bluuebunny/crossref_metadata_2025 huggingface dataset:
Constitutive expression of CaHSP22.5 enhances chilling tolerance in transgenic tobacco by promoting the activity of antioxidative enzymes
Authors: Li Meifang , Ji Lusha , Jia Zefeng , Yang Xinghong , Meng Qingwei , Guo Shangjing
Published: January 2018

Chilling stress limits the productivity and geographical distribution of many organisms throughout the world. In plants, the small heat shock proteins (sHSPs) belong to a group of proteins known as chaperones. The sweet pepper (Capsicum annuum L.) cDNA clone CaHSP22.5, which encodes an endoplasmic reticulum-located sHSP (ER-sHSP), was isolated and introduced into tobacco (Nicotiana tabacum L.) plants and Escherichia coli. The performance index and the maximal efficiency of PSII photochemistry (Fv/Fm) were higher and the accumulation of H2O2 and superoxide radicals (O2–) was lower in the transgenic lines than in the untransformed plants under chilling stress, which suggested that CaHSP22.5 accumulation enhanced photochemical activity and oxidation resistance. However, purified CaHSP22.5 could not directly reduce the contents of H2O2 and O2– in vitro. Additionally, heterologously expressed recombinant CaHSP22.5 enhanced E. coli viability under oxidative stress, helping to elucidate the cellular antioxidant function of CaHSP22.5 in vivo. At the same time, antioxidant enzyme activity was higher, which was consistent with the lower relative electrolyte conductivity and malondialdehyde contents of the transgenic lines compared with the wild-type. Furthermore, constitutive expression of CaHSP22.5 decreased the expression of other endoplasmic reticulum molecular chaperones, which indicated that the constitutive expression of ER-sHSP alleviated endoplasmic reticulum stress caused by chilling stress in plants. We hypothesise that CaHSP22.5 stabilises unfolded proteins as a chaperone and increases the activity of reactive oxygen species-scavenging enzymes to avoid oxidation damage under chilling stress, thereby suggesting that CaHSP22.5 could be useful for improving the tolerance of chilling-sensitive plant types.
The cyclin-dependent kinase inhibitor, JNJ-7706621, improves in vitro developmental competence of porcine parthenogenetic activation and somatic cell nuclear transfer embryos
Authors: Guo Qing , Jin Long , Zhu Hai-Ying , Xing Xiao-Xu , Xuan Mei-Fu , Luo Qi-Rong , Zhang Guang-Lei , Luo Zhao-Bo , Wang Jun-Xia , Yin Xi-Jun , Kang Jin-Dan
Published: January 2018

In this study we examined the effects of JNJ-7706621, a cyclin-dependent kinase inhibitor, on the in vitro growth of pig embryos that had been produced either by parthenogenetic activation (PA) or somatic cell nuclear transfer (SCNT). A significantly higher percentage of PA embryos reached the blastocyst stage by Day 7 after exposure to 10 µM JNJ-7706621 for 4 h compared with embryos exposed to 5 µg mL−1 cytochalasin B for 4 h (P < 0.05). Similarly, the rate of Tyr15 phosphorylation of the complex of cyclin and p34cdc2 (CDK1) was significantly elevated in the JNJ-7706621-treated embryos compared with embryos exposed to cytochalasin B or non-treated controls (P < 0.05). In contrast, Thr161 phosphorylation of CDK1 was significantly lower in the JNJ-7706621-treated group compared with the cytochalasin B-treated as well as the non-treated group (P < 0.05). Similarly, the level of M-phase-promoting factor (MPF) in embryos was significantly lower in the JNJ-7706621-treated group compared with the cytochalasin B-treated and non-treated groups (P < 0.05). In addition, more SCNT embryos reached the blastocyst stage after treatment with JNJ-7706621 than following exposure to cytochalasin B (P < 0.05). In conclusion, these results reveal that exposure to 10 µM JNJ-7706621 for 4 h improves early development of PA and SCNT porcine embryos by suppressing the activity of CDK1 and a concomitant reduction in the level of MPF.
Revision of zonal and related graptolites of the Lancefieldian–Bendigonian (early Floian) graptolite sequence in Victoria
Authors: VandenBerg Alfons H.M.
Published: January 2018

The topmost Lancefieldian (La3, earliest Floian, Early Ordovician) Paratetragraptus approximatus Biozone of Victoria contains a previously undocumented graptolite fauna that includes, in addition to the nominative species, Paratetragraptus cooperi sp. nov., P. thomassmithi sp. nov., P. acclinans, P.? henrywilliamsi sp. nov., and Tshallograptus cymulus gen. et sp. nov., interpreted as the direct ancestor of Tshallograptus fruticosus (J. Hall). Taxa such as Kinnegraptus, Laxograptus, Pseudobryograptus, Phyllograptus, Tetragraptus and Loganograptus also make their first appearance in this zone. The succeeding Bendigonian stage, traditionally subdivided into four biozones using overlapping ranges of P. approximatus and the four- and three-stiped morphs of the T. fruticosus clade, is revised to accommodate the earlier than documented appearance of the 3-stiped morph, here renamed Tshallograptus tridens sp. nov., in the Be1 Biozone. The new subdivision consists of three biozones: Be1 P. approximatus + T. fruticosus Biozone, Be2+3 T. fruticosus + T. tridens Biozone, and Be4 T. tridens Biozone. T. tridens is vanishingly rare in Be1 and Be2 but appears in abundance in Be3 which is retained as a local subzone.
Linguistic relativity in L2 acquisition
Authors: Liu Yeu-Ting
Published: January 2018

Proponents of the Linguistic Relativity Principle has maintained that the language we use modulates our thinking and that our thinking also shapes or determines how the language is parsed and understood. Existing research has provided compelling evidence for the above relativistic view in monolingual speakers. Recently, a growing number of studies have also started to investigate the relativistic view on language and thought in L2 learners. These L2 studies have yielded evidence regarding the cognitive constraint of an early-learned language (e.g. L1) on the later-learned language (e.g. L2). Despite this vigorous research effort, much remains unknown about whether the cognitive development in the later-learned language would modulate how the early-learned language is parsed (lower-level processing) and understood (higher-level processing). To fill the gap, this study drew on the self-paced reading experimental paradigm to study linguistic relativity effects on advanced L2 learners’ reading of L1 (Chinese) counterfactual statements – a concept encoded differently in these learners’ L1 and L2. The participants’ online response time and offline accuracy data were both the foci of the analyses; while the analyses of the response time data were suggestive of the participants’ initial lower-level parsing of the L1 counterfactual statements, the analyses of the accuracy data shed light on how the concept of counterfactuality is represented and understood in the L1. Throughout these analyses, this study intends to address the following questions: Does L2 acquisition impose any cognitive constraint on bilinguals’ lower-level L1 parsing and/or on their higher-level L1 processing? If so, in what way and to what extent? Furthermore, the study also intends to empirically establish whether the cognitive constraint as stipulated by the Linguistic Relativity Principle would be modulated by different onset age of learning the L2 (early vs. late). Findings of this study are discussed vis-à-vis the Linguistic Relativity Principle, L2 processing mechanism, and L2 literacy instruction.
Pruning and training.
Authors: Strik B. C. , Takeda F. , Gao G.
Published: January 2018

This chapter focuses on the different pruning and training practices for various blackberry types (trailing, erect and semi-erect) and noting the important differences by production region.
Comparison of the structure and properties of equiatomic and non-equiatomic multicomponent alloys
Authors: Zhou Y. , Jin X. , Du X. Y. , Zhang L. , Li B. S.
Published: January 2018

A series of equiatomic and non-equiatomic Fe x(NiCrCo)100− x (at.-%, x = 25, 45, 55, 65, 75 and 85) multicomponent alloys were prepared and studied. With the increase in x, the phase structure of the alloys evolves from a single FCC phase ( x = 25, 45 and 55), to a mixture of FCC and BCC phases ( x = 55) and finally to a single BCC phase ( x = 65 and 75). As a result, the BCC-structured alloys have much higher strength and hardness than the FCC-structured alloys. The existing VEC criteria are unable to predict the FCC-BCC phase transition in these alloys.
Comparison of physiological functions of antagonistic insulin-like peptides, INS-23 and INS-18, in Caenorhabditis elegans
Authors: Matsunaga Yohei , Matsukawa Toshiya , Iwasaki Takashi , Nagata Koji , Kawano Tsuyoshi
Published: January 2018

In Caenorhabditis elgans, insulin-like peptides have significant roles in modulating larval diapause and adult lifespan via the insulin/IGF-1 signaling (IIS) pathway. Although 40 insulin-like peptides (ILPs) have been identified, it remains unknown how ILPs act as either agonists or antagonists for their sole receptor, DAF-2. Here we found 1) INS-23 functions as an antagonistic ILP to promote larval diapause through the IIS pathway like a DAF-2 antagonist, INS-18, 2) INS-23 and INS-18 have similar biochemical functions. In addition, our molecular modeling suggests that INS-23 and INS-18 have characteristic insertions in the B-domain, which are crucial for the recognition of the insulin receptor, when compared with DAF-2 agonists. These characteristic insertions in the B-domain of INS-23 and INS-18 would modulate their intermolecular interactions with the DAF-2 receptor, which may lead these molecules to act as antagonistic ligands. Our study provides new insight into the function and structure of ILPs.
The organised chaos of English adolescent rugby union: Influence of weekly match frequency on the variability of match and training loads
Authors: Phibbs Padraic J. , Jones Ben , Roe Gregory , Read Dale , Darrall‐Jones Joshua , Weakley Jonathon , Rock Andrew , Till Kevin
Published: January 2018

The aims of this study were to determine the variability of weekly match and training loads in adolescent rugby union players across a competitive season, and to investigate the effect of match frequency on load distribution across different activities. Internal match and training load data (i.e. session‐rating of perceived exertion (sRPE)) were collected daily from 20 players from a regional academy across a 14‐week season. Data were analysed using a mixed‐effects linear model, and variability was reported as a coefficient of variation (CV). Differences between 0‐, 1‐, 2‐, and 3‐match weeks were assessed using Cohen's d effect sizes and magnitude‐based inferences. Mean weekly total match and training sRPE load was 1425 ± 545 arbitrary units (AU), with a between‐player CV of 10 ± 6% and within‐player CV of 37 ± 3%. Mean week‐to‐week change in total sRPE load was 497 ± 423 AU (35%), and 40% of weekly observations were outside the suggested acute:chronic workload ratio ‘safe zone’. Total weekly sRPE loads increased substantially with match frequency (1210 ± 571, 1511 ± 489, and 1692 ± 517 AU, for 0‐, 1‐, and 2‐match weeks, respectively), except for 3‐match weeks (1520 ± 442 AU). Weekly match and training loads were highly variable for adolescent rugby players during the competitive season, and match frequency has a substantial effect on the distribution of loads. Therefore, match and training loads should be coordinated, monitored, and managed on an individual basis to protect players from negative training consequences, and to promote long‐term athlete development.
Toppar: an interactive browser for viewing association study results
Authors: Juliusdottir Thorhildur , Banasik Karina , Robertson Neil R , Mott Richard , McCarthy Mark I
Published: January 2018

Data integration and visualization help geneticists make sense of large amounts of data. To help facilitate interpretation of genetic association data we developed Toppar, a customizable visualization tool that stores results from association studies and enables browsing over multiple results, by combining features from existing tools and linking to appropriate external databases.

Availability and implementation

Detailed information on Toppar’s features and functionality are on our website http://mccarthy.well.ox.ac.uk/toppar/docs along with instructions on how to download, install and run Toppar. Our online version of Toppar is accessible from the website and can be test-driven using Firefox, Safari or Chrome on sub-sets of publicly available genome-wide association study anthropometric waist and body mass index data (Locke et al., 2015; Shungin et al., 2015) from the Genetic Investigation of ANthropometric Traits consortium.
On Weak Reducing Disks for the Unknot in 3-Bridge Position
Authors: Kwon Bo-hyun , Lee Jung Hoon
Published: January 2018

We show that the complex of weak reducing disks for the unknot in 3-bridge position is contractible.
The Digital Activism Gap: How Class and Costs Shape Online Collective Action
Authors: Schradie Jen
Published: January 2018

What is the relationship between social class and online participation in social movements? Scholars suggest that low costs to digital activism broaden participation and challenge conventional collective action theories, but given the digital divide, little is known about cost variation across social movement organizations from different social classes. A focus on high levels of digital engagement and extraordinary events leaves scant information about the effect of social class on digital mobilization patterns and everyday practices within and across organizations. This study takes a field-level approach to incorporate all groups involved in one statewide political issue, thereby including organizations with different social class compositions, from Tea Parties to labor unions. Data collection spans online and off-line digital activism practices. With an index to measure digital engagement from an original data set of over 90,000 online posts, findings show deep digital activism inequalities between working-class and middle/upper-class groups. In-depth interviews and ethnographic observations reveal that the mechanisms of this digital activism gap are organizational resources, along with individual disparities in access, skills, empowerment and time. These factors create high costs of online participation for working-class groups. Rather than reduced costs equalizing online participation, substantial costs contribute to digital activism inequality.
Blockade of BAFF Receptor BR3 on T Cells Enhances Their Activation and Cytotoxicity
Authors: Bloom Debra D. , Reshetylo Sofiya , Nytes Cassandra , Goodsett Claudia T. , Hematti Peiman
Published: January 2018

The BAFF receptor BR3 plays key roles in B-cell activation, maturation, and survival whereas the function of BR3 on T lymphocytes is less well characterized. Previous reports have demonstrated that BR3 costimulates human T-cell activation in vitro in the presence of high nonphysiological levels of plate-bound BAFF. Here, relying on the soluble and membrane-bound BAFF expressed by T cells themselves, we investigated the function of BR3 on activated primary CD4+ and CD8+ T lymphocytes using a BR3-specific neutralization antibody and shRNA gene down-modulation. Interestingly, the anti-BR3 blocking antibody resulted in significant augmentation of CD25 and IFN-γ expression by both subsets, as did shRNA-mediated down-modulation of BR3. In addition, granzyme B expression was substantially elevated in anti-BR3–treated and BR3-silenced T cells. Anti-BR3 blockade increased the expression of CD25 on cytolytic CRTAM+ T cells. Importantly, anti-BR3 significantly enhanced redirected killing of P-815 cells by both CD4+ and CD8+ cytotoxic T cells [cytotoxic T lymphocytes (CTLs)]. Furthermore, anti-BR3–augmented CD4+ T-cell–mediated killing of class II+ melanoma cell line A375 and cervical cancer cell line HeLa in vitro, increasing the level of granzyme B activity as measured by PARP-1 cleavage and active caspase 3. Together, our data indicate that BR3 neutralization increases the activation and cytolytic function of CD4+ and CD8+ cytotoxic T lymphocytes. Our findings provide a novel strategy for ex vivo T-cell activation applicable to T-cell immunotherapy platforms such as TIL or CAR-T cell therapeutics.
Anterior Segment Parameters in Patients With Wilson Disease
Authors: Kara Necip , Seyyar Sevim Ayca , Saygili Oguzhan , Seyyar Mustafa , Gulsen Murat Taner , Gungor Kıvanc
Published: January 2018

Purpose:

To investigate anterior segment parameters in patients with Wilson disease (WD).

Methods:

In this cross-sectional study, 22 patients with WD (study group) and 22 healthy subjects (control group) were enrolled. Each participant underwent a comprehensive ophthalmic assessment including best-corrected visual acuity, slit-lamp biomicroscopy, fundus examination, and intraocular pressure. Anterior segment parameters were measured by the Sirius anterior segment analyzer system (Costruzione Strumenti Oftalmici, Florence, Italy).

Results:

Mean central corneal thickness was 522 ± 47 μm in the study group and 568 ± 37 μm in the control group (P < 0.001). Mean flat keratometry was 42.4 ± 1.7 diopter (D) in the study group and 41.5 ± 1.16 D in the control group (P = 0.011); mean steep keratometry was 43.4 ± 2.0 and 42.4 ± 1.4 D in the study and control groups, respectively (P = 0.025). The anterior corneal elevation value was 5.5 ± 3.2 μm in the study group and 4.08 ± 2.2 μm in the control group (P = 0.029); the mean posterior corneal elevation value was 15.1 ± 6.0 and 10.1 ± 4.1 μm in the study and control groups, respectively (P = 0.002). The mean anterior chamber depth was 2.97 ± 0.3 μm in the study group and 3.16 ± 0.3 μm in the control group (P = 0.01); the mean horizontal visible iris diameter was 11.9 ± 0.4 and 12.2 ± 0.4 μm in the study and control groups, respectively (P = 0.001).

Conclusions:

This study indicates that patients with WD have differences in the anterior segment parameters including central corneal thickness, keratometric values, anterior and posterior elevations, horizontal visible iris diameter, and anterior chamber depth when compared with healthy controls.
Correlation Between Postoperative Central Corneal Thickness and Endothelial Damage After Cataract Surgery by Phacoemulsification
Authors: Perone Jean Marc , Boiche Mathilde , Lhuillier Louis , Ameloot Francis , Premy Shamour , Jeancolas Anne-Laure , Goetz Christophe , Neiter Estelle
Published: January 2018

Purpose:

To study the correlation between postoperative corneal edema and endothelial cell loss after cataract surgery by microcoaxial phacoemulsification.

Methods:

Eighty-five eyes of 85 consecutive patients with mild cataract (up to C5, N4, and P5: per LOCS III classification) were included in a prospective study from September 2014 to November 2014. Eighty-five eyes were necessary to obtain a precision of 0.15 for computation of the Pearson correlation coefficient. Pachymetry and endothelial cell density measurements were taken preoperatively, 2 hours after surgery, and 4 days, 15 days, and 1 month after surgery using CEM-530 noncontact specular microscopy (Nidek CO Ltd, Japan). Every surgery was performed using the Stellaris device (Bausch & Lomb, Bridgewater, NJ) in a microcoaxial mode with 2.2-mm incisions.

Results:

Mean age was 73 ± 2.1 years, with 41 women (48%) and 44 men (52%). The mean surgical time was 8 ± 5.5 minutes, and the mean effective phacoemulsification time was 7 ± 3.7 seconds. Mean central corneal thickness augmentation was 46.68 ± 10 μm (8.39%) 2 hours after surgery, 10 ± 18 μm (1.8%) 4 days after surgery, and only 0.76 ± 11.4 μm (0.1%) 15 days after surgery. Mean endothelial cell loss was 3.0 ± 1.5% at 2 hours, 9.0 ± 3.3% at D4, 10 ± 4.6% at D15, and 11 ± 4.7% at 1 month. At D4, significant endothelial loss (>15%) was mostly related to significant immediate corneal edema (>15%), whereas low postoperative edema (<5%) did not lead to significant endothelial loss (loss <5%). At D15 and D30, endothelial cell loss seemed to be closely correlated with immediate postoperative edema (Pearson correlation coefficient between central corneal edema at H2 and endothelial cells loss at 1 month: r = 0.4, P < 0.0001).

Conclusions:

Postoperative corneal thickness measurement may therefore become a marker of endothelial damage after phacoemulsification.
Factors Influencing the Diagnostic Accuracy of Laser-Scanning In Vivo Confocal Microscopy for Acanthamoeba Keratitis
Authors: Kheirkhah Ahmad , Satitpitakul Vannarut , Syed Zeba A. , Müller Rodrigo , Goyal Sunali , Tu Elmer Y. , Dana Reza
Published: January 2018

Purpose:

To determine the factors that influence the sensitivity and specificity of laser-scanning in vivo confocal microscopy (IVCM) for diagnosing Acanthamoeba keratitis (AK).

Methods:

This retrospective, controlled study included 28 eyes of 27 patients with AK and 34 eyes of 34 patients with bacterial keratitis (as the control group). All patients had undergone corneal imaging with a laser-scanning IVCM (Heidelberg Retina Tomograph 3 with the Rostock Cornea Module). The IVCM images were independently evaluated by 2 experienced and 2 inexperienced masked observers. Sensitivity and specificity of IVCM for diagnosing AK and the effects of various clinical and imaging parameters on the sensitivity were then investigated.

Results:

Overall, IVCM had average sensitivity and specificity of 69.7% ± 2.5% and 97.1% ± 4.2% for experienced observers and 59.0% ± 7.6% and 92.7% ± 10.4% for inexperienced observers, respectively. However, the sensitivity did not show any significant association with the duration of disease, size of ulcer, depth of involvement, culture results, or cyst morphology. Although interobserver agreement was good (κ = 0.60, P < 0.001) for the experienced observers, it was only at a moderate level (κ = 0.48, P < 0.001) for the inexperienced observers.

Conclusions:

IVCM has a moderate sensitivity and a high specificity for diagnosis of AK. Although clinical parameters do not affect this diagnostic accuracy, a higher sensitivity is seen when images are interpreted by experienced observers.
Intraocular Pressure After Phacoemulsification in Open-angle Glaucoma Patients With Uncontrolled or Marginally Controlled Glaucoma and/or With Severe Visual Field Loss
Authors: Bojikian Karine D. , Chen Philip P.
Published: January 2018

Background/Aims:

To evaluate intraocular pressure (IOP) after phacoemulsification in open-angle glaucoma (OAG) patients with uncontrolled or marginally controlled glaucoma and/or severe visual field (VF) loss.

Patients and Methods:

Retrospective case series of OAG patients without prior glaucoma surgery undergoing phacoemulsification. Uncontrolled or marginally controlled glaucoma was defined as IOP>21 mm Hg despite maximally tolerated medications or requiring >3 topical drugs for IOP control. Severe VF loss was defined as VF mean deviation ≤−12 dB. Eyes with postoperative IOP elevation were identified using 4 different definitions.

Results:

Of 56 eyes (56 patients), 10 eyes (17.8%) had IOP elevation ≥10 mm Hg at postoperative day 1. At 1 year (N=45), the average preoperative IOP of 14.3±3.5 mm Hg decreased to 13.8±3.6 mm Hg (P=0.312), and number of medications of 3.2±1.1 decreased to 2.8±1.2 (P=0.165). Eleven eyes (24.4%) had increase in IOP of ≥3 mm Hg, whereas 14 eyes (31.1%) had decrease of ≥3 mm Hg. Nine eyes (20.0%) had higher IOP without medication changes and 9 eyes (20.0%) required additional medications or surgery for IOP control; 3 eyes (6.7%) required trabeculectomy. Higher IOP at 1 year was associated with IOP elevation ≥10 mm Hg at postoperative week 1 (P=0.020).

Conclusions:

Phacoemulsification resulted in nonsignificant 1-year IOP change in OAG patients with uncontrolled or marginally controlled glaucoma and/or with severe VF loss. Although 40% of eyes had higher IOP after phacoemulsification at 1-year postoperatively, only 6.7% required trabeculectomy.
Localized Retinal Nerve Fiber Layer Defects in Red-free Photographs Versus En Face Structural Optical Coherence Tomography Images
Authors: Jung Jae Hoon , Park Ji-Hye , Yoo Chungkwon , Kim Yong Yeon
Published: January 2018

Purpose:

The purpose of this article is to compare the locations of localized retinal nerve fiber layer (RNFL) defects in red-free fundus photographs and optical coherence tomography (OCT) en face images.

Methods:

We performed a retrospective, comparative study on 46 eyes from 46 glaucoma patients with localized RNFL defects observed in red-free fundus photographs. En face structural images were obtained in the superficial and whole retinal layers using OCT and were overlaid on the corresponding red-free fundus photographs. The proximal/distal angular locations and angular width of each RNFL defect in red-free photos (red-free defects) and in en face structural images (en face defects) were compared.

Results:

In the superficial retinal layer, there were no significant differences between red-free and en face defects on the proximal/distal angular location and angular width. In the whole retinal layer, the degree of the distal angular location of the en face defects was significantly larger than that of the red-free defects (71.85±18.26 vs. 70.87±17.90 degrees, P=0.003). The correlations of clinical variables with the differences in angular parameters between red-free and en face defects were not significant in the superficial retinal layer. The average RNFL thickness was negatively correlated with the difference in the distal angular location in the whole retinal layer (Pearson correlation coefficient=−0.401, P=0.006).

Conclusions:

Localized RNFL defects detected in OCT en face structural images of the superficial retinal layer showed high topographic correlation with defects detected in red-free photographs. OCT en face structural images in the superficial layer may be an alternative to red-free fundus photography for the identification of localized RNFL defects in glaucomatous eyes.
The Association Between Body Mass Index and Open-angle Glaucoma in a South Korean Population-based Sample
Authors: Lin Shuai-Chun , Pasquale Louis R. , Singh Kuldev , Lin Shan C.
Published: January 2018

Purpose:

The purpose of this article is to investigate the association between body mass index (BMI) and open-angle glaucoma (OAG) in a sample of the South Korean population.

Materials and Methods:

The sample consisted of a cross-sectional, population-based sample of 10,978 participants, 40 years of age and older, enrolled in the 2008 to 2011 Korean National Health and Nutrition Examination Survey. All participants had measured intraocular pressure <22 mm Hg and open anterior chamber angles. OAG was defined using disc and visual field criteria established by the International Society for Geographical and Epidemiological Ophthalmology. Multivariable analyses were performed to determine the association between BMI and OAG. These analyses were also performed in a sex-stratified and age-stratified manner.

Results:

After adjusting for potential confounding variables, lower BMI (<19 kg/m2) was associated with greater risk of OAG compared with normal BMI (19 to 24.9 kg/m2) [odds ratio (OR), 2.28; 95% confidence interval (CI), 1.22-4.26]. In sex-stratified analyses, low BMI remained adversely related to glaucoma in women (OR, 3.45; 95% CI, 1.42-8.38) but not in men (OR, 1.72; 95% CI, 0.71-4.20). In age-stratified analyses, lower BMI was adversely related to glaucoma among subjects 40- to 49-year old (OR, 5.16; 95% CI, 1.86-14.36) but differences in glaucoma prevalence were not statistically significant between those with low versus normal BMI in other age strata.

Conclusions:

Lower BMI was associated with increased odds of OAG in a sample of the South Korean population. Multivariate analysis revealed the association to be statistically significant in women and those in the youngest age stratum.
Comparison of Peripapillary OCT Angiography Vessel Density and Retinal Nerve Fiber Layer Thickness Measurements for Their Ability to Detect Progression in Glaucoma
Authors: Holló Gábor
Published: January 2018

Purpose:

The aim of this study was to investigate the applicability of peripapillary optical coherence tomography angiography angioflow vessel density measurements in the retinal nerve fiber layer for the detection of glaucomatous progression and to compare its performance with that of retinal nerve fiber layer thickness (RNFLT) measurements.

Methods:

Prospective RNFLT and vessel density measurements with the same Angiovue/RTVue-XR instrument were made immediately one after another on 1 eye of 9 normal eyes, 20 under treatment ocular hypertension eyes, and 24 under treatment open angle glaucoma eyes at 6-month intervals for 2 years (5 visits for all eyes). High image quality (signal strength index 50 to 91) was obtained for all measurements. No surgery was performed on any study eye during the study period. The normal and OHT cases were combined for comparison with the glaucoma group.

Results:

A statistically significant negative RNFLT slope was found in 16 eyes, whereas no eye had a significant negative vessel density slope (P<0.0001). The relative RNFLT and vessel density slopes were significantly different in the combined normal and OHT group, the glaucoma group, and the total population, respectively (P<0.0001). For the same groups, the relative residual SD was significantly higher for vessel density than for RNFLT measurements (P≤0.0019). The relative residual SD of RNFLT measurements was higher in the glaucoma group than in the combined normal and OHT group (P=0.0056), whereas the relative residual SD of vessel density measurements did not differ between the groups (P=0.3032).

Conclusion:

In this 2-year prospective study, peripapillary vessel density measurement did not support the detection of glaucomatous progression.
Association Between Optic Disc Hemorrhage and Renal Function in South Korea
Authors: Lee Jae Yeun , Kim Joon Mo , Shim Seong Hee , Lee Jin Young , Yoo Chungkwon , Won Yu Sam , Hyun Young Youl , Park Ki Ho
Published: January 2018

Purpose:

The purpose of this article is to investigate the relationship between renal function and disc hemorrhage (DH).

Materials and Methods:

This retrospective cross-sectional survey was conducted at Kangbuk Samsung Hospital Health Screening Center between August 2012 and July 2013, and a total of 168,044 participants at least 20 years of age who voluntarily visited the health screening center for systemic and ophthalmologic examinations, including fundus photography, were enrolled. All subjects underwent a physical examination and provided samples for laboratory analysis. Digital fundus photographs of both eyes were taken and reviewed. Estimated glomerular filtration rate (eGFR) was calculated from serum creatinine concentration using the Modification of Diet in Renal Disease (MDRD) formula and Cockcroft-Gault (CG) formula. Subjects were stratified by eGFR into quartiles.

Results:

Among participants, 220 (0.1%) showed DH, and 2376 (1.6%) showed glaucomatous retinal nerve fiber layer defects. The DH group showed higher creatinine and lower eGFR than the non-DH group. A significant trend was observed among higher creatinine, decreased eGFR as obtained by the MDRD and CG formulas, and the prevalence of DH (P for trend ≤0.003, logistic regression analysis). A multiple logistic regression model adjusted for age, sex, hypertension, diabetes, and hyperlipidemia showed that the lowest eGFR quartiles estimated by MDRD and CG were significantly associated with DH compared with the highest eGFR quartile (adjusted odds ratio, 1.96; 95% confidence interval, 1.22-3.14 by CG, 1.86; 95% confidence interval, 1.17-2.96 by MDRD).

Conclusion:

Renal function impairment was independently associated with a higher prevalence of DH in a South Korean population.
Functional Capacity but Not Early Uptake of Cardiac Rehabilitation Predicts Readmission in Patients With Metabolic Syndrome
Authors: Siegmund Lee Anne , Albert Nancy M. , McClelland Mark S. , Bena James F. , Morrison Shannon L.
Published: January 2018

Background:

Phase II cardiac rehabilitation reduces hospital readmissions and cardiovascular disease risk factors and improves functional capacity. Cardiovascular disease risk factors double with patients with metabolic syndrome, a population less likely to adhere to cardiac rehabilitation.

Purpose:

The aim of this study was to determine relationships between cardiac rehabilitation uptake timing, demographic variables and functional capacity, and readmission in patients with metabolic syndrome.

Methods:

This retrospective, medical records study involved 353 patients with metabolic syndrome who subsequently received cardiac rehabilitation. Logistic regression was used to examine relationships between time from discharge to cardiac rehabilitation uptake and readmission. Unordered categorical factors were compared between readmission groups using Pearson χ2 tests. Multivariable logistic regression was used to identify predictors of readmission.

Results:

Patients readmitted within 30 and 90 days of hospitalization were more often women (P ≤ .018) and nonwhite (P ≤ .002) and had lower functional capacity (P < .001). In multivariable analysis, white race (odds ratio [OR], 0.50 [95% confidence interval (CI), 0.25–0.99]; P = .045) and higher functional capacity (OR, 0.80 [95% CI, 0.68–0.93]; P = .005) were protective against hospital readmission within the first 90 days. Race, sex, and functional capacity remained significant predictors of readmission at 1 year. In multivariable analysis, only race (OR, 0.41 [95% CI, 0.22–0.79]; P = .007) and functional capacity (OR, 0.83 [95% CI, 0.73–0.95]; P = .007) were significant. Early cardiac rehabilitation was not associated with readmission at any time point (P > .05).

Conclusions:

Sex, race, and functional capacity were important predictors of readmission for metabolic syndrome, even when cardiac rehabilitation intake was delayed. Results raise questions about the unique traits of patients with metabolic syndrome and need for novel approaches to improve cardiac rehabilitation utilization and functional capacity in metabolic syndrome.
Integrating Quantitative Pupillometry Into Regular Care in a Neurotrauma Intensive Care Unit
Authors: Anderson Maighdlin , Elmer Jonathan , Shutter Lori , Puccio Ava , Alexander Sheila
Published: January 2018

In the setting of acute traumatic brain injury (TBI), an abnormal pupil assessment may suggest a worsening intracranial lesion. Early detection of pupillary changes may expedite emergent care to improve outcomes. Automated, handheld pupillometers have been commercially available for 20 years, and several studies suggest that their use may facilitate early recognition of worsening injury and intracranial hypertension. The use of pupillometry as a bedside tool in the routine care of patients with severe TBI (Glasgow Coma Scale score ≤ 8) has not been described. We performed a quality improvement project to implement routine use of quantitative pupillometry in our neurotrauma intensive care unit. Nursing staff were trained on device use and the project’s aims in a 30-minute in-service session. Nurses caring for severe TBI patients completed standard pupil assessments using (a) a flashlight and (b) a pupillometer to quantify pupil size and reactivity (Neurological Pupil index) every hour. Abnormal results were reported to on-call providers. We administered surveys to evaluate knowledge, practical use of the pupillometer data, and satisfaction with the device every 3 months. Data were available for 22 nurses at 4 separate time points. Staff were positive about their ability to use and understand the device (µ = 8.7 and 9.1, respectively, on a 10-point scale) and reported that it added value to patient care and critical decision-making. Use of automated pupillometry is acceptable to nursing staff in a neurotrauma intensive care unit, and staff believed that pupillometry results enhanced clinical decision-making.
Experiences Related to Urinary Incontinence of Stroke Patients: A Qualitative Descriptive Study
Authors: Arkan Gulcihan , Beser Ayse , Ozturk Vesile
Published: January 2018

Introduction: Poststroke urinary incontinence is a common problem, with a prevalence ranging from 32% to 79%. Urinary incontinence after stroke has negative physiological, psychological, and economic effects, which lead to lifestyle changes for both patients and caregivers. Nurses play an important role in preventing and improving incontinence, understanding the experiences of individuals experiencing incontinence, providing healthcare for them, and implementing behavioral therapy methods. The aim of this study was to determine the experience related to urinary incontinence of stroke patients. Methods: In this qualitative descriptive study, using semistructured interviews, 15 participants with urinary incontinence after stroke selected through purposeful sampling were interviewed. Data were collected with a semistructured interview form prepared within the framework of the Health Belief Model. All data were analyzed using content analysis. Results: Three main themes were identified: “perception of urinary incontinence,” “effects of urinary incontinence,” and “management of urinary incontinence.” The respondents explained that urinary incontinence also adversely affected their caregivers. They experienced many daily life and psychological problems because of urinary incontinence. In addition, they made several changes to management urinary incontinence such as limiting fluid intake, changing underwear frequently, using waterproof mattress protectors, applying traditional practice, and taking medicine. Conclusions: This study revealed that stroke patients needed help and support for urinary incontinence management. Nurses should provide information about management and urinary incontinence after stroke.
Alzheimer Disease and Related Disorders and Out-of-Pocket Health Care Spending and Burden Among Elderly Medicare Beneficiaries
Authors: Dwibedi Nilanjana , Findley Patricia A. , Wiener R Constance , Shen Chan , Sambamoorthi Usha
Published: January 2018

Objective:

To estimate the excess burden of out-of-pocket health care spending associated with Alzheimer disease and related disorders (ADRD) among older individuals (age 65 y and older).

Methods:

We adopted a retrospective, cross-sectional study design with data from 2012 Medicare Current Beneficiary Survey. The study sample comprised of elderly community-dwelling individuals who had positive total health care expenditures, and enrolled in Medicare throughout the calendar year (462 with ADRD, and 7160 without ADRD). We estimated the per-capita total annual out-of-pocket spending on health care and out-of-pocket spending by service type: inpatient, outpatient, home health, prescription drugs, and other services. We measured out-of-pocket spending burden by calculating the percentage of income spent on health care and defined high out-of-pocket spending burden as having this percentage above 10%. Multivariable analyses included ordinary least squares regressions and logistic regressions and these analyses adjusted for predisposing, enabling, need, personal health care practices and external environment characteristics.

Results:

The average annual per-capita out-of-pocket health care spending was greater among individuals with ADRD compared with those without ADRD ($3285 vs. $1895); home health and prescription drugs accounted for 52% of total out-of-pocket spending among individuals with ADRD and 34% among individuals without ADRD. Elderly individuals with ADRD were more likely to have high out-of-pocket spending burden (adjusted odds ratio, 1.49; 95% confidence interval, 1.13–1.97) compared with those without ADRD.

Conclusion:

ADRD is associated with excess out-of-pocket health care spending, primarily driven by prescription drugs and home health care use.
Impact of Medication Adherence on Health Services Utilization in Medicaid
Authors: Roebuck Mark C. , Kaestner Robert J. , Dougherty Julia S.
Published: January 2018

Objective:

To examine the impact of adherence to chronic disease medications on health services utilization among Medicaid enrollees.

Subjects:

Eligibility, claims, and encounter data from the Medicaid Analytic Extract files from 10 states (Alabama, California, Florida, Illinois, Indiana, Louisiana, New Hampshire, New Mexico, New York, and Virginia) were used to construct a 3-year (2008–2010), longitudinal dataset of Medicaid recipients 18–64 years of age, including 656,646 blind/disabled individuals and 704,368 other adults. Patients were classified as having ≥1 of 7 chronic conditions: (1) congestive heart failure; (2) hypertension; (3) dyslipidemia; (4) diabetes; (5) asthma/chronic obstructive pulmonary disease; (6) depression; and (7) schizophrenia/bipolar.

Methods:

Poisson regression was used to estimate associations between medication adherence [continuous and categorical proportion of days covered (PDC)] and 3 dependent variables: number of inpatient hospitalizations, emergency department visits, and outpatient physician/clinic visits.

Results:

Full adherence was associated with 8%–26% fewer hospitalizations and 3%–12% fewer emergency department visits among those with congestive heart failure, hypertension, diabetes, and schizophrenia/bipolar. In all analyses, full adherence was associated with up to 15% fewer outpatient physician/clinic visits. Moreover, low and moderate levels of adherence were also related to less health care use.

Conclusions:

Substantial reductions in health services utilization and costs may be realized with improved medication adherence in Medicaid. These benefits begin to accrue at adherence levels below the common 0.80 PDC threshold. Therefore, interventions should focus not just on perfecting moderate adherers, but also on encouraging Medicaid patients with chronic conditions to initiate pharmacotherapy.
Higher Recurrence Rate After Endoscopic Totally Extraperitoneal (TEP) Inguinal Hernia Repair With Ultrapro Lightweight Mesh
Authors: Roos Marleen , Bakker Wouter J. , Schouten Nelleke , Voorbrood Charlotte , Clevers Geert Jan , Verleisdonk Egbert Jan , Davids Paul , Burgmans Josephina
Published: January 2018

Objective:

The aim of this study was to determine inguinal hernia recurrence rates 5 years after endoscopic totally extraperitoneal (TEP) inguinal hernia repair when either lightweight or heavyweight mesh was used.

Background:

Recurrence is an important complication of inguinal hernia surgery. Higher recurrence rates of Ultrapro lightweight meshes after TEP repair have been demonstrated, yet data regarding long-term follow-up are limited.

Methods:

From 2010 to 2012, 950 male adult patients with primary unilateral hernias were randomized to TEP hernia repair with heavyweight (Prolene) or lightweight (Ultrapro) mesh. Five years postoperatively, the validated PINQ-PHONE telephone questionnaire was carried out. Participants with a positive questionnaire reply were scheduled for a clinical visit. A recurrence was defined as a clinically detectable bulge in the operated groin on physical examination.

Results:

Data on development of recurrence could be obtained from 790 patients (83.2% 5-year follow–up rate). Four patients presented with a recurrence at the outpatient clinic between 2 and 5 years postoperatively. Thirty-five patients (4.6%) with a positive PINQ-PHONE reply (60.0% lightweight vs 40.0% heavyweight) were physically examined at the outpatient clinic. In 2 patients (lightweight) a recurrence was detected. The total 5-year recurrence rate after TEP hernia repair was 2.4% (3.8% lightweight, 1.1% heavyweight, P = 0.01). A significantly higher recurrence rate for lightweight mesh in primary direct hernias was found (P = 0.003).

Conclusions:

The overall recurrence rate 5 years after TEP repair was low. Ultrapro lightweight meshes showed higher recurrence rates than heavyweight meshes and are not recommended for endoscopic TEP inguinal hernia repair.
Mucus Microbiome of Anastomotic Tissue During Surgery Has Predictive Value for Colorectal Anastomotic Leakage
Authors: van Praagh Jasper B. , de Goffau Marcus C. , Bakker Ilsalien S. , van Goor Harry , Harmsen Hermie J. M. , Olinga Peter , Havenga Klaas
Published: January 2018

Objective:

The aim of the present study is to investigate the association of gut microbiota, depending on treatment method, with the development of colorectal anastomotic leakage (AL).

Background:

AL is a major cause for morbidity and mortality after colorectal surgery, but the mechanism behind this complication still is not fully understood.

Methods:

Bacterial DNA was isolated from 123 “donuts” of patients where a stapled colorectal anastomosis was made and was analyzed using 16S MiSeq sequencing. In 63 patients, this anastomosis was covered with a C-seal, a bioresorbable sheath stapled to the anastomosis.

Results:

In non-C-seal patients, AL development was associated with low microbial diversity (P = 0.002) and correspondingly with a high abundance of the dominant Bacteroidaceae and Lachnospiraceae families (P = 0.008 and 0.010, respectively). In C-seal samples, where AL rates were slightly higher (25% vs 17%), an association with the gut microbiota composition was almost undetectable. Only a few opportunistic pathogenic groups of low abundance were associated with AL in C-seal patients, in particular Prevotella oralis (P = 0.007).

Conclusions:

AL in patients without a C-seal can be linked to the intestinal microbiota, in particular with a low microbial diversity and a higher abundance of especially mucin-degrading members of the Bacteroidaceae and Lachnospiraceae families. In C-seal patients, however, it seems that any potential protective benefits or harmful consequences of the gut microbiota composition in regard to wound healing are negated, as progression to AL is independent of the initially dominant bacterial composition.
Olfactory and Vomeronasal Receptor Feedback Employ Divergent Mechanisms of PERK Activation
Authors: Dalton Ryan P , Karagöz G Elif , Kahiapo Jerome , Sharma Ruchira , Bashkirova Lisa E , Lyons David B. , Matsunami Hiroaki , Walter Peter
Published: January 2018

Mutually-exclusive chemoreceptor expression in olfactory and vomeronasal sensory neurons (OSNs and VSNs) enables odorant discrimination. This configuration involves chemoreceptor mediated activation of the endoplasmic reticulum (ER)-resident kinase PERK. PERK drives translation of the transcription factor ATF5 to preclude additional chemoreceptor expression. ATF5 translation is transient in OSNs but persistent in VSNs, suggesting chemoreceptor-specific modes of PERK activation. Herein, we showed that the ER-lumenal domain (LD) of PERK recognized vomeronasal receptor (VR)-derived peptides, suggesting direct PERK activation drives persistent ATF5 translation in VSNs. In contrast, PERK LD did not recognize olfactory receptor (OR)-derived peptides in vitro, and facilitating OR maturation in vivo prevented PERK activation, suggesting that ORs activate PERK indirectly through a failure to exit the ER. Importantly, impairing or prolonging ATF5 expression drove specific chemoreceptor repertoire biases. Together, these results demonstrate mechanistic divergence in chemoreceptor feedback and establish that differences in PERK activation promote qualitatively different gene regulatory results.