bluuebunny/crossref_metadata_2025 huggingface dataset:
The proteasome controls presynaptic differentiation through modulation of an on-site pool of polyubiquitinated conjugates
Authors: Pinto Maria J. , Alves Pedro L. , Martins Luís , Pedro Joana R. , Ryu Hyun R. , Jeon Noo Li , Taylor Anne M. , Almeida Ramiro D.
Published: March 2016

Differentiation of the presynaptic terminal is a complex and rapid event that normally occurs in spatially specific axonal regions distant from the soma; thus, it is believed to be dependent on intra-axonal mechanisms. However, the full nature of the local events governing presynaptic assembly remains unknown. Herein, we investigated the involvement of the ubiquitin–proteasome system (UPS), the major degradative pathway, in the local modulation of presynaptic differentiation. We found that proteasome inhibition has a synaptogenic effect on isolated axons. In addition, formation of a stable cluster of synaptic vesicles onto a postsynaptic partner occurs in parallel to an on-site decrease in proteasome degradation. Accumulation of ubiquitinated proteins at nascent sites is a local trigger for presynaptic clustering. Finally, proteasome-related ubiquitin chains (K11 and K48) function as signals for the assembly of presynaptic terminals. Collectively, we propose a new axon-intrinsic mechanism for presynaptic assembly through local UPS inhibition. Subsequent on-site accumulation of proteins in their polyubiquitinated state triggers formation of presynapses.
Reverse vaccinology 2.0: Human immunology instructs vaccine antigen design
Authors: Rappuoli Rino , Bottomley Matthew J. , D’Oro Ugo , Finco Oretta , De Gregorio Ennio
Published: March 2016

Traditionally, vaccines have been developed by cultivating infectious agents and isolating the inactivated whole pathogen or some of its purified components. 20 years ago, reverse vaccinology enabled vaccine discovery and design based on information deriving from the sequence of microbial genomes rather than via the growth of pathogens. Today, the high throughput discovery of protective human antibodies, sequencing of the B cell repertoire, and the increasing structural characterization of protective antigens and epitopes provide the molecular and mechanistic understanding to drive the discovery of novel vaccines that were previously impossible. We are entering a “reverse vaccinology 2.0” era.
Knockdown of fast skeletal myosin-binding protein C in zebrafish results in a severe skeletal myopathy
Authors: Li Mei , Andersson-Lendahl Monika , Sejersen Thomas , Arner Anders
Published: March 2016

Myosin-binding protein C (MyBPC) in the muscle sarcomere interacts with several contractile and structural proteins. Mutations in the cardiac isoform (MyBPC-3) in humans, or animal knockout, are associated with cardiomyopathy. Function of the fast skeletal isoform (MyBPC-2) in living muscles is less understood. This question was addressed using zebrafish models, combining gene expression data with functional analysis of contractility and small-angle x-ray diffraction measurements of filament structure. Fast skeletal MyBPC-2B, the major isoform, was knocked down by >50% using morpholino antisense nucleotides. These morphants exhibited a skeletal myopathy with elevated apoptosis and up-regulation of factors associated with muscle protein degradation. Morphant muscles had shorter sarcomeres with a broader length distribution, shorter actin filaments, and a wider interfilament spacing compared with controls, suggesting that fast skeletal MyBPC has a role in sarcomere assembly. Active force was reduced more than expected from the decrease in muscle size, suggesting that MyBPC-2 is required for optimal force generation at the cross-bridge level. The maximal shortening velocity was significantly increased in the MyBPC-2 morphants, but when related to the sarcomere length, the difference was smaller, reflecting that the decrease in MyBPC-2B content and the resulting myopathy were accompanied by only a minor influence on filament shortening kinetics. In the controls, equatorial patterns from small-angle x-ray scattering revealed that comparatively few cross-bridges are attached (as evaluated by the intensity ratio of the 11 and 10 equatorial reflections) during active contraction. X-ray scattering data from relaxed and contracting morphants were not significantly different from those in controls. However, the increase in the 11:10 intensity ratio in rigor was lower compared with that in controls, possibly reflecting effects of MyBPC on the cross-bridge interactions. In conclusion, lack of MyBPC-2 results in a severe skeletal myopathy with structural changes and muscle weakness.
Complex regional pain syndrome: evidence for warm and cold subtypes in a large prospective clinical sample
Authors: Bruehl Stephen , Maihöfner Christian , Stanton-Hicks Michael , Perez Roberto S.G.M. , Vatine Jean-Jacques , Brunner Florian , Birklein Frank , Schlereth Tanja , Mackey Sean , Mailis-Gagnon Angela , Livshitz Anatoly , Harden R. Norman
Published: March 2016

Limited research suggests that there may be Warm complex regional pain syndrome (CRPS) and Cold CRPS subtypes, with inflammatory mechanisms contributing most strongly to the former. This study for the first time used an unbiased statistical pattern recognition technique to evaluate whether distinct Warm vs Cold CRPS subtypes can be discerned in the clinical population. An international, multisite study was conducted using standardized procedures to evaluate signs and symptoms in 152 patients with clinical CRPS at baseline, with 3-month follow-up evaluations in 112 of these patients. Two-step cluster analysis using automated cluster selection identified a 2-cluster solution as optimal. Results revealed a Warm CRPS patient cluster characterized by a warm, red, edematous, and sweaty extremity and a Cold CRPS patient cluster characterized by a cold, blue, and less edematous extremity. Median pain duration was significantly (P < 0.001) shorter in the Warm CRPS (4.7 months) than in the Cold CRPS subtype (20 months), with pain intensity comparable. A derived total inflammatory score was significantly (P < 0.001) elevated in the Warm CRPS group (compared with Cold CRPS) at baseline but diminished significantly (P < 0.001) over the follow-up period, whereas this score did not diminish in the Cold CRPS group (time × subtype interaction: P < 0.001). Results support the existence of a Warm CRPS subtype common in patients with acute (<6 months) CRPS and a relatively distinct Cold CRPS subtype most common in chronic CRPS. The pattern of clinical features suggests that inflammatory mechanisms contribute most prominently to the Warm CRPS subtype but that these mechanisms diminish substantially during the first year postinjury.
The impacts of climate change and disturbance on spatio‐temporal trajectories of biodiversity in a temperate forest landscape
Authors: Thom Dominik , Rammer Werner , Dirnböck Thomas , Müller Jörg , Kobler Johannes , Katzensteiner Klaus , Helm Norbert , Seidl Rupert
Published: March 2016

The ongoing changes to climate challenge the conservation of forest biodiversity. Yet, in thermally limited systems, such as temperate forests, not all species groups might be affected negatively. Furthermore, simultaneous changes in the disturbance regime have the potential to mitigate climate‐related impacts on forest species. Here, we (i) investigated the potential long‐term effect of climate change on biodiversity in a mountain forest landscape, (ii) assessed the effects of different disturbance frequencies, severities and sizes and (iii) identified biodiversity hotspots at the landscape scale to facilitate conservation management.

We employed the model iLand to dynamically simulate the tree vegetation on 13 865 ha of the Kalkalpen National Park in Austria over 1000 years, and investigated 36 unique combinations of different disturbance and climate scenarios. We used simulated changes in tree cover and composition as well as projected temperature and precipitation to predict changes in the diversity of Araneae, Carabidae, ground vegetation, Hemiptera, Hymenoptera, Mollusca, saproxylic beetles, Symphyta and Syrphidae, using empirical response functions.

Our findings revealed widely varying responses of biodiversity indicators to climate change. Five indicators showed overall negative effects, with Carabidae, saproxylic beetles and tree species diversity projected to decrease by more than 33%. Six indicators responded positively to climate change, with Hymenoptera, Mollusca and Syrphidae diversity projected to increase more than twofold.

Disturbances were generally beneficial for the studied indicators of biodiversity. Our results indicated that increasing disturbance frequency and severity have a positive effect on biodiversity, while increasing disturbance size has a moderately negative effect. Spatial hotspots of biodiversity were currently found in low‐ to mid‐elevation areas of the mountainous study landscape, but shifted to higher‐elevation zones under changing climate conditions.

Synthesis and applications. Our results highlight that intensifying disturbance regimes may alleviate some of the impacts of climate change on forest biodiversity. However, the projected shift in biodiversity hotspots is a challenge for static conservation areas. In this regard, overlapping hotspots under current and expected future conditions highlight priority areas for robust conservation management.
Inequalities in the provision of paediatric speech and language therapy services across London boroughs
Authors: Pring Tim
Published: March 2016

Background

The inverse‐care law suggests that fewer healthcare resources are available in deprived areas where health needs are greatest.

Aims

To examine the provision of paediatric speech and language services across London boroughs and to relate provision to the level of deprivation of the boroughs.

Methods & Procedures

Information on the employment of paediatric speech and language therapists was obtained from London boroughs by freedom‐of‐information requests. The relationship between the number of therapists and the index of multiple deprivation for the borough was examined.

Outcomes & Results

Twenty‐nine of 32 boroughs responded. A positive relationship between provision and need was obtained, suggesting that the inverse‐care law does not apply. However, large inequalities of provision were found particularly among the more socially deprived boroughs. In some instances boroughs had five times as many therapists per child as other boroughs.

Conclusions & Implications

The data reveal that large differences in speech and language therapy provision exist across boroughs. The reasons for these inequalities are unclear, but the lack of comparative information across boroughs is likely to be unhelpful in planning equitable services. The use of freedom of information in assessing health inequalities is stressed and its future availability is desirable.
Reliability of the Test of Integrated Language and Literacy Skills (TILLS)
Authors: Mailend Marja‐Liisa , Plante Elena , Anderson Michele A. , Applegate E. Brooks , Nelson Nickola W.
Published: March 2016

Background

As new standardized tests become commercially available, it is critical that clinicians have access to the information about a test's psychometric properties, including aspects of reliability.

Aims

The purpose of the three studies reported in this article was to investigate the reliability of a new test, the Test of Integrated Language and Literacy Skills (TILLS), with consideration of both internal and external sources of measurement error.

Methods & Procedures

The TILLS was administered to children aged 6;0–18;11 years. The participants varied in terms of their language and literacy skills and included children with typical language development as well as those diagnosed with language or learning disability. The sample of children also varied in terms of their racial and socioeconomic backgrounds. Study 1 (N = 1056) assessed the internal consistency of TILLS calculating the coefficient omega for each subtest. Study 2 (N = 103) and Study 3 (N = 39) used the intra‐class correlation coefficients to report on test–retest and inter‐rater reliability respectively.

Outcomes & Results

The results indicate strong internal consistency and inter‐rater reliability for all subtests of TILLS. The test–retest reliability was strong for all but one subtest, for which the intra‐class correlation coefficient was in the acceptable range.

Conclusion & Implications

This article provides clinicians with essential scientific information that supports the internal and external reliability of a new test of oral and written language skills, the TILLS. Information about reliability is critical for guiding the selection of an appropriate diagnostic tool amongst a number of options.
Pricing of Regional Airline Services in Australia and New Zealand, 2011–2015
Authors: Gillen David , Hazledine Tim
Published: March 2016

We analyse more than 9500 airfares offered on Eastern Australia and New Zealand regional routes – those linking towns and smaller cities to main trunk cities and/or to each other – with around 2000 main trunk airfares as comparators, in 2011, 2013, 2014 and 2015. We are able to successfully estimate a well‐specified pricing model, which shows strong effects of competition on fares, quite substantial intertemporal price discrimination effected by various customer‐separating devices, and few systematic differences between regional and main trunk route pricing. Airfares are more expensive in Australia.
Comparison of Digital 12‐Lead ECG and Digital 12‐Lead Holter ECG Recordings in Healthy Male Subjects: Results from a Randomized, Double‐Blinded, Placebo‐Controlled Clinical Trial
Authors: Wang Duolao , Bakhai Ameet , Arezina Radivoj , Täubel Jörg
Published: March 2016

Background

Electrocardiogram (ECG) variability is greatly affected by the ECG recording method. This study aims to compare Holter and standard ECG recording methods in terms of central locations and variations of ECG data.

Methods

We used the ECG data from a double‐blinded, placebo‐controlled, randomized clinical trial and used a mixed model approach to assess the agreement between two methods in central locations and variations of eight ECG parameters (Heart Rate, PR, QRS, QT, RR, QTcB, QTcF, and QTcI intervals).

Results

A total of 34 heathy male subjects with mean age of 25.7 ± 4.78 years were randomized to receive either active drug or placebo. Digital 12‐lead ECG and digital 12‐lead Holter ECG recordings were performed to assess ECG variability. There are no significant differences in least square mean between the Holter and the standard method for all ECG parameters. The total variance is consistently higher for the Holter method than the standard method for all ECG parameters except for QRS. The intraclass correlation coefficient (ICC) values for the Holter method are consistently lower than those for the standard method for all ECG parameters except for QRS, in particular, the ICC for QTcF is reduced from 0.86 for the standard method to 0.67 for the Holter method.

Conclusions

This study suggests that Holter ECGs recorded in a controlled environment are not significantly different but more variable than those from the standard method.
Explaining Foreign Holdings of Asia's Debt Securities: The Feldstein–Horioka Paradox Revisited*
Authors: Horioka Charles Yuji , Terada‐Hagiwara Akiko , Nomoto Takaaki
Published: March 2016

In this paper, we find that home bias is still present in all economies and regions, especially in the case of short‐term debt securities, but that there are substantial variations among economies and regions in the strength of home bias, with the eurozone economies, the USA and developing Asia showing relatively weak home bias and advanced Asia, especially Japan, showing relatively strong home bias. We then examine trends over time in foreign holdings of debt securities and find that capital has been flowing from the USA and the eurozone economies to both advanced Asia (especially Japan) and developing Asia, and that foreign holdings of debt securities have been increasing in advanced as well as developing Asia but for different reasons. The main reason in the case of advanced Asia (especially Japan) appears to be higher risk‐adjusted returns, whereas the main reason in the case of developing Asia appears to be the growth of debt securities markets combined with relatively weak home bias and (in the case of short‐term securities) lower exchange rate volatility. Finally, we find that since the global financial crisis, foreign holdings of debt securities have declined (i.e. that home bias has strengthened) in all economies and regions except developing Asia, where they have increased (except for a temporary decline in 2008) but where their share is still much lower than the optimal share warranted by the capital asset pricing market model.
Currency Substitution in Laos
Authors: Xaiyavong Inthiphone , Toyoda Toshihisa
Published: March 2016

This study investigates the determinants of currency substitution in Laos based on the function of money demand. The empirical model is estimated using the autoregressive distributed lag approach to cointegration for the period 1993–2012. Our estimation results indicate that the interest rate differential is a significant currency substitution determinant in the Laos economy. Moreover, there is evidence supporting the existence of a ratchet effect in the currency allocation of deposits, implying that particularly strong policies should be pursued over an extended period of time in order to convince depositors to switch back to kip‐denominated assets.
Expression of estrogen receptor 1 and progesterone receptor in primary goat mammary epithelial cells
Authors: Ogorevc Jernej , Dovč Peter
Published: March 2016

The exact role and sensitivity of cells to estrogen and progesterone mediated through the steroid receptors during lactation is not known. Expression of estrogen receptor 1 (ESR1) and progesterone receptor (PGR) was quantified in mammary tissue‐derived primary goat mammary epithelial cells (pgMECs) to determine the influence of donor tissue physiology (lactating and juvenile) and cell culture growth conditions (basal and lactogenic) on ESR1 and PGR expression in the derived cells. Relative messenger RNA (mRNA) levels for both receptors were the highest in cell lines derived from mammary tissue of juvenile goats. Maintaining pgMECs in lactogenic conditions resulted in up‐regulation of ESR1 (1.36‐ to 12.35‐fold) and in down‐regulation of PGR (‐2.53‐ to ‐3.62‐fold), compared to basal conditions. Based on Western blotting analysis we suggest that the differences in mRNA expression are translated to the protein level. We suggest that differential expression in lactating conditions is correlated with terminal differentiation of the pgMECs. Double immunostainings showed that estrogen receptor alpha (ER‐α) positive cells do not exclusively belong to the luminal lineage and that ER‐α and PGR can be expressed individually or co‐expressed in the pgMECs. The derived primary cultures/lines in early passages are hormone‐responsive and represent a useful surrogate for mammary tissue in research experiments.
Adverse drug event reporting systems: a systematic review
Authors: Bailey Chantelle , Peddie David , Wickham Maeve E. , Badke Katherin , Small Serena S. , Doyle‐Waters Mary M. , Balka Ellen , Hohl Corinne M.
Published: March 2016

Aim

Adverse drug events (ADEs) are harmful and unintended consequences of medications. Their reporting is essential for drug safety monitoring and research, but it has not been standardized internationally. Our aim was to synthesize information about the type and variety of data collected within ADE reporting systems.

Methods

We developed a systematic search strategy, applied it to four electronic databases, and completed an electronic grey literature search. Two authors reviewed titles and abstracts, and all eligible full‐texts. We extracted data using a standardized form, and discussed disagreements until reaching consensus. We synthesized data by collapsing data elements, eliminating duplicate fields and identifying relationships between reporting concepts and data fields using visual analysis software.

Results

We identified 108 ADE reporting systems containing 1782 unique data fields. We mapped them to 33 reporting concepts describing patient information, the ADE, concomitant and suspect drugs, and the reporter. While reporting concepts were fairly consistent, we found variability in data fields and corresponding response options. Few systems clarified the terminology used, and many used multiple drug and disease dictionaries such as the Medical Dictionary for Regulatory Activities (MedDRA).

Conclusion

We found substantial variability in the data fields used to report ADEs, limiting the comparability of ADE data collected using different reporting systems, and undermining efforts to aggregate data across cohorts. The development of a common standardized data set that can be evaluated with regard to data quality, comparability and reporting rates is likely to optimize ADE data and drug safety surveillance.
Predictors of renal function progression in adults with homozygous sickle cell disease
Authors: Asnani Monika , Serjeant Graham , Royal‐Thomas Tamika , Reid Marvin
Published: March 2016

Longitudinal studies of renal function may improve understanding of the pathophysiological mechanisms underlying sickle cell disease (SCD) nephropathy and may identify possible biological and clinical markers of renal function determined over time. Data from the Jamaica Sickle Cell Cohort Study (JSCCS) were extracted and the glomerular filtration rate (GFR) was estimated using the Chronic Kidney Disease Epidemiological and the SCD specific JSCCS‐GFR equations from all adulthood serum creatinine measurements in homozygous SS patients. The other dataset consisted of measured GFR at two times about 13 years apart. Linear mixed model (LMM) regression analyses were conducted to determine predictors of GFR and serum creatinine over time. 191 individuals with SS disease had 867 GFR estimates available. Serum creatinine significantly increased from baseline whereas estimated GFR showed a significant decline. Serum creatinine showed positive association with increasing age, male gender, body mass index and sodium levels. Haemoglobin was a significant negative predictor of estimated GFR in age‐ and gender‐adjusted models. A total of 24 females and 17 males had repeat measurements of their GFR. The mean annual decline in GFR was −3·2 ± 2·83 ml/min/1·73 m2. Haemoglobin was a significant positive predictor whereas serum creatinine, systolic blood pressure and urinary albumin: creatinine ratio were negative predictors of GFR.
The role of upfront autologous stem cell transplantation in high‐risk younger patients with primary central nervous system lymphoma
Authors: Cho Hyunsoo , Chang Jong Hee , Kim Yu Ri , Kim Soo‐Jeong , Chung Haerim , Park Hyunsung , Lee Jung Yeon , Jang Ji Eun , Kim Yundeok , Kim Se Hoon , Yang Woo Ick , Suh Chang‐Ok , Cheong June‐Won , Min Yoo Hong , Kim Jin Seok
Published: March 2016

Upfront autologous stem cell transplantation (ASCT) has shown favourable outcome in patients with primary central nervous system lymphoma (PCNSL), but the role of risk‐adapted upfront ASCT consolidation has not been evaluated in PCNSL. As PCNSL patients with the International Extranodal Lymphoma Study Group (IELSG) prognostic score ≥2 or those who did not achieve complete response after two courses of induction chemotherapy (non‐CR1) have shown inferior outcomes, we retrospectively analysed the role of upfront ASCT in 66 high‐risk (IELSG ≥2 and/or non‐CR1) younger (age <65 years) immunocompetent PCNSL patients who achieved at least partial response after initial high‐dose methotrexate‐based chemotherapy. Nineteen patients who received upfront ASCT exhibited significantly better overall survival (OS, P = 0·021) and progression‐free survival (PFS, P = 0·005) compared to 47 patients who did not. In univariate and multivariate analyses, upfront ASCT was associated with better OS (P = 0·037 and P = 0·025, respectively) and PFS (P = 0·009 and P = 0·007, respectively). In a propensity score‐matched cohort (n = 36), patients who received upfront ASCT also showed better outcome (P = 0·037 for OS, P = 0·001 for PFS). Our results suggest that upfront ASCT consolidation might be especially beneficial for high‐risk PCNSL patients.
Revisiting the Borrobol Tephra
Authors: Lind Ewa M. , Lilja Carl , Wastegård Stefan , Pearce Nicholas J. G.
Published: March 2016

The Borrobol Tephra has been identified as one of the key tephra horizons for the Lateglacial time period but it also exemplifies many of the promises and problems of tephrochronology. Additional horizons with similar major element composition and approximately the same age have been identified around the North Atlantic region. Here, we revisit the Borrobol Tephra identified at two Swedish sites, Hässeldala port and Skallahult, and also the Borrobol type‐site in Scotland. We present the first set of minor element data (trace and rare earth analyses) along with new analyses of major elements from these three sites. The analysed minor and the trace elements have a similar signature; however, the glass from the Scottish type‐site seems to imply two populations. To answer if this truly represents two populations, or if it reflects magmatic differentiation additional and larger data sets of minor elements are needed. The new major elements are compared to other Borrobol‐type tephras identified in the North Atlantic region. Our results are in line with earlier investigations, which showed no differences in major elements. Further, comparison of minor elements from glass analyses from our sites with those for eruptions associated with Icelandic central volcanoes implies an Icelandic origin for the Borrobol‐type tephras.
Efficacy of modified rapid economic acetic acid‐based Papanicolaou stain
Authors: Bhagat P. , Susheilia S. , Singh K. , Sadhukhan S. , Rajwanshi A. , Dey P.
Published: March 2016

Background

Papanicolaou (Pap) staining is used with various modifications for the staining of cervical smears. It gives a good contrast with sharp nuclear features which aid in accurate interpretation. However, it utilises ethyl alcohol, which is expensive and difficult to purchase. We have attempted to devise a rapid Pap technique which uses acetic acid instead of ethyl alcohol, and yet provides good staining for correct diagnosis.

Methods

Liquid‐based cytology samples were collected from 102 patients as a part of routine screening. Two smears were prepared from each sample, which were stained with conventional as well as rapid Pap. In the rapid Pap method, the smears were fixed in methanol and dehydration was performed before and after OG6 with 0.5% acetic acid. The final dehydration was performed with methanol. Smears from both techniques were compared by two independent observers for staining quality.

Results

With the rapid Pap stain, nuclear staining was comparable with that of conventional Pap (P < 0.05). Cytoplasmic staining was optimal in 69.6% of cases; however, the suboptimal staining in the rest of the smears did not pose any diagnostic problem.

Conclusion

The rapid Pap technique is a cost‐effective alternative to conventional Pap which also saves time and provides good staining quality without compromising the diagnostic interpretation.
Longitudinal development of hand function in children with unilateral spastic cerebral palsy aged 18 months to 12 years
Authors: Nordstrand Linda , Eliasson Ann‐Christin , Holmefur Marie
Published: March 2016

Aim

The aim of the study was to describe the development of hand function, particularly the use of the affected hand in bimanual tasks, among children with unilateral cerebral palsy aged 18 months to 12 years.

Method

A convenience sample of 96 children (53 males, 43 females) was assessed with the Assisting Hand Assessment (AHA) at regular intervals from the ages of 18 months to 12 years. The children ranged from 17 to 127 months (median age 24mo) at recruitment. Subgroups were created to identify differences in development using the child's AHA at 18 months and the Manual Ability Classification System (MACS). A nonlinear mixed effects model was used to analyze data according to a ‘stable limit’ development model.

Results

The results were based on 702 AHA sessions. The children showed a rapid development at a young age and reached 90% of their stable limit between 30 months and 8 years. The subgroups, based on the 18‐month AHA and the MACS levels respectively, had distinctly different patterns of development.

Interpretation

The AHA at 18 months may be used to make a crude prediction of future development.
Siblings with Idiopathic Left Atrial Appendage Ostial Stenosis and Cor Triatriatum
Authors: Okada Seigo , Ishiguchi Yukiko , Moritoh Yuji , Shohi Mayuko , Nakagawa Naomi , Okamoto Kengo , Kamada Masahiro
Published: March 2016

Isolated left atrial appendage (LAA) ostial stenosis is a very rare entity found coincidentally in adults by transesophageal echocardiography. A 3‐month‐old healthy infant was suspected as having cor triatriatum. His brother had a history of surgical treatment of cor triatriatum. A cardiac catheterization revealed a narrowed ostium of the LAA and confirmed the echocardiographic diagnosis of isolated LAA ostial stenosis. This is the first pediatric case of idiopathic LAA ostial stenosis. The siblings called our attention to the differential diagnosis and the etiopathogenesis between LAA ostial stenosis and cor triatriatum.
Risk of cancer among cardiologists who frequently perform percutaneous coronary interventions: a population‐based study
Authors: Ho Tzu‐Lung , Shieh Shwn‐Huey , Lin Cheng‐Li , Shen Wu‐Chung , Kao Chia‐Hung
Published: March 2016

Background

Cardiologists who frequently perform percutaneous coronary interventions (PCIs) are exposed to high levels of radiation; therefore, their risk of cancer may be higher compared with other internists or cardiologists who perform fewer PCIs.

Methods

Data were obtained from the Taiwan National Health Insurance Research Database for the 2000–2011 period. A cohort of 542 cardiologists was randomly frequency‐matched according to age and sex with four other internists to form a cohort of noncardiologist controls. The incidence of cancer was measured for both cohorts, who were followed up until the end of 2011. Cox proportional hazards models were employed to analyse the risk of cancer between cardiologist and control cohorts.

Results

In general, the cardiologists did not have a higher risk of cancer compared with the other internists. However, the cardiologists who worked in medical centres or regional hospitals had a higher risk of cancer than did the other internists in the same work settings. Furthermore, the cardiologists working in medical centres or regional hospitals (large hospitals) who performed >15 PCIs per year had a higher risk of cancer than did those working in district hospitals (small hospitals) or clinics who performed ≤15 PCIs per year.

Conclusion

Cardiologists who frequently perform PCIs have a higher risk of cancer compared with other internists or cardiologists who perform relatively fewer PCIs. Protection from radiation exposure should therefore be emphasized in coronary catheterization laboratories.
Land‐use change outweighs projected effects of changing rainfall on tree cover in sub‐Saharan Africa
Authors: Aleman Julie C. , Blarquez Olivier , Staver Carla A.
Published: March 2016

Global change will likely affect savanna and forest structure and distributions, with implications for diversity within both biomes. Few studies have examined the impacts of both expected precipitation and land use changes on vegetation structure in the future, despite their likely severity. Here, we modeled tree cover in sub‐Saharan Africa, as a proxy for vegetation structure and land cover change, using climatic, edaphic, and anthropic data (R2 = 0.97). Projected tree cover for the year 2070, simulated using scenarios that include climate and land use projections, generally decreased, both in forest and savanna, although the directionality of changes varied locally. The main driver of tree cover changes was land use change; the effects of precipitation change were minor by comparison. Interestingly, carbon emissions mitigation via increasing biofuels production resulted in decreases in tree cover, more severe than scenarios with more intense precipitation change, especially within savannas. Evaluation of tree cover change against protected area extent at the WWF Ecoregion scale suggested areas of high biodiversity and ecosystem services concern. Those forests most vulnerable to large decreases in tree cover were also highly protected, potentially buffering the effects of global change. Meanwhile, savannas, especially where they immediately bordered forests (e.g. West and Central Africa), were characterized by a dearth of protected areas, making them highly vulnerable. Savanna must become an explicit policy priority in the face of climate and land use change if conservation and livelihoods are to remain viable into the next century.
Implementation of personalized medicine for fracture risk assessment in osteoporosis
Authors: Mori Seijiro , Zhou Heying
Published: March 2016

The present review summarizes our efforts to identify genetic polymorphisms associated with osteoporotic fractures and to establish a genetic risk score (GRS) to predict fracture risk in consecutive Japanese autopsy cases carried out at Tokyo Metropolitan Geriatric Hospital between 1995 and 2011. Three single nucleotide polymorphisms in transforming growth factor β‐1, rs1800470; thrombospondin, type 1, domain‐containing 7A, rs12673692; and formiminotransferase N‐terminal subdomain‐containing gene, rs7605378, showed a significant association with vertebral fracture prevalence, whereas five (α‐l‐iduronidase, rs3755955; C7orf58, rs190543052; homeobox C4, rs75256744; G patch domain‐containing gene 1, rs2287679; and Werner syndrome, rs2230009) were significantly associated with femoral fracture. GRS values were calculated as the sum of risk allele counts (unweighted GRS) or of weighted scores estimated from logistic regression coefficients (weighted GRS). Both GRS values using the five single nucleotide polymorphisms adequately predicted femoral fracture prevalence for 924 male subjects; the areas under receiver‐operating characteristic curves were 0.750 (95% confidence interval [CI] 0.660–0.840) and 0.770 (95% CI 0.681–0.859), respectively. Logistic regression analysis showed that the odds ratio for the association between fracture prevalence and unweighted GRS ≥3 (n = 124) was 8.39 (95% CI 4.22–16.69, P < 0.001) relative to GRS < 3 (n = 797). Likewise, the odds ratio for a weighted GRS of 6–15 (n = 135) was 7.73 (95% CI 3.89–15.36, P < 0.001) relative to GRS 0–5 (n = 786). Therefore, the GRS based on the risk allele profiles of these five single nucleotide polymorphisms could help identify at‐risk individuals and enable implementation of preventive measures for femoral fracture. Geriatr Gerontol Int 2016; 16 (Suppl. 1): 57–65.
Involvement of senescence marker protein‐30 in glucose metabolism disorder and non‐alcoholic fatty liver disease
Authors: Kondo Yoshitaka , Ishigami Akihito
Published: March 2016

Senescence marker protein‐30 (SMP30) was found to decrease in the liver, kidneys and lungs of mice during aging. SMP30 is a pleiotropic protein that acts to protect cells from apoptosis by enhancing plasma membrane Ca2+‐pump activity and is bona fide gluconolactonase (EC 3.1.1.17) that participates in the penultimate step of the vitamin C biosynthetic pathway. For the past several years, we have obtained strong evidence showing the close relationship between SMP30, glucose metabolism disorder and non‐alchoholic fatty liver disease in experiments with SMP30 knockout mice. Emerging proof links the following abnormalities: (i) the reduction of SMP30 by aging and/or excessive dietary fat or genetic deficiency causes a loss of Ca2+ pumping activity, which impairs acute insulin release in pancreatic β‐cells, initiates inflammatory responses with oxidative stress and endoplasmic reticulum stress in non‐alchoholic steatohepatitis, exacerbates renal tubule damage, and introduces tubulointerstitial inflammation and fibrosis in diabetic nephropathy; (ii) vitamin C insufficiency also impairs acute insulin secretion in pancreatic β‐cells by a mechanism distinct from that of the SMP30 deficiency; and (iii) the increased oxidative stress by concomitant deficiencies of SMP30, superoxide dismutase 1 and vitamin C similarly causes hepatic steatosis. Here, we review recent advances in our understanding of SMP30 in glucose metabolism disorder and non‐alchoholic fatty liver disease. Geriatr Gerontol Int 2016; 16 (Suppl. 1): 4–16.
Public health approach to preventing frailty in the community and its effect on healthy aging in Japan
Authors: Shinkai Shoji , Yoshida Hiroto , Taniguchi Yu , Murayama Hiroshi , Nishi Mariko , Amano Hidenori , Nofuji Yu , Seino Satoshi , Fujiwara Yoshinori
Published: March 2016

Effective methods to prevent or delay the onset of frailty are urgently required in aging societies, such as Japan. As a public health approach, we carried out a 10‐year community intervention for frailty prevention, and examined its impact on healthy aging among older adults. The target population was all residents aged 65 years or older in the town of Kusatsu, Gunma Prefecture, Japan. For community empowerment, we organized a community forum, and discussed how to address the frailty issue in the community. For primary prevention, we attempted to promote physical activity, nutrition and social participation by means of a health education program to motivate older residents. For secondary prevention, we added a comprehensive geriatric assessment to routine annual health check‐ups, which helped older participants improve self‐care ability of functional health. High‐risk persons were screened and encouraged to participate in a frailty prevention class with a multicomponent program. The attendance rate at annual health check‐ups has remained constant at 30–40% of the target population; however, over 80% of the population appeared at least once during the 10 year‐period. For evaluation, we carried out biennial health monitoring surveys, and reviewed the records of the local Long‐Term Care Insurance system. The functional health of older residents was significantly improved as a result of the interventions; the incidence rate of Long‐Term Care Insurance system certification in the old‐old population (age ≥75 years) was decreased by one second, and healthy life expectancy at age 70 years was extended by 1.2 years for women and 0.5 years for men. Such trends greatly contrasted with those in the reference area, and Japan as a whole. In summary, the present public health approach to frailty prevention appears to promote healthy aging among older adults. Geriatr Gerontol Int 2016; 16 (Suppl. 1): 87–97.
Development of the dementia assessment sheet for community‐based integrated care system
Authors: Awata Shuichi , Sugiyama Mika , Ito Kae , Ura Chiaki , Miyamae Fumiko , Sakuma Naoko , Niikawa Hirotoshi , Okamura Tsuyoshi , Inagaki Hiroki , Ijuin Mutsuo
Published: March 2016

A series of our studies on the development of the Dementia Assessment Sheet for Community‐based Integrated Care System 21‐items (DASC‐21) were reviewed. Study 1: to examine the distribution of scores and internal reliability of DASC‐21, trained nurses and researchers visited the homes of 1341 participants aged 65 years and older and living in the community. The nurses interviewed the participants and, when possible, their family members, to complete the DASC‐21. Then, the Mini‐Mental State Examination was carried out to select the participants of study 2. Study 2: to examine the concurrent and discriminant validity, experienced psychiatrists and psychologists, who were blind to the findings of study 1, visited the homes of 131 subjects who were selected from the participants of study 1 and completed the Clinical Dementia Rating (CDR), the Mini‐Mental State Examination and the Frontal Assessment Battery (FAB). Cronbach's coefficient alpha of the DASC‐21 was 0.808–0.950. Scores of the DASC‐21 significantly correlated with CDR total and box scores, Mini‐Mental State Examination and Frontal Assessment Battery. In an analysis of variance, CDR had the main effect on the score of the DASC‐21. Receiver operating characteristic analysis showed that the DASC‐21 had sufficient discriminatory ability between dementia (CDR1+) and non‐dementia (CDR0 or CDR0.5; area under the curve = 0.804–0.895). When using a cut‐off point of 30/31, sensitivity was 83.3–94.1% and specificity was 77.3–86.4%. The DASC‐21 has sufficient reliability and validity as a tool to evaluate impairments in daily functioning and in cognitive functions, to detect dementia, and to assess the severity of dementia in the community. Geriatr Gerontol Int 2016; 16 (Suppl. 1): 123–131.
Reconsidering long‐term care in the end‐of‐life context in Japan
Authors: Shimada Chiho , Hirayama Ryo , Wakui Tomoko , Nakazato Kazuhiro , Obuchi Shuichi , Ishizaki Tatsuro , Takahashi Ryutaro
Published: March 2016

In this article, we propose expanding the scope of long‐term care such that it involves caring for dying individuals; that is, end‐of‐life care. In doing so, we identify challenges that families and care/medical professionals face in attempts to design and provide end‐of‐life care under Japan's societal contexts. Because of the difficulty judging whether an individual is in an end‐of‐life phase, as well as a growing number of older adults who are unable to communicate their care preferences as a result of cognitive impairment, efforts were almost automatically made to prolong older patients' lives. To respect patients' desires and values, communication among older adults, their families, and care/medical professionals has been increasingly encouraged to make a mutually agreeable end‐of‐life care decision. At the same time, older adults are expected to indicate their care preferences earlier because their ability to express their ideas should be limited when approaching the end‐of‐life phase. We thus suggest including advance care planning in the course of long‐term care such that older adults, with the help of care/medical professionals, can tell their preferences to their families, who are required to serve as surrogate decision makers in Japan. Our research, however, has shown that Japanese older adults are hesitant to discuss end‐of‐life issues with their families. On the basis of our findings suggesting older adults' concern that they might make trouble for their families by clarifying their care preferences, we discuss how care/medical professionals should facilitate family discussions on end‐of‐life care. Geriatr Gerontol Int 2016; 16 (Suppl. 1): 132–139.
Modeling irrigation and fertilizer use for chlorophyll production
Authors: Pérez Ortolá Marta , Daccache Andre , Knox Jerry W.
Published: March 2016

Chlorophyll is a natural coloring extract used extensively in the food and pharmaceutical industries. In Europe, most chlorophyll is produced commercially from rainfed grassland production in eastern England. This paper describes a biogeochemical modeling study to assess the potential yield benefits associated with switching from rainfed to irrigated production. The research is in response the impacts of recent summer droughts on yield coupled with risks regarding climate change, rainfall reliability and long‐term viability of rainfed production. The Denitrification‐Decomposition model was calibrated and validated using multiple field data (n = 47) from 2000 to 2009 for a tall fescue grass (Festuca arundinacea) to simulate a range of irrigation and fertilizer management regimes on yield (annual and individual yield per cut). For chlorophyll production, a schedule combining 300 mm year−1 irrigation with 300 kg N ha−1 was shown to provide the highest average yield (an uplift of +62% above current levels). Switching from rainfed to irrigated production could also potentially halve (54%) current levels of fertilizer application. The implications for reducing environmental impacts from nitrate leaching are discussed.
Involving self‐help groups in health‐care institutions: the patients’ contribution to and their view of ‘self‐help friendliness’ as an approach to implement quality criteria of sustainable co‐operation
Authors: Nickel Stefan , Trojan Alf , Kofahl Christopher
Published: March 2016

Background

The importance of patient participation and involvement is now widely acknowledged; in the past, few systematic health‐care institution policies existed to establish sustainable co‐operation. In 2004, in Germany, the initiative ‘Self‐Help Friendliness (SHF) and Patient‐Centeredness in Health Care’ was launched to establish and implement quality criteria related to collaboration with patient groups.

Objectives

The objective of this study was to describe (i) how patients were involved in the development of SHF by summarizing a number of studies and (ii) a new survey on the importance and feasibility of SHF.

Setting and participants

In a series of participative studies, SHF was shaped, tested and implemented in 40 health‐care institutions in Germany. Representatives from 157 self‐help groups (SHGs), 50 self‐help organizations and 17 self‐help clearing houses were actively involved. The second objective was reached through a survey of 74 of the 115 member associations of the biggest self‐help umbrella organization at federal level (response rate: 64 %).

Results

Patient involvement included the following: identification of the needs and wishes of SHGs regarding co‐operation, their involvement in the definition of quality criteria of co‐operation, having a crucial role during the implementation of SHF and accrediting health‐care institutions as self‐help friendly. The ten criteria in total were positively valued and perceived as moderately practicable.

Conclusions

Through the intensive involvement of self‐help representatives, it was feasible to develop SHF as a systematic approach to closer collaboration of professionals and SHGs. Some challenges have to be taken into account involving patients and the limitations of our empirical study.
Why Has the Ethics of Care Become an Issue of Global Concern?
Authors: Okano Yayo
Published: March 2016

Since Carol Gilligan published her masterpiece,In a Different Voice, many scholars, especially feminist scholars in various fields, including moral theory, philosophy, and political and legal theory, have been inspired to establish a more inclusive approach to social injustice as well as sexual inequality. The purpose of this article is to explore the depth and expanse of the ethics of care for its potential as a political philosophy. To pursue this end, the article analyzes first the main claims of care ethics by responding to its typical counterarguments, which criticize the ethics of care as being too dependent on gender differences, particularism, and essentialism. The second section examines three challenges that care ethics poses to the male‐oriented mainstream of political philosophy, especially the theory of justice. The ethics of care provides us with a new approach to moral and political issues because it focuses responsively on social injustice, proposes a new idea of relational self and takes the social connection model to justice. With these three perspectives proposed by the ethics of care in mind, the article turns its eyes to global implications of care ethics by referring to the issue of the “comfort women” of Japanese troops during the Second World War.