates further study among survivors.
Co-occurrence of depressive symptoms and executive dysfunction after stroke: associations with brain pathology and prognosis
Authors: Douven Elles , Aalten Pauline , Staals Julie , Schievink Syenna H J , van Oostenbrugge Robert J , Verhey Frans R J , Köhler Sebastian
Published: February 2018

Objective

To examine, first, whether the co-occurrence of executive dysfunction (ED) and poststroke depression (PSD) shows different associations with neuroimaging markers and the course of depression and executive function, and second, whether it is associated with a different course on other cognitive domains and quality of life.

Methods

The present study included 245 stroke patients (35.9% female, mean age 67.5 years (SD=11.9). All patients completed neuropsychological and neuropsychiatric assessment 3 months poststroke, which were repeated at 6-month and 12-month follow-up. A subset (n=186) received 3-Tesla brain MRI at baseline to evaluate lesion-related imaging markers, white matter hyperintensity volume, global brain atrophy and total cerebral small vessel disease burden.

Results

Patients with ‘depression–executive dysfunction syndrome’ (DES) showed higher white matter hyperintensity volumes compared with all other groups and more frequently showed left-sided lesions compared with ED only and PSD only. They also had more frequently old infarcts and higher total cerebral small vessel disease burden compared with PSD only and patients with neither ED nor PSD, and more global brain atrophy compared with PSD only. Longitudinal analyses showed that patients with DES had a more chronic course of depressive symptoms relative to PSD only, and a stable pattern of worse cognitive performance similar to patients with ED only.

Conclusions

The co-occurrence of ED and PSD is associated with a worse prognosis of depression, persistent cognitive impairment and a higher amount of vascular and degenerative brain pathology. Future studies are needed to examine whether these patients represent a more severe subtype within the PSD spectrum.

Clinical trial registration

NCT02585349;Results.
Social networks as drivers of syphilis and HIV infection among young men who have sex with men
Authors: Fujimoto Kayo , Flash Charlene A , Kuhns Lisa M , Kim Ju-Yeong , Schneider John A
Published: February 2018

Objectives

Syphilis and HIV epidemics overlap, yet little is known about combined network and behavioural factors that drive syphilis-HIV coinfection. Our study objective was to assess network contexts and sexual behaviours associated with syphilis-HIV co-infection and monoinfection among a particularly vulnerable subgroup: young Black men who have sex with men (YBMSM). To achieve this objective, we examined factors associated with coinfection by each subgroup as classified by syphilis-HIV infection status: (A) HIV monoinfected, (B) syphilis monoinfected and (C) neither syphilis infected nor HIV infected. In addition, we further identified the factors that are associated with HIV infection or syphilis monoinfection.

Methods

Data were collected from a sample of 365 YBMSM, aged 16–29 years, recruited through respondent-driven sampling between 2014 and 2016, in two cities with large HIV epidemics: Houston, TX, and Chicago, IL. We conducted a series of multinomial logistic regression models to predict coinfection, HIV monoinfection and syphilis monoinfection as a function of network and sexual behavioural factors.

Results

Coinfection was associated with having network members who are coinfected or HIV infected within one’s social network. Syphilis monoinfection was associated with a higher number of social venues attended, and HIV monoinfection was associated with having more condomless top partners.

Conclusion

Public health interventions that address the diagnosis and treatment of syphilis infection and ensure that those with syphilis are being tested for HIV may be promising in limiting the synergy of syphilis-HIV infections in onward transmission. Advancing HIV and syphilis prevention efforts in high-prevalence networks may allow prioritisation of limited resources.
Evaluation of model uncertainties in reliability-based design of steel H-piles in axial compression
Authors: Tang Chong , Phoon Kok-Kwang
Published: February 2018

To account for uncertainties of load and resistance in a more rational way, reliability-based design (RBD) concepts have been increasingly applied to design bridge foundations. One of critical elements in the geotechnical RBD process is the characterization of model uncertainties. This paper compiles 126 and 23 reliable static load tests for steel H-piles in axial compression from two databases: Pile-Load Tests (PILOT) and Deep Foundation Load Test Database (DFLTD), respectively. The Davisson offset limit is adopted to define the measured resistance in clay, sand, and layered soil, which is verified with the L1–L2method developed for drilled shafts. A hyperbolic model with two parameters is chosen to fit the measured load–settlement curves. The uncertainties in resistance calculations and the load–settlement curves are captured by a ratio (or model factor) of measured to calculated resistance and the hyperbolic parameters. The mean values, coefficients of variation, and the probability distributions of the model factors are established from 149 load tests. The statistics of the resistance model factor are applied to calibrate the resistance factors (for the ultimate limit state) in load and resistance factor design of steel H-piles in axial compression. In future, the statistics of the hyperbolic parameters can be incorporated into the development of RBD of steel H-piles at the serviceability limit state.
Renin–angiotensin system inhibition ameliorates CCl4-induced liver fibrosis in mice through the inactivation of nuclear transcription factor kappa B
Authors: Saber Sameh , Mahmoud Amr A.A. , Helal Noha S. , El-Ahwany Eman , Abdelghany Rasha H.
Published: February 2018

Therapeutic interventions for liver fibrosis are still limited due to the complicated molecular pathogenesis. Renin–angiotensin system (RAS) seems to contribute to the development of hepatic fibrosis. Therefore, we aimed to examine the effect of RAS inhibition on CCl4-induced liver fibrosis. Mice were treated with silymarin (30 mg·kg−1), perindopril (1 mg·kg−1), fosinopril (2 mg·kg−1), or losartan (10 mg·kg−1). The administration of RAS inhibitors improved liver histology and decreased protein expression of alpha smooth muscle actin (α-SMA) and hepatic content of hydroxyproline. These effects found to be mediated via inactivation of nuclear transcription factor kappa B (NFκB) pathway by the inhibition of NFκB p65 phosphorylation at the Ser536 residue and phosphorylation-induced degradation of nuclear factor kappa-B inhibitor alpha (NFκBia) subsequently inhibited NFκB-induced TNF-α and TGF-β1, leading to lower levels of tissue inhibitor of metalloproteinase-1 (TIMP-1) and vascular endothelial growth factor (VEGF). We concluded that the tissue affinity of the angiotensin converting enzyme inhibitors (ACEIs) has no impact on its antifibrotic activity and that interfering the RAS either through the inhibition of ACE or the blockade of AT1R has the same therapeutic benefit. These results suggest RAS inhibitors as promising candidates for further clinical trials in the management of hepatic fibrosis.