bluuebunny/crossref_metadata_2025 huggingface dataset:
Validity of self‐reported hospital admissions in clinical trials depends on recall period length and individual characteristics
Authors: Seidl Hildegard , Meisinger Christa , Kirchberger Inge , Burkhardt Katrin , Kuch Bernhard , Holle Rolf
Published: December 2015

Rationale, aims and objectives

We investigated the validity of self‐reported admission data compared to administrative records in a clinical trial.

Method

In the randomized KORINNA study (ISRCTN02893746), hospital admission data were collected in telephone interviews with 273 elderly patients quarterly over a 1‐year period and thereafter annually over a 2‐year period. Data were compared with administrative records and discharge letters. Mixed models were used to investigate if recall period and individual characteristics influence validity.

Results

Specificity (>99%) and sensitivity (94%) of self‐reported data did not differ for different recall periods (3 months vs. 12 months). The differences between self‐reported and registered inpatient days were not statistically significant. Having regard to all the admissions within the time period of last interview and dropping out, the bias was up to 40% underestimation. The chance of disagreement was significantly smaller [odds ratio (OR) of misremember an admission = 0.596, P = 0.049, confidence interval (CI) = 0.355 to 1.00; OR of misremember length of stay = 0.521, P = 0.002, CI = 0.344 to 0.789] for 3‐month periods, but this was primarily driven by number of admissions within the recall period. Individuals with better health and longer stays had a significantly smaller chance of disagreement.

Conclusions

The bias within one year was not influenced by applying various recall periods, although the probability of correctly self‐reported single hospital admission was higher using a recall period of three months. It can be recommended that lengthened recall periods of 12 months are appropriate for gathering self‐reported hospital admission data in elderly people with myocardial infarction.
Maternal kisses are not effective in alleviating minor childhood injuries (boo‐boos): a randomized, controlled and blinded study
Authors:   The Study of Maternal and Child Kissing (SMACK) Working Group
Published: December 2015

Background

The practice of maternal kissing of minor injuries of childhood (boo‐boos), though widely endorsed and practised, has never been demonstrated to be of benefit to children.

Objective

To determine the efficacy, if any, of maternal kissing of boo‐boos in toddlers.

Design

Randomized, controlled and double‐blinded study of children with experimentally induced minor injuries. Control arms included both no intervention group and ‘sham’ (non‐maternal) kissing. Children were blinded to the identity of the kisser in both the maternal and sham control groups.

Setting

Outpatient research clinics in Ottawa, Canada.

Participants

943 maternal–toddler pairs recruited from the community.

Measurements

Toddler Discomfort Index (TDI) pre‐injury, 1 and 5 minutes post‐injury.

Results

One‐minute and 5‐minute TDI scores did not differ significantly between the maternal and sham kiss groups. Both of these groups had significantly higher TDI scores at 5 minutes compared to the no intervention group.

Conclusions

Maternal kissing of boo‐boos confers no benefit on children with minor traumatic injuries compared to both no intervention and sham kissing. In fact, children in the maternal kissing group were significantly more distressed at 5 minutes than were children in the no intervention group. The practice of maternal kissing of boo‐boos is not supported by the evidence and we recommend a moratorium on the practice.
Nutritional Characteristics of Lambs Meat Fed Diets with Cotton Cake
Authors: Pereira Luana , Pires Aureliano J.V. , Carvalho Gleidson G.P. , Silva Rosani V.M.M. , Simionato Julliana I. , Lacerda Ellen C.Q. , Bezerra Lais S. , Eiras Carlos E. , Carvalho Bruna M.A.
Published: December 2015

This study aimed to evaluate the nutritional quality of meat of lambs fed with cake originating from cotton production of biodiesel. Forty noncastrated lambs, crossbredDorper versusSantaInês from 20.9 to 36.7 kg of body weight finished in feedlot of 99 days and fed diets containing levels of cotton cake (0, 33, 66 and 100%) replacing soybean meal. The chemical composition and physicochemical characteristics were not influenced (P > 0.05) by the levels of cotton cake in the concentrate. Regarding the fatty acids found in the meat, there were no differences attributable to diet composition. The fatty acid found in the highest concentration (P < 0.05) of cotton cake was the mono‐unsaturated oleic acid (49.7%), followed by saturated palmitic acid (23.6%) and stearic acid (18.5%), unsatured poly‐linolenic acid (1.93%), saturated myristic (1.58%) and the mono‐unsaturated palmitoleic (1.45%).

Practical Applications

In diets for feedlot lambs, the cotton cake can replace soybean meal in the concentrate, corresponding to 120 g/kg of the total diet, and it does not change the nutritional characteristics of meat. Thus, cotton cake, with low cost ingredients, if used in diets for the production of lambs, provides good nutritional quality meat.
Body mass index among Special Olympics athletes from Muslim majority countries: Differences in gender and adult status
Authors: Patka M. , Murry A.
Published: December 2015

Background

Obesity is higher in adults with intellectual disability than in the general population and for women more than men. Past research however has specifically focused on individuals with intellectual disability in the United States and the United Kingdom with little attention on individuals with intellectual disability in Muslim majority countries.

Method

The present study examined differences in body mass index (BMI) among 1314 men and women Special Olympics athletes from 32 Muslim majority countries in 2003, 2005, 2006, 2007, 2009 and 2011. Athletes' gender, adult status (minor or adult) and the interaction between gender and adult status were used to predict increases in BMI with a hierarchical linear regression, where athletes were nested within country controlling for athletes' nation's Gross‐domestic product.

Results

Being female significantly predicted an increase in obesity while adulthood predicted a decrease in BMI. The interaction between gender and adulthood was also significant, however, indicating that obesity decreases with adulthood only for men. For women, BMI continues to increase with age.

Conclusions

This study extends our knowledge on one important indicator of health status for individuals with intellectual disability in Asia, Africa and Eastern Europe. The results may be used to inform health care practices with individuals with intellectual disabilities and stimulate future research to understand contextual factors contributing to health disparities.
Weight, nutrition, food choice, and physical activity in adults with intellectual disability
Authors: Koritsas S. , Iacono T.
Published: December 2015

Background

The aim of this study was to describe the nutrition, food choice, physical activity and weight status in a group of adults with intellectual disability (ID) in Victoria, Australia.

Method

Disability workers and adults with ID were recruited through disability services. In total, 51 disability workers (11 men, 40 women) and 68 (47 men, 21 women) adults with ID participated in the research. Disability workers provided information about the nutrition, food choice and physical activity levels of adults with ID through a questionnaire administered by a general practitioner or research nurse. The questionnaire also included The Australian Nutrition Screening Initiative checklist.

Results

Body Mass Index was in the healthy range for only 37.5% of participants and in the obese range for almost half (41%). Similarly, the majority of participants had an abdominal circumference in a range that put them at increased or substantially increased risk of metabolic complications. The mean score obtained on the Australian Nutrition Screening Initiative checklist indicated a moderate risk of malnutrition (M = 4.2); however, 17.6% of participants achieved scores that put them in the high‐risk category. More than half of the participants were reported to have a little choice in the type of food they ate and when they ate. Physical activity data indicated that the majority of participants (60.3%) did not meet national physical activity guidelines.

Conclusions

These findings suggest that people with ID are at risk of developing diseases associated with obesity, inactivity, and poor nutrition. Strategies to encourage people with ID to engage in physical activity and healthy eating are, therefore, a matter of priority and should involve their disability workers.
Age‐dependent damage of hair cuticle: contribution of S100A3 protein and its citrullination
Authors: Takahashi Toshie , Mamada Akira , Kizawa Kenji , Suzuki Ryosuke
Published: December 2015

Background

There are two types of damage pattern of human hair cuticle: type L, where the cell membrane complex is split and the cuticle lifts up, and type E, where the fragile substructure of the cuticle cell (endocuticle) is broken. In our previous paper, it was reported that the dominant damage pattern shifts from type L to E with the subjects' age around the 40s. Loss of the cuticle due to daily grooming stresses increases with the subjects' age and is related to the level of type E damage. It is supposed that deterioration of endocuticle advances the loss of cuticle. S100A3 protein, located at the endocuticle, was found to be citrullinated and transformed into tetramer to improve its Ca2+‐binding ability. It is postulated that this biochemical property affects the maturation of cuticle and contributes to its reinforcement.

Aims

This study aims to elucidate the role that S100A3 plays in age‐dependent cuticle damage.

Methods

Hair fibers collected from Japanese females were evaluated for the content and citrullination rate of S100A3, incidence of type E damage, and resistance of cuticle.

Results

In the aged hair, the content of S100A3 was positively correlated with the level of type E damage and low resistance to stress. Hair fibers in which S100A3 is highly citrullinated, however, showed low levels of type E damage and high resistance of cuticle, even in the aged hair as well as at younger ages.

Conclusions

S100A3 and its citrullination process are related to rigidity of endocuticle of aged hair.
Invention of ultrasonic Doppler fetal actocardiograph and continuous recording of fetal movements
Authors: Maeda Kazuo
Published: December 2015

Aims

To enable scientific studies on fetal movements and its relation to fetal heart rate directly detecting fetal chest motion with ultrasonic Doppler method.

Methods

A prototype of an ultrasonic Doppler fetal actocardiograph (ACG) was designed and handmade by the author. A 2 MHz ultrasound fetal heart rate (FHR) monitor was remodeled to detect fetal heartbeat and chest movement Doppler signals with a single ultrasound probe. The fetal movement Doppler signal was 20–50 Hz using 2 MHz ultrasound, separated from the fetal heartbeat Doppler signal, which was 100 or more Hz and sent to the autocorrelation FHR meter to record FHR curve, while fetal movement Doppler signals were detected through 20–80 Hz band‐pass filter, and changed to spikes recorded on a cardiotocography chart.

Results

The spike amplitudes of a moving steel ball expressed fetal movement on the ACG. FHR acceleration synchronized with fetal movement bursts. Fetal resting and active states are separated using the ACG. Fetal hiccupping movements on ACG were regular continuous spikes with 2–3 s intervals.

Conclusion

Fetal movements and hiccups were correctly recorded with the FHR curve. The relation of FHR and movement will be further clarified in future ACG readings.
Non‐Peutz‐Jeghers syndrome‐associated ovarian sex cord tumor with annular tubules: Report of a malignant case
Authors: Han Ying , Li Shumin , Wu Lingying , Zhang Xun , Cao Dengfeng
Published: December 2015

A sex cord tumor with annular tubules (SCTAT) is a rare but distinctive subtype of sex cord stromal tumor of the ovary. Its clinical features depend on an association with Peutz‐Jeghers syndrome (PJS). SCTAT associated with PJS typically manifests as bilateral, multifocal, and small lesions and is clinically benign. In contrast, SCTAT not associated with PJS often manifests as a unilateral large mass and 20% of such tumors have malignant potential. Most patients with SCTAT are diagnosed at stage I, and metastasis is rare. Here we present a case of malignant SCTAT of stage III A1(ii) (retroperitoneal lymph node metastasis, largest dimension of metastasis >10 mm) in a 14‐year‐old girl without PJS.
Trend of Cadherin‐11 expression and its impact on cartilage degradation in the temporomandibular joints of guinea pigs with spontaneous osteoarthritis
Authors: Wu Mengjie , Lu Haiping , Yu Fengyang , Zhou Yiqun
Published: December 2015

Background

This study aims to investigate spatial and temporal changes in cadherin‐11 (CAD‐11) expression and their effects on cartilage degeneration in the temporomandibular joint (TMJ) of guinea pigs with spontaneous osteoarthritis (OA).

Methods

Dunkin‐Hartley (DH) and Bristol strain 2 (BS2) guinea pigs at ages of 1, 3, 6, 9, and 12 months were categorized into two groups and analyzed. The bilateral TMJ condyles of DH and BS2 guinea pigs were harvested and fixed. The distribution and expression profiles of CAD‐11, collagen type II, and matrix metalloproteinase 3 (MMP‐3) were detected by immunohistological assays. Histological micrographs of the condyle cartilage were obtained and analyzed.

Results

Osteoarthritis can be spontaneously induced by mechanical stress in DH guinea pigs. The main histopathological changes in the TMJ structure and increased expression of MMP‐3 occurred within 6–9 months of ages in DH guinea pigs with spontaneous OA. By contrast, minimal to mild cartilage degradations were observed in the TMJ of BS2 guinea pigs even at the age of 12 months. From as early as 3 months of age, the expression levels of CAD‐11 were upregulated in the TMJ of DH guinea pigs compared with those in BS2 animals. CAD‐11 expression differed between the two groups at 12 months of age.

Conclusions

Increased CAD‐11 expression within cartilage is associated with the development and progression of OA between the two strains of guinea pigs. Therefore, CAD‐11 expression in TMJ could be an important predisposing factor for the development of spontaneous OA.
Aberrant expression of interleukin‐22 and its targeting microRNAs in oral lichen planus: a preliminary study
Authors: Shen Zhengyu , Du Guanhuan , Zhou Zengtong , Liu Wei , Shi Linjun , Xu Hui
Published: December 2015

Background

Oral lichen planus (OLP) is a T cell‐mediated autoimmune disease involving oral mucosa. Interleukin‐22 (IL‐22) as the signature cytokine of T helper 22 cells is increasingly recognized as a key regulator in various autoimmune diseases. Our previous study reported that IL‐22 immunoexpression in OLP was significantly increased compared with the normal controls.

Methods

The objective of this preliminary study was to compare the IL‐22 expression levels in oral biopsies from patients with OLP (n = 50) against normal oral mucosa (n = 19) using RT‐qPCR and Western blot, identify the potential targeting miRNAs of IL‐22, and examine the miRNA expression levels in OLP.

Results

Interleukin‐22 expression level in OLP was significantly increased compared with the normal controls. The Dual‐Luciferase reporter assay system in human embryonic kidney 293 (HEK293) cells demonstrated that miR‐562 and miR‐203 were the target miRNAs of IL‐22, which was consistent with predictions from bioinformatics software analyses. Interestingly, miR‐562 expression in OLP was significantly decreased, but miR‐203 expression in OLP was significantly increased compared with the normal controls.

Conclusion

This preliminary study for the first time reported that aberrant expression levels of miR‐562 and miR‐203 were associated with high expression of IL‐22 and demonstrated the target relationship between miRNAs and IL‐22 in HEK293 cells. Our data indicated that IL‐22 and its targeting miRNAs contribute to the pathogenesis of OLP. Further studies are required to investigate the regulatory pathways of IL‐22 and miR‐562 and miR‐203 in OLP.
Comparison of the Effect of Addition of Cyanoacrylate, Epoxy Resin, and Gum Arabic on Surface Hardness of Die Stone
Authors: Tripathi Arvind , Gupta Ashutosh , Bagchi Soumyojeet , Mishra Lallan , Gautam Abhina , Madhok Riti
Published: December 2015

Purpose

To observe the effects of incorporating cyanoacrylate, epoxy resins, and gum arabic on the abrasion resistance of type IV gypsum die materials.

Materials and Methods

Forty specimens were prepared and divided into four groups (10 specimens in each group), namely group A (control), group B (die stone mixed with cyanoacrylate), group C (die stone mixed with epoxy resin), group D (die stone mixed with gum arabic). All the specimens were subjected to abrasion testing, wear volume analysis, Fourier transform infrared spectroscopy (FT‐IR), and scanning electron microscope (SEM) analysis.

Results

Abrasion testing showed maximum wear in the control group and minimum wear in the gum arabic group. Intergroup differences were statistically significant (p < 0.001). The largest mean difference was between control and gum arabic. The lowest was between cyanoacrylate and the control group. The mean wear volume was lowest in the gum arabic group (4.23 mm3) and highest in the control group (6.78 mm3). The FT‐IR graphs of the gum arabic models showed the presence of CH2, which is responsible for its binding activity. SEM revealed that the irregular particles of gum arabic display an interlocking arrangement. This jigsaw puzzle pattern results in stronger physical bond formation.

Conclusion

Observations from this study showed that the addition of gum arabic increases resistance to abrasion in type IV gypsum. Cyanoacrylates are good adhesives as well, but a major drawback is that they have very low resistance to chemical action with water and physical actions such as sunlight. Epoxy resins are powerful adhesives, but they attain their full efficiency when cured with heat. Cyanoacrylate and epoxy resin displayed poor physical bonding, primarily because of inhomogeneity.
Clinical Practice Guidelines for Recall and Maintenance of Patients with Tooth‐Borne and Implant‐Borne Dental Restorations
Authors: Bidra Avinash S. , Daubert Diane M. , Garcia Lily T. , Kosinski Timothy F. , Nenn Conrad A. , Olsen John A. , Platt Jeffrey A. , Wingrove Susan S. , Chandler Nancy Deal , Curtis Donald A.
Published: December 2015

Purpose

To provide guidelines for patient recall regimen, professional maintenance regimen, and at‐home maintenance regimen for patients with tooth‐borne and implant‐borne removable and fixed restorations.

Materials and Methods

The American College of Prosthodontists (ACP) convened a scientific panel of experts appointed by the ACP, American Dental Association (ADA), Academy of General Dentistry (AGD), and American Dental Hygienists Association (ADHA) who critically evaluated and debated recently published findings from two systematic reviews on this topic. The major outcomes and consequences considered during formulation of the clinical practice guidelines (CPGs) were risk for failure of tooth‐ and implant‐borne restorations. The panel conducted a round table discussion of the proposed guidelines, which were debated in detail. Feedback was used to supplement and refine the proposed guidelines, and consensus was attained.

Results

A set of CPGs was developed for tooth‐borne restorations and implant‐borne restorations. Each CPG comprised (1) patient recall, (2) professional maintenance, and (3) at‐home maintenance. For tooth‐borne restorations, the professional maintenance and at‐home maintenance CPGs were subdivided for removable and fixed restorations. For implant‐borne restorations, the professional maintenance CPGs were subdivided for removable and fixed restorations and further divided into biological maintenance and mechanical maintenance for each type of restoration. The at‐home maintenance CPGs were subdivided for removable and fixed restorations.

Conclusions

The clinical practice guidelines presented in this document were initially developed using the two systematic reviews. Additional guidelines were developed using expert opinion and consensus, which included discussion of the best clinical practices, clinical feasibility, and risk‐benefit ratio to the patient. To the authors’ knowledge, these are the first CPGs addressing patient recall regimen, professional maintenance regimen, and at‐home maintenance regimen for patients with tooth‐borne and implant‐borne restorations. This document serves as a baseline with the expectation of future modifications when additional evidence becomes available.
THE EFFECT OF YOUTH POVERTY RATES AND MIGRATION ON ADULT WAGES
Authors: Knapp Thomas A. , White Nancy E.
Published: December 2015

We created a migration and earnings history from the National Longitudinal Survey of Youth to analyze the effects of youth county poverty rates on the adult earnings of white male migrants. We estimate a log wage equation that includes human capital measures, migration types, county poverty rates, and a rural–poverty rate interaction variable. Growing up in a rural county has a negative impact on adult wages independent of youth county poverty rates, but the rural effect is significantly greater for those who grew up in high poverty counties. Youth county poverty rates indirectly affect wages through the returns to migration.
Diagnostic value of neutrophil–lymphocyte and albumin–globulin ratios in canine soft tissue sarcoma
Authors: Macfarlane L. , Morris J. , Pratschke K. , Mellor D. , Scase T. , Macfarlane M. , Mclauchlan G.
Published: December 2015

OBJECTIVE

To investigate the ability of neutrophil‐to‐lymphocyte ratio and albumin‐to‐globulin ratio to differentiate soft tissue sarcoma from benign soft tissue tumours.

METHODS

A retrospective study of pretreatment haematology and biochemistry in dogs diagnosed with soft tissue sarcoma or benign soft tissue tumours. The neutrophil‐to‐lymphocyte ratio and albumin‐to‐globulin ratio were compared between the two groups. In dogs diagnosed with soft tissue sarcoma, the relationship of neutrophil‐to‐lymphocyte ratio and albumin‐to‐globulin ratio to histological tumour grade (I toIII) was assessed.

RESULTS

In the dogs with soft tissue sarcoma (n=22), the neutrophil‐to‐lymphocyte ratio was significantly increased and the albumin‐to‐globulin ratio decreased compared to those with benign soft tissue tumours (n=14). The neutrophil‐to‐lymphocyte ratio and albumin‐to globulin ratio were not useful as predictors of tumour grade in dogs diagnosed with soft tissue sarcoma.

CLINICAL SIGNIFICANCE

Pretreatment neutrophil‐to‐lymphocyte ratio and albumin‐to globulin ratio may aid with diagnosis and optimal treatment planning. Further investigation into their prognostic implications is warranted.
Curing bacterial infections with protein aggregates
Authors: Ventura Salvador
Published: December 2015

A growing number of human diseases seem to be associated with protein misfolding and deposition into aggregates. Bednarska and colleagues exploit the cytotoxic nature of protein aggregates to target bacterial infections. Protein aggregation is at the same time generic and sequence dependent; this allowed the authors to develop novel aggregation‐prone antimicrobial peptides that penetrate bacteria and induce a peptide specific proteostatic collapse that leads to fast bacterial death, without any observable effects on host cells. The applicability of this intriguing strategy was demonstrated by curing animal models from bacterial sepsis. Although the precise mechanisms underlying the bactericidal activity of the peptide aggregates are still not clear, there is no doubt that this approach offers an exciting therapeutic alternative to conventional antibiotics.
The hmsT 3′ untranslated region mediates c‐di‐GMP metabolism and biofilm formation in Yersinia pestis
Authors: Zhu Hui , Mao Xu‐Jian , Guo Xiao‐Peng , Sun Yi‐Cheng
Published: December 2015

Yersinia pestis, the cause of plague, forms a biofilm in the proventriculus of its flea vector to enhance transmission. Biofilm formation in Y. pestis is regulated by the intracellular levels of cyclic diguanylate (c‐di‐GMP). In this study, we investigated the role of the 3′ untranslated region (3′UTR) in hmsT mRNA, a transcript that encodes a diguanylate cyclase that stimulates biofilm formation in Y. pestis by synthesizing the second messenger c‐di‐GMP. Deletion of the 3′UTR increased the half‐life of hmsT mRNA, thereby upregulating c‐di‐GMP levels and biofilm formation. Our findings indicate that multiple regulatory sequences might be present in the hmsT 3′UTR that function together to mediate mRNA turnover. We also found that polynucleotide phosphorylase is partially responsible for hmsT 3′UTR‐mediated mRNA decay. In addition, the hmsT 3′UTR strongly repressed gene expression at 37°C and 26°C, but affected gene expression only slightly at 21°C. Our findings suggest that the 3′UTR might be involved in precise and rapid regulation of hmsT expression, allowing Y. pestis to fine‐tune c‐di‐GMP synthesis and consequently regulate biofilm production to adapt to the changing host environment.
Protein–protein interactions indicate composition of a 480 kDa SELMA complex in the second outermost membrane of diatom complex plastids
Authors: Lau Julia B. , Stork Simone , Moog Daniel , Schulz Julian , Maier Uwe G.
Published: December 2015

Most secondary plastids of red algal origin are surrounded by four membranes and nucleus‐encoded plastid proteins have to traverse these barriers. Translocation across the second outermost plastid membrane, the periplastidal membrane (PPM), is facilitated by a ERAD‐(ER‐associated degradation) derived machinery termed SELMA (symbiont‐specific ERAD‐like machinery). In the last years, important subunits of this translocator have been identified, which clearly imply compositional similarities between SELMA and ERAD. Here we investigated, via protein–protein interaction studies, if the composition of SELMA is comparable to the known ERAD complex. As a result, our data suggest that the membrane proteins of SELMA, the derlin proteins, are linked to the soluble sCdc48 complex via the UBX protein sUBX. This is similar to the ERAD machinery whereas the additional SELMA components, sPUB und a second Cdc48 copy might indicate the influence of functional constraints in developing a translocation machinery from ERAD‐related factors. In addition, we show for the first time that a rhomboid protease is a central interaction partner of the membrane proteins of the SELMA system in complex plastids.
An orphaned Mce‐associated membrane protein of Mycobacterium tuberculosis is a virulence factor that stabilizes Mce transporters
Authors: Perkowski Ellen Foot , Miller Brittany K. , McCann Jessica R. , Sullivan Jonathan Tabb , Malik Seidu , Allen Irving Coy , Godfrey Virginia , Hayden Jennifer D. , Braunstein Miriam
Published: December 2015

Mycobacterium tuberculosis proteins that are exported out of the bacterial cytoplasm are ideally positioned to be virulence factors; however, the functions of individual exported proteins remain largely unknown. Previous studies identified Rv0199 as an exported membrane protein of unknown function. Here, we characterized the role of Rv0199 in M. tuberculosis virulence using an aerosol model of murine infection. Rv0199 appears to be a member of a Mce‐associated membrane (Mam) protein family leading us to rename it OmamA, for orphaned Mam protein A. Consistent with a role in Mce transport, we showed OmamA is required for cholesterol import, which is a Mce4‐dependent process. We further demonstrated a function for OmamA in stabilizing protein components of the Mce1 transporter complex. These results indicate a function of OmamA in multiple Mce transporters and one that may be analogous to the role of VirB8 in stabilizing Type IV secretion systems, as structural similarities between Mam proteins and VirB8 proteins are predicted by the Phyre 2 program. In this study, we provide functional information about OmamA and shed light on the function of Mam family proteins in Mce transporters.
Delineating PAS‐HAMP interaction surfaces and signalling‐associated changes in the aerotaxis receptor Aer
Authors: Garcia Darysbel , Watts Kylie J. , Johnson Mark S. , Taylor Barry L.
Published: December 2015

The Escherichia coli aerotaxis receptor, Aer, monitors cellular oxygen and redox potential via FAD bound to a cytosolic PAS domain. Here, we show that Aer‐PAS controls aerotaxis through direct, lateral interactions with a HAMP domain. This contrasts with most chemoreceptors where signals propagate along the protein backbone from an N‐terminal sensor to HAMP. We mapped the interaction surfaces of the Aer PAS, HAMP and proximal signalling domains in the kinase‐off state by probing the solvent accessibility of 129 cysteine substitutions. Inaccessible PAS‐HAMP surfaces overlapped with a cluster of PAS kinase‐on lesions and with cysteine substitutions that crosslinked the PAS β‐scaffold to the HAMP AS‐2 helix. A refined Aer PAS‐HAMP interaction model is presented. Compared to the kinase‐off state, the kinase‐on state increased the accessibility of HAMP residues (apparently relaxing PAS‐HAMP interactions), but decreased the accessibility of proximal signalling domain residues. These data are consistent with an alternating static‐dynamic model in which oxidized Aer‐PAS interacts directly with HAMP AS‐2, enforcing a static HAMP domain that in turn promotes a dynamic proximal signalling domain, resulting in a kinase‐off output. When PAS‐FAD is reduced, PAS interaction with HAMP is relaxed and a dynamic HAMP and static proximal signalling domain convey a kinase‐on output.
Quantitative analysis of CagA type IV secretion by Helicobacterpylori reveals substrate recognition and translocation requirements
Authors: Schindele Franziska , Weiss Evelyn , Haas Rainer , Fischer Wolfgang
Published: December 2015

Bacterial type IV secretion systems are protein transporters with a remarkable diversity of substrates and substrate recognition mechanisms. Type IV‐secreted proteins often contain C‐terminal secretion signals, but may also require other regions for recognition as secretory substrates, or for full secretion efficiency. For example, type IV secretion of CagA, a major pathogenicity factor of the human gastric pathogen Helicobacter pylori, depends on a C‐terminal signal and on N‐terminal protein regions. To examine the involvement of individual CagA regions for type IV secretion efficiency, we have established and evaluated a β‐lactamase‐dependent reporter system which allows quantitative determination of translocation into host cells. For validation, we used this reporter system to obtain quantitative data for type IV secretion of CagA variants with sequential C‐terminal truncations. Alanine‐scanning mutagenesis of the CagA C‐terminus revealed that none of the characteristic charged residues in this region is necessary for type IV secretion. Translocation rates measured for CagA variants with N‐terminal deletions show that CagA does not have an N‐terminal signal sequence, but requires its N‐terminal domain for efficient secretion. Finally, we provide evidence that only newly synthesized CagA protein is translocated, supporting a model in which type IV secretion is coupled to protein biosynthesis.
A twinfilin‐like protein coordinates karyokinesis by influencing mitotic spindle elongation and DNA replication in Leishmania
Authors: Kumar Gaurav , Kajuluri Lova P. , Gupta Chhitar M. , Sahasrabuddhe Amogh A.
Published: December 2015

Twinfilin is an evolutionarily conserved actin‐binding protein, which regulates actin‐dynamics in eukaryotic cells. Homologs of this protein have been detected in the genome of various protozoan parasites causing diseases in human. However, very little is known about their core functions in these organisms. We show here that a twinfilin homolog in a human pathogen Leishmania, primarily localizes to the nucleolus and, to some extent, also in the basal body region. In the dividing cells, nucleolar twinfilin redistributes to the mitotic spindle and remains there partly associated with the spindle microtubules. We further show that approximately 50% depletion of this protein significantly retards the cell growth due to sluggish progression of S phase of the cell division cycle, owing to the delayed nuclear DNA synthesis. Interestingly, overexpression of this protein results in significantly increased length of the mitotic spindle in the dividing Leishmania cells, whereas, its depletion adversely affects spindle elongation and architecture. Our results indicate that twinfilin controls on one hand, the DNA synthesis and on the other, the mitotic spindle elongation, thus contributing to karyokinesis in Leishmania.
The prevalence of Candida onychomycosis in Southeastern Serbia from 2011 to 2015
Authors: Otašević Suzana , Barac Aleksandra , Pekmezovic Marina , Tasic Sinisa , Ignjatović Aleksandra , Momčilović Stefan , Stojanović Predrag , Arsic Arsenijevic Valentina , Hay Roderick
Published: December 2015

Despite the increasing of onychomycosis caused by Candida spp., in referent literature, there is still data insufficiency about this nail infection. The objectives of this retrospective study were to determine epidemiological characteristics of Candida onychomycosis, the antifungal susceptibility of isolated species in vitro, and to compare the results of antifungal susceptibility testing with conducted treatment in period from 2011 to the end of March 2015. Out of 761 patients who were underwent clinical and mycological examinations, 137 had Candida species isolated from nails. The dominant species was Candida albicans (C. albicans) (36.59%) followed by C. parapsilosis (23.78%), C. krusei (9.76%), and C. guilliermondii (6.71%). Antifungal susceptibility in vitro testing showed good susceptibility to antimycotics, except C. krusei, which was resistance to fluconazole (FCZ) and isolates of C. tropicalis and C. glabrata which were dose dependent to itraconazole (ITZ) and fluconazole. Evaluation of medical histories determined that combined therapy, which included pulsed systemic regimen of ITZ with topical application of clotrimazole, had better clinical outcomes regarding the proscribed only topical application of clotrimazole. Multidisciplinary approach of dermatologists and mycologists is required in solving the problem of onychomycosis, which is the dominant nail disease.
Incidence and risk factors of acute kidney injury following transcatheter aortic valve replacement
Authors: Thongprayoon Charat , Cheungpasitporn Wisit , Srivali Narat , Kittanamongkolchai Wonngarm , Greason Kevin L , Kashani Kianoush B
Published: December 2015

Aim

This study aimed to determine the incidence and risk factors of acute kidney injury (AKI) following transcatheter aortic valve replacement (TAVR).

Methods

We included all adult patients undergoing TAVR for aortic stenosis from 1 January 2008 to 30 June 2014 at a tertiary referral hospital. AKI was defined based on Kidney Disease: Improving Global Outcomes criteria. We performed a multivariate logistic regression to identify factors associated with post‐procedural AKI occurrence.

Results

Three hundred eighty‐six patients met the inclusion criteria, of which 106 (28%) developed AKI. In multivariate analysis, AKI development was independently associated with a transapical approach (odds ratio (OR), 2.81; 95% confidence interval (CI), 1.72–4.65 compared with transfemoral approach) and the need for an intra‐aortic balloon pump (OR, 9.11; 95% CI, 1.77–68.29). Higher baseline renal function (OR, 0.78 per 10 mL/min per 1.73 m2 increment in glomerular filtration rate; 95% CI, 0.68–0.87) was significantly associated with a decreased risk of AKI. After adjustment for the Society of Thoracic Surgeons' risk score, post‐procedural AKI development remained significantly associated with an increased in‐hospital (OR, 4.74; 95% CI, 1.39–18.48) and 6‐month mortality (OR, 4.66; 95% CI, 2.32–9.63).

Conclusion

In a cohort of patients undergoing TAVR for aortic stenosis, AKI commonly occurred and was significantly associated with increased mortality. Baseline renal function, procedure approach and the need for circulatory support were important predictive factors for post‐procedural AKI occurrence.
Relationship between declining glomerular filtration rate and measures of cardiac and vascular autonomic neuropathy
Authors: Clyne Naomi , Hellberg Matthias , Kouidi Evangelia , Deligiannis Asterios , Höglund Peter
Published: December 2015

Aim

Cardiac and vascular autonomic neuropathy contributes to increased morbidity and mortality in patients with chronic kidney disease. The aim of this study was to analyze the effects of a decline in glomerular filtration rate (GFR) on heart rate variability (HRV) and nocturnal blood pressure dipping.

Methods

This cross‐sectional study comprises 124 patients (46 women, 78 men; age 66 ± 14 years) with chronic kidney disease (CKD) 3–5, not on renal replacement therapy. GFR was measured with iohexol clearance, HRV with 24 h Holter electrocardiogram (ECG) and nocturnal dipping with 24 hour ambulatory blood pressure.

Results

The GFR was 22.5 ± 8.5 mL/min per 1.73 m2. The main finding was a significant curvilinear association between the 24 h standard deviation of NN interval (24SDNN) in the HRV analysis and GFR (P = 0.01), logGFR (P = 0.006), diabetes mellitus (P = 0.05) and beta blocker treatment (0.03), respectively. The effect of diabetes mellitus on 24SDNN corresponded to a decline in GFR from 30 to 12 mL/min per 1.73 m2. There were significant curvilinear associations between systolic nocturnal dipping (P = 0.02) and diastolic nocturnal dipping (P = 0.05), respectively, and diabetes mellitus but not with GFR or logGFR.

Conclusion

In conclusion, cardiac sympathetic overdrive and decreased vagal control appear during CKD 4 and 5. The association with GFR is curvilinear. Diabetes mellitus was significantly associated with both cardiac and vascular autonomic neuropathy, as measured by heart rate variability and nocturnal blood pressure dipping, respectively. Knowing that arrhythmias, often due to sympathetic hyperactivity, are an important cause of sudden death in the dialysis population, this study contributes important knowledge on possible intervention thresholds.
Intrahospital transports of critically ill patients: critical care nurses' perceptions
Authors: Ringdal Mona , Chaboyer Wendy , Warrén Stomberg Margareta
Published: December 2015

Background

Between 30% and 70% of intrahospital transports is associated with some form of adverse event, compromising patient safety.

Aims

(1) To describe critical care nurses' perceptions of intrahospital transport problems, including the stress associated with transport and their perceived ability to respond appropriately to these problems; (2) to determine if there were associations between problems and responses.

Design and methods

This survey was conducted in three intensive care units. Descriptive data and correlations between perceived problems and responses and correlations between perceptions of the problems and ability to respond appropriately were calculated. Results from the open‐ended item were categorised.

Results

Eighty‐six nurses completed the web survey, a response rate of 57%. Two‐thirds said their intensive care Units had written transport guidelines, and two‐thirds of the transports were performed by nurses without physicians. Circulatory failure was the most frequently perceived problem (4·2 ± 2·8) followed by decreased levels of consciousness (3·5 ± 2·9). Positive correlations between two perceived patient problems, circulatory failure and neurological deterioration and nurses' perceptions of how to respond appropriately to them, were identified. Failure in pulse oximetry and equipment‐related problems were positively correlated to nurses' responses. Nurses described the transports as an unsafe and stressful task: ‘It's like a marathon race’.

Conclusion

Nurses report that undertaking transports were a stressful activity, but they perceived transport problems to be an infrequent occurrence. They stated that they respond appropriately to the problem.

Relevance to clinical practice

Nurses reported they were alert to the potential risks patients face during transport. Because fewer staff remained in the intensive care units, these remaining patients are also at risk during intrahospital transport.
Unraveling mechanisms of mesenchymal stromal cell–mediated immunomodulation through patient monitoring and product characterization
Authors: Schepers Koen , Fibbe Willem E.
Published: December 2015

Mesenchymal stromal cells (MSCs) are increasingly used in the treatment of a variety of clinical conditions and to modulate immune responses in conditions related to auto‐/alloimmunity, including graft‐versus‐host disease (GvHD). Although pilot data are promising, treatment responses have been highly variable, and further development of this as a therapeutic modality depends on increased insight into the properties of clinical MSC products and on understanding the mechanisms underlying responses in patients. Here we review the mechanisms that possibly underlie the capacity of MSCs to treat auto‐/alloimmunity, and describe how patient monitoring can help to identify the in vivo mechanisms of action in the treatment of GvHD. Since MSCs used in the clinic originate from various donors and from a heterogeneous population of cells, we will also discuss recent insights into MSC heterogeneity and their implications for clinical MSC products. Finally, we describe a framework to improve our understanding of the efficacy and working mechanism of MSCs, which involves patient monitoring and more extensive characterization of the heterogeneity within and between different MSC preparations.
Living well with dementia: enhancing dignity and quality of life, using a novel intervention, Dignity Therapy
Authors: Johnston Bridget , Lawton Sally , McCaw Catriona , Law Emma , Murray Joyce , Gibb John , Pringle Jan , Munro Gillian , Rodriguez Cesar
Published: December 2015

Aims and objectives

To assess the feasibility, acceptability and potential effectiveness of Dignity Therapy to improve the quality of life and reduce psychological and spiritual distress in older people with early stage dementia.

Background

Dementia is a syndrome with several causes that leads to a progressive decline in multiple areas of functioning. The maintenance of dignity and enhancement of quality of life are key elements of care. Meaningful communication may become more difficult with condition progression. Improvements in communication may have positive effects on the person's quality of life. Dignity Therapy is a short psychotherapeutic intervention that uses a trained therapist to take the person with dementia through a guided interview process, producing a ‘generativity’ document that creates a lasting, written legacy during a time when they are still able to communicate well.

Design and method

This was a feasibility mixed method study. Dignity Therapy was undertaken with patients diagnosed as having early stage dementia. Data were gathe‐red from pre‐ and post‐Dignity Therapy interviews, a focus group, interviews with key stakeholders, and three outcome measures: The Herth Hope Index; The Patient Dignity Inventory; Perceived Quality of Life/Satisfaction with Quality Life Ratings.

Findings

This study demonstrated that Dignity Therapy is feasible, acceptable and potentially effective for older people with dementia. Three overarching themes emerged: A life in context, A key to connect and Personal legacy.

Conclusions

We recommend that this feasibility study forms the basis for further study, advocating the prospective benefits to patients with dementia, families and nursing practice.

Implications for practice

Dignity Therapy, as a psychosocial intervention, has the potential to improve the quality of life and enhance person centred care for people with dementia.
Factors influencing nurses’ readiness to care for hospitalised older people
Authors: Baumbusch Jennifer , Leblanc Marie‐Eve , Shaw Maureen , Kjorven Mary
Published: December 2015

Aims and objectives

To gain a better understanding of nurses’ perspectives on factors that influence their readiness to provide appropriate care for hospitalised older people.

Background

Hospitals have consistently been criticised for failing to address the unique, complex needs of older people. Research suggests that multiple issues have led to this situation, including a lack of educational preparation for nurses, limited attention to environmental factors, and an absence of organisational preparedness that ensures hospitals are adapted to meet the needs of older people.

Design

An exploratory, qualitative approach was used.

Methods

Forty‐one Registered Nurses participated (24 point‐of‐care nurses; 17 organisational leaders). Six focus groups and one individual interview were conducted. Thematic data analysis was employed to generate the main study findings.

Results

An overarching theme of ‘Poor Fit’ emerged. While participants identified the shifting needs of patients towards more complex and relational care, the broader organisational and societal contexts were, largely, unchanging. This resulted in nurses recognising the factors needed to be ready to care for older patients and their families, but working in hospitals that were not suited to these needs.

Conclusions

The findings identify factors at the point‐of‐care, the organisational level, and in broader societal attitudes that shape nurses’ readiness to care for hospitalised older people. However, many of these factors are modifiable and care for older people could be improved through quality improvement initiatives and nursing leadership. This study offers insight into ways to re‐imagine nursing care that can be responsive to older people's complex needs in hospitals.

Implications for practice

With a growing contingent of hospitalised older people, it is imperative that nurses, who comprise the largest workforce in this setting, be included in the planning and delivery of healthcare services to ensure readiness to meet the needs of this population.
Thrombocytopenia‐associated multi‐organ failure caused by diabetic ketoacidosis
Authors: Alsaied Tarek , Goldstein Stuart L , Kaddourah Ahmad , Poynter Sue E
Published: December 2015

Thrombocytopenia‐associated multi‐organ failure (TAMOF) is an increasingly reported entity in the pediatric intensive care unit. The clinical presentation is similar to thrombotic thrombocytopenic purpura, but with no evidence of hemolysis and no schistocytes on peripheral smear. We report a case of TAMOF induced by diabetic ketoacidosis and treated with therapeutic plasma exchange (TPE). Early diagnosis and initiation of TPE significantly decrease the morbidity associated with TAMOF.